Application of Differential Subsampling with Cartesian Ordering in Evaluating Left Ovarian Venous Reflux for Pretreatment Planning for Pelvic Venous Disorders.

The diagnosis of a common cause of chronic pelvic pain can be made by visualizing reflux in the ovarian veins. Fluoroscopic venography is the gold standard for diagnosing ovarian vein reflux, but it is an invasive technique that exposes patients to ionizing radiation. MRI, with its lack of ionizing radiation and capability of high-temporal and spatial-resolution vascular imaging, has the potential to provide similar diagnostic information.

Intraoperative Multivessel Embolization Reduces Blood Loss and Transfusion Requirements Compared to Internal Iliac Artery Balloon Placement during Cesarean Hysterectomy for Placenta Accreta Spectrum.

Purpose: To evaluate the effectiveness and safety of prophylactic multivessel selective embolization (MVSE) compared to those of internal iliac artery occlusion balloon (IIABO) placement in patients undergoing cesarean hysterectomy for placenta accreta spectrum (PAS).

Materials And Methods: An institutional review board-approved retrospective series was conducted with consecutive patients with PAS at a single institution between 2010 and 2021. MVSE was performed in a hybrid operating room after cesarean section prior to hysterectomy.

May-Thurner syndrome in patients with postural orthostatic tachycardia syndrome and Ehlers-Danlos syndrome: a case series.

Background: Postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos syndrome (EDS), and May-Thurner syndrome (MTS) are three syndromes that are often misdiagnosed or underdiagnosed. The true prevalence of these syndromes may be higher than currently reported. The following case series is the first to report a three-way association between POTS, EDS, and MTS.

Deep Learning Automated Background Phase Error Correction for Abdominopelvic 4D Flow MRI.

Background Four-dimensional (4D) flow MRI has the potential to provide hemodynamic insights for a variety of abdominopelvic vascular diseases, but its clinical utility is currently impaired by background phase error, which can be challenging to correct. Purpose To assess the feasibility of using deep learning to automatically perform image-based background phase error correction in 4D flow MRI and to compare its effectiveness relative to manual image-based correction. Materials and Methods A convenience sample of 139 abdominopelvic 4D flow MRI acquisitions performed between January 2016 and July 2020 was retrospectively collected.

Placenta Accreta Spectrum Treatment With Intraoperative Multivessel Embolization: the PASTIME protocol.

Background: Multidisciplinary care of placenta accreta spectrum cases improves pregnancy outcomes, but the specific components of such a multidisciplinary collaboration varies between institutions. As experience with placenta accreta spectrum increases, it is crucial to assess new surgical techniques and protocols to help improve maternal outcomes and to advocate for hospital resources.

Objective: This study aimed to assess a novel multidisciplinary protocol for the treatment of placenta accreta spectrum that comprises cesarean delivery, multivessel uterine embolization, and hysterectomy in a single procedure within a hybrid operative suite.

Needle localization of small pulmonary nodules: Lessons learned.

Background: Lung nodules that are small and deep within lung parenchyma, and have semisolid characteristics are often challenging to localize with video-assisted thoracoscopic surgery (VATS). We describe our cumulative experience using needle localization of small nodules before surgical resection. We report procedural tips, operative results, and lessons learned over time.

Prophylactic Internal Iliac Artery Occlusion Balloon Placement to Reduce Operative Blood Loss in Patients with Invasive Placenta.

Purpose: To evaluate efficacy and safety of prophylactic internal iliac occlusion balloon placement before cesarean hysterectomy for invasive placenta.

Material And Methods: A retrospective analysis was performed of patients with invasive placenta treated with and without occlusion balloon placement. Preoperative occlusion balloons were placed in 90 patients; 61 patients were treated without balloon placement (control group).

Pelvic Blood Flow Predicts Fibroid Volume and Embolic Required for Uterine Fibroid Embolization: A Pilot Study With 4D Flow MR Angiography.

Objective: We report here an initial experience using 4D flow MRI in pelvic imaging-specifically, in imaging uterine fibroids. We hypothesized that blood flow might correlate with fibroid volume and that quantifying blood flow might help to predict the amount of embolic required to achieve stasis at subsequent uterine fibroid embolization (UFE).

Materials And Methods: Thirty-three patients with uterine fibroids and seven control subjects underwent pelvic MRI with 4D flow imaging.

ABR Subspecialty Certifications in Hospice and Palliative Medicine and Pain Medicine.

The ACGME currently approves fellowship training in 11 subspecialties of radiology, and the ABR currently offers six subspecialty certificates (vascular interventional radiology will be phased out in 2017) to its primary certificate holders. Four of the ABR-sponsored or co-sponsored subspecialties have been available to ABR diplomates for more than 18 years, but two-hospice and palliative medicine and pain medicine-are relatively new. The nature of specialty and subspecialty certificate development and details related to these two specific programs will be considered.

Intravascular Ultrasound in the Creation of Transhepatic Portosystemic Shunts Reduces Needle Passes, Radiation Dose, and Procedure Time: A Retrospective Study of a Single-Institution Experience.

Purpose: To assess whether intravascular ultrasound (US) guidance impacts number of needle passes, contrast usage, radiation dose, and procedure time during creation of transjugular intrahepatic portosystemic shunts (TIPS).

Materials And Methods: Intravascular US-guided creation of TIPS in 40 patients was retrospectively compared with conventional TIPS in 49 patients between February 2010 and November 2015 at a single tertiary care institution. Patient sex and age, etiology of liver disease (hepatitis C virus, alcohol abuse, nonalcoholic steatohepatitis), severity of liver disease (mean Model for End-Stage Liver Disease score), and indications for TIPS (variceal bleeding, refractory ascites, refractory hydrothorax) in conventional and intravascular US-guided cases were recorded.

Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations.

Purpose: The purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).

Materials And Methods: A retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation.

Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function.

Comparative efficacy of new interfaces for intra-procedural imaging review: the Microsoft Kinect, Hillcrest Labs Loop Pointer, and the Apple iPad.

We adapted and evaluated the Microsoft Kinect (touchless interface), Hillcrest Labs Loop Pointer (gyroscopic mouse), and the Apple iPad (multi-touch tablet) for intra-procedural imaging review efficacy in a simulation using MIM Software DICOM viewers. Using each device, 29 radiologists executed five basic interactions to complete the overall task of measuring an 8.1-cm hepatic lesion: scroll, window, zoom, pan, and measure.

Informatics in Radiology: developing a touchless user interface for intraoperative image control during interventional radiology procedures.

Review of prior and real-time patient images is critical during an interventional radiology procedure; however, it often poses the challenge of efficiently reviewing images while maintaining a sterile field. Although interventional radiologists can "scrub out" of the procedure, use sterile console covers, or verbally relay directions to an assistant, the ability of the interventionalist to directly control the images without having to touch the console could offer potential gains in terms of sterility, procedure efficiency, and radiation reduction. The authors investigated a potential solution with a low-cost, touch-free motion-tracking device that was originally designed as a video game controller.

Transjugular intrahepatic portosystemic shunt for treatment of cirrhosis-related chylothorax and chylous ascites: single-institution retrospective experience.

Purpose: To investigate the efficacy and safety of the use of transjugular intrahepatic portosystemic shunt (TIPS) creation to treat cirrhosis-related chylous collections (chylothorax and chylous ascites).

Methods: We retrospectively reviewed data from four patients treated for refractory cirrhosis-related chylous collections with TIPS at our institution over an 8 year period.

Results: One patient had chylothorax, and three patients had concomitant chylothorax and chylous ascites.

Preoperative intravascular balloon catheters and surgical outcomes in pregnancies complicated by placenta accreta: a management paradox.

Objective: The objective of the study was to compare outcomes between patients who did and did not receive preoperative uterine artery balloon catheters in the setting placenta accreta.

Study Design: This was a retrospective case-control study of patients with placenta accreta from 1990 to 2011.

Results: Records from 117 patients with pathology-proven accreta were reviewed.

A novel image-guided balloon vaginoplasty method to treat obstructive vaginal anomalies.

Obstructive anomalies of the vagina that impair uterovaginal outflow and lead to hematocolpos have conventionally been corrected with surgery, but emerging nonsurgical therapies may offer an attractive alternative. The present report describes a method of serial balloon dilation over a transvaginally inserted guide wire to create a durable outflow tract from the uterus to the lower vagina. This technique was successfully used to treat one case each of vaginal atresia and transverse vaginal septum without the immediate need for surgery.