Imaging of Cervical Spine Trauma: Update of Techniques and Clinical Relevance.

Imaging of cervical spine trauma most commonly begins with computed tomography (CT) for initial osseous and basic soft tissue evaluation, followed by magnetic resonance imaging (MRI) for complementary evaluation of the neural structures (i.e., spinal cord, nerves) and soft tissues (i.

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence-Based Review with Recommendations.

Background: Acute invasive fungal sinusitis (AIFS) is an aggressive disease that requires prompt diagnosis and multidisciplinary treatment given its rapid progression. However, there is currently no consensus on diagnosis, prognosis, and management strategies for AIFS, with multiple modalities routinely employed. The purpose of this multi-institutional and multidisciplinary evidence-based review with recommendations (EBRR) is to thoroughly review the literature on AIFS, summarize the existing evidence, and provide recommendations on the management of AIFS.

Imaging of Painful Ophthalmologic Disorders.

Cross-sectional imaging with computed tomography (CT) and MRI are diagnostic examinations useful in the diagnosis of painful ophthalmologic disorders and their potential complications. CT is a first-line imaging study for suspected orbital infections, particularly useful in differentiating preseptal cellulitis and orbital cellulitis and detecting complications such as orbital abscess. When compared with CT, MRI is better for orbital soft tissue evaluation, particularly useful for optic neuritis, ocular diseases such as endophthalmitis, and invasive fungal rhinosinusitis with orbital involvement.

Ipilimumab-related orbitopathy: a case report.

Ipilimumab, an immune checkpoint inhibitor used in the treatment of metastatic melanoma, can cause immune-related adverse events including rare ocular-related inflammation. This is a case of a 54-year-old man with metastatic melanoma and bilateral orbital inflammation associated with ipilimumab that occurred after drug rechallenge 6 years after initial orbital inflammation with ipilimumab use. Imaging revealed tendon-involving myositis.

Magnetic resonance imaging of musculoskeletal infections.

Magnetic resonance imaging (MRI) is a powerful imaging modality in the evaluation of musculoskeletal (MSK) soft tissue, joint, and bone infections. It allows prompt diagnosis and assessment of the extent of disease, which permits timely treatment to optimize long-term clinical outcomes. MRI is highly sensitive and specific in detecting the common findings of MSK infections, such as superficial and deep soft tissue oedema, joint, bursal and tendon sheath effusions, lymphadenopathy, bone marrow oedema, erosive bone changes and periostitis, and bone and cartilage destruction and sequestration.

99mTc-Sestamibi Scintigraphy Reveals Parathyroid Adenoma Masquerading as Esophageal Diverticulum.

A 74-year-old woman with primary hyperparathyroidism diagnosed from routine laboratory tests described symptoms of fatigue and difficulty with concentration. During surgical consultation, the cervical and thoracic spine MRI scans from the preceding 10-year period, performed for relapsing-remitting multiple sclerosis, were reviewed. In this clinical context, the slowly enlarging left upper paraesophageal lesion, reported as a lateral proximal esophageal (Killian-Jamieson) diverticulum, was reevaluated for a potential parathyroid adenoma.

Magnetic resonance imaging of the spine.

Low back and neck pain are common and result in significant patient disability and health care expenditure. When conservative treatment fails or worrisome clinical findings are present, magnetic resonance imaging (MRI) is the imaging modality of choice to assess the cause and complicating features of spine pain. There are many potential aetiologies of spine pain with similar clinical presentation, including degenerative changes, infection, and insufficiency and pathologic fractures.

Extracranial Metastases From Glioblastoma With Primitive Neuronal Components on FDG PET/CT.

A 17-year-old girl with World Health Organization grade IV glioblastoma with primitive neuronal components (histone H3 G34-mutant and IDH1 wild type) underwent whole-body FDG PET/CT staging due to vertebral metastases on initial MRI. PET/CT revealed extracranial metastatic disease with spinal leptomeningeal dissemination, osseous metastases, and peritoneal seeding via a ventriculoperitoneal shunt. Glioblastoma is uncommon in pediatric patients and particularly those with primitive neuronal components.

Primary Nasolacrimal Duct Obstruction Visualized on I Preablation Scan for Papillary Thyroid Carcinoma.

A 56-y-old man underwent total thyroidectomy and bilateral central and right lateral neck dissection for papillary thyroid carcinoma with lymph nodes metastases. Before radioiodine ablation, a I scan established the diagnosis of primary nasolacrimal duct obstruction (dacryostenosis).

A systematic approach in the diagnosis of paediatric skull lesions: what radiologists need to know.

Paediatric skull lesions are commonly identified on imaging. They can be challenging to image, given their location and size, and often require several imaging modalities to narrow down the differential diagnosis. Accurate diagnosis of these lesions is paramount because the clinical therapy can vary tremendously.

Update on Imaging of Spinal Fixation Hardware.

This article discusses instrumented spinal surgeries, the radiologic assessment of spinal fixation hardware, and the potential complications of spinal hardware. Radiography is the standard for the postoperative assessment of spinal hardware. Computed tomography and magnetic resonance imaging play a valuable role in the detection of hardware and postsurgical-related complications such as infection, pseudarthrosis, and malpositioned instrumentation.

Physics for clinicians: Fluid-attenuated inversion recovery (FLAIR) and double inversion recovery (DIR) Imaging.

Unlabelled: A pedagogical review of fluid-attenuated inversion recovery (FLAIR) and double inversion recovery (DIR) imaging is conducted in this article. The basics of the two pulse sequences are first described, including the details of the inversion preparation and imaging sequences with accompanying mathematical formulae for choosing the inversion time in a variety of scenarios for use on clinical MRI scanners. Magnetization preparation (or T2prep), a strategy for improving image signal-to-noise ratio and contrast and reducing T weighting at high field strengths, is also described.

An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion.

Object: Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion.

Methods: The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm.

Inter-rater reliability of published flow diversion occlusion scales.

Background: With increasing use of flow-diverting stents for the treatment of intracranial aneurysms, standardized methods and a common language to evaluate angiographic outcomes are needed. Multiple grading scales have been developed for this purpose but none has been widely adopted.

Objective: To analyze these scales to determine interobserver reliability.

Ocular dysmotility after intra-arterial chemotherapy for retinoblastoma.

We report the case of a 15-month-old boy with retinoblastoma who developed exotropia secondary to a right medial rectus infarct after intra-arterial chemotherapy. He had unilateral sporadic group C tumor (International Classification of Retinoblastoma) and was treated with intra-arterial melphalan. One week after the first session of intra-ophthalmic arterial melphalan chemotherapy, he was noted to have orbital congestion, exotropia, and right adduction limitation.

Imaging of Orbital Trauma and Emergent Non-traumatic Conditions.

Diagnostic imaging has become critical in the care of patients suffering from traumatic or nontraumatic emergent orbital conditions. Multidetector computed tomography (MDCT) has become the standard imaging modality for assessing orbital trauma because of its accurate assessment of orbital skeletal and soft tissues injuries. Contrast-enhanced MR imaging is the first-line examination in the assessment of nontraumatic orbital conditions given its excellent evaluation of the orbital soft tissues.