Imaging techniques for diagnosing and managing Peyronie disease.

Erectile dysfunction (ED) affects up to 50% of men to some degree and has a variety of physiologic and psychologic causes, but many patients do not seek specialist treatment. One cause of ED is Peyronie disease (PD) defined by the presence of fibrotic plaques in the tunica albuginea which cause painful penile contractures. While diagnosing PD relies on clinical history and a focused history and physical exam, adding imaging studies can identify nonpalpable plaques and any underlying vasculogenic ED to tailor the extent of surgical treatment and determine when implantable penile prostheses are beneficial.

Comparison of Radiation Exposure in Third-Generation Second-Generation Dual-Source Dual-Energy CT for Imaging Urinary Calculi.

To investigate the potential for decreasing radiation dose when utilizing a third-generation second-generation dual-source dual-energy CT (dsDECT) scanner, while maintaining diagnostic image quality and acceptable image noise. : Retrospective analysis of patients who underwent dsDECT for clinical suspicion of urolithiasis from October 2, 2017, to September 5, 2018. Patient demographics, body mass index, abdominal diameter, scanning parameters, and CT dose index volume (CTDIvol) were recorded.

Multimodality Imaging of Abdominopelvic Tumors with Venous Invasion.

A broad range of abdominal and pelvic tumors can manifest with or develop intraluminal venous invasion. Imaging features at cross-sectional modalities and contrast-enhanced US that allow differentiation of tumor extension within veins from bland thrombus include the expansile nature of tumor thrombus and attenuation and enhancement similar to those of the primary tumor. Venous invasion is a distinctive feature of hepatocellular carcinoma and renal cell carcinoma with known prognostic and treatment implications; however, this finding remains an underrecognized characteristic of multiple other malignancies-including cholangiocarcinoma, adrenocortical carcinoma, pancreatic neuroendocrine tumor, and primary venous leiomyosarcoma-and can be a feature of benign tumors such as renal angiomyolipoma and uterine leiomyomatosis.

Perinephric myxoid pseudotumor of fat: A very rare entity that can mimic a renal cyst and retroperitoneal liposarcoma on imaging.

We present a case of perinephric myxoid pseudotumor of fat, a rare benign entity that often occurs in patients with non-neoplastic renal disease. In our case, an 80 year old man with end-stage renal disease was imaged over the course of 5 years during evaluation for renal transplantation. Imaging identified a left perinephric mass whose appearance over time and on different imaging modalities variably suggested a simple cyst, cystic neoplasm, and liposarcoma.

Multidetector CT Findings in the Abdomen and Pelvis after Damage Control Surgery for Acute Traumatic Injuries.

After experiencing blunt or penetrating trauma, patients in unstable condition who are more likely to die of uncorrected shock than of incomplete injury repairs undergo emergency limited exploratory laparotomy, which is also known as (DCS). This surgery is part of a series of resuscitation steps, with the goal of stabilizing the patient's condition, with rapid surgical control of hemorrhage followed by supportive measures in the intensive care unit before definitive repair of injuries. These patients often are imaged with multidetector CT within 24-48 hours of the initial surgery.

Bilateral Sustained Nephrograms After Parenteral Administration of Iodinated Contrast Material: A Potential Biomarker for Acute Kidney Injury, Dialysis, and Mortality.

Objective: To determine whether persistent bilateral global nephrograms are associated with acute kidney injury (AKI), dialysis, and mortality.

Patients And Methods: All patients who underwent (1) contrast-enhanced computed tomography (CT) or cardiac catheterization with iohexol between January 1, 2000, and December 31, 2014, and (2) noncontrast abdominal CT in the subsequent 24±6 hours were identified. Patients without preprocedure and postprocedure creatinine measurements or who received additional contrast material were excluded.

The Capabilities and Limitations of Clinical Magnetic Resonance Imaging for Detecting Kidney Stones: A Retrospective Study.

The purpose of this work was to investigate the performance of currently available magnetic resonance imaging (MRI) for detecting kidney stones, compared to computed tomography (CT) results, and to determine the characteristics of successfully detected stones. Patients who had undergone both abdominal/pelvic CT and MRI exams within 30 days were studied. The images were reviewed by two expert radiologists blinded to the patients' respective radiological diagnoses.

Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol.

Background: Concern for contrast-induced nephropathy (CIN) may result in administration of more costly agents. We prospectively compared outpatient CIN incidence of iodixanol to iohexol.

Methods: Patients were randomized to receive 100ml of iohexol (n=47) or iodixanol (n=55).

The Clinical Impact of Accurate Cystine Calculi Characterization Using Dual-Energy Computed Tomography.

Dual-energy computed tomography (DECT) has recently been suggested as the imaging modality of choice for kidney stones due to its ability to provide information on stone composition. Standard postprocessing of the dual-energy images accurately identifies uric acid stones, but not other types. Cystine stones can be identified from DECT images when analyzed with advanced postprocessing.

Detection of different kidney stone types: an ex vivo comparison of ultrashort echo time MRI to reference standard CT.

Background And Purpose: With the development of ultrashort echo time (UTE) sequences, it may now be possible to detect kidney stones by using magnetic resonance imaging (MRI). In this study, kidney stones of varying composition and sizes were imaged using both UTE MRI as well as the reference standard of computed tomography (CT), with different surrounding materials and scan setups.

Methods: One hundred and fourteen kidney stones were inserted into agarose and urine phantoms and imaged both on a dual-energy CT (DECT) scanner using a standard renal stone imaging protocol and on an MRI scanner using the UTE sequence with both head and body surface coils.

Motion artifacts in kidney stone imaging using single-source and dual-source dual-energy CT scanners: a phantom study.

Purpose: Dual-energy computed tomography (DECT) has shown the capability of differentiating uric acid (UA) from non-UA stones with 90-100% accuracy. With the invention of dual-source (DS) scanners, both low- and high-energy images are acquired simultaneously. However, DECT can also be performed by sequential acquisition of both images on single-source (SS) scanners.

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.

Kidney stone imaging with 3D ultra-short echo time (UTE) magnetic resonance imaging. A phantom study.

Computed tomography (CT) is the current gold standard for imaging kidney stones, albeit at the cost of radiation exposure. Conventional magnetic resonance imaging (MRI) sequences are insensitive to detecting the stones because of their appearance as a signal void. With the development of 2D ultra-short echo-time (UTE) MRI sequences, it becomes possible to image kidney stones in vitro.

Characterization of ureteral stents by dual-energy computed tomography: Clinical implications.

Dual-energy computed-tomography (DECT) has been suggested as the method of choice for imaging urinary calculi due to the modality's high sensitivity for detecting stones and its capability of accurately differentiating between uric-acid (UA) and non-UA (predominantly calcium) stones. The clinical significance of the latter feature relates to the differences in management of UA vs non-UA calculi. Like calculi, ureteral stents are assigned color by the dual-energy post-processing algorithm, which may lead to improved or worsened stone visualization based on the resulting stent/stone contrast.

In vivo comparison of radiation exposure of dual-energy CT versus low-dose CT versus standard CT for imaging urinary calculi.

Purpose: Dual-energy computed tomography (DECT) is an emerging imaging modality with the unique capability of determining urinary stone composition. This study compares radiation exposure of DECT, standard single-energy CT (SECT), and low-dose renal stone protocol single-energy CT (LDSECT) for the evaluation of nephrolithiasis in a single in vivo patient cohort.

Materials And Methods: Following institutional review board (IRB) approval, we retrospectively reviewed 200 consecutive DECT examinations performed on patients with suspected urolithiasis over a 6-month period.

Accuracy and efficiency of determining urinary calculi composition using dual-energy computed tomography compared with Hounsfield unit measurements for practicing physicians.

Objective: To compare speed and accuracy for determining urinary calculi composition between dual-energy computed tomography (DECT) and Hounsfield unit (HU) measurements of calculi by a set of reviewers at varying levels of training and practice.

Materials And Methods: Sixteen patients with known stone composition were randomly selected. Fourteen reviewers of varying levels of practice interpreted DECT and HU images from the selected patients to predict stone composition in 2 sessions (day 1: tutorial or flow sheet available for image interpretation and day 2: tutorial or flow sheet not available).

Case series demonstrating the clinical utility of dual energy computed tomography in patients requiring stents for urinary calculi.

Dual energy computed tomography (DECT) utilizes the material change in attenuation when imaged at two different energies to determine the composition of urinary calculi as uric acid or non-uric acid. We discuss a series of case reports illustrating DECT's ability to provide immediate determination of uric acid versus non-uric acid calculi and facilitate more informed clinical decision-making. Further, these cases demonstrate a unique population of patients with ureteral stents and percutaneous nephrostomy tubes that benefit from DECT's ability to create a virtual color contrast between an indwelling device and the stone material and thereby significantly impacting patient morbidity.