Ferumoxytol-enhanced MR demonstration of changes to internal placental structure in placenta accreta spectrum: Preliminary findings.

Introduction: The goal of this pilot study is to determine if ferumoxytol-enhanced MR might provide a new approach to the diagnosis of placenta accreta spectrum (PAS), and if so, to identify signs of PAS.

Methods: Ten pregnant women were referred for MRI evaluation for PAS. MR studies consisted of pre-contrast SSFSE, SSFP, DWI, and ferumoxytol-enhanced sequences.

Ferumoxytol-enhanced magnetic resonance imaging with volume rendering: A new approach for the depiction of internal placental structure in vivo.

Introduction: Placental function is vitally important, but placental assessment is limited by current imaging methods in vivo. The goal of this study is to determine if ferumoxytol-enhanced MR studies might be used to depict placental structure during pregnancy.

Methods: Ten pregnant women were referred for MRI evaluation of abnormal placentation.

Normal placental structural anatomy: ultrasound and doppler features elucidated with US-MR image fusion and ferumoxytol-enhanced MRI.

Purpose: To elucidate ultrasound features of normal placental anatomy through correlation of gray-scale and ultrasound Doppler with ferumoxytol-enhanced MRI features using US-MR image fusion.

Methods: All patients referred to MR for ultrasound findings worrisome for PAS (placenta accreta spectrum) were included in this retrospective study. MR studies included a ferumoxytol-enhanced T1-weighted MRI.

Placenta accreta spectrum: the pattern and character of intraplacental blood flow by color and spectral Doppler.

Purpose: To characterize intraplacental blood flow patterns in placenta accreta spectrum (PAS) with color and spectral Doppler imaging.

Methods: Thirty-two patients at risk for PAS underwent ultrasound imaging with both color and spectral Doppler. The placenta was inspected for areas of vascularity by color Doppler, particularly within the lower uterine segment.

Toward Ergonomic Design in Ultrasound Scanning: Strategies to Mitigate Injurious Forces.

Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands.

Opportunistic osteoporosis screening using routine computed tomography images to identify bone loss in gynecologic cancer survivors.

Objective: Cancer treatment-induced bone loss is a known side effect of cancer therapy. Computed tomography (CT) bone mineral density screening is a novel tool for identifying bone loss. This study aims to use routine CT images to determine long-term bone mineral density changes and osteoporosis risk among women with gynecologic cancers.

How to Read an Abdominal CT: Insights from the Visual and Cognitive Sciences Translated for Clinical Practice.

When first learning abdominal CT studies, residents are often given little concrete, practical direction. There is, however, a large literature from the visual and cognitive sciences that can provide guidance towards search strategies that maximize efficiency and comprehensiveness. This literature has not penetrated radiology teaching to any great extent.

Identification of the Most Important Subset of Doppler, Laboratory, and Clinical Parameters for Serial TIPS Evaluation.

The purpose of the present study was to identify the subset of a wide range of serial Doppler, laboratory, and clinical parameters most predictive (both individually and in combination) of TIPS dysfunction in a large patient sample. The medical records of 189 patients who had undergone TIPS procedures were analyzed. The patients (mean age, 52 years; 62% of whom were men) had undergone 1139 Doppler studies and 323 portovenograms.

Ultrasound Elastographic Measurement of Rigor Mortis in an Animal Model: A Feasibility Study for Improved Time-of-Death Estimates in Forensic Investigations.

The purpose of our study was to assess the feasibility of 2D shear wave ultrasound elastography to quantitatively measure changes of rigor mortis. Muscle stiffness of two live pigs and nine sacrificed pigs was measured in kilopascals using ultrasound elastography. The nine sacrificed pigs were divided into three groups of three pigs each and placed in one of three environments at 90°F (32°C), 70°F (21°C), or 34°F (1°C).

The Search Patterns of Abdominal Imaging Subspecialists for Abdominal Computed Tomography: Toward a Foundational Pattern for New Radiology Residents.

Objectives: The routine search patterns used by subspecialty abdominal imaging experts to inspect the image volumes of abdominal/pelvic computed tomography (CT) have not been well characterized or rendered in practical or teachable terms. The goal of this study is to describe the search patterns used by experienced subspecialty imagers when reading a normal abdominal CT at a modern picture archiving and communication system workstation, and utilize this information to propose guidelines for residents as they learn to interpret CT during training.

Material And Methods: Twenty-two academic subspecialists enacted their routine search pattern on a normal contrast-enhanced abdominal/pelvic CT study under standardized display parameters.

The Back Alleys and Dark Corners of Abdomen and Pelvis Computed Tomography: The Most Frequent Sites of Missed Findings in the Multiplanar Era.

Objectives: Radiologists reading multiplanar abdominal/pelvic computed tomography (CT) are vulnerable to oversight of specific anatomic areas, leading to perceptual errors (misses). The aims of this study are to identify common sites of major perceptual error at our institution and then to put these in context with earlier studies to produce a comprehensive overview.

Material And Methods: We reviewed our quality assurance database over an 8-year period for cases of major perceptual error on CT examinations of the abdomen and pelvis.

Diurnal variation of major error rates in the interpretation of abdominal/pelvic CT studies.

Rationale And Objective: Variation of visual selective attention through the day has been demonstrated in several arenas of human performance, including radiology. It is uncertain whether this variation translates to an identifiable diurnal pattern of error rates for radiology interpretation. The purpose of this study was to attempt to identify particular days of the week and times of the day when radiologists might be most prone to error.

Respiratory Fluctuation of Peak Systolic Velocities in the Carotid Doppler Waveforms of Patients With Obstructive Airway Disease: Evidence of Pulsus Paradoxus With Experimental Validation.

Objectives: To characterize fluctuations in peak systolic velocities (PSVs) in Doppler waveforms of the carotid artery in patients with and without obstructive airway disease and in volunteers subjected to incremental levels of airway resistance in an experimental model.

Methods: The PSV variation in common carotid waveforms was measured in 100 patients who had had a carotid ultrasound examination and no respiratory or carotid disease. This was compared to that of patients who had this study during an admission for acute exacerbation of chronic obstructive pulmonary disease (COPD).

Measurement of the Internal Carotid Artery Cross-Sectional Area: Systematic Differences Depending on Grayscale, Power Doppler, and Color Doppler Techniques.

Objectives: To determine how measurements of the internal carotid artery (ICA) cross-sectional area will differ systematically when obtained by grayscale, color Doppler, and power Doppler imaging.

Methods: A total of 451 patients had greater than 40% diameter stenosis in at least a single ICA. Anteroposterior and transverse luminal diameters were measured in 609 arteries on grayscale, color, and power Doppler transverse images of the carotid bulb and proximal and distal ICAs.

Readability of Lumbar Spine MRI Reports: Will Patients Understand?

Objective: Radiology reports have traditionally been written for referring clinical providers. However, as patients increasingly access their radiology reports through online medical records, concerns have been raised about their ability to comprehend these complex documents. The purpose of this study was to assess the readability of lumbar spine MRI reports.

Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy.

Objective: The purpose of this study was to prospectively evaluate the accuracy of proton-density fat-fraction, single- and dual-energy CT (SECT and DECT), gray-scale ultrasound (US), and US shear-wave elastography (US-SWE) in the quantification of hepatic steatosis with MR spectroscopy (MRS) as the reference standard.

Subjects And Methods: Fifty adults who did not have symptoms (23 men, 27 women; mean age, 57 ± 5 years; body mass index, 27 ± 5) underwent liver imaging with un-enhanced SECT, DECT, gray-scale US, US-SWE, proton-density fat-fraction MRI, and MRS for this prospective trial. MRS voxels for the reference standard were colocalized with all other modalities under investigation.

Four-dimensional flow magnetic resonance imaging and ultrasound assessment of cerebrospinal venous flow in multiple sclerosis patients and controls.

A possibly causal relationship between multiple sclerosis and chronic cerebrospinal venous insufficiency has recently been hypothesized. Studies investigating chronic cerebrospinal venous insufficiency have reported conflicting results and few have employed multiple diagnostic imaging modalities across a large patient and control population. In this study, three complementary imaging modalities were used to investigate the chronic cerebrospinal venous insufficiency hypothesis in patients with multiple sclerosis and two age- and sex-matched control groups: healthy volunteers and patients with other neurological diseases.

Cornelia de Lange syndrome: Correlation of brain MRI findings with behavioral assessment.

Neurobehavioral and developmental issues with a broad range of deficits are prominent features of Cornelia de Lange syndrome (CdLS), a disorder due to disruption of the cohesin protein complex. The etiologic relationship of these clinical findings to anatomic abnormalities on neuro-imaging studies has not, however, been established. Anatomic abnormalities in the brain and central nervous system specific to CdLS have been observed, including changes in the white matter, brainstem, and cerebellum.

Dynamic and quasi-static mechanical testing for characterization of the viscoelastic properties of human uterine tissue.

Ultrasound elastography is envisioned as an optional modality to augment standard ultrasound B-mode imaging and is a promising technique to aid in detecting uterine masses which cause abnormal uterine bleeding in both pre- and post-menopausal women. In order to determine the effectiveness of strain imaging, mechanical testing to establish the elastic contrast between normal uterine tissue and stiffer masses such as leiomyomas (fibroids) and between softer pathologies such as uterine cancer and adenomyosis has to be performed. In this paper, we evaluate the stiffness of normal uterine tissue, leiomyomas, and endometrial cancers using a EnduraTEC ElectroForce (ELF) system.

Correlation of cognitive function with ultrasound strain indices in carotid plaque.

Instability in carotid vulnerable plaque can generate cerebral micro-emboli, which may be related to both stroke and eventual cognitive abnormality. Strain imaging to detect plaque vulnerability based on regions with large strain fluctuations, with arterial pulsation, may be able to determine the risk of cognitive impairment. Plaque instability may be characterized by increased strain variations over a cardiac cycle.

Accuracy of sonographic diagnosis of superficial masses.

Objectives: The purpose of this study was to retrospectively review the diagnostic accuracy of sonography in the evaluation of superficial masses with surgical and histologic findings as the reference standard.

Methods: Institutional Review Board approval was obtained, informed consent was waived, and Health Insurance Portability and Accountability Act compliance was maintained. Seventy-two superficial masses in 62 patients were examined sonographically by a single radiologist (reader 1) and subsequently underwent surgical therapy.

Impaired cognitive function in patients with atherosclerotic carotid stenosis and correlation with ultrasound strain measurements.

Introduction: It has been postulated that up to 11 million "silent" strokes occur annually. While these patients are without classic neurologic deficits, they may exhibit cognitive decline. In this study, we examine the cognitive function of patients with carotid stenosis.

Characterizing the compression-dependent viscoelastic properties of human hepatic pathologies using dynamic compression testing.

Recent advances in elastography have provided several imaging modalities capable of quantifying the elasticity of tissue, an intrinsic tissue property. This information is useful for determining tumour margins and may also be useful for diagnosing specific tumour types. In this study, we used dynamic compression testing to quantify the viscoelastic properties of 16 human hepatic primary and secondary malignancies and their corresponding background tissue obtained following surgical resection.

A novel saline infusion sonohysterography-based strain imaging approach for evaluation of uterine abnormalities in vivo: preliminary results.

In this article, we demonstrate the feasibility of saline infusion sonohysterography-based strain imaging for the determination of stiffness variations in uterine masses in vivo. Strain images are estimated using a 2-dimensional multilevel hybrid algorithm developed for sector array ultrasound transducers. Coarse displacements are initially estimated using envelope echo signals, followed by a guided finer displacement estimation using window lengths on the order of 6 wavelengths and 7 A-lines on radiofrequency data.