Current Medical Imaging - Current Issue

The aims were to assess different branching patterns of segmental bronchi in the right superior lobe (RSL), as well as to investigate the anatomical diversity and sex-related variations of these branches in a large sample of the research population.

10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups.

Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05).

The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

This study aimed to investigate the diagnosis of the external jugular venous aneurysm on color Doppler ultrasound and its relationship with pathological characteristics.

A retrospective analysis of 17 patients with external jugular venous aneurysm admitted to the Provincial Hospital Affiliated with Shandong First Medical University from May, 2010, to June, 2020, was performed. The color Doppler ultrasound characteristics of 17 patients with external jugular vein aneurysms were analyzed and summarized, which were then compared with postoperative pathological outcomes.

All 17 patients with external jugular venous aneurysms were presented with cystic structures adjacent to and communicated with the external jugular vein. Color Doppler flow imaging showed a bidirectional venous flow signal in the communication between the cystic structure and the external jugular vein. Among the 17 patients, ultrasound diagnosis showed true venous aneurysm due to degenerative changes in the venous wall in 8 cases, venous pseudoaneurysm in 4 cases, and external jugular venous aneurysm in 5 cases, and postoperative pathology indicated degenerative changes in the venous wall in all 17 patients.

Bidirectional blood flow at the communication between the cystic lesion and the external jugular vein on color Doppler ultrasound should not be the criterion for the diagnosis of external jugular venous pseudoaneurysm, which requires pathological support.

One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings.

Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system. Grouping was carried out on the basis of AMI (n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations.

The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001).

In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper-thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found.

We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD and a significant relationship between survival and QTc in the AMI group.

Chronic kidney disease has become one of the world's major public health problems, immunoglobulin A (IgA) nephropathy is a common pathological type of CKD. Delaying the progression of IgA nephropathy has currently become the main clinical treatment strategy, precise evaluation of renal pathological injury during follow-up of patients with IgA nephropathy is important. Therefore, it is imperative to develop an accurate and non-invasive imaging technique for effective follow-up of renal pathological injury in patients with IgA nephropathy.

To investigate the clinical value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in assessing renal pathological injury in patients with immunoglobulin A (IgA) nephropathy compared with a mono-exponential model.

Altogether, 80 patients with IgA nephropathy were divided into the mild (41 cases) andmoderate–severe (m–s) renal injury groups (39 cases) according to pathology scores, and 20 healthy volunteers were recruited as controls. All participants underwent IVIM-DWI of the kidneys, and renal parenchymal apparent diffusion coefficient (ADC), pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) values were measured. One-way analysis of variance, receiver operating characteristic (ROC) curve analysis, and Pearson correlation analysis were performed for all the DWI-derived parameters.

The DWI-derived parameters of the m–s renal injury group were significantly lower than those of the mild renal injury and control groups (P < 0.01). The ROC analysis revealed that f had the largest area under the ROC curve for differentiation between the m–s and mild renal injury groups and between the m–s renal injury and control groups. The f had the largest correlation coefficient with renal pathology scores (r=−0.81), followed by the D* (−0.69), ADC (−0.54), and D values (−0.53), respectively (all P<0.01).

IVIM-DWI demonstrated better diagnostic performance than the mono-exponential model in assessing renal pathological injury in patients with IgA nephropathy.

Many studies have reported Xp 11.2 translocation renal cancer in radioimaging,but there is little literature on the evaluation of Xp11.2 translocation renal cell carcinoma by ultrasound.

To investigate the ultrasonographic features and diagnostic value of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in children and adolescents.

The clinical and ultrasonographic data of 10 patients with renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion confirmed by pathology in our hospital were analyzed retrospectively. The age ranged from 3 to 18 years old, including 7 males and 3 females. The tumor location, size, boundary, echo, hemorrhage, cystic change, calcification, blood flow, lymph node status and metastasis were mainly observed, and the results were compared with the pathological results.

There were 10 masses in 10 cases of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion, including 4 in the right kidney and 6 in the left kidney; the maximum diameter line is 5-23cm; 9 cases had clear mass boundary (90%); 9 masses (90%) showed mixed cystic and solid masses with high echo of solid components, and 1 mass (10%) showed huge multilocular cystic mass with multiple septations; necrosis and cystic changes were seen in all 10 masses (100%); calcification in 5 masses (50%); blood flow signals were seen in the solid components of the mass (100%).

Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in children and adolescents are mostly large cystic and solid mixed echo masses, with high echo of solid components, and often accompanied by cystic changes and calcification. Its ultrasonic manifestations have certain characteristics. Color Doppler ultrasound has a certain diagnostic value for this disease.

Fibrosarcoma of bone is a rare malignant spindle cell tumor.

Herein, we present a case of fibrosarcoma in a 40-year-old male who was presented to the clinic with left-sided great toe pain for 20 years. Simple radiographs showed acrolysis at the distal phalanx of great toe. Magnetic resonance imaging (MRI) revealed a 1.5 cm sized heterogenous high signal intensity mass on T2-weighted images and iso signal intensity on T1- weighted images. Dorsal and distal portion of the mass showed markedly dark signal intensity on T1 and T2-weighted images.

In an enhanced image, the mass showed heterogenous enhancement. Surgical removal was performed and pathologic analysis revealed fibrosarcoma. Although extremely rare, fibrosarcoma of the bone should be kept in mind as a possibility when a lesion exhibits a black signal intensity component on an MRI with acrolysis.

Diagnosis of pulmonary thromboembolism (PTE) can be delayed if the signs and symptoms of patients are nonspecific.

To assess the clinical value of deep vein thrombosis (DVT) density on computed tomography (CT) venography for predicting PTE.

From 2016 to 2021, patients with DVT diagnosed on lower-extremity CT venography were included. Of these patients, those without PTE were classified into ‘DVT-only group’ and those with PTE were classified into the ‘DVT with PTE group’. The DVT Hounsfield unit (HU) density was measured by drawing free-hand region-of-interests within the thrombus at the most proximal filling defect level. The risk factors associated with PTE were identified by using multivariate logistic regression analysis. A receiver operating characteristic (ROC) analysis was used to evaluate the value of DVT density for predicting the risk of PTE.

This study included 177 patients with a mean age of 41.7 ± 10.3 years (DVT-only group: 105 patients; DVT with PTE group: 72 patients). DVT density was significantly higher in DVT with the PTE group than DVT-only group (66.8HU ± 8.7 vs. 57.9HU ± 11.1, p < 0.001). The ROC analysis revealed that the area under the curve (AUC), sensitivity, and specificity for predicting the risk of PTE were 0.737, 72.2%, and 66.7%, respectively, at a DVT density cutoff of 63.0 HU. On univariate and multivariate analysis, DVT density was the only significant risk factor associated with PTE.

Higher DVT density was a significant risk factor for PTE. In addition, DVT density could be a predictive factor for PTE.

In the past, many experts considered chronic obstructive pulmonary disease (COPD) and bronchiectasis to be separate, chronic respiratory diseases. Nonetheless, the widespread use of high-resolution lung computed tomography (CT) has led to the discovery that these diseases can occur alone or together.

The current study aimed to compare the effects of nutritional status on the clinical outcomes in moderate to severe COPD patients with bronchiectasis.

This study identifies the nutritional risk in hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during acute exacerbation screened using computer tomography (CT). Also, determines its correlation with disease progression.

NRS 2002 (Nutrition Risk Screening Evaluation Tool) was used to determine and evaluate the nutritional risk status in 182 hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during an acute exacerbation. Selected patients were divided into the nutritional risk (NR) group and the non-nutritional risk (NNR) group according to their nutritional status determined by NRS 2002. The body mass index (BMI), serum albumin (ALB), pre albumin (PAB), lymphocyte count (TLC), FEV1/FVC, FEV1% predicted, PEF% predicted, blood gas analysis, number of acute exacerbations in the past year, number of respiratory failure cases, number of anti-infection days, and length of hospitalization of the two groups were observed.

The hospitalized patients in acute exacerbation of moderate to severe COPD complicated by bronchiectasis phenotype had a nutritional risk of 62.64%. BMI, ALB, PAB, TLC, FEV1% predicted, FEV1/FVC, PEF% predicted, blood gas analysis, number of acute exacerbations in the past year, number of respiratory failure cases, number of anti-infection days, and length of hospitalization were statistically significantly different between the NR group and NNR group (P<0.05).

Hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during acute exacerbation are often associated with nutritional risk. An increase in nutritional risk reduces the level of pulmonary function of the patient and elevates the risk for repeated acute exacerbations, which predispose the patient to respiratory failure, thereby increasing the length of hospitalization. Therefore, the nutritional risk status of COPD patients with bronchiectasis was closely related to the occurrence, development, and prognosis of the disease.

Obstructive sleep apnea syndrome (OSAS) can cause sudden death during sleep. Previous findings have suggested that OSAS development is related to maxillofacial morphology. Evaluation of facial morphology can determine the risk of developing the disease, and establishing an objective method to assess the underlying etiology of OSAS-related death would be advantageous.

The objective of this study is to determine the key features of obstructive sleep apnea syndrome (OSAS) using postmortem oral and pharyngeal computed tomography (CT).

We retrospectively assessed autopsy cases of patients with (n=25) and without (n=25) OSAS-related death. We used oral and pharyngeal CT images to compare the oral and pharyngeal cavity volume (OPCV), oral and pharyngeal soft tissue volume (OPSV), oral and pharyngeal air space volume (OPAV), and OPAV to OPCV ratio (%air). Receiver operating curve (ROC) analysis was used to determine the accuracy of OSAS prediction. We assessed participants with body mass index (BMI) values within the normal range.

Among the 50 subjects, we observed significant between-group differences in OPSV, OPAV, and % air, whereas there were significant between-group differences in OPSV and %air among 28 subjects with normal BMI values. Both comparisons suggested that OSAS-related death was associated with low %air and high OPSV values.

The % air and OPSV are useful for assessing postmortem oropharyngeal CT images. OSAS-related sudden death is likely when %air and OPSV values are ≤20.1% and ≥127.2 ml, respectively. Among those with normal BMI values, % air and OPSV values of ≤22.8% and ≥111.5 ml, respectively, predict OSAS-related sudden death.

Breast cancer is the most common malignant tumour in women. Radical mastectomy with postoperative radiotherapy is now the standard treatment for locally advanced breast cancer. Intensity-modulated radiotherapy (IMRT) has now been developed, which employs linear accelerators to deliver precise radiation to a tumour while minimizing the dose to surrounding normal tissue. It significantly improves the efficacy of breast cancer treatment. However, there are still some flaws that must be addressed.

To assess the clinical application of the three-dimensional (3D)-printed chest wall conformal device for breast cancer patients who need to be treated by chest wall intensity modulated radiotherapy (IMRT) after radical mastectomy.

The 24 patients were divided into three groups. During a computed tomography (CT) scan, patients in the study group were fixed by a 3D-printed chest wall conformal device, nothing in control group A, and a traditional 1-cm thick silica gel compensatory pad on the chest wall in control group B. The parameters of mean Dmax, Dmean, D2%, D50%, D98%, the conformity index (CI), and the homogeneity index (HI) of the planning target volume (PTV) are compared.

The study group had the best dose uniformity (HI = 0.092) and the highest conformation (CI = 0.97), the worst in control group A (HI = 0.304, CI = 0.84). The mean Dmax, Dmean, and D2% of the study group were lower than control groups A and B (p<0.05). The mean D50% was higher than control group B (p<0.05), while the mean D98% was higher than control groups A and B (p<0.05). The mean Dmax, Dmean, D2%, and HI of control group A were higher than control group B (p<0.05), whereas the mean D98% and CI were lower than control group B (p<0.05).

By improving the efficacy of postoperative radiotherapy for breast cancer, using 3D-printed chest wall conformal devices may greatly improve the accuracy of repeating position fixation, increase the dose on the skin surface of the chest wall, optimise the dose distribution of the target area, and thus further reduce tumour recurrence and prolong patients' survival.

Researchers have made several advancements in this field, including automatic segmentation techniques, computer-aided diagnosis, mobile-based technology, deep learning methods, hybrid methods etc. All these techniques are beneficial in diagnosing melanoma or segregating skin lesions into different categories.

This paper aims to define different types of skin cancers, diagnosis procedures and statistics. This paper presents skin cancer statistics over a period of time in India. The increment in the number of skin carcinoma and melanoma cases from 1990 to 2020 as well as the mortality rates, has been presented in this paper. Also, this paper provides a review of different technologies used by researchers in detecting melanoma.

The rise in the number of cases by 2040 and mortality rates are compared. The statistics that are used in this paper are as per hospital-based cancer registries (HBCR) 2021 prepared by the Indian Council of Medical Research - National Centre for Disease Informatics and Research, Bengaluru (ICMR-NCDIR) and from World Health Organization (WHO).

The present study aimed to analyze the prevalence of hypothyroidism in patients with rheumatoid arthritis (RA). In addition, the study aimed to elucidate the correlation of hypothyroidism with RA activity and to investigate the relationship between RA and thyroid dysfunction.

A total of 314 patients were categorized into two groups according to thyroid stimulating hormone (TSH) level: RA without hypothyroidism and RA with hypothyroidism. All patients underwent routine laboratory investigation, including thyroid function testing, and complete clinical assessment. These included the determination of the erythrocyte sedimentation rate as well as the level of TSH, free triiodothyronine, free thyroxine, total triiodothyronine level, total thyroxine level, C-reactive protein, rheumatoid factor immunoglobulin (RF-Ig), RF-IgA, RF-IgG, RF-IgM, cyclic citrullinated peptide immunoglobulin G (CCP IgG), complement component 3, and complement component 4. Based on these data, thyroid function, and rheumatoid factor levels were analyzed.

Curve estimation using linear regression revealed that CCP Ig level was significantly correlated with the TSH level (r = 0.122, P = 0.031).

TSH level may be used as an auxiliary test to assess disease severity in patients with RA and to evaluate thyroid function. This evaluation parameter may be considered for determining clinical prognosis in patients with RA.

Thyroid disorders are prevalent worldwide and impact many people. The abnormal growth of cells in the thyroid gland region is very common and even found in healthy people. These abnormal cells can be cancerous or non-cancerous, so early detection of this disease is the only solution for minimizing the death rate or maximizing a patient's survival rate. Traditional techniques to detect cancerous nodules are complex and time-consuming; hence, several imaging algorithms are used to detect the malignant status of thyroid nodules timely.

This research aims to develop computer-aided diagnosis tools for malignant thyroid nodule detection using ultrasound images. This tool will be helpful for doctors and radiologists in the rapid detection of thyroid cancer at its early stages. The individual machine learning models are inferior to medical datasets because the size of medical image datasets is tiny, and there is a vast class imbalance problem. These problems lead to overfitting; hence, accuracy is very poor on the test dataset.

This research proposes ensemble learning models that achieve higher accuracy than individual models. The objective is to design different ensemble models and then utilize benchmarking techniques to select the best model among all trained models.

This research investigates four recently developed image transformer and mixer models for thyroid detection. The weighted average ensemble models are introduced, and model weights are optimized using the hunger games search (HGS) optimization algorithm. The recently developed distance correlation CRITIC (D-CRITIC) based TOPSIS method is utilized to rank the models.

Based on the TOPSIS score, the best model for an 80:20 split is the gMLP + ViT model, which achieved an accuracy of 89.70%, whereas using a 70:30 data split, the gMLP + FNet + Mixer-MLP has achieved the highest accuracy of 82.18% on the publicly available thyroid dataset.

This study shows that the proposed ensemble models have better thyroid detection capabilities than individual base models for the imbalanced thyroid ultrasound dataset.

It is difficult to accurately determine whether emergent patients with small-bowel obstruction (SBO) have small-bowel ischemia and necrosis (SBIN). Therefore, in this study, we aimed to assess the ability of abdominal CT scans to predict SBIN and establish a new predictive model.

From March 2018 to May 2023, a rigorous posthoc analysis was conducted on whether 177 emergent patients with SBO had SBIN. Four clinical indexes and 19 CT signs were analyzed, and a multivariate scoring model for predicting SBIN was established using logistic regression analysis. A receiver operating characteristic (ROC) curve was used to assess the accuracy of this model.

Multivariate analysis showed that mesenteric edema and effusion (OR=23.450), significant thickening and the target sign on the small-bowel wall on plain scans (OR=23.652), significant thinning of the small-bowel wall (OR=30.439), significant decrease in small-bowel wall density (OR=12.885), and significant increase in small-bowel wall density (OR=19.550) were significantly correlated with SBIN (P<0.05). According to their multivariate ORs, an appropriate “predictive score” was assigned to each sign, and the rates of SBIN among those with a total score of 0-4, 5-6, and 7-8 were 2.2%, 86.4%, and 96.9%, respectively. The AUC of this predictive scoring model for SBIN exceeded 0.980.

We have developed a predictive scoring model for SBIN, for which the incidence of SBIN increases with increasing predictive scores. This model can be useful for clinical treatment.

The objective of this study is to investigate whether quantitatively measured infrapatellar fat pad (IPFP) signal intensity alteration is associated with joint effusion-synovitis in people with knee osteoarthritis (OA) over two years.

Among 255 knee OA patients, IPFP signal intensity alteration represented by four measurement parameters [standard deviation of IPFP signal intensity (IPFP sDev), upper quartile value of IPFP high signal intensity region (IPFP UQ (H)), ratio of IPFP high signal intensity region volume to whole IPFP volume (IPFP percentage (H)), and clustering factor of IPFP high signal intensity (IPFP clustering factor (H))] was measured quantitatively at baseline and two-year follow-up using magnetic resonance imaging (MRI). Effusion-synovitis of the suprapatellar pouch and other cavities were measured both quantitatively and semi-quantitatively as effusion-synovitis volume and effusion-synovitis score at baseline and two-year follow-up using MRI. Mixed effects models assessed the associations between IPFP signal intensity alteration and effusion-synovitis over two years.

In multivariable analyses, all four parameters of IPFP signal intensity alteration were positively associated with total effusion-synovitis volume and effusion-synovitis volumes of the suprapatellar pouch and of other cavities over two years (all P<0.05). They were also associated with the semi-quantitative measure of effusion-synovitis except for IPFP percentage (H) with effusion-synovitis in other cavities.

Quantitatively measured IPFP signal intensity alteration is positively associated with joint effusion-synovitis in people with knee OA, suggesting that IPFP signal intensity alteration may contribute to effusion-synovitis and a coexistent pattern of these two imaging biomarkers could exist in knee OA patients.

During the COVID-19 pandemic, various complications have been reported in patients with this infection worldwide, including a wide range of neurological disorders. In this study, we have reported a novel neurological complication in a 46-years-old woman who was referred due to a headache following a mild COVID-19 infection. Also, we have had a quick review of previous reports of dural and leptomeningeal involvements in COVID-19 patients.

The patient's headache was persistent, global, and compressive with radiation to the eyes. The severity of the headache was increased during the disease course and was exacerbated by walking, coughing, and sneezing but decreased with rest. The high severity of the headache disrupted the patient’s sleep. Neurological examinations were completely normal, and laboratory tests did not have abnormal findings except for an inflammatory pattern. Finally, in the brain MRI, a concurrent diffuse dural enhancement and leptomeningeal involvement were observed, which is a new finding in COVID-19 patients and has not been reported so far. The patient was hospitalized and treated with Methylprednisolone pulses. After completing the therapeutic course, she was discharged from the hospital in good condition and with an improved headache. A repeated brain MRI was requested 2 months after discharge, which was completely normal and showed no evidence of dural and leptomeningeal involvements.

Inflammatory complications of the central nervous system caused by COVID-19 can occur in different forms and types, and clinicians should consider them.

The application of compressed sensing (CS) has enabled breath-hold 3D-MRCP with a shorter acquisition time in clinical practice.

To compare the image quality of breath-hold (BH) and respiratory-triggered (RT) 3D-MRCP with or without CS application in the same study population.

In this retrospective study, from February to July 2020, a total of 98 consecutive patients underwent four different acquisition types of 3D-MRCP.; 1) BH MRCP with the generalized autocalibrating partially parallel acquisition (GRAPPA) (BH-GRAPPA), 2) RT-GRAPPA-MRCP, 3) RT-CS-MRCP and 4) BH-CS-MRCP. Relative contrast of common bile duct, 5-scale visibility score of biliary pancreatic ducts, 3-scale artifact score and 5-scale overall image quality score were evaluated by two abdominal radiologists.

Relative contrast value was significantly higher in BH-CS or RT-CS than in RT-GRAPPA (0.90 ± 0.057 and 0.89 ± 0.079, respectively, vs. 0.82 ± 0.071, p < 0.01) or BH-GRAPPA (vs. 0.77 ± 0.080, p < 0.01). The area affected by artifact was significantly lower in BH-CS among 4 MRCPs (p < 0.01). Overall image quality score in BH-CS was significantly higher than BH-GRAPPA (3.40 vs. 2.71, p < 0.01). There were no significant differences between RT-GRAPPA and BH-CS (vs. 3.13, p = 0.67) in overall image quality.

In this study, our results revealed BH-CS had higher relative contrast and comparable or superior image quality among four MRCP sequences.

Symmetrical bilateral lower extremity edema (BLEE) needs to be treated effectively. Finding the cause of this condition increases the success of treatment. Fluid increase in the interstitial space (FIIS) is always present as a cause or a result. Subcutaneously administered nanocolloid is transported by uptake by lymphatic pre-collectors, and this uptake takes place in the interstitium. We aimed to evaluate the interstitium with labeled nanocolloid and contribute to the differential diagnosis in cases with BLEE.

Our retrospective study included 74 female patients who underwent lymphoscintigraphy for bilateral lower extremity edema. Technetium 99m (Tc-99m) albumin colloid (nanocolloid), a marked colloidal suspension, was applied subcutaneously to two different areas on the dorsum of both feet with a 26 gauge needle The dose volume administered intradermally is approximately 0.2-0.3 ml, and each injector has 22-25MBq of activity. Siemens E-Cam dual-headed SPECT gamma camera was used for imaging. Dynamic and scanning images were taken with a high-resolution parallel hole collimator. Ankle images were re-evaluated by two nuclear medicine specialists, independent of physical examination and scintigraphy findings.

74 female patients with bilateral lower extremity edema were divided into two groups based on physical examination and lymphoscintigraphy findings. There were 40 and 34 patients in Groups I and II, respectively. In the physical examination, patients in Group I were evaluated as lymphedema, and patients in Group II were evaluated as lipedema. The main lymphatic channel (MLC) was not observed in any of the patients in Group I in the early images, and the MLC was observed at a low level in the late imaging in 12 patients. The sensitivity of the presence of distal collateral flows (DCF) in the presence of significant MLC in early imaging in demonstrating increased fluid in the interstitial space (FIIS) was calculated as 80%, specificity as 80%, PPV 80%, and NPV 84%.

While MLC is present in early images, concomitant DCF occurs in cases of lipoedema. The transport of increased lymph fluid production in this group of patients can be covered by the existing MLC. Although MLC is evident, the presence of significant DCF supports the presence of lipedema. It can be used as an important parameter in the diagnosis in early cases where physical examination findings are not evident.

Chondrosarcoma in the mastoid is extremely rare, and it is easily misdiagnosed as a facial nerve schwannoma.

To identify and compare computed tomography (CT) and magnetic resonance imaging (MRI) features of chondrosarcoma in the mastoid involving the facial nerve, including diffusion-weighted MRI characteristics, with those of facial nerve schwannoma.

CT and MRI features of 11 chondrosarcomas in the mastoid involving the facial nerve and 15 facial nerve schwannomas, confirmed by histopathology, were retrospectively reviewed. The tumor location, size, morphological features, bone change, calcification, signal intensity, texture, enhancement characteristics, the extent of lesions, and apparent diffusion coefficients (ADCs) were evaluated.

On CT imaging, calcification could be found in 81.8% of chondrosarcomas (9/11) and 33.3% of facial nerve schwannomas (5/15). Chondrosarcoma in the mastoid appeared significantly hyperintense on T2-weighted images (T2WI) with low signal intensity septa in eight patients (72.7%, 8/11). After contrast, all chondrosarcomas showed inhomogeneous enhancement, and septal and peripheral enhancement could be found in six cases (54.5%, 6/11). Facial nerve schwannoma demonstrated inhomogeneous hyperintensity on T2WI in 12 cases (80%, 12/15), with obvious hyperintense cystic changes in seven cases. There were significant differences in calcification (P=0.014), T2 signal intensity (P=0.006), and septal and peripheral enhancement (P=0.001) between chondrosarcomas and facial nerve schwannomas. The ADCs of chondrosarcoma were significantly higher than those of facial nerve schwannomas (P<0.001).

CT and MRI with ADCs had the potential to improve the diagnostic accuracy of chondrosarcoma in the mastoid involving the facial nerve.

For patients with acetabular osteolytic metastases involving the articular surfaces, current treatments cannot efficiently rebuild the acetabular bone frame structure and strengthen bone defect area mechanics for weight-bearing. The purpose of this study is to show the operational procedure and clinical outcomes of multisite percutaneous bone augmentation (PBA) for the treatment of incidental acetabular osteolytic metastases involving the articular surfaces.

According to the inclusion and exclusion criteria, 8 patients (4 males and 4 females) were included in this study. Multisite (3 or 4 sites) PBA was successfully performed in all patients. The pain and function evaluation and imaging observation were examined by VAS and Harris hip joint function scores at the different time points (pre-procedure, 7 days, one month, last follow-up in 5-20 months).

There were significant differences (p<0.05) in VAS and Harris scores before and after the surgical procedure. Moreover, these two scores had no obvious changes during the follow-up process (7 days after the procedure, one month after the procedure, and the last follow-up) after the procedure.

The proposed multisite PBA is an effective and safe procedure for the treatment of acetabular osteolytic metastases involving the articular surfaces.

Clinical Trial Reg # The clinical trial registration number was ChiCTR2000032667

To analyze the value of magnetic resonance imaging (MRI) in suspicious cases for prenatal detection of placenta accreta (PA).

A total of 50 placental MRI exams performed on a 1.5T scanner were retrospectively reviewed by two radiologists in consensus. HASTE (half-Fourier acquisition single-shot turbo spin echo)and True-FISP (true fast imaging with steady-state precession) sequences were acquired. Findings from MRI were compared with the final diagnosis, which was determined by clinical findings at delivery and pathological examination of specimens.

Of 50 pregnant women in the analysis, 33 required cesarean hysterectomy, and 17 underwent cesarean delivery.MRI signs such as myometrial thinning, loss of T2 hypointense interface(loss of retroplacental clear space on US), heterogenous intraplacental sign, and intraplacental T2 dark bands were more likely to be seen in this group.

In this group, the cases that were finally clinically and pathologically confirmed were 12, 16, and 22 cases of placenta accreta vera, placenta increta, and placenta percreta respectively.

MRI is particularly useful in cases where US is inconclusive and to assess the extent to which the placenta penetrates the uterine serosa and invades outward into surrounding tissues.MRI has become a routine examination for patients with suspected PA in clinical practice.

Massive parenchymal hemorrhage of the thyroid gland is very rare. Some of these can reach a life-threatening level.

A 70-year-old female patient approached the emergency department with swelling and redness on her neck after a routine dialysis session. In the neck computed tomography obtained, there was a massive hematoma originating from the thyroid gland parenchyma. The hematoma was causing airway compression. We performed thyroid artery embolization and within days, hematoma dimensions and compression effect disappeared without surgical treatment.

Massive hemorrhage of the thyroid gland parenchyma is very rare and can reach life-threatening dimensions. Effective and rapid treatment should be done. As an alternative to surgery, endovascular treatment can be life-saving.

Calcific tendinopathy is a common cause of painful shoulder easily identified with ultrasound or conventional radiography. Although the rotator cuff is by far the most common location of the disease and diagnostic or treatment strategies are well known in clinical practice, a lack of awareness characterizes the assessment of the other sites affected by this condition; consequently, the risk of underestimating the prevalence of atypical non-rotator cuff calcific tendinopathy is high. This may lead to expensive or invasive diagnostic exams and/or inappropriate treatment, whereas the condition is usually self-limited.

The present study aims at analysing the frequency of calcific tendinitis in uncommon sites, in order to fill a gap in knowledge and awareness regarding non-rotator cuff calcific tendinopathy, thus avoiding improper clinical choices and helping to identify this condition.

This systematic review was conducted following the PRISMA guidelines. We performed a search on Pubmed and Scopus databases concerning atypically sited extra-rotator cuff calcific tendinopathy published since 1950.

The research found a total of 267 articles and 793 non-rotator cuff cases of calcific tendinopathy registered. The spine (213 – 26.86%), foot and ankle (191 – 23.95%), and hip (175 – 22.06%) appeared to be the most common sites of calcific tendinopathy after the rotator cuff, whereas the longus colli C1-C2 (204 – 25.72%), Achilles (173 – 21.81%), and rectus femori (61 – 7.69%) were the most commonly affected tendons.

A better awareness of this condition in several different sites of the body than the rotator cuff could avoid unnecessary choices both in assessment and treatment.

Volumetric Modulated Arc Therapy (VMAT) has recently become a pivotal treatment of oncological diseases due to the high-precise delineation of target volume contours with sparing organs at risk. This procedure requires a high level of experience and precision and is achievable only with advanced diagnostic support. Magnetic Resonance (MRI) and multimodality imaging, such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), are fundamental in implementing radiotherapy guidance.

A 54-year-old patient underwent surgery twice to remove primitive and recurrent cardiac sarcomas of the left atrium. The appearance of a further relapse required radiotherapy as the only possible treatment. Cardiac MRI was then performed to define the degree of atrial mass invasiveness, and 18F-FDG PET/CT was performed to assess the activity and staging of the cardiac lesion. It revealed high 18F-FDG uptake not only in the left atrium lesion but also in a pancreatic lesion with elevated 18F-FDG uptake (SUV max 5.5). The pancreatic biopsy performed a few days later confirmed the myxoid sarcoma metastasis, and surgeons defined it as not operable due to the patient’s clinical condition. Radiotherapy was then urgently performed with the VMAT technique. After 40 days, a cardiac MRI showed a reduction in the cardiac mass with improvement in the respiratory and cardiac symptoms; then, the patient started chemotherapy. One year after diagnosis, the patient is still alive and is receiving chemotherapy with gemcitabine and docetaxel with good compliance.

The correct and timely management of a patient suffering from a rare oncological disease has allowed a better and longer survival, especially due to VMAT, a sophisticated procedure that requires high expertise. This case also demonstrates that cardiac MRI and whole-body imaging procedures, such as 18FDG PET/CT, can be useful in staging patients with oncological diseases.

Portal hypertension has various manifestations, and varices are a common manifestation. Varices can appear in any vein in the body associated with the portal venous system.

Herein, we report a case of portal hypertension with gallbladder varices as the main manifestation, which was confirmed by abdominal contrast-enhanced CT with three-dimensional reconstruction and color Doppler ultrasonography. The patient had concomitant liver cirrhosis and portal vein thrombosis. Various auxiliary examinations and biochemical indicators of the patient confirmed liver cirrhosis, portal vein thrombosis, and portal hypertension, all of which were mild and did not reach the decompensation stage.

As illustrated by this case, when there is an embolism in certain parts of the portal system, portal hypertension can appear during the compensatory period and transition into severe varices in the thrombotic part during the de-compensatory period.

Lemmel’s syndrome is defined as obstructive jaundice due to a PDD in the absence of choledocholithiasis or a neoplasm. The most common cause is the presence of PDD which arise within 2-3 cm from the ampulla of Vater. Currently, there are very few case reports of this condition, which was first named in 1934 after Dr. Gerhard Lemmel.

A 74-year-old female patient presented to the emergency department with complaints of abdominal pain and jaundice, and also had signs of pancreatitis, with laboratory results showing elevated liver and pancreatic enzymes and hyperbilirubinemia. We present a case of a patient who was diagnosed with Lemmel’s syndrome after abdominal CT, MRCP, and ERCP.

Although rare, it is imperative for physicians to recognize this syndrome in order to deliver prompt care. Because making the correct diagnosis in these patients is very important for correct treatment and preventing the development of complications.

Ultrasound-guided needle biopsies, including fine-needle aspirations (FNA) and core needle biopsies (CNB), have become an effective technique in the evaluation of thyroid nodules. In this report, we discuss the first reported case, to our knowledge, of thyroid pneumatosis after ultrasound-guided FNA.

A 44-year-old woman underwent ultrasound-guided FNA in other hospitals after thyroid ultrasound revealed a solid lesion in the left lobe classified as TI-RADS 4. Two days later, this female presented to our hospital for an excision of a thyroid mass. Pre- and post-contrast CT scans of the thyroid showed extensive accumulation of gas in the thyroid gland and the retropharyngeal and retrotracheal space. A CT scan of the thyroid two days later revealed obvious absorption of thyroid gas and faint low-density nodules in the left lobe of the thyroid. The lesion was histopathologically confirmed as papillary carcinoma of the thyroid.

We thought the aforementioned issues originating from the limited imaging capacity of ultrasound in the context of thyroid biopsy. To avoid these limitations, we highlight the need to thoroughly examine the location of a lesion prior to thyroid biopsy to understand in detail the relationship between the lesion and the adjacent tissues, especially the proximity of the lesion to the trachea, the occurrence of coughing during a biopsy (indicating puncture of the trachea) is what operators need to be aware of so that they can manage such cases. On the other hand, we recommend that pre-operative use of CT before thyroid biopsy and especially if CT is needed anyway later for nodules evaluation before surgery to ensure the CT image quality.

Cerebral microbleeds (CMBs) are commonly present in patients with hypertension, producing iron-containing metabolites. A small amount of regional iron deposition is hardly discernible on conventional magnetic resonance imaging (MRI). Three-dimensional enhanced susceptibility-weighted angiography (ESWAN) provides tissue images with high spatial resolution and signal-noise ratio, and has been widely used to measure brain iron deposition in neurodegenerative diseases and intracranial hemorrhage.

The study aimed to demonstrate iron deposition in the brain of hypertensive patients using ESWAN.

Twenty-seven hypertension patients, with or without CMBs, and 16 matched healthy controls (HCs) were enrolled. From the post-processed ESWAN images, phase and magnitude values of the regions of interest (ROIs) were calculated. Two-sample t-test and one-way variance analysis were applied to compare groups. The relationship between ESWAN parameters and clinical variables was assessed using Pearson’s correlation coefficient.

Compared to HCs, the phase value of the hippocampus, head of caudate nucleus (HCN), and substantia nigra (SN) was decreased in hypertension with the CMBs subgroup, while that of HCN and SN was decreased in hypertension without CMBs subgroup. Similarly, the magnitude value of the hippocampus, HCN, thalamus red nucleus, and SN was significantly lower in the hypertension group than HCs. In addition, the phase and magnitude values showed a correlation with clinical variables, including disease duration and blood pressure.

Deep grey matter nuclei displayed greater iron content in hypertension patients. Iron deposition may precede the appearance of CMBs on MRI, serving as a potential marker of microvascular damage.

The quantitative measure of dopamine transporter (DaT) in the human midbrain is generally used as a biomarker for analyzing Parkinson’s disease (PD).

DaT scan images or Single- photon emission computed tomography (SPECT) images are utilized to capture the dopamine content more accurately.

Only sixteen slices out of ninety-one of SPECT images were chosen on the basis of the high amount of dopamine content and were named Volume rendering image slices (VRIS). This paper proposes a novel Convolutional Neural Network (CNN) called JAN Net which particularly treats the VRIS for identifying PD. The JAN Net preserves the edges and spatial features of the striatum by using a modified exigent feature (M-ExFeat) block, that contains convolutional and additive layer. The different-sized convolutional layer extracts both low- and high-level features of Striatum. The additive layer adds up all the features of different filter sized convolutional layers like 1x1, 3x3, and 5x5. The added output features are used to improve the learnability of neurons in the hidden layer. The network performance is tested for stride 1 and stride 2.

The results are validated using the dataset taken from the Parkinson’s Progression Markers Initiative (PPMI) database. The JAN Net ensures improved performance in terms of accuracy. The training and validation accuracy for stride 2 is 100% with minimum losses. The outcome has been compared with different deep learning architectures and the machine learning techniques like Extreme Learning Machines (ELM), and Artificial Neural Networks (ANN) to highlight the efficacy of the proposed architecture.

Hence, the present work could be of great aid to the experts in neurology to protect the neurons from impairment.

Arthritis of the hip caused by arteriovenous malformations (AVMs) has been rarely reported. Therefore, total hip replacement (THR) in patients with AVM-induced arthritis of the hip is challenging.

We report a 44-year-old woman with aggravated right hip pain during the past decade. The patient presented with severe pain and a functional disorder of the right hip. X-ray examination revealed severely narrowed right hip joint space and abnormal trabecular bone loss in the femoral neck and trochanter area. Doppler ultrasound, magnetic resonance imaging and computed tomography angiography revealed AVMs surrounding the right hip, along with erosion. To ensure the safety of THR, we performed vascular embolization and temporary balloon occlusion of the iliac artery three times during the operation. However, serious hemorrhage occurred, which was rescued by the multimodality blood conservation strategy. THR was successfully performed, and the patient was discharged 8 d later for rehabilitation. Postoperative pathological examination showed osteonecrosis of the femoral head with malformed thick-walled vessels and focal granulomatous inflammation of the surrounding soft tissues. The Harris Hip Scale score increased from 31 to 82 at 3 mo of follow-up. The patient was followed up for 1 year, and all her clinical symptoms were significantly alleviated.

Arthritis of the hip caused by AVMs is rare in clinical practice. The activity and function of the involved hip joint can be effectively treated with THR after comprehensive imaging and multidisciplinary consultation.

Arthritis of the hip caused by arteriovenous malformations is rarely reported. Total hip replacement (THR) is a reliable and effective option for the treatment of advanced arthritis of the hip. We report a 44-year-old woman with aggravated pain in the right hip during the past decade. With the vascular intervention and multimodality blood conservation strategy. THR can be successfully performed in patients with AVM-induced arthritis of the hip.

Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is a rare tumor that arises in the myometrium of the uterus. It is regarded as an intermediate malignant tumor according to the recent World Health Organization classification. Few studies have reported the radiologic findings of STUMP, and the differentiation of STUMP from leiomyoma remains controversial.

A 42-year-old nulliparous female presented at our institution with massive vaginal bleeding. Radiological studies, including ultrasonography, computed tomography (CT), and magnetic resonance imaging, revealed an oval-shaped mass with well-defined margins in the uterus protruding into the vagina. The patient underwent a total abdominal hysterectomy, and the final pathology was confirmed as STUMP.

Distinguishing STUMP from leiomyomas based solely on radiological findings can be challenging. However, if the uterine mass appears as a single mass lacking acoustic shadowing on ultrasound and demonstrates diffusion restriction with high T2 signal intensity on magnetic resonance imaging, consideration of STUMP may be necessary for proper patient management, given the poor prognosis associated with this tumor.

With the advancement of computer and medical imaging technologies, a number of high-resolution, voxel-based, full-body human anatomical models have been developed for medical education, industrial design, and physics simulation studies. However, these models are limited in many applications because they are often only in an upstanding posture.

To quickly develop multi-pose human models for different applications. A semi-automatic framework for voxel deformation is proposed in the study.

This paper describes a framework for human pose deformation based on three-dimensional (3D) medical images. The voxel model is first converted into a surface model using a surface reconstruction algorithm. Second, a deformation skeleton based on human bones is defined, and the surface model is bound to the skeleton. The bone Glow algorithm is used to assign weights to the surface vertices. Then, the model is deformed to the target posture by using the Smoothed Rotation Enhanced As-Rigid-As-Possible (SR-ARAP) algorithm. Finally, the volume-filling algorithm is applied to refill the tissues into the deformed surface model.

The proposed framework is used to deform two standing human models, and the sitting and running models are developed. The results show that the framework can successfully develop the target pose. When compared to the results of the As-Rigid-As-Possible algorithm, SR-ARAP preserves local tissues better.

The study proposes a frame for voxel human model deformation and improves the local tissue integrity during deformation.

Carbonated beverages and puffed foods are popular among young people during leisure and entertainment. However, there have been a few death cases reported after ingesting large amounts of junk food in a short time.

A 34-year-old woman was admitted to the hospital with acute abdominal pain due to a bad mood and consumption of large amounts of carbonated beverages and puffed foods. Emergency surgery revealed a ruptured dilated stomach combined with severe abdominal infection, and the patient died after the surgery.

We should keep in mind the possibility of gastrointestinal perforation in patients with acute abdomen with a history of heavy consumption of carbonated beverages and puffed foods. We need to evaluate the acute abdomen patients after taking large amounts of carbonated beverages and puffed foods in combination with symptoms, signs, inflammatory indicators, imaging and other examinations, and the possibility of gastric perforation needs to be considered, and emergency repair surgery should be arranged.

This study aimed to assess the response of combretastatin-A4-phosphate (CA4P) in rabbit VX2 liver tumors using intravoxel incoherent motion diffusion-weighted MRI (IVIM DW-MRI).

Forty rabbits with implanted VX2 liver tumors underwent baseline MRI and were then given 10 mg/kg CA4P (n=20) or saline (n=20). After 4 h, 10 rabbits from each group underwent an MRI examination and were then sacrificed. The remaining rabbits underwent MRI after 1, 3, and 7 days and were then sacrificed. Liver samples were processed for H&E and immunohistochemical staining. IVIM parameters (D, f, D*) were compared in the treatment and control groups, and the correlations of IVIM parameters with microvascular density (MVD) were determined.

At 4 h, the two treatment groups had significantly different f and D* values (p<0.001), and these values were at their minimum in the treatment group. The treatment group had moderate correlations between MVD and f at 4 h (r=0.676, p=0.032) and 7 days (r=0.656, p=0.039) and with D* at 4 h (r=0.732, p=0.016) and 7 days (r=0.748, p=0.013), but no correlation was reported between MVD and f or D* in the control group (all P>0.05).

IVIM DW-MRI is a sensitive imaging technique. It successfully evaluated the effect of CA4P on VX2 liver tumors in rabbits. The f and D* values correlated with MVD at 4 h and 7 days after using CA4P, indicating that these parameters have the potential to be used as indicators of tumor angiogenesis after treatment.

To analyze the MRI findings of stage IA ovarian cancer.

The data on age distribution, clinical symptoms at onset, CA125 detection, MRI findings, including tumor volume, structure, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and enhancement, etc., of the patients with stage IA ovarian cancer, who were admitted to Nantong tumor Hospital between 2013 and 2020 were analyzed retrospectively.

Only 11 cases of stage IA ovarian cancer were recorded. The age of patients was 30–67 (average 52) years. The initial symptoms were mostly lower abdominal distension and abdominal pain. CA125 was 90% positive. MRI features 1. Large pelvic mass with a volume range of 23–2,009 cm³ (average 669 cm³). 2. Five cases of cyst type (with plaque-like, papillary, or mural nodule vegetations), two cases of cystic-solid mixed type (with thickened septum or wall), and four cases of solid type. 3. DWI diffusion was limited, and ADC was reduced on all solid components (vegetation, septa, and cyst wall). 4. The solid parts were significantly enhanced on T1-enhanced MRI. 5. There was no metastasis in the pelvic cavity, and a few ascites (negative tumor cells) in three patients.

MRI characteristics of stage IA ovarian carcinomas were large tumors; cystic, cystic-solid, or solid; solid parts limited diffusion on DWI and low ADC; enhancement of the cyst wall, vegetation, and septa; no pelvic metastasis.

Imaging studies play a crucial role in diagnosing femoroacetabular impingement (FAI), including plain radiography and Magnetic Resonance Imaging (MRI). FAI is a combined pathology of bony abnormality, labral and labrocartilagenous erosions. Surgical treatment for such cases has become more established and preoperative imaging is the roadmap that includes the assessment of labrum and articular cartilage.

During a period of 2 years, thirty-seven patients with a clinical diagnosis of FAI were retrospectively enrolled in this study, including 17 men and 20 women, aged 27–62 years. There were 22 right hips and 15 left hips. MRI was done for all patients to identify bony details, labral and chondral abnormalities and to exclude coexisting disorders. The imaging findings were compared with the arthroscopic data.

15 patients had Pincer FAI, 11 patients had CAM, and 11 patients had combined Cam/Pincer FAI. Labral tear was detected in 100% of patients, 97% had an anterosuperior labral tear. 82% of patients had partial thickness cartilage lesions and 8% had full thickness cartilage lesions. MRI had a sensitivity of 100% compared to hip arthroscopy in detecting labral tear, 60% in detecting cartilage erosion.

Conventional hip MRI detects bony changes in FAI, type of impingement and associated labral tear and cartilage erosions in comparison to the hip arthroscopy.

Subchondral insufficiency fractures (SIF) of the knee joint are prevalent in osteoporosis patients over the age of 55. Early diagnosis of SIF fracture of the medial femoral condyle is crucial for delaying disease progression, early therapy, and potential disease reversal. Magnetic resonance imaging (MRI) is useful in detecting SIF, which is often undetectable on initial radiographs.

This study aimed at developing a grading system for subchondral insufficiency fractures (SIF) based on MRI to predict outcomes and evaluate risk factors.

In this study, MRI was used to examine SIF risk variables in the medial condyle of the femur to help clinicians diagnose, treat, and delay the condition. A total of 386 patients with SIF from 2019 to 2021 were retrospectively analyzed and divided into 106 patients in the disease group and 280 patients in the control group according to whether they had SIF. The lesion site, meniscus, ligament, and other parameters were evaluated and compared. At the same time, a grading system was introduced to stratify and statistically analyze the size of the lesion area, the degree of bone marrow edema (BME), meniscus tears, and other parameters in the patients.

Most SIF were low-grade (LG) fractures, and the predictors of LG and high-grade (HG) fractures included heel tear (P =0.031), degree of medial malleolus degeneration (P < 0.001), advanced age (P < 0.001), and lesion size (P < 0.001). The prognostic factors that showed significant differences between the two groups included age (P =0.027), gender (P =0.005), side (P =0.005), medial tibial plateau injury (P < 0.0001), femoral medullary bone marrow edema (P < 0.0001), medial tibial plateau bone marrow edema (P < 0.0001), meniscus body partial injury (P =0.016), heel tear (P =0.001), anterior cruciate ligament injury (P =0.002), and medial collateral ligament injury (P < 0.0001).

This current study proposed an MRI-based grading system for inferior condylar fractures of the femur, in which HG inferior condylar fractures are associated with severe medial malleolus degeneration, advanced age, lesion size (correlation), and meniscus heel tears.

The study was conducted on patients who received diagnostic X-rays in King Khalid Hospital (KKH), Majmaah.

The study included the seven most frequently performed investigations, which were carried out on over 1504 patients using digital radiography equipment.

The X-ray tube's output and exposure parameters were used to calculate the effective dose (ED) and patient entry surface air kerma (ESAK). Additionally, based on these results, conversion coefficients were determined. This study also examined the 75th percentile distributions of ESAK and KAP. The findings of this research were compared with the findings of other researchers throughout the country and the world. The study presents the uncertainty U values, as well as the mean ESAK, KAP, and ED values.

The results of the ESAK, KAP, and ED values were 0.12-5.74 mGy, 0.9-1.84 Gy cm², and 0.01-0.23 mSv, respectively. As a result, the dosages were much lower than those previously published for the European DRL, national standards, and other studies.

The study concludes that during dose surveys, the importance of detecting and comprehending radiation doses, as well as the proper technique for taking the finest photos possible, can be emphasized to patients in order to assist them in avoiding radioactive particles and radiation exposure.

The combination of FFDM and DBT can significantly improve the diagnostic efficiency of breast cancer, but with the increase of breast radiation absorbed dose.

To compare and analyze the radiation dose and diagnostic performance of different mammography positions combinations of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) for different density types of breasts.

This retrospective study involved 1,195 patients who underwent simultaneous breast DBT and FFDM. The mammography combinations were Group A, FFDM(CC+MLO); Group B, FDM(CC)+DBT(MLO); Group C, FFDM(MLO)+DBT(CC); Group D, DBT(CC+MLO); and Group E, FFDM(CC+MLO)+DBT(CC+MLO). An intergroup comparative analysis of radiation dose and diagnostic performance of different combinations of mammography positions for different breast density types was performed using the pathologic and 24-month follow-up results as the diagnostic basis.

Overall, 2,403 mammograms indicated 477 cases of non-dense breast tissues and 1,926 cases of dense breast tissues. Differences in the mean radiation dose for each non-dense and dense breast group were statistically significant. The areas under the diagnostic receiver operating characteristic (ROC) curves for the non-dense breast group were not statistically significant. In the dense breast group, the z-values were 1.623 (p = 0.105) and 1.724 (p = 0.085) for the area under the ROC curve in Group C compared with Groups D and E, respectively, and 0.724 (p = 0.469) when comparing Group D with Group E. The differences between the remaining groups were statistically significant.

Group A had the lowest radiation dose and no significant difference in diagnostic performance compared with the other non-dense breast groups. Group C had high diagnostic performance in the dense breast group considering the low radiation dose.

Inadvertent puncture of the adjacent structures during a central venous catheterization is a well-known complication which may be managed conservatively when the injury is self-limiting, but requires a further treatment when there’s a proof of an active bleeding and/or a growing hematoma.

We report a case of a 57-year-old bone-marrow-transplant patient with neck hematoma and bleeding followed by a non-sonographic-guided central venous line placement. CT showed a right sided hematoma in the neck region with a midline shift of the airway. The patient was under prophylactic LMWH. Emergent angiography demonstrated three different bleeding sites which were successfully embolized with coil and liquid embolic agents by endovascular means.

Interventional radiology offers a quick and safe approach in the management of potentially life-threatening bleeding complications.

Toxoplasma gondii (T. gondii) infection is not uncommon in daily life, primary infection with T. gondii acquired during gestation may lead to a series of fetal complications. Prenatal ultrasound and postpartum neonatal T. gondii encephalitis have been reported previously, but fetal MRI findings of T. gondii encephalitis are quite rare. It is important to identify the severity of cerebral damage and assess fetal prognosis.

The purpose of this report is to emphasize that MRI can provide more excellent anatomic information on abnormalities in cerebral parenchyma than ultrasound, which is helpful for the diagnosis of prenatal infectious encephalitis.

A 38-year-old woman presented to our hospital at a gestation age of 29 weeks due to an ultrasound that showed fetal ventriculomegaly. The fetus demonstrated ventriculomegaly, intrauterine growth restriction, and multiple cystic lesions close to the corticomedullary junction of the frontal, temporal and parietal lobes on both sides. The woman chose to terminate the pregnancy, and pathological examination confirmed the diagnosis of congenital toxoplasma encephalitis.

This is a rare report of MRI manifestations of fetal congenital toxoplasma encephalitis. Detailed knowledge of MRI findings in fetal congenital toxoplasma encephalitis is helpful for prenatal consultation and pregnancy management.

The cerebellar tentorium, the second-largest dural reflection in the brain, separates supratentorial and infratentorial structures. This study aimed to determine the frequency of tentorial hypoplasia (TH) and gyral herniation and their relationship with clinical findings.

The standard brain MRIs were examined retrospectively. The presence of TH and laterality were investigated. If hypoplasia was accompanied by a gyrus extending inferior to the line where the tentorium should be located, this was recorded as tentorial hypoplasia-herniated gyrus (TH-HG), while the cases with hypoplasia alone were noted as isolated TH. It was also determined which gyrus or gyri were herniated. The clinical findings of the patients were obtained, and the correlation between HG was explored.

Standard brain MRIs of the 2051 patients were evaluated. Two hundred ten patients were excluded from the study due to different intracranial disorders, and 1841 patients, 739 (40.1%) males, and 1102 (59.9%) females, were included. Isolated TH or TH-HG was present in 56 patients, resulting in a prevalence of 3.04%. Of the patients with TH or TH-HG, 15 were men, and 41 were women. TH and TH-HG were significantly more common in women (p=0.038). TH-HG was unilateral in 22 (39.2%) patients and bilateral in 21 (37.5%). Left TH was found in 11 (19.6%) patients, left TH-HG in 29 (51.7%), right TH in eight (14.2%), and left TH-HG in 35 (62.5%).

Hypoplasia of the tentorium is a rare and unknown anomaly that can be easily diagnosed using MRI, and different gyral herniations may accompany TH.