Medical Specialties Commons^™

Mri Of Suspected Appendicitis During Pregnancy: Interradiologist Agreement, Indeterminate Interpretation And The Meaning Of Non-Visualization Of The Appendix, Richard Tsai, Constantine Raptis, Kathryn J. Fowler, Joseph W. Owen, Vincent M. Mellnick

Radiology Faculty Publications

Objective: To determine the degree of interradiologist agreement between the MRI features of appendicitis during pregnancy, the outcomes associated with an indeterminate interpretation and the negative predictive value of non-visualization of the appendix.

Methods: Our study was approved by the institutional review board at the Washington University in St. Louis, Missouri (WUStL) and was HIPAA (Health Insurance Portability and Accountability Act of 1996)-compliant. The informed consent requirement was waived. Cases of suspected appendicitis during pregnancy evaluated using MRI were retrospectively identified using search queries. Scans were re-reviewed by two radiologists (7 and 9 years experience, respectively) to evaluate the interradiologist …

Robust Head Ct Image Registration Pipeline For Craniosynostosis Skull Correction Surgery, Shusil Dangi, Hina Shah, Antonio Porras, Beatriz Paniagua, Cristian Linte, Marius George Linguraru, Andinent Enquobahrie

Radiology Faculty Publications

Craniosynostosis is a congenital malformation of the infant skull typically treated via corrective surgery. To accurately quantify the extent of deformation and identify the optimal correction strategy, the patient-specific skull model extracted from a pre-surgical computed tomography (CT) image needs to be registered to an atlas of head CT images representative of normal subjects. Here, the authors present a robust multi-stage, multi-resolution registration pipeline to map a patient-specific CT image to the atlas space of normal CT images. The proposed registration pipeline first performs an initial optimisation at very low resolution to yield a good initial alignment that is subsequently …

Gastrointestinal Bleeding From Supraduodenal Artery With Aberrant Origin, Qiong Han, Chenghao Qian, Gaby Gabriel, Steven Krohmer, Driss Raissi

Radiology Faculty Publications

Angiography and endovascular embolization play an important role in controlling acute arterial upper gastrointestinal hemorrhage, particularly when endoscopic intervention fails to do so. In our case, the patient presented with recurrent life-threatening bleed in spite of multiple prior endoscopic interventions and gastroduodenal artery embolization. Our teaching points focus on the role of angiography in acute upper gastrointestinal bleed and when to conduct empiric embolization, while reviewing the supraduodenal artery as an atypical but important potential culprit for refractory upper gastrointestinal bleed.

Breast Cancer Screening In Patients With Newly Diagnosed Lung And Colorectal Cancer: A Population-Based Study Of Utilization, Gelareh Sadigh, Ruth C. Carlos, Kevin C. Ward, Jeffrey M. Switchenko, Renjian Jiang, Kimberly E. Applegate, Richard Duszak Jr.

Radiology Faculty Publications

Purpose—To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls.

Methods—Female fee-for-service Medicare beneficiaries who were ≥ 67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as …

Primary Lung Carcinoid Metastatic To The Breast, Marianna Zagurovskaya, Karen Tran-Harding, Richard Gibbs

Radiology Faculty Publications

Lung carcinoid tumors account for approximately 2% of lung cancers, with 10% of the tumors represented by the atypical type. While atypical carcinoids are metastatic to intrathoracic lymph nodes in approximately half of the cases on the initial presentation, distant metastases are seen in only 20% of the patients and are found most frequently in bones, liver, adrenal glands, and brain. We present a case of an unusual metastatic disease to the breast in 51-year-old female who developed a new breast mass 2 years after left lower lobectomy due to atypical carcinoid tumor. Atypical pulmonary carcinoid metastases to the breast …

The Use Of Intraosseous Needles For Injection Of Contrast Media For Computed Tomographic Angiography Of The Thoracic Aorta, Michael A. Winkler, Cynthia Talley, Connor Woodward, Alexander Kingsbury, Frank Appiah, Hossam Elbelasi, Kevin P. Landwehr, Xingzhe Li, Dominik Fleischmann

Radiology Faculty Publications

Background

The objective of this study is to evaluate the safety and quality of computed tomographic angiography of the thoracic aorta (CTA-TA) exams performed using intraosseous needle intravenous access (ION-IVA) for contrast media injection (CMI).

Methods

All CTA-TA exams at the study institution performed between 1/1/2013 and 8/14/2015 were reviewed retrospectively to identify those exams which had been performed using ION-IVA (ION-exams). ION-exams were then analyzed to determine aortic attenuation and contrast-to-noise ratio (CNR). Linear regression was used to determine how injection rate and other variables affected image quality for ION-exams. Patient electronic medical records were reviewed to identify any …

Peritoneal Mesothelioma In A Young Woman: Case Report Of Radiopathologic Findings And Review Of The Literature, Amy L Ellenbogen, Stephanie Barak, Esma A. Akin

Radiology Faculty Publications

Peritoneal mesothelioma is a rare diagnosis most often seen in middle-aged men and exceedingly rarely in individuals in their teens and twenties. Diagnosis is often delayed secondary to nonspecific presenting symptoms and a misconception that there must be a history of asbestos exposure to garner such a diagnosis. Here, we present the case of a 21 year-old female with a histologically confirmed diagnosis of peritoneal mesothelioma and review the key radiologic and histologic findings of this rare diagnosis.

Altered Cerebellar Biochemical Profiles In Infants Born Prematurely, Marie Brossard-Racine, Jonathan Murnick, Marine Bouyssi-Kobar, Janie Coloumbe, Taeun Chang, Catherine Limperopoulos

Radiology Faculty Publications

This study aims to compare the cerebellar biochemical profiles in preterm (PT) infants evaluated at term equivalent age (TEA) and healthy full-term newborns using proton magnetic resonance spectroscopy (1H-MRS). We explore the associations between altered cerebellar metabolite profiles and brain injury topography, severity of injury, and prematurity-related clinical complications. We prospectively collected high quality 1H-MRS in 59 premature infants born ≤32 weeks and 61 healthy full term controls. 1H-MRS data were processed using LCModel software to calculate absolute metabolite concentration for N-acetyl-aspartate (NAA), choline (Cho) and creatine (Cr). PT infants had significantly lower cerebellar NAA (p < 0.025) and higher Cho (p < 0.001) at TEA when compared to healthy controls. Creatine was not different between the two groups. The presence of cerebellar injury was consistently associated with reduced concentrations for NAA, Cho, and Cr. Postnatal infection was negatively associated with NAA and Cr (p < 005), while cerebral cortical brain injury severity was inversely associated with both Cho and Cr (p < 0.01). We report for the first time that premature birth is associated with altered cerebellar metabolite profiles when compared to term born controls. Infection, cerebellar injury and supratentorial injury are important risk factors for impaired preterm cerebellar biochemistry.

Ureterovaginal Fistula Secondary To Retained Vaginal Foreign Body In A Young Girl, Anjum Bandarkar, Adebunmi O. Adeyiga, Eglal Shalaby-Rana

Radiology Faculty Publications

We present the case of a 13-year-old girl with a recurrent urinary tract infection, malodorous vaginal discharge, and urinary incontinence caused by a retained vaginal foreign body. The foreign body, an aerosol cap retained for over 2 years, resulted in the formation of a ureterovaginal fistula, an extremely rare complication. The critical value of ultrasound and magnetic resonance urography in delineating the foreign body, the fistulous tract, and the intraperitoneal urine leak is described. Through this unique diagnostic dilemma, we wish to highlight that the evaluation of persistent unusual urinary symptoms and vaginal discharge in a young girl must include …

Ct And Pet Findings For Urachal Adenocarcinoma: A Case Report, Merissa Zeman, Ethan Silver, Esma A. Akin

Radiology Faculty Publications

As urachal adenocarcinomas are rare cancers, experience with diagnosing and staging them are limited. To help illustrate CT and PET imaging findings and the role they each play in the workup of urachal adenocarcinomas, we present the case of a 43 y.o. male who was diagnosed at our institution with a T3aN0M0 high grade mucin-producing urachal adenocarcinoma.

Composite Iron Oxide–Prussian Blue Nanoparticles For Magnetically Guided T1-Weighted Magnetic Resonance Imaging And Photothermal Therapy Of Tumors, Shraddha Kale, Rachel Burga, Elizabeth E. Sweeney, Zungho Zun, Raymond Sze, Anthony Tuesca, J Anand Subramony, Rohan Fernandes

Radiology Faculty Publications

Theranostic nanoparticles offer the potential for mixing and matching disparate diagnostic and therapeutic functionalities within a single nanoparticle for the personalized treatment of diseases. In this article, we present composite iron oxide-gadolinium-containing Prussian blue nanoparticles (Fe3O4@GdPB) as a novel theranostic agent for T1-weighted magnetic resonance imaging (MRI) and photothermal therapy (PTT) of tumors. These particles combine the well-described properties and safety profiles of the constituent Fe3O4 nanoparticles and gadolinium-containing Prussian blue nanoparticles. The Fe3O4@GdPB nanoparticles function both as effective MRI contrast agents and PTT agents as determined by characterizing studies performed in vitro and retain their properties in the presence …