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Incidental Finding Of Anomalous Pulmonary Venous Return Of The Left Upper Lobe, A Rare Anatomical Variation, Anika Dutta, Loren Zuiderveld 2021 Chicago Medical School

Incidental Finding Of Anomalous Pulmonary Venous Return Of The Left Upper Lobe, A Rare Anatomical Variation, Anika Dutta, Loren Zuiderveld

Journal of Patient-Centered Research and Reviews

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium. In this synthesis of the literature on PAPVR of the left upper lobe, we attempt to illustrate this clinical entity using a case detected incidentally on chest computed tomography, explain the anatomical aspects of this anomaly, and summarize the reported incidence and etiology of left-sided PAPVR. Lastly, differential diagnoses, clinical relevance, and management of left-sided PAPVR are presented. The identification of this variant is important, as it may have serious ...


Skin Nodules As A First Presentation Of Synchronous Bilateral Invasive Lobular Breast Carcinoma: A Case Report, Sara Khodair, Iman Ewais, Hanaa Abolmagd, Rehab El Sheikh, Sughra Raza, Leah H. Portnow, Hanan Gewefel 2021 Women and Fetal Imaging Center, Cairo, Egypt

Skin Nodules As A First Presentation Of Synchronous Bilateral Invasive Lobular Breast Carcinoma: A Case Report, Sara Khodair, Iman Ewais, Hanaa Abolmagd, Rehab El Sheikh, Sughra Raza, Leah H. Portnow, Hanan Gewefel

Journal of Global Radiology

The most common cause of skin metastases in adult women is primary breast carcinoma, which comprises about 70% of cases [1]. Skin metastases have non-specific clinical appearances, making it challenging to differentiate them from other benign conditions [1]. We present a case of a 52-year-old female with type II diabetes and a three-month history of refractory skin lesions who did not respond to anti-inflammatory treatment. The patient subsequently complained of a right breast lump, evaluation of which led to the diagnosis of bilateral synchronous invasive lobular carcinoma.


Artificial Intelligence In Medical Ultrasonography: Driving On An Unpaved Road, Young H. Kim 2021 University of Massachusetts Medical School

Artificial Intelligence In Medical Ultrasonography: Driving On An Unpaved Road, Young H. Kim

Radiology Publications

Recent advances in deep-learning technology have brought revolutionary changes to artificial intelligence (AI) research and application across industries, yielding major innovations such as facial recognition and self-driving cars. Medicine is no exception, and radiology, which is based on the interpretation of image data obtained through various methods-and has often been compared with computer vision using pattern analysis-is anticipated to experience a major revolution. Despite expectations for increasing research and development of AI-empowered ultrasonography, the clinical implementation of AI in medical ultrasonography faces unique obstacles. It will be necessary to standardize image acquisition, regulate operator and interpreter qualification and performance, integrate ...


Colonic Migration Of A Nephroureteral Stent Through A Colovesical Fistula, Nicholas Pigg, Kevin Carr, Julio Zayas, Eduardo Franca 2021 Aventura Hospital and Medical Center

Colonic Migration Of A Nephroureteral Stent Through A Colovesical Fistula, Nicholas Pigg, Kevin Carr, Julio Zayas, Eduardo Franca

HCA Healthcare Journal of Medicine

We describe a case of a patient with a two-year history of prostate cancer who underwent placement of nephroureteral stents. He subsequently presented to the hospital with complications from prolonged retention of the stents, which ultimately lead to a secondary diagnosis of adenocarcinoma of the rectum. A colonoscopy performed approximately two weeks after a bilateral nephroureteral tube exchange demonstrated what was believed to be locoregional metastatic disease and a fistulous connection with the distal nephroureteral stents. Radiographic features of this complication are discussed together with proper management and possible complications of distal nephroureteral stents. Both nephroureteral stents were explanted, and ...


Extrapulmonary Tuberculosis: A Case Report Involving The Spine And Soft Tissues, Aden Gunnar Miller, Paul J. Spicer 2021 University of Kentucky

Extrapulmonary Tuberculosis: A Case Report Involving The Spine And Soft Tissues, Aden Gunnar Miller, Paul J. Spicer

Radiology Faculty Publications

Tuberculosis (TB) is a major health concern worldwide, and its incidence is increasing in developed countries, especially among immigrant populations. Extrapulmonary TB with musculoskeletal involvement is often a difficult and delayed diagnosis, as the disease can mimic metastases or infection. We present a case of extrapulmonary TB affecting the spine and soft tissues of a Vietnamese-born patient living in the United States. We discuss the imaging findings associated with extrapulmonary TB of the spine. Familiarity with key imaging features of disease can lead to early suspicion and detection of the disease as well as timely treatment.


Renal Artery Pseudo-Aneurysms: Do All Of Them Require Endovascular Management?, Naseer Choh, Mudasir Bhat, Omair Shah, Imran Hafeez, Faiz Shera, Tariq Gojwari, Feroze Shaheen 2021 Sheri Kashmir Institute of Medical Sciences

Renal Artery Pseudo-Aneurysms: Do All Of Them Require Endovascular Management?, Naseer Choh, Mudasir Bhat, Omair Shah, Imran Hafeez, Faiz Shera, Tariq Gojwari, Feroze Shaheen

Journal of Global Radiology

Purpose: Our study examines the etiological profile, clinical and imaging features of renal artery pseudo aneurysms (RAPs), as well as the efficacy and need for the angioembolization of RAPs in a resource-constrained setting.

Materials and Methods: A total of 36 patients with RAPs were included in our study. Initial diagnosis was made by Doppler Ultrasonography (USG) followed by CT renal angiography in all cases. DSA was performed in 28 patients, as eight patients showed spontaneous resolution by thrombosis on immediate pre-procedure Doppler study. Angioembolization with a microcoil was performed for 30 aneurysms in 28 patients. Technical success was confirmed at ...


A Case Of Distal Limb Arterial Tortuosity And Dilation: Observations And Potential Clinical Significance, Yasmin Carter, Desmond J. Bennett, Vadim Molla, Alexandra E. Wink, Amanda J. Collins, Eustathia Lela Giannaris 2021 University of Massachusetts Medical School

A Case Of Distal Limb Arterial Tortuosity And Dilation: Observations And Potential Clinical Significance, Yasmin Carter, Desmond J. Bennett, Vadim Molla, Alexandra E. Wink, Amanda J. Collins, Eustathia Lela Giannaris

Radiology Publications

Arterial tortuosity describes variation via bending of the arterial wall and has been noted in several arteries throughout the body. Tortuous blood vessels can cause nerve compression, as well as present difficulties to surgeons and radiologists. Here we present an unusual case of multi-vessel arterial tortuosity discovered in 78-year-old Hispanic male cadaver, independent of systemic pathology. The left ulnar and right tibial arteries were dissected, and using calibrated digital calipers, their external and internal diameters were measured both at the origin site and at the site of greatest dilation. Both wall thickness and the number of inflection points were also ...


Prevalence Of Allergic Fungal Sinusitis Among Patients With Nasal Polyposis, Rahim Dhanani, Shayan Khalid, Basit Salam, Hamdan Ahmed Pasha, Farah Hafiz Yousuf, Mubasher Ikram 2021 Aga Khan University

Prevalence Of Allergic Fungal Sinusitis Among Patients With Nasal Polyposis, Rahim Dhanani, Shayan Khalid, Basit Salam, Hamdan Ahmed Pasha, Farah Hafiz Yousuf, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Objective: To determine the frequency of allergic fungal sinusitis among patients with nasal polyps, and to compare Lund-Mackay scores of patients with and without allergic fungal sinusitis.
Methods: The cross-sectional longitudinal study was conducted at a tertiary healthcare centre in Karachi, Pakistan, from December 2016 to November 2018, and comprised patients with sinonasal polyposis undergoing surgery. The patients were categorised as having allergic fungal sinusitis when histopathology showed allergic mucin with fungal hyphae and culture was positive for fungal growth. Lund-Mackay scoring of each patient was noted and mean scores of allergic fungal sinusitis and non-allergic fungal sinusitis patients were ...


Interventional Treatment With The Transjugular Intrahepatic Portosystemic Shunt (Tips) Procedure May Offer A Preferable Alternative To Systemic Anticoagulation In Patients With Cirrhosis And Portal Vein Thrombosis, Molly N. Pantelic 2021 Wayne State University School of Medicine

Interventional Treatment With The Transjugular Intrahepatic Portosystemic Shunt (Tips) Procedure May Offer A Preferable Alternative To Systemic Anticoagulation In Patients With Cirrhosis And Portal Vein Thrombosis, Molly N. Pantelic

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Wang Z, Jiang MS, Zhang HL, et al. Is post-tips anticoagulation therapy necessary in patients with cirrhosis and portal vein thrombosis? A randomized controlled trial. Radiology. 2016;279(3):943-951. https://doi.org/10.1148/radiol.2015150369

for a patient with cryptogenic cirrhosis, gastroesophageal varices, pancreatic cancer, and portal vein thrombosis.


Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, MD 2021 Hospital for Special Surgery, New York, New York, USA

Radiologic Measurements In The Assessment Of Patellar Instability: A Systematic Review And Meta-Analysis., Alex E White, Peters T Otlans, Dylan P. Horan, Daniel Calem, William Emper, Kevin Freedman, Fotios Tjoumakaris, Md

Rothman Institute Faculty Papers

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability.

Study Design: Systematic review; Level of evidence, 4.

Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the ...


Lack Of Progression Of Intraventricular Hemorrhage In Premature Infants: Implications For Head Ultrasound Screening, Jaclyn Daigneault, Heather White, Alexandra Dube, Qiming Shi, Jean-Marc Gauguet, Lawrence M. Rhein 2021 University of Massachusetts Medical School

Lack Of Progression Of Intraventricular Hemorrhage In Premature Infants: Implications For Head Ultrasound Screening, Jaclyn Daigneault, Heather White, Alexandra Dube, Qiming Shi, Jean-Marc Gauguet, Lawrence M. Rhein

Radiology Publications

Very preterm infants are at risk for germinal matrix hemorrhage- intraventricular hemorrhage (GH-IVH). Severe GH-IVH may cause death or severe neurodevelopmental disability while mild GH-IVH is considered a static, non-progressive disease. This retrospective study aimed to determine if infants with no GH-IVH or mild GH-IVH on initial screening head ultrasound (HUS) advanced to severe GH-IVH. A total of 353 eligible infants with birth gestational age < /=32 0/7 weeks who received a HUS during hospitalization were identified. Of the 343 (97%) infants who had mild GH-IVH (grade II or less) on initial screening, only 4 (1.2%) progressed to severe (grade III or IV). Each of these infants required mechanical ventilation for at least 40 days. Therefore, premature infants who have no GH-IVH or mild GH-IVH on initial routine screening HUS without other risk factors may not require follow-up HUSs. Infants with prolonged mechanical ventilation may require further screening despite reassuring initial HUS findings.


Opioid And/Or Psychotropic Use Increases Intraprocedural Sedation Drug Requirements, Sreeja Sanampudi, Ravi Jayavarapu, Trae C. Brooks, Driss Raissi 2021 University of Kentucky

Opioid And/Or Psychotropic Use Increases Intraprocedural Sedation Drug Requirements, Sreeja Sanampudi, Ravi Jayavarapu, Trae C. Brooks, Driss Raissi

Radiology Faculty Publications

Objectives Acute pain management in opioid users can be challenging in the perioperative period. This study focuses on whether use of opioids increases sedation medication requirements in patients undergoing port placement under moderate sedation.

Materials and Methods A retrospective review was performed on all patients undergoing port placement between June 1, 2017, and June 30, 2019. Exclusion criteria included receiving general anesthesia, no sedation, and errors in data entry. Data collection included demographics, use of opioids, benzodiazepines, antidepressants, tobacco, alcohol, and sedation data.

Results Opioid, benzodiazepine, and selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs) use was significantly associated ...


Myocarditis Following Covid-19 Vaccination, Elisabeth Albert, Gerard P. Aurigemma, Jason Saucedo, David S. Gerson 2021 University of Massachusetts Medical School

Myocarditis Following Covid-19 Vaccination, Elisabeth Albert, Gerard P. Aurigemma, Jason Saucedo, David S. Gerson

COVID-19 Publications by UMMS Authors

The coronavirus disease 2019 (COVID-19) vaccination frequently leads to minor side-effects, that may be more intense after the second dose, but more serious side effects have been reported. We report a case of a 24-year-old man who presented to the hospital with acute substernal chest pain, 4 days after his second COVID-19 Moderna vaccination. Laboratory studies revealed elevated troponins and negative viral serologies. Cardiac magnetic resonance imaging (cMRI) demonstrated edema and delayed gadolinium enhancement of the left ventricle in a midmyocardial and epicardial distribution. The patient was diagnosed with myocarditis following Moderna vaccination. Our case report raises concern that myocarditis ...


Pediatric Pulmonary Artery Aneurysms Causing Pulmonary Hemorrhage: A Case Of Transcatheter Intervention While On Va Ecmo Support, Igor Areinamo 2021 Children's Mercy Kansas City

Pediatric Pulmonary Artery Aneurysms Causing Pulmonary Hemorrhage: A Case Of Transcatheter Intervention While On Va Ecmo Support, Igor Areinamo

Research Days

Background: The incidence of pulmonary artery aneurysm (PAA) in children remains unknown. There are few reports of a transcutaneous interventional approach to address this type of pathology. Management of PAAs while on VA ECMO has not been described in pediatrics.

Objectives/Goal:

Methods/Design:

Case: 9-year-old previously healthy male presented with MRSA associated ARDS and sepsis requiring urgent VA ECMO cannulation. Chest CT done on ECMO day 22 showed development of right sided PAAs. Patient had an episode of significant pulmonary hemorrhage. Angiogram demonstrated two fusiform right PAAs, one of which had ruptured and was bleeding into the lung parenchyma ...


Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. McLouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker 2021 University of Kentucky

Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

BACKGROUND: Emergent large vessel occlusion (ELVO) strokes are devastating ischemic vascular events for which novel treatment options are needed. Using vascular cell adhesion molecule 1 (VCAM1) as a prototype, the objective of this study was to identify proteomic biomarkers and network signaling functions that are potential therapeutic targets for adjuvant treatment for mechanical thrombectomy.

METHODS: The blood and clot thrombectomy and collaboration (BACTRAC) study is a continually enrolling tissue bank and registry from stroke patients undergoing mechanical thrombectomy. Plasma proteins from intracranial (distal to clot) and systemic arterial blood (carotid) were analyzed by Olink Proteomics for N=42 subjects. Statistical ...


Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk 2021 Valparaiso University

Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk

Evidence-Based Practice Project Reports

The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A ...


Labrad : Vol 46, Issue 3 - May 2021, Aga Khan University Hospital, Karachi 2021 Aga Khan University

Labrad : Vol 46, Issue 3 - May 2021, Aga Khan University Hospital, Karachi

LABRAD

  • Laboratory Diagnostic Tools for HIV in Neonates and Infants
  • Intussusception in Pediatric Patients: Role of Radiology in Diagnosis and Management
  • Fecal Calprotectin as an Inflammatory Marker in Inflammatory Bowel Disease
  • Spectrum of Tools for the Detection of Enteric Pathogens in A Clinical Laboratory
  • Pleuropulmonary Blastoma Type III with Rhabdomyosarcomatous and Chondrsarcomatous Differentiation in a Five year old Child, A rare case
  • Radiology Pathology Correlation: Orthopedic Pathology
  • Updates in Reporting Wilms Tumor (nephrectomy) Specimen
  • Biotinidase Deficiency- a Rare but Easily Treatable Disorder
  • Renal Tubular Disorders and Biochemical Diagnostics
  • TSH Receptor Antibodies (TRAb) in Neonatal Hyperthyroidism: What We Need to Know
  • The ...


Cardiovascular Mechanisms In Covid-19: Methodology Of A Prospective Observational Multimodality Imaging Study (Cosmic-19 Study), Shirjel Alam, Anoop Shah, Kevin Onyinkwa, Edward Nganga, Samuel Gitau, Khalid Makhdomi, Michael Chung, Sudhir Vinayak 2021 Manchester University

Cardiovascular Mechanisms In Covid-19: Methodology Of A Prospective Observational Multimodality Imaging Study (Cosmic-19 Study), Shirjel Alam, Anoop Shah, Kevin Onyinkwa, Edward Nganga, Samuel Gitau, Khalid Makhdomi, Michael Chung, Sudhir Vinayak

Imaging & Diagnostic Radiology, East Africa

Background: 8-28% of patients infected with COVID-19 have evidence of cardiac injury, and this is associated with an adverse prognosis. The cardiovascular mechanisms of injury are poorly understood and speculative. We aim to use multimodality cardiac imaging including cardiac magnetic resonance (CMR) imaging, computed tomography coronary angiography (CTCA) and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG-PET/CT) to identify the cardiac pathophysiological mechanisms related to COVID-19 infections.

Methods: This is a single-centre exploratory observational study aiming to recruit 50 patients with COVID-19 infection who will undergo cardiac biomarker sampling. Of these, 30 patients will ...


Investigating Diffusion Tensor Imaging Correlates Of Cognitive Impairment In Idiopathic Normal Pressure Hydrocephalus And Alzheimer's Disease, Omar Hasan, Omar Hasan 2021 The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences

Investigating Diffusion Tensor Imaging Correlates Of Cognitive Impairment In Idiopathic Normal Pressure Hydrocephalus And Alzheimer's Disease, Omar Hasan, Omar Hasan

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

Modest expansion of the human brain cerebrospinal fluid (CSF)-filled ventricles is normal with aging, and because of this, it can be difficult for physicians to accurately diagnose and treat enlarged ventricles (ventriculomegaly), called hydrocephalus1 (fluid or water in the brain) Ventriculomegaly occurs due to an obstruction (such as a blood clot or tumor), or a change in CSF absorption2. Primary hydrocephalus, also called idiopathic normal pressure hydrocephalus (iNPH), is non-obstructive and may be comorbid with other neurodegenerative diseases such as Alzheimer’s disease (AD) or frontotemporal dementia (FTD). Clinically, it can be difficult to tell whether the ...


Imaging Based Prediction Of Pathology In Adult Diffuse Glioma With Applications To Therapy And Prognosis, Evan Gates 2021 The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences

Imaging Based Prediction Of Pathology In Adult Diffuse Glioma With Applications To Therapy And Prognosis, Evan Gates

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

The overall aggressiveness of a glioma is measured by histologic and molecular analysis of tissue samples. However, the well-known spatial heterogeneity in gliomas limits the ability for clinicians to use that information to make spatially specific treatment decisions. Magnetic resonance imaging (MRI) visualizes and assesses the tumor. But, the exact degree to which MRI correlates with the actual underlying tissue characteristics is not known.

In this work, we derive quantitative relationships between imaging and underlying pathology. These relations increase the value of MRI by allowing it to be a better surrogate for underlying pathology and they allow evaluation of the ...


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