Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-AnalysisRead the full article
Radiology Research and Practice publishes articles on all areas of medical imaging. The journal promotes evidence-based radiology practice though the publication of original research, reviews, and clinical studies for a multidisciplinary audience.
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A Concise Review and Required Precautions for COVID-19 Outbreak in Diagnostic and Interventional Radiology
A global outbreak of a novel coronavirus (COVID-19) pneumonia began in December 2019 in Wuhan, China. The World Health Organization (WHO) announced a pandemic on March 11, 2020. The rapid rise in the case numbers and mortality led to the saturation of hospitals in many countries. COVID-19 patients usually present with fever, fatigue, dry cough, and dyspnea. Given the shortage of diagnostic kits in many countries and very high sensitivity of computed tomography (CT) for diagnosis of COVID-19 in clinically suspicious patients, the chest CT has been implemented among the primary initial methods of diagnosis before the confirmatory laboratory tests. This puts radiologists and radiology staff on the front line of this alarming pandemic. This report summarizes chest CT findings of COVID-19 patients to facilitate diagnosis and reviews a list of necessary precautions and safety measures for diagnostic and interventional radiology personnel. These precautionary plans are extremely important to avoid contamination of the health-care providers, as well as cross-contamination between patients.
Advanced Ultrasound Screening for Temporomandibular Joint (TMJ) Internal Derangement
Purpose. To present an advanced ultrasound (US) technique and propose its use as a screening diagnostic tool for temporomandibular joint (TMJ) internal derangement. Materials and Methods. The technique is based on maintaining the US probe parallel to the articular disc, rather than traditional axial and coronal views, with the position described relative to a clock face. Validation was achieved by direct comparison with magnetic resonance imaging (MRI). A total of 61 patients, with age ranging from 13 to 67 years, were prescreened for TMJ pain and internal derangement, underwent US imaging for screening, and MRI evaluation for final diagnosis. Results. 29 of the 61 patients had disc pathology on MRI. US screening produced no false positive results and only 6 false negative results, corresponding to a sensitivity of 79% and specificity of 100%. Half of the false negative cases involved disc pathology with a medial component to the disc displacement. Conclusion. US is both a sensitive and a specific screening tool for TMJ dysfunction when used by an appropriately trained operator, with the exception of medially displaced discs. If TMJ assessment is found to be abnormal, the patient should be referred for MRI, and any patient scheduled for surgery must have the diagnosis confirmed by MRI. If a component of medial disc displacement is suspected, MRI should be performed despite a normal screening US.
Comparative Study on the Outcomes of Elective-Start versus Urgent-Start Peritoneal Dialysis Catheter Placement
The aim of this study is to compare the outcomes of the elective-start versus urgent-start use of peritoneal dialysis (PD) catheters using percutaneous radiologic or laparoscopic techniques. Patients having their first peritoneal dialysis catheter placed and used between January 2005 and January 2018 were identified, and their medical records were retrospectively reviewed. Two groups were identified: elective-start (n = 211) and urgent-start (n = 29). Patient’s demographics were similar between the two groups with the exception of age, which was higher in the elective-start group. The catheter complication rates and catheter removal rates at 3 and 12 months, mean days-to-first complication, mean days-to-catheter removal, and overall patient survival at 12 months were analyzed. Catheter complication rates at 3 and 12 months were similar between the two groups (27.8% and 48.9%, respectively, in the elective-start group versus 35.9% and 54.2%, respectively, in the urgent-start group, ). The catheter removal rates at 3 and 12 months were also similar between the two groups (). Catheter leak was higher in the urgent-start group (13.8% versus 3.3%, respectively, ). There was no difference between the elective-start and the urgent-start groups in the mean days-to-first complication (95 vs 69, ), mean days-to-catheter removal (145 vs 127, ), and overall patient survival at 12 months (100% vs 97%, ). In conclusion, apart from catheter leak, there were similar rates of catheter complication and removal for PD catheter used for the elective-start compared to the urgent-start PD. Furthermore, the technique of placement did not affect the outcomes.
Image Quality and Dose Comparison of Single-Energy CT (SECT) and Dual-Energy CT (DECT)
CT and its comprehensive usage have become one of the most indispensable components in medical field especially in the diagnosis of several diseases. SECT and DECT have developed CT diagnostic potentials in several means. In this review article we have discussed the basic principles of single-energy and dual-energy computed tomography and their important physical differences which can cause better diagnostic evaluation. Moreover, different organs diagnostic evaluations through single-energy and dual-energy computed tomography have been discussed. Conventional or single-energy CT (SECT) uses a single polychromatic X-ray beam (ranging from 70 to 140 kVp with a standard of 120 kVp) emitted from a single source and received by a single detector. The concept of dual-energy computed tomography (DECT) is almost as old as the CT technology itself; DECT initially required substantially higher radiation doses (nearly two times higher than those employed in single-energy CT) and presented problems associated with spatial misregistration of the two different kV image datasets between the two separate acquisitions. The basic principles of single-energy and dual-energy computed tomography and their important physical differences can cause better diagnostic evaluation. Moreover, different organs diagnostic evaluations through single-energy and dual-energy computed tomography have been discussed. According to diverse data and statistics it is controversial to definitely indicate the accurate comparison of image quality and dose amount.
Preoperative Portal Vein Embolization in Hepatic Surgery: A Review about the Embolic Materials and Their Effects on Liver Regeneration and Outcome
Liver volume and function after hepatectomies are directly correlated to postoperative complications and mortality. Consequently contemporary liver surgery has focused on reaching an adequate future liver remnant so as to diminish postoperative morbidity and mortality. Portal vein embolization has evolved and is the standard of care as a liver regenerative strategy in many surgery departments worldwide before major liver resections. Different embolic materials have been used for portal vein embolization including gelfoam, ethanol, polyvinyl-alcohol particles, calibrated microspheres, central vascular plugs, coils, n-butyl-cyanoacrylate glue, fibrin glue, polidocanol-foam, alcoholic prolamin solution, and ethylene vinyl alcohol copolymer, as sole occluders or in varied combinations. While to date there has been no prospective controlled trial comparing the efficacy of different embolic materials in portal vein embolization, retrospective data insinuates that the use of n-butyl-cyanoacrylate and absolute ethanol produces higher contralateral liver hypertrophies. In this review, we evaluated publications up to August 2019 to assess the technical and regenerative results of portal vein embolization accomplished with different embolic materials. Special attention was given to specific aspects, advantages, and drawbacks of each embolic agent used for portal vein embolization, its liver regenerative performance, and its influence on patient outcome.
Assessment of the Local Exposure Level during Adult Chest X-Rays at the Ngaoundere Regional Hospital, Cameroon
Background. The purpose of this study was to estimate the doses delivered to adult patients during chest examination for comparison with those elsewhere and to establish a local diagnostic reference level for the chest. The doses delivered in the standard X-ray examinations are not sufficiently optimized and controlled. The working protocols for the same exam given differ for similar morphotypes within the same hospital structure. Materials and Methods. The entrance skin dose (mGy) of the chest was evaluated on 105 adult patients with a mass of 70 ± 10 kg in accordance with the 75th percentile of the irradiation parameters. The analysis and processing of the data was carried out by Excel 2010. The entrance skin dose of the chest obtained in mGy was 0.18 ± 0.21 for the PA incidence. Conclusion. The present study allowed us to observe large variations at the entrance skin doses of the chest. These variations have made it possible to understand that the entrance skin doses to the chest are optimized and do not exceed the proportions of those estimated by others and standards internationally. This aspect demonstrates that the diagnostic reference levels as enumerated are dependent on the doses delivered and include not only the notions of quality of the radiographic image and the quality assurance of the radiological equipments but also the level of the manipulators trained.