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1.
Clin Imaging ; 103: 109986, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37742411

ABSTRACT

Biliary stents have been widely used to treat both malignant and benign biliary obstruction. Biliary stenting serves as a temporary measure to maintain ductal patency and promote bile drainage. Biliary decompression can help relieve clinical symptoms of pain, obstructive jaundice, pruritis, fat malabsorption, and failure to thrive and prevent disease progression, such as secondary biliary cirrhosis and end-stage liver failure. Endoscopic placement of biliary endoprosthesis is a minimally invasive procedure well tolerated by most patients but is not without problems. Multiple early and late complications have been reported in the literature and Computed Tomography (CT) is the most used modality to assess normal positions and evaluate patients suspected of stent complications. The aim of this article is to provide a review various of biliary stent related complications, as seen on CT. Current literature on risk factors, diagnosis and management is also discussed.


Subject(s)
Bile Duct Neoplasms , Cholangiopancreatography, Endoscopic Retrograde , Humans , Treatment Outcome , Cholangiopancreatography, Endoscopic Retrograde/methods , Stents , Tomography, X-Ray Computed , Bile Ducts/pathology , Drainage/methods , Bile Duct Neoplasms/pathology
2.
Clin Imaging ; 97: 34-43, 2023 May.
Article in English | MEDLINE | ID: mdl-36889113

ABSTRACT

Hepatocellular carcinoma (HCC) is the 5th most common neoplasm and the 3rd leading cause of cancer related mortality worldwide. Early stages of the neoplasm may be treated curatively with liver resection or orthotopic liver transplant. However, HCC has a high propensity for vascular and locoregional invasion, which can preclude these treatment options. The portal vein is the most invaded structure, while other regional structures affected include the hepatic vein, inferior vena cava, gallbladder, peritoneum, diaphragm, and the gastrointestinal tract. Management of invasive and advanced stages of HCC includes modalities such as transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and systemic chemotherapy, which are non-curative and focus on relieving tumor burden and slowing progression. A multimodality imaging approach is effective in identifying areas of tumor invasion and distinguishing between bland and tumor thrombi. Due to implications in prognosis and management, it is imperative for radiologists to accurately identify imaging patterns of regional invasion by HCC and to distinguish between bland and tumor thrombus in cases of potential vascular invasion.


Subject(s)
Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/therapy , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy , Liver Neoplasms/pathology , Prognosis , Portal Vein/pathology , Treatment Outcome
3.
Radiol Case Rep ; 17(8): 2639-2642, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35663809

ABSTRACT

This case report describes the findings of septic pulmonary embolism (SPE) in a young adult male with a history of intravenous drug use who initially presented with signs and symptoms of acute sepsis. The patient underwent evaluation by computed tomography (CT) imaging as well as blood cultures and echocardiography, which confirmed the diagnosis of SPE secondary to Staphylococcus aureus positive bacterial endocarditis. In this case report, we discuss the presentation and characteristic CT imaging findings of SPE as well as highlight the value of this imaging modality in the timely diagnosis and management of this urgent condition.

5.
Cureus ; 13(2): e13231, 2021 Feb 08.
Article in English | MEDLINE | ID: mdl-33728180

ABSTRACT

The evaluation of renal cell carcinoma (RCC) is routinely performed using the multimodality imaging approach, including ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Ultrasonography is the most frequently used imaging modality for the initial diagnosis of renal masses. The modality of choice for the characterization of the renal mass is multiphasic CT. Recent advances in CT technology have led to its widespread use as a powerful tool for preoperative planning, reducing the need for catheter angiography for the evaluation of vascular invasion. CT is also the standard imaging modality for staging and follow-up. MRI serves as a problem-solving tool in selected cases of undefined renal lesions. Newer MRI techniques, such as arterial spin labeling and diffusion-weighted imaging, have the potential to characterize renal lesions without contrast media, but these techniques warrant further investigation. PET may be a useful tool for evaluating patients with suspected metastatic disease, but it has modest sensitivity in the diagnosis and staging of RCC. The newer radiotracers may increase the accuracy of PET for RCC diagnosis and staging. In summary, the main imaging modality used for the characterization, staging, and surveillance of RCC is multiphasic CT. Other imaging modalities, such as MRI and PET, are used for selected indications.

6.
Emerg Radiol ; 27(6): 761-764, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33025218

ABSTRACT

COVID-19, caused by the novel coronavirus strain SARS-CoV-2 that emerged in late 2019, has resulted in a global pandemic. COVID-19 was initially believed to occur less frequently in children with relatively mild disease. However, severe disease and varied presentations have been reported in infected children, one of such being intussusception. There have only been three reported cases of intussusception in the pediatric population infected with COVID-19. In this paper, we will discuss the management and treatment of a novel fourth case of COVID-19-associated intussusception. This case is the first reported in the USA and suggests that COVID-19 may be implicated in the development of intussusception. Pediatricians should consider the possibility of intussusception when a child with COVID-19 presents with abdominal pain.


Subject(s)
Coronavirus Infections/complications , Intussusception/diagnostic imaging , Intussusception/virology , Pneumonia, Viral/complications , Abdominal Pain , Betacoronavirus , COVID-19 , Diagnosis, Differential , Humans , Infant , Intussusception/therapy , Male , Pandemics , SARS-CoV-2 , United States
7.
Radiol Case Rep ; 15(10): 1849-1852, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32817775

ABSTRACT

Spinal dural arteriovenous fistulas (SDAVF) are rare entities, which mainly occur in the thoracic and lumbar regions of older adults with a significant male predominance. The clinical manifestations are nonspecific such as myelopathy and this can make it challenging to diagnose. Rarely these have been described in the cervical region with even rare manifestations including subarachnoid hemorrhage. In the few reports of hemorrhage, it is usually infratentorial. We present a case of 40-year-old female (uncommon gender and younger age) who presented with headaches and was found to have supra tentorial subarachnoid hemorrhage and a suspicious lesion in the spinal canal. This proved to be a type 1 AVM of the spinal canal (per the American British and French classification). This was successfully treated endovascularly. With the discussion of the relevant literature we hope that this case can add to our medical knowledge as another presentation of this uncommon condition and ultimately help in diagnosing this illusive and rare entity.

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