Myocarditis Following COVID-19 Vaccination: Cardiac Imaging Findings in 118 Studies.

We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after COVID-19 vaccination were reported (462, 86.8% men and 70, 13.2% women, age range 12 to 80) with the following distribution: Pfizer-BioNTech: 367 (69%), Moderna: 137 (25.8%), AstraZeneca: 12 (2.3%), Janssen/Johnson & Johnson: 6 (1.1%), COVAXIN: 1 (0.1%), and unknown mRNA vaccine: 9 (1.7%). The distribution of patients receiving vaccine dosage was investigated. On cardiac MR Imaging, late intravenous gadolinium enhancement (LGE) was observed mainly in the epicardial/subepicardial segments (90.8%, 318 of 350 enhancing segments), with the dominance of inferolateral segment and inferior walls. Pericardial effusion was reported in 13.1% of cases. The vast majority of patients (94%, 500 of 532) were discharged from the hospital except for 4 (0.7%) cases. Post-COVID-19 myocarditis was most commonly reported in symptomatic men after the second or third dose, with CMRI findings including LGE in 90.8% of inferior and inferolateral epicardial/subepicardial segments. Most cases were self-limited.

A review of more than 2000 cases of site-specific pelvic endometriosis rates by MRI: a guide to minimizing under/overdiagnosis non-invasively.

OBJECTIVES: To statistically study the incidence of endometrioma and deep infiltrating endometriosis (DIE) in various anatomical sites and to illustrate the significance and potential implications for each site. Furthermore, to improve the knowledge of the community for a non-invasive diagnosis alternative to laparoscopy. METHODS: This study includes 2040 patients who had been referred with clinical evidence of pelvic endometriosis. These patients had been examined and undergone transvaginal sonography by the referring gynecologists. The imaging modality used to discover and locate various anatomical locations of involvement was MRI with contrast. Two radiologists with expertise in endometriosis separately assessed the patients' MRIs and highlighted the involved areas. RESULTS: In total, 79.1% were positive for either endometrioma or DIE. We detected both DIE and ovarian endometrioma in 78.2% of positive cases. Isolated endometrioma or DIE was present exclusively in 13.7% and 8.1% of patients, respectively. Uterosacral ligaments were detected as the most common (73.8%) site of DIE involvements and in 2.9% of cases were the sole affected location. Interestingly, very rare independent involvement of the genitourinary tract was seen in two patients. CONCLUSIONS: In this study, MRI was used to assess the likely involvement sites of endometrioma and DIE, as well as the frequency of incidences in various places and their relationships over a large dataset. Understanding the possibly involved sites, their statistics, and their co-existence can provide radiologists with a roadmap for non-invasive endometriosis diagnosis and treatment planning. These principles should hopefully assist reduce under- and overdiagnosis.

Endometrial cavity-myoma fistula after uterine artery embolization diagnosed by pelvic MRI: case report.

Uterine cavity-myoma fistula is a rare entity which has scarcely been reported in the literature. They are mainly secondary to a treatment and intervention. The reported options for patient evaluation and treatment are mainly invasive such as hysteroscopy. The case, described here, is a 26-year-old woman who had significant symptoms for myoma and went through uterine artery embolization. After few months of being asymptomatic, she complained of continuous spotting with minimal pain; subsequently, pelvic MRI was performed and a clear connection between endometrial cavity and myoma was shown resulting in the final treatment by radio-frequency ablation and the complete relief of the symptoms. The case highlights the importance of the necessity of the proper case selection in terms of size and the site of myoma and also the significance of imaging, mainly MRI, for rare complications corresponding to myoma treatments.

Comparison of findings of spontaneous splenorenal shunt in color Doppler sonography with multislice CT scan (64 slices) in liver transplant candidates.

BACKGROUND: Liver transplantation is the only definite treatment for end stage liver disease and it has high costs for the medical system so decreasing its complication and increasing its effectiveness is crucial. One of the factors that affect liver transplantation is the presence of spontaneous splenorenal shunt. Its diagnosis is mainly overlooked in pre-liver transplant patients. Main modality for its diagnosis is multislice CT scan however this is more expensive than sonography. Also, it exposes the patients to ionizing radiation. Considering the advantages of color Doppler ultrasound, studies to determine the sensitivity and specificity for detection of spontaneous splenorenal shunt is essential. MATERIALS AND METHODS: In our study 70 cirrhotic patients who were referred by liver transplant surgeons for evaluation of abdomen by CT and sonograhy were assessed for presence of spontaneous splenorenal shunt, left adrenal varix and left renal vein diameter and velocity and sensitivity and specificity of both modalities were checked. Patients in whom left renal vein could not evaluated by sonography and patients with splenectomy and nutcracker syndrome were excluded. RESULTS: In the point of 10 mm diameter of left renal vein in CT scan there was 78.6% sensitivity and 67.9% specificity for the presence of spontaneous splenorenal shunt. Left adrenal varix in CT had sensitivity of 71.4%, specificity of 100%, and positive predictive value of 100% and negative predictive value of 70% and varix below spleen in CT had sensitivity of 54.8%, specificity of 96.4%, and positive predictive value of 95.8% and negative predictive value of 58.7% for the presence of spontaneous splenorenal shunt. In the point of 8 mm diameter of left renal vein in sonography there was 66.7% sensitivity and 85.7% specificity for the presence of spontaneous splenorenal shunt. For the velocity of more than 35 cm/s of left renal vein in sonography there was 61.9% sensitivity and 82.1% specificity for the presence of spontaneous splenorenal shunt. Left adrenal varix in sonography had sensitivity of 45.2%, specificity of 96.4%, positive predictive value of 95% and negative predictive value of 54% for the presence of spontaneous splenorenal shunt. CONCLUSION: There was moderate agreement between CT scan and sonography for detection of spontaneous splenorenal shunt. CT scan is choice for detection of SSRS but sonography is somehow useful. It means that if sonograhy is positive it is sufficient, if negative, then CT should be performed. This is due to low sensitivity of sonography.

CFD simulation of hemodynamics in sequential and individual coronary bypass grafts based on multislice CT scan datasets.

There is still controversy over the differences in the patency rates of the sequential and individual coronary artery bypass grafting (CABG) techniques. The purpose of this paper was to non-invasively evaluate hemodynamic parameters using complete 3D computational fluid dynamics (CFD) simulations of the sequential and the individual methods based on the patient-specific data extracted from computed tomography (CT) angiography. For CFD analysis, the geometric model of coronary arteries was reconstructed using an ECG-gated 64-detector row CT. Modeling the sequential and individual bypass grafting, this study simulates the flow from the aorta to the occluded posterior descending artery (PDA) and the posterior left ventricle (PLV) vessel with six coronary branches based on the physiologically measured inlet flow as the boundary condition. The maximum calculated wall shear stress (WSS) in the sequential and the individual models were estimated to be 35.1 N/m(2) and 36.5 N/m(2), respectively. Compared to the individual bypass method, the sequential graft has shown a higher velocity at the proximal segment and lower spatial wall shear stress gradient (SWSSG) due to the flow splitting caused by the side-to-side anastomosis. Simulated results combined with its surgical benefits including the requirement of shorter vein length and fewer anastomoses advocate the sequential method as a more favorable CABG method.