Search results for " diagnostic"

The "spoke wheel" sign in mesenteric carcinoid.

2019

Communicating with the hepatobiliary surgeon through structured report

2019

Communicating radiological findings to hepatobiliary surgeons is not an easy task due to the complexity of liver imaging, coexistence of multiple hepatic lesions and different surgical treatment options. Recently, the adoption and implementation of structured report in everyday clinical practice has been supported to achieve higher quality, more reproducibility in communication and closer adherence to current guidelines. In this review article, we will illustrate the main benefits, strengths and limitations of structured reporting, with particular attention on the advantages and challenges of structured template in the preoperative evaluation of cirrhotic and non-cirrhotic patients with fo…

Hepatocellular carcinoma: Diagnostic imaging criteria

2020

The diagnosis of hepatocellular carcinoma (HCC) can be reached noninvasively on imaging in patients at high risk as discussed in chapter “Hepatocellular carcinoma: Diagnostic Guidelines.” In this chapter, we describe the CT and MR imaging criteria more commonly used in the guidelines for the diagnosis and management of patients with HCC, including arterial phase hyperenhancement, washout, capsule, growth, and hypointensity on hepatobiliary phase MR imaging. The provided definitions are based on the latest version (v2018) of the liver imaging reporting and data system (LI-RADS) document (American College of Radiology 2018, https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-…

Infarct characterization using CT

2017

Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contra…

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

2017

Purpose The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Methods Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negat…

New frontiers in liver ultrasound: From mono to multi parametricity

2021

Modern liver ultrasonography (US) has become a "one-stop shop " able to provide not only anatomic and morphologic but also functional information about vascularity, stiffness and other various liver tissue properties. Modern US techniques allow a quantitative assessment of various liver diseases. US scanning is no more limited to the visualized plane, but three-dimensional, volumetric acquisition and consequent post-processing are also possible. Further, US scan can be consistently merged and visualized in real time with Computed Tomography and Magnetic Resonance Imaging examinations. Effective and safe microbubble-based contrast agents allow a real time, dynamic study of contrast kinetic f…

Role of computed tomography and magnetic resonance imaging in local complications of acute pancreatitis

2019

Acute pancreatitis (AP) represents a pancreas inflammation of sudden onset that can present different degrees of severity. AP is a frequent cause of acute abdomen and its complications are still a cause of death. Biliary calculosis and alcohol abuse are the most frequent cause of AP. Computed tomography (CT) and magnetic resonance imaging (MRI) are not necessary for the diagnosis of AP but they are fundamental tools for the identification of the cause, degree severity and AP complications. AP severity assessment is in fact one of the most important issue in disease management. Contrast-enhanced CT is preferred in the emergency setting and is considered the gold standard in patients with AP.…

Transcranial Magnetic Resonance-Guided Focused Ultrasound Surgery for Brain Tumor Ablation: Are We Ready for This Challenging Treatment?

2018

The treatment of high-grade gliomas (HGGs) remains a challenge for modern therapy. The prognosis for these patients has been poor. The median patient survival after diagnosis has been ∼1 year with surgery and/or radiotherapy and temozolomide.1 The need for a histological diagnosis of tumor tissue in each case and the importance of decompression in symptomatic patients are well established, and extensive surgical resection has been shown to significantly prolong survival. Several factors play a role in the prognosis of patients with HGG, including age, performance status using the Karnofsky performance scale, and the extent of resection.2, 3 At present, the standard therapy for HHG consists …

Clinical Pitfalls in Diagnosis of Nonmuscle-Invasive Bladder Cancer

2015

Current global economic crisis imposes healthcare system to reduce unnecessary investigations and increase early detection of tumors, to decrease the costs of an advanced disease. Several diagnostic pitfalls may occur dealing with bladder cancer (BC), particularly in nonmuscle-invasive (NMIBC) one. Hematuria, the commonest sign in NMIBC, is often underestimated. Urinary cytology is highly specific for high-grade tumors, but has a low sensitivity for low-grade BC, is operator dependent, and not always obtainable in clinical practice. Numerous urinary tests are available to ameliorate the accuracy of cytology, but none of them is routinly used in urological practice. Ultrasound could hardly …

Relevance of diagnostic investigations in chronic inflammatory demyelinating poliradiculoneuropathy: Data from the Italian CIDP database

2020

The objective of our work was to report the clinical features and the relevance of diagnostic investigations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We retrospectively reviewed data from patients with a clinical diagnosis of CIDP included in a national database. Among the 500 included patients with a clinical diagnosis of CIDP, 437 patients (87%) fulfilled the European Federation of Neurological Societies and Peripheral Nerve Society criteria for CIDP (definite in 407, probable in 26, possible in four). In 352 patients (86%) motor nerve conduction abnormalities consistent with demyelination were sufficient for the diagnosis of definite CIDP. In 55 …