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Background Basidiobolomycosis is a fungal infection exhibiting a wide spectrum of clinical manifestations that frequently resemble abdominal malignancies or inflammatory conditions. This study elucidates the characteristic imaging features that can help make an accurate diagnosis. Methods We examined pretreatment imaging studies (CT, MRI, ultrasound) of 32 histopathologically proven cases of basidiobolomycosis at a tertiary referral center between 2015 and 2021. Two radiologists, blind to the pathology results, scrutinized the lesions for localization, morphology, enhancement pattern, and ancillary findings. Results The cohort (mean age 9.8 ± 13.8 years and 53% male) demonstrated three basic imaging patterns: (1) hepatic lesions (21.9%) appearing as heterogeneously enhancing masses with necrotic cores; (2) gastrointestinal involvement (18.8%) showing circumferential wall thickening chiefly affecting the ileocecal region; and (3) mesenteric masses (15.6%) with peripheral enhancement and central necrosis. Other findings included regional lymphadenopathy (31.3%) and obstructive uropathy. At first, the misdiagnosis rate was 78%, most frequently as malignancy (37.5%) or appendicitis (31.2%). The follow-up indicated that 90.6% were responsive to treatment. Conclusion Basidiobolomycosis shows distinct imaging characteristics, especially necrotic hepatic masses, and segmental bowel wall thickening, which could help differentiate the condition from neoplasms or inflammatory diseases. These findings act as a compelling argument to always include fungal etiologies within the differential diagnosis in patients with pertinent imaging findings in endemic regions.

The CT findings of cirrhosis caused by primary sclerosing cholangitis (PSC) differ from cryptogenic cirrhosis. PSC could become complicated with biliary cirrhosis and cholangiocarcinoma. This study aimed at augmenting the information on the role of the three-phasic-abdominopelvic CT scan in PSC. A total of 185 CT scans were retrospectively reviewed, including 100 patients with cryptogenic cirrhosis and 85 patients with PSC-cirrhosis. Different morphologic criteria were compared, including segmental atrophy/hypertrophy, hepatic contour, portal-hypertension, perihilar lymphadenopathy, biliary tree dilatation, gallbladder appearance. Inflammatory-bowel-disease (IBD) and cholangiocarcinoma frequency, presence of perihilar lymph nodes (LNs), and their size during end-stage PSC cirrhosis are investigated. Six findings occur more frequently with PSC than those diagnosed with cryptogenic cirrhosis. Modified caudate/right lobe (m-CRL) ratio >0.73, moderate and severe lobulated liver contour, lateral left lobe atrophy, over distended gallbladder (GB), biliary tree dilatation and wall thickening, and LN sizes were higher in PSC patients as compared to cryptogenic cirrhosis (P < 0.005). Ascites and portosystemic collateral formations were significant in cryptogenic cirrhosis compared to PSC patients (P < 0.005). Cholangiocarcinoma frequency in PSC patients was 14.7%, and the frequency of inflammatory bowel disease (IBD) was 57.6%. Further, 22.4% of the patients were diagnosed with IBD and PSC simultaneously. The LN number and size in PSC patients were not different between those with or without cholangiocarcinoma. Using three-phasic CT scans and PSC characteristics could be considered as an additional suggestion besides pathology measures. Diagnosis of PSC based on histological findings could be a last resort due to its invasive essence and specific characteristics of PSC in imaging.

Background: Coronavirus disease 2019 (COVID-19), with its rapid transmission and emergence, has become a major global public health concern. COVID-19 patients are at an increased risk of acute skeletal muscle loss and complications such as muscular weakness, depression, and anxiety. Furthermore, sarcopenia has been linked to COVID-19 vulnerability, hospitalization rates, and severity. This study aims to investigate the relationship between pre-existing sarcopenia, subcutaneous fat, and the prognosis of COVID-19. Methods: Patients over 18 with positive tests who had chest CT scans without underlying conditions were included in this cohort study. The ratio of muscle volume to the total body surface area was calculated. Patients were divided into four subgroups: outpatients, hospitalized, ICU admitted, and deceased. The initial muscle volume for each group was compared. Results: In total, 127 patients were included in the study, 63 (49%) of whom were male. The mean age of the patients was 51.8 ± 18.16 (from 23 to 87 years). In total, 27 patients (21.3%) were treated as outpatients, 49 patients (38.6%) were hospitalized, and 23 (18.1%) were admitted to the ICU. Twenty-eight patients (22%) died. The total muscle/surface area ratio was significantly associated with disease outcome and prognosis. The ratio was significantly lower in dead individuals (p = 0.017). Conclusions: Sarcopenia was discovered to be significantly associated with the severity of COVID-19 and a poor prognosis. Reducing the risk of severe COVID-19 is possible by identifying and managing sarcopenia-related risk factors.

Background: Standards for the Reporting of diagnostic accuracy studies (STARD) statement was developed to improve the accuracy and completeness of reporting of studies of diagnostic accuracy. It allows readers evaluate the internal and external validity and enable readers to assess the potential for bias in the study and the generalizability of the results. Objectives: Up to date, few data exist about the quality of diagnostic accuracy studies in Iran. Therefore, we evaluated the extent of adherence to the STARD for the quality of reports on diagnostic accuracy studies in the Iranian journal of radiology. Methods: In this cross-sectional descriptive study, we searched Iranian journal of radiology and retrieved all diagnostic accuracy studies for recent 3 years and evaluated their adherence to STARD. We used STARD checklist (version January 2003) available at www.stard-statement.org Results: We identified about 14 potential diagnostic accuracy studies meeting our inclusion criteria. In this preliminary study 50% identified the article as diagnostic accuracy study in the title or abstract (MeSH heading sensitivity and specificity). 4% reported details of blinding. 3% had a flow diagram. 38% described the number, training and expertise of the persons reading the index tests and the reference standard. 25% reported definition of cutoffs and/or categories of the results of the index tests and the reference standard. Only 40% of the reports of diagnostic evaluations reported precision for the estimates of diagnostic accuracy. The occurrence of uninterpretable, indeterminate and intermediate test results were 30%. The report time interval from the index tests to the reference standard was 40%. Only 40% of articles reported on more than 50% of STARD items, while no articles reported on more than 85%. A flow chart was presented in 3 articles. Assessment of reporting on individual items of the STARD statement revealed wide variation, with some items described in 15% of articles and others in 100%. Mean STARD score (0 - 25 points available) was 14.8 (range, 5.5 ± 19.5). Conclusions: These findings show non-adherence to the STARD. The authors, reviewers, and editors should pay more attention to reporting by checking STARD statement items and including a flow diagram to represent study design and patient flow. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).

Background: Multiple sclerosis (MS) is a demyelinating disease, involving almost 2.5 million people around the world. There are different MR pulse sequences, which are used to detect MS plaques. Objectives: This study aimed to compare, T2 weighted, short-tau inversion recovery (STIR) and phase-sensitive inversion recovery (PSIR) pulse sequences, for detecting cervical spinal cord lesions in MS patients. Patients and Methods: Sixty patients with definite MS diagnoses, participated in this study from June to December 2016. 1.5 T Siemens (Avanto, Erlangen, Germany) MR scanner and three pulse sequences (T2 weighted, STIR and PSIR sequences) were used for cervical cord MR imaging. To assess the effectiveness of these pulse sequences, the lesion to cord ratio (LCR) and lesion to noise ratio (LNR) were calculated. Results: The LCR and LNR of the T2 and PSIR were the same (LCR of 0.04, -0.03 and LNR of 2.74, -2.09 respectively), just the intensities were reverse. STIR had a significantly different LCR and LNR [0.23 (P < 0.001) and 22.7(P < 0.001) respectively], hence it was better in diagnosing cervical cord MS plaques. Conclusion: According to the results, using 1.5 T MRI machine, it implies that the STIR pulse sequence was the best pulse sequence in comparison to T2 and PSIR in detecting cervical cord MS plaques.

Sulfur mustard (SM) gas was used in the Iran-Iraq war (1981 - 1989) as a vesicant chemical warfare against the Iranian warriors. This alkylating agent with the potential of producing chemical injury in the skin, eyes, and lung, may damage both upper and lower respiratory tract, which in turn can cause different types of sequels such as asthma, bronchiectasis, chronic bronchitis and lung fibrosis. This study was performed on 274 patients with documented history of SM gas exposure. All of the participants complained of respiratory problems. Patients with a positive history of cigarette smoking, respiratory problems before the exposure to SM gas, cardiovascular problems, surgery of the lung, and exposure to occupational toxic chemicals were excluded from the study. Results of all chest HRCTs were evaluated by a radiologist. HRCT findings showed that bronchiectasis involved 53 patients (19.34%) of all cases. Varicose bronchiectasis and cystic bronchiectasis was observed in 10 (18.9%) and 6 cases (11.3%) respectively. Among patients with bronchiectasis, the involvement rate of different lobes was as follows: right upper lobe (RUL) 7.5%, right middle lobe (RML) 11.3%, left upper lobe (LUL) 15.1%, left lower lobe (LLL) 26.4% and right lower lobe (RLL) 39.6%. Findings of chest HRCT demonstrated tubular bronchiectasis was the most frequent type of this disease that involve the chemically injured patients and RLL had been the most frequently involved lobe of the lung with bronchiectasis. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).

Solitary pulmonary nodule (SPN) is explained as a separate, well-determined obscurity with the maximum size of 3cm which is enclosed by typical lung tissue and is not related to any other anomalies in the lung or adjacent lymph nodes. Among imaging modalities MRI has more benefits such as high spatial resolution and usage of nonionizing radiation, however, the efficacy of this imaging modality in lung nodules diagnosis has not been well established. Thus CT scan is considered a proper modality for the SPN diagnosis. The objective of this study was to evaluate the accuracy of MRI in the detection of SPNs which has verified by CT scan. The study was conducted as a prospective case-control study. 32 SPN patients whose disease confirmed by CT scan findings and 11 patient with normal CT scan were included in this study. Sensitivity, specificity, positive and negative predictive values of MRI were determined. The location and the size of pulmonary nodules as well as different MRI sequences were evaluated. Statistical analysis revealed that T1w sequences (27%) had the least diagnostic sensitivity, T2w images, and Fat-sat slices had 55% and 36% sensitivity respectively. Specificity of T1w, T2w, and Fat-sat images were 97%, 90% for the last two imaging sequences. According to the results, it can be concluded that although the specificity of different MRI sequences was ? 90%, low sensitivity and breath holding technique prevents its clinical routine usage for the suspected patients with SPN or early detection of pulmonary nodules in high-risk patients. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).

Purpose: Despite therapeutic effects of radioiodine in patients with differentiated thyroid cancer, there are some disadvantages due to harmful radiation to other tissues. According to the current guidelines, patients are recommended to drink lots of water and frequent voiding to reduce the amount of 131I in the body. This study was designed to assess the impact of the amount of liquid intake on reduction of the measured dose rate of radioiodine-treated patients. Materials and Methods: A total of 42 patients with differentiated thyroid cancer without metastasis who had undergone total thyroidectomy and had been treated with radioiodine were selected. The patients were divided into two groups according to the amount of their fluid intake which was measured during the first 48 h after 131I administration. In all patients, the dose rate was measured immediately and 48 h after iodine administration. Results: Each group included 21 patients. Dose rate ratio (the ratio of the second dose rate to the first dose rate) and dose rate difference ratio (the ratio of the difference between the two measured dose rates to the first dose rate) were calculated for each patient. Despite the significant difference in the amount of the liquid drunk, no statistically significant difference was seen between the different groups in parameters of dose-rate ratio and dose-rate difference ratio. Conclusion: Higher fluid intake (>60 ml/h in our study) alone would not effectively reduce the patient's radiation dose rate at least not more than a well-hydrated state. It seems that other interfering factors in the thyroidectomized patients may also have some impacts on this physiologic process.

Background: Recently there have been attempts to link fetal growth retardation to placental morphology as well as apparent-diffusion coefficient (ADC) values. Objectives: The purpose of this study was to investigate the possible correlation of apparent diffusion coefficient (ADC) values of normal placentas with different gestational ages and various Grannum grades (Gg). Patients and Methods: Thirty-eight women were included in this study. All women with singleton pregnancies referred for fetal MRI who were proven normal in pre/postnatal follow-up were included in the study. All placentas were evaluated by ultrasound trans-abdominally. The placenta was assessed for maximal thickness, subjective shape, presence of possible infarcts, sub-placental, and subchorionic hemorrhage. Placentas were also evaluated for G-grading and signal intensities in T2 half-fourier acquisition single-shot turbo spin-echo (HASTE) images. Diffusion weighted imaging (DWI) images were done using two b-value sets (0, 1000 and 50, 400, 800). Largest possible regions of interest (ROI) were drawn over the placenta and ADC values were correlated with gestational-age and Gg using linear regression and Kruskal-Wallis, respectively. Results: There were 11, 18, 9, 0 patients with normal looking placentas with Gg of 0, 1, 2, and 3 respectively. ADC values obtained from b values of 0, and 1000 show a significant correlation with gestational-age (R2 = 0.60, P = 0.000) and Gg (P = 0.004) respectively, while ADC values obtained from b values of 50, 400, and 800 did not show significant correlation with gestational age (R2 = 0.087, P = 0.073) or Gg (P = 0.236). Conclusion: ADC values which were obtained from sets of b values of 0 and 1000 correlated with placental maturity (both gestational age (GA) and Grannum grades). This can be attributed to lower b-values covering the microperfusion in addition to diffusion characteristics of the tissue.

Background: Fluoroscopy guided imaging, which is going to be more routine these days require a long time of fluoroscopic observing, which can increase the radiation dose of the physician and other staff who have to stay near the patient during the procedure. In our department, one of the senior interventionists had observed the hair loss in his lower limb. Thus the objective of this study was measuring the radiation dose of the physician’s leg during common procedures in order to find out that whether the radiation dose exceeds the threshold of deterministic effects of radiation or not?. Methods: Thermo luminescent-dosimeters (TLD-100) set on the leg part of the anthropomorphic whole body phantom PBU-50, was used in order to measure the radiation dose in 2 centers where our interventionist work. Meanwhile, the duration of exposure in important procedures was observed and recorded in center 1 for 2 months. During this period some data such as age, height, and weight of the patients and radiation exposure time, dose (mGy) and dose area product (dap) (Gy.cm2) was recorded Results: The result of TLD dosimetry shown that the mean effective dose in center 1 and 2 was 0.20 and 0.86 mSv, and also the mean-dose (mSv)/min in these centers was 0.02 ± 0.00 and 0.20 ± 0.015 mSv/min respectively. Conclusions: The effective annual dose of interventionists who work in center 1 and 2 was 143.08 and 1226.78 mSv respectively. The high radiation dose which delivers to the leg of physicians in center 2 can be an important cause of radiation dermatitis occurred on the leg of our interventionist. Patient dose during most of the procedures was less than the threshold dose for occurring erythema but unfortunately in TIPS procedure which is a time-consuming procedure the patient radiation dose exceeds the threshold. It would be useful if a plan design to reduce the dose of patients and even physicians. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).