Catalogue Search | MBRL
هل أنت متأكد أنك تريد إزالة الكتاب من الرف؟
{{itemTitle}}
207,562
نتائج ل
"Radiology"
صنف حسب:
Hinman Syndrome: A Rare Entity With Neurogenic Bladder-Like Symptoms
Hinman syndrome, as is the case with many other rare conditions, is a disease very commonly under-considered or missed in the diagnosis of patients with the presenting symptoms. Clinical and radiographic manifestations of the condition are easily confused with neurogenic bladder without proper history collection and neurological examination. Patients typically present with symptoms including enuresis, urinary retention, reoccurring urinary tract infections, and encopresis. Imaging often shows hydroureteronephrosis and marked bladder wall thickening. While these signs are characteristic of neurogenic bladder, routine neurologic examinations and MRIs of patients with Hinman syndrome often show normal results, and their condition is currently thought to be an acquired behavioral and psychological disorder, often associated with abnormal family dynamics. We present the case of a 14-year-old boy, who presented to the emergency department with nausea, bilateral flank pain, and urinary retention. The patient had an over seven-year history of recurrent urinary tract infections (UTI) and intermittent encopresis and followed up with different providers. Due to the patient’s extensive history and the failure of previous treatments, he was evaluated for causes of neurogenic bladder, but the MRI of the lumbar spine was normal. Fluoroscopic voiding cystourethrogram (VCUG) was ordered and demonstrated abnormal and trabeculated contour of the urinary bladder with bilateral vesicoureteral reflux consistent with the diagnosis of Hinman syndrome.
Journal Article
Gastrostomy Exchange With Displacement Into the Jejunum
A 54-year-old female with a gastrostomy tube presented with persistent nausea, vomiting, and abdominal pain. On physical examination, the gastrostomy tube was completely advanced into the abdominal cavity with only the external retention ring and hub on the exterior. The first step in the workup was obtaining a scout radiograph. This imaging was appropriate to show the location of the gastrostomy catheter which was overlying the left upper quadrant. The distal tip was heading in the direction of the left lower quadrant. The course of the gastrostomy catheter did not follow the expected direction of the duodenal C-loop. Proceeding forward, contrast was injected through the existing catheter which showed opacification of the jejunal bowel loops. The patient could now be properly diagnosed with gastroenteric intussusception and proper measures could be taken. Following the injected contrast showing jejunal opacification, a stiff Glidewire was advanced through the existing catheter all the way into the jejunum. Deflation of the balloon and removal of the catheter caused an almost instantaneous change in the course of the Glidewire to the more conventional path following the course of the duodenal C-loop. A sheath was then advanced over the wire which was now shown crossing the midline in the proper gastroduodenojejunal course. The final step was to advance a new 22-French MIC gastrostomy catheter over the Glidewire. The contrast was then injected to demonstrate proper opacification of the rugal folds and gastric fundus. The patient reported an immediate resolution of symptoms and was later discharged.
Journal Article
Revealing an Uncommon Presentation of Chiari I Malformation With Diverse Craniovertebral Anomalies in the Absence of Syringomyelia and Atlanto-Occipital Subluxation: A Case Report
A Chiari I malformation is a frequently encountered anomaly of the posterior fossa, occurring in a notable percentage of the population. It often coexists with various other craniovertebral junction abnormalities, albeit less frequently with Klippel-Feil syndrome. Interestingly, the majority of individuals with Chiari I malformation do not exhibit any symptoms. We present a rare case of a 25-year-old male with chronic neck and occipital pain, along with progressive weakness and sensory disturbances in all four limbs, urinary urgency, and elevated left shoulder. Examination unveiled spasticity, weakness, and brisk reflexes. On extensive radiological evaluation (X-ray, CT, and MRI), findings revealed various anomalies in the craniovertebral junction, including complete atlanto-occipital assimilation, basilar invagination, and platybasia. Furthermore, cervical segmentation abnormalities indicative of Klippel-Feil syndrome were observed, along with Sprengel's deformity. MRI confirmed Chiari I malformation with tonsillar herniation and myelomalacia, as well as compression at the cervico-medullary junction. This patient underwent a surgical procedure that included transoral odontoidectomy combined with occipito-cervical fixation, after which a good clinical response was observed. It emphasizes the necessity of radiological imaging for the diagnosis of Chiari and other associated abnormalities in the craniovertebral junction.
Journal Article
Ruptured Mycotic Aneurysm of the Superior Mesenteric Artery: A Case Report
An infected (mycotic) aneurysm of the visceral arteries is an uncommon entity, which may arise from a secondary infection of a preexisting aneurysm or be due to degeneration from a primary infection. Mycotic aneurysms require prompt recognition and definitive treatment; otherwise, there can be devastating morbidity and mortality. We present the case of a 51-year-old female with HIV and Crohn's disease who presented with subacute abdominal pain, nausea, and vomiting and was found to have an ultimately fatal mycotic aneurysm of the superior mesenteric artery. In addition, we discuss the characteristic imaging features of mycotic aneurysms on computed tomography and magnetic resonance imaging.
Journal Article
Artificial Intelligence (AI) in Radiology: A Deep Dive Into ChatGPT 4.0's Accuracy with the American Journal of Neuroradiology's (AJNR) \Case of the Month\
The advent of artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT 4.0, holds significant potential in healthcare, specifically in radiology. This study examined the accuracy of ChatGPT 4.0 (July 20, 2023, version) in solving diagnostic quizzes from the American Journal of Neuroradiology's (AJNR) \"Case of the Month.\" We evaluated the diagnostic accuracy of ChatGPT 4.0 when provided with a patient's history and imaging findings weekly over four weeks, using 140 cases from the AJNR \"Case of the Month\" portal (from November 2011 to July 2023). The overall diagnostic accuracy was found to be 57.86% (81 out of 140 cases). The diagnostic performance varied across brain, head and neck, and spine subgroups, with accuracy rates of 54.65%, 67.65%, and 55.0%, respectively. These findings suggest that AI models such as ChatGPT 4.0 could serve as useful adjuncts in radiological diagnostics, thus potentially enhancing patient care and revolutionizing medical education.
Journal Article
Review of the Efficacy and Safety of Gadopiclenol: A Newly Emerging Gadolinium-Based Contrast Agent
Gadolinium-based contrast agents (GBCAs) are one of the most commonly used agents in magnetic resonance imaging. Gadopiclenol is a new GBCA aimed at providing improved diagnostic efficacy with a favorable safety profile. The proposed advantages are due to its specific pharmacological properties, one of which is high relaxivity values. The aim of this review is to assess the efficacy, diagnostic accuracy, and safety of gadopiclenol in comparison to other currently used gadolinium-based contrast agents. PubMed and other database systems were used to identify relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed, resulting in 10 articles that were included in the review. The outcomes were reviewed according to several factors regarding efficacy and accuracy in terms of qualitative and quantitative descriptors relative to properties of enhancement provided by the contrast agent. In terms of safety profile, a number of outcomes were assessed such as the occurrence of serious adverse effects, severe kidney injury, and organ-based contrast retention. Gadopiclenol was found to provide outcomes comparable to other commonly used GBCAs at lower doses with further favorable results at higher doses while maintaining an acceptable safety profile. However, it was found to have high rates of retention within the liver and can cause nonsignificant QT prolongation in healthy individuals, which arguably creates the need for further research regarding more long-term implications of these possible adverse effects.
Journal Article
Insights Into Meningioma Visibility on Arterial Spin Labeling MRI: Location Outweighs Size
Background Arterial Spin Labeling (ASL) MRI is a non-invasive imaging technique with potential applications for assessing meningiomas. This retrospective study aimed to investigate the impact of tumor location, size, age, and sex on the ASL visibility of meningiomas. Methods We retrospectively analysed 40 patients with meningiomas, who underwent 3 Tesla MRI examinations using a three-dimensional (3D) pulsed ASL technique. Tumor location was categorized as around the skull base or elsewhere, and size was determined by the area in the transverse plane. Results Our findings revealed that meningiomas around the skull base were significantly more likely to be ASL-visible compared to those located elsewhere (p < 0.001), whereas tumor size, age, and sex did not show a significant correlation with ASL visibility. This observation suggests that tumor location is a critical factor in determining the visibility of meningiomas on ASL MRI. Conclusion The results contribute to a better understanding of ASL visibility in meningiomas, highlighting the importance of tumor location over size. Further research, including larger cohorts and additional factors, such as histological variants, is needed to expand upon these findings and explore their clinical implications.
Journal Article
Quality and Reliability Analysis of YouTube Videos on Magnetic Resonance Imaging Claustrophobia
Aim Magnetic resonance imaging (MRI)-induced anxiety is not infrequent with a reported incidence as high as 37% and the rate of failed MRI imaging due to claustrophobia ranges between 0.5% and 14.5%. The objective of this study was to evaluate the quality and reliability of YouTube
videos on MRI claustrophobia. Methods Sixty-five videos were included in the final analysis. Video information analyzed included video length (minutes), video content, qualification of the video uploaders, time of upload, time since upload, the number of total views and the mean daily views, and like counts. We divided the videos according to the uploaders into professional and non-professional groups and further grouped the videos as useful and misleading. Data obtained from the videos were evaluated with three tools including subjective evaluation, Quality Criteria for Consumer Health Information (DISCERN), and Global Quality Scale (GQS) tools. Results The mean video duration was found as 4.14±4.45 minutes. The mean view count was 104.59±408,788.68 and the mean like count was found as 272.55±1096.25. Seventeen (26.15%) videos were uploaded by professionals and 48 (73.85%) by non-professionals. Twenty-eight (43.08%) of the videos were useful and 37 (56.92%) were useless. The mean DISCERN and GQS scores were statistically significantly higher in the professional videos compared to the non-professional videos and in useful videos compared to non-useful videos (for all, p<0.001). Conclusion A majority of the YouTube
videos concerning MRI claustrophobia were uploaded by non-professionals. Physicians and other healthcare personnel should be encouraged to provide useful and accurate videos and to direct patients appropriately.
Journal Article