Current Issue : January - March Volume : 2020 Issue Number : 1 Articles : 5 Articles
Background: Pocket-sized ultrasound devices are increasingly used in a variety of clinical situations, and perform\nwell against standard ultrasound machines. We sought to investigate if a pocket-sized ultrasound device can assess\nmuscle thickness and architecture in healthy volunteers.\nMethods: Healthy male volunteers (n = 21) across a range of ages were recruited to the study. Laying supine,\nultrasound images were taken from the right anterior and lateral thigh. Thickness of the rectus femoris (RFMT),\nvastus intermedius (VIMT), and the two combined (anterior thigh, AMT) were measured, along with thickness of\nvastus lateralis (VLMT), pennation angle (VLPA) and derived fascicle length (VLFL). These scans were performed\ninitially using a pocket-sized ultrasound (VScan) and then using a standard device (Telemed Echoblaster 128).\nResults: In all six variables, there was no significant difference between the two sets of measurements. Intra-class\ncorrelation co-efficients (ICC) for VLMT, VLPA, and AMT were all excellent (0.93, 0.89, 0.90 respectively) with the\nderived value of VLFL having an ICC of 0.84. All ICC values were statistically significant. Regression analysis\ndemonstrated no evidence of proportional bias in any of the measured or derived variables.\nConclusion: A pocket-sized ultrasound device gives similar measurements of lower limb muscle thickness and\narchitecture as a standard device in healthy volunteers....
Background: Imaging methods for the plantar fascia have included radiography, ultrasound and magnetic\nresonance imaging (MRI), all of which have provided valuable information. This study assessed the reliability\nof ultrasonography examinations of the plantar fascia using a comparative study.\nMethods: Fifty healthy adult volunteers (25 males and 25 females, mean age������....
Background: Opsoclonus-myoclonus syndrome (OMS) is a rare clinical disorder and typically occurs in association\nwith occult neuroblastic tumor in pediatric patients. I-123 metaiodobenzylguanidine (mIBG) scintigraphy is widely\nadopted as screening procedure in patients with suspected neuroblastic tumor. Also, contrast-enhanced magnetic\nresonance imaging (MRI) or computed tomography (CT) are involved in the imaging workup, primarily for the\nassessment of the primary tumor region. However, the diagnostic value of whole-body MRI (WB-MRI) for the\ndetection of occult neuroblastic tumor in pediatric patients presenting with OMS remains unknown.\nCase presentation: We present three cases of patients with OMS, in whom WB-MRI revealed occult neuroblastic\ntumor masses, whereas scintigraphy was inconclusive:\nIn a 17 months old girl with OMS, WB-MRI revealed a paravertebral mass. After thoracoscopic resection,\nhistopathology revealed a ganglioneuroblastoma.\nA 13 months old boy presenting with OMS WB-MRI detected a tumor of the left adrenal gland; histopathology\ndemonstrated a ganglioneuroblastoma after adrenalectomy.\nIn a 2 year old boy with OMS, immunoscintigraphy at the time of diagnosis was inconclusive. At the age of 13\nyears, a WB-MRI was performed due to persistent neurological symptoms, revealing a paravertebral retroperitoneal\nmass, which was classified as ganglioneuroblastoma.\nConclusion: In OMS, particularly in the setting of inconclusive scintigraphy, WB-MRI may be considered as a\nvaluable alternative in the early phase of diagnostic work-up....
Background: Myxoid tumors pose diagnostic challenges for radiologists and pathologists. All myxoid tumors can\nbe differentiated from each other using fluorescent in-situ hybridization (FISH) or immunohistochemical markers,\nexcept for myxomas and myxofibrosarcomas. Myxomas and myxofibrosarcomas are rare tumors. Myxomas are\nbenign and histologically bland, whereas myxofibrosarcomas are malignant and histologically heterogenous.\nBecause of the histological heterogeneity, low grade myxofibrosarcomas may be mistaken for myxomas on core\nneedle biopsies. We evaluated the performance of T1-weighted signal intensity (T1SI), tumor volume, and radiomic\nfeatures extracted from magnetic resonance imaging (MRI) to differentiate myxomas from myxofibrosarcomas.\nMethods: The MRIs of 56 patients (29 with myxomas, 27 with myxofibrosarcomas) were analyzed. We extracted 89\nradiomic features. Random forests based classifiers using the T1SI, volume features, and radiomic features were used\nto differentiate myxomas from myxofibrosarcomas. The classifiers were validated using a leave-one-out\ncross-validation. The performances of the classifiers were then compared.\nResults: Myxomas had lower normalized T1SI than myxofibrosaromas (p = 0.006) and the AUC using the T1SI was\n0.713. However, the classification model using radiomic features had an AUC of 0.885 (accuracy = 0.839,\nsensitivity = 0.852, specificity = 0.828), and outperformed the classification models using T1SI (AUC = 0.713) and\ntumor volume (AUC = 0.838). The classification model using radiomic features was significantly better than the\nclassifier using T1SI values (p = 0.039).\nConclusions: Myxofibrosarcomas are on average higher in T1-weighted signal intensity than myxomas.\nMyxofibrosarcomas are larger and have shape differences compared to myxomas. Radiomic features performed\nbest for differentiating myxomas from myxofibrosarcomas compared to T1-weighted signal intensity and tumor\nvolume features....
Background: Traditionally, the diagnosis of post-dural puncture headache (PDPH) relied upon the patientâ??s history\nregarding dural puncture and symptoms, such as orthostatic headache. However, such evidence may not always be\nreliable or specific. We report an unexpected diagnosis with spontaneous intracranial hypotension (SIH), which was\nconfirmed upon examination of Magnetic Resonance (MR) images in a patient who was initially suspected to have\nPDPH because he had recently undergone a uncertain dural puncture.\nCase presentation: A 45-year-old man had undergone a thoracic epidural catheter insertion for perioperative\nanalgesia prior to general anesthesia induction. Due to intermittent dripping of fluid while the epidural needle was\nbeing advanced, a dural puncture was suspected. The patient complained of an orthostatic headache after recovery\nfrom surgery, therefore a PDPH was suspected. MR images revealed signs of SIH: dural sinus engorgement, contrast\nenhancement along the neural sleeves of the left C6-7, bilateral C7-T1, T1-2, T2-3, T3-4, T4-5, and T5-6.\nComputed tomography-guided epidural blood patching (EBP) was performed the following day, with the patient\nexperiencing immediate relief of the headache.\nConclusion: The benefits of radiological imaging in this case included confirming the correct diagnosis, guiding\nthe accurate level and proper approach of EBP, distinguishing the epidural space from the intrathecal space, and\nultimately increasing the likelihood of successful EBP....
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