Current Issue : July-September Volume : 2023 Issue Number : 3 Articles : 5 Articles
Urine sedimentation in the bladder can occur in various circumstances and can lead to urinary obstruction/stasis with associated pain. It is usually diagnosed with an ultrasound; however, CT is also used to assess the amount and to further check for urinary stones. Depending on the composition, urine sedimentation and stones can be treated medically by alkalinisation of the urine with potassium sodium hydrogen citrate in the case of uric acid-based sedimentation/stones. Due to technical developments and improved material differentiation and characterisation in CT imaging, dual-energy CT allows for differentiation of uric acid from calcium, which can be used for sedimentation/stone composition analysis. Subsequently, treatment decisions can be made based on the findings in dual-energy CT....
Pediatric renal cell carcinoma (RCC) is a rare malignancy. Magnetic resonance imaging (MRI) is the preferred imaging modality for assessment of these tumors. The previous literature has suggested that cross-sectional-imaging findings differ between RCC and other pediatric renal tumors and between RCC subtypes. However, studies focusing on MRI characteristics are limited. Therefore, this study aims to identify MRI characteristics of pediatric and young-adult RCC, through a single-center case series and literature review. Six identified diagnostic MRI scans were retrospectively assessed, and an extensive literature review was conducted. The included patients had a median age of 12 years (63–193 months). Among other subtypes, 2/6 (33%) were translocationtype RCC (MiT-RCC) and 2/6 (33%) were clear-cell RCC. Median tumor volume was 393 cm3 (29– 2191 cm3). Five tumors had a hypo-intense appearance on T2-weighted imaging, whereas 4/6 were iso-intense on T1-weighted imaging. Four/six tumors showed well-defined margins. The median apparent diffusion coefficient (ADC) values ranged from 0.70 to 1.20x10−3 mm2/s. In thirteen identified articles focusing on MRI characteristics of MiT-RCC, the majority of the patients also showed T2-weighted hypo-intensity. T1-weighted hyper-intensity, irregular growth pattern and limited diffusion– restriction were also often described. Discrimination of RCC subtypes and differentiation from other pediatric renal tumors based on MRI remains difficult. Nevertheless, T2-weighted hypointensity of the tumor seems a potential distinctive characteristic....
Objective: The current research study aims to calculate entrance surface air kerma for skull, chest, cervical spine, lumbar spine, and pelvic X-ray examinations in interior posterior and posterior interior positions and generate a method for chest dose reduction to decrease radiation risk. Materials and Methods: The indirect dose measurement was used in the current research. The X-ray tube output was measured using RAD-CHECK Plus ionization chamber and the indirect entrance surface air kerma was calculated via applying physical acquisition parameters such as a focus on skin distance, tube current times exposure time (mAs), and applied tube voltage (kV), and applying a mathematical model. Results: The main findings were obtained from comparing the radiation doses with the reference levels of International organizations such as the American College of Radiology and the International Atomic Energy Authority. The mean entrance skin dose for the skull (AP), skull (PA), skull (LAT), cervical spine (PA), cervical spine (LAT), lumbar spine (AP), lumbar spine (LAT), pelvis (AP), and pelvis (LAT) of adult X-ray examinations was within the diagnostic reference dose level values obtained by ACR (2018) except for the ESD for chest (AP) which was 0.88 mGy. Conclusions: The results of the study concluded that by adjusting the applied tube voltage, kV, and tube current product time, mAs decreased the radiation dose to the chest X-ray by 58%....
Background: Fluid overload is frequent in Haemodialysis (HD) and is one of the major factors of cardiovascular morbidity and mortality for chronic HD patients. The main challenge with chronic haemodialysis patients is indeed the maintenance of a normal extracellular volume through dry weight determination. Our study aimed at assessing the role of lung ultrasound in the detection of B-lines for the determination of hydration status in chronic HD patients. Methods: We conducted a cross-sectional study including 31 patients undergoing chronic HD treatment for at least 3 months, in the Yaounde University Teaching Hospital dialysis unit. Lung ultrasonography and clinical examinations were performed immediately before dialysis, and 30 minutes after dialysis. Differences between clinical and ultrasound variables before and after dialysis were measured to assess the effects of dialysis. Association between categorical variables was assessed with the Chi-squared test or Fischer test, and Rho’s Spearman coefficient for quantitative variables. Results: There was a reduction in the median of B-lines score after dialysis [12 (7 - 26) versus 8 (5 - 13)], clinical score [2 (1 - 3) versus 0 (−1 - 2)], mean of systolic blood pressure (164.74 ± 26.50 versus 158.48 ± 27.89), frequency of dyspnoea in patients (32.3% versus 6.5%); and raising of the frequency of cramps in patients (0% versus 19.4%) and all statistically significant (p ≤ 0.031). B-lines score before and after dialysis was associated with dyspnoea and raised jugular venous pressure (p < 0.05). B-lines score before dialysis was correlated with B-lines score after dialysis (r = 0.805; p < 0.001), B-lines reduction (r = 0.862; p <0.001), and clinical score (r = 0.49; p = 0.005). Reduction of B-lines score was not correlated with weight loss. Conclusion: Lung ultrasound for the detection of B-lines reflects the variation of extracellular volume during dialysis and can even capture pulmonary oedema at a pre-clinical stage. It is then a reliable and sensible method for assessing extravascular lung water and thus hydration status of haemodialysis patients. It could constitute a better alternative for an objective and accurate definition of dry weight, specifically in the African and Cameroonian context, with its assets being low cost, availability, and easiness to perform in a large population of HD patients. We, therefore, recommend further multicentric studies in order to design a standardized protocol of ultrasound follow-up for all chronic HD patients’ hydration status assessments....
Objectives To investigate the value of preoperative positron emission tomography/computed tomography (PET/CT) in differentiating the invasive degree of hypometabolic lung adenocarcinoma. Methods We retrospectively analyzed the data of patients who underwent PET/CT examination, high-resolution computed tomography, and surgical resection for low-metabolism lung adenocarcinoma in our hospital between June 2016 and December 2021. We also investigated the relationship between the preoperative PET/CT findings and the pathological subtype of hypometabolic lung adenocarcinoma. Results A total of 128 lesions were found in 113 patients who underwent resection for lung adenocarcinoma, including 20 minimally invasive adenocarcinomas (MIA) and 108 invasive adenocarcinomas (IAC), whose preoperative PET/ CT showed low metabolism. There were significant differences in the largest diameter (Dmax), lesion type, maximum standard uptake value (SUVmax), SUVindex (the ratio of SUVmax of lesion to SUVmax of contralateral normal lung paranchyma), fasting blood glucose, lobulation, spiculation, and pleura indentation between the MIA and IAC groups (p < 0.05). Multivariate logistic regression analysis showed that the Dmax (odds ratio (OR) = 1.413, 95% confidence interval (CI: 1.155–1.729, p = 0.001)) and SUVmax (OR = 12.137, 95% CI: 1.068–137.900, p = 0.044) were independent risk factors for predicting the hypometabolic IAC (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the Dmax ≥ 10.5 mm and SUVmax ≥ 0.85 were the cut-off values for differentiating MIA from IAC, with high sensitivity (84.3% and 75.9%, respectively) and specificity (84.5% and 85.0%, respectively), the Combined Diagnosis showed higher sensitivity (91.7%) and specificity (85.0%). Conclusions The PET/CT findings correlated with the subtype of hypometabolic lung adenocarcinoma. The parameters Dmax and SUVmax were independent risk factors for predicting IAC, and the sensitivity of Combined Diagnosis prediction is better....
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