New technology in radiological diagnosis: An investigation of diagnostic image quality in digital displays of radiographs

Digital radiology is undergoing rapid evolution. Its objectives can be summarized as the creation within the modern radiology department - and indeed within the entire hospital - of a harmonious, integrated, electronic network capable of handling all diagnostic radiological images, obviating the need for conventional film-based radiology. One of the limiting factors in the introduction and exploitation of digital technology is the issue of image display quality: if electronic display systems are to be widely used for primary radiological diagnosis, it is essential that the diagnostic quality of the displayed images should not be compromised. From the perspective of the practising radiologist, this study examines the performance of the first two commercially available digital radiological display systems to be purchased and installed in a British hospital. This work incorporates an extensive observer performance investigation of image quality from existing 1024- and 1280-line display systems, and suggests that displayed images digitized at a pixel size of 210?m show a significant reduction in diagnostic performance when compared with original film. Such systems appear to be unsuitable for primary radiological diagnosis of subtle lesions. Some of the physical properties of such systems, some relevant methodological issues, and the relationship between image quality and other factors influencing the development acceptance and implementation of digital technology, have also been investigated; the results are presented. This is a controversial subject, and conflicting views have been expressed in the British literature concerning the issue of whether or not the technology is now ready for total system implementation; the view of this author is that careful testing of display systems, and of every other component of digital networks, should precede their entry into clinical use

To study the relationship of apparent diffusion coefficient (ADC) values of renal parenchyma and renal resistive index (RRI) with serum markers of renal dysfunction and stage of chronic kidney disease.

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DW‑MRI) in renal diseases is an emerging field and its utility is yet to be fully realized. AIM: To study the relationship between apparent diffusion coefficient (ADC) values of renal parenchyma, Renal Resistive Index (RI) with serum markers of renal function and stage of chronic kidney disease (CKD). Materials and Methods: A prospective study was performed 100 patients with normal and elevated renal parameters .Patients underwent DW‑MRI (at b‑values of 0, 250 and 500 s/mm2) and renal Doppler examination. Of these 25 normal GFR, 26 patient’s stage2, 20patients stage3, 10 patients stage4, 19 patients stage 5 CKD and were staged depending on disease severity. ADC values were determined for renal parenchyma and compared. Receiver operating characteristic (ROC) curves were drawn to establish cut‑off ADC values. Pearson’s correlation coefficient (R) was calculated between ADC and renal function parameters. Results: ADC values in patients with renal dysfunction were significantly lower than in patients with normal renal function . ADC values lower than 1.986 x10-3mm2/sec for right side ,1.97067 x10-3mm2/sec for left side were seen only with renal dysfunction and higher than 2.49318 (×10‑3 mm2/s) for right side 2.4706for left side , were seen only with normal function. Average ADC value for both side: 2.334 X 10- 3mm2/sec below which indicates renal dysfunction. There was significant inverse correlation between ADC of renal parenchyma and serum creatinine, blood urea . There is significant linear correlation between the ADC of renal parenchyma and estimated glomerular filtration rate (eGFR). ADC values showed a statistically significant decreasing trend with increasing stage of CKD. Renal resistive index is not persistently elevation in all the patients with elevated renal parameters and couldn’t be reliable in predicting the renal dysfunction. Conclusion: ADC values may serve as an additional marker for the presence and degree of renal dysfunctio

Placement of a subcutaneous ureteral bypass for the treatment of ureteral obstruction in cats : a retrospective study

Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de ClínicaA obstrução ureteral em gatos é uma condição multifatorial e potencialmente fatal com tendência crescente, sendo a causa mais comum a obstrução intraluminal secundária a ureterolitíase. A manifestação pode ser rápida ou insidiosa, e após o diagnóstico, a intervenção imediata é essencial para aliviar a pressão no bacinete renal e evitar uma redução da função renal e lesões renais irreversíveis. O diagnóstico é determinado com base na avaliação dos sinais clínicos, análises sanguíneas, particularmente as concentrações séricas da creatinina e BUN, e exames imagiológicas, tipicamente ultrassonografia e radiografia. Para o tratamento, a abordagem médica deve ser tentada por um curto período de tempo para estabilizar o paciente e procurar resolução. No caso de insucesso da terapêutica médica, a implantação de um bypass subcutâneo ureteral (SUB) surge como uma terapia promissorapelo seu potencial na resolução de obstruções ureterais que não teriam outra resolução. O presente estudo, descreve os resultados e as complicações da colocação do dispositivo SUB em gatos, para o tratamento de obstruções ureterais, no Hospital Veterinário do Porto. Foram analisados de forma detalhada os registos médicos de 5 gatos com ureterolitíase obstrutiva, submetidos à colocação do dispositivo SUB. Os resultados indicam que este procedimento proporciona alívio imediato do bacinete renal, com consequente resolução da lesão renal aguda pós-renal desencadeada pela ureterolitíase obstrutiva. No entanto verificaram-se as seguintes complicações: infeção urinária por bactérias com resistência a múltiplos antibióticos, resultando na morte de dois pacientes. Outras complicações incluíram hipotermia, obstipação, anemia, hematúria e disúriaABSTRACT - Placement of a subcutaneous ureteral bypass for the treatment of ureteral obstruction in cats: a retrospective study - Benign ureteral obstruction in cats is a multifactorial and life-threatening condition with an increasing tendency, with the most common cause being an intraluminal obstruction, secondary to ureterolithiasis. The manifestation can be rapid or insidious, and upon diagnosis, immediate intervention is essential to relieve the pressure on the renal pelvis and prevent a decline in renal function and irreversible renal lesions. The diagnosis is determined based on the evaluation of the clinical signs, blood analysis, particularly serum creatinine and BUN concentrations, and imaging modalities, typically ultrasonography and radiography. For treatment, medical management must be attempted for a short period of time in order to stabilize the patient and seek resolution. However, in case of failure of medical therapy, the implantation of a subcutaneous ureteral bypass emerges as a promising therapy due to its potential in resolving ureteral obstructions that would not have any resolution. The present study describes the outcomes and complications of placing the SUB device in cats for the treatment of ureteral obstructions at the Veterinary Hospital of Porto. The medical records of 5 cats with obstructive ureterolithiasis undergoing SUB device placement were thoroughly analyzed. The results indicate that this procedure provides immediate relief of the renal pelvis, leading to the resolution of post-renal acute kidney injury triggered by obstructive ureterolithiasis. However, the following complications were observed: urinary tract infection caused by bacteria resistant to multiple antibiotics, resulting in the death of two patients. Other complications included hypothermia, constipation, anemia, hematuria, and dysuriaN/

Urology

УЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯУРОЛОГИЯУРОЛОГИЧЕСКИЕ БОЛЕЗН

Diabetes Insipidus

The first chapter of the book reports on the management of Langerhans cell histiocytosis (LCH)-induced central diabetes insipidus and its associated endocrinological/neurological sequelae in the national survey. The next chapter addresses DI and head injuries. Next, the management of neuroendocrine instability during maintenance of potential organ donors is described. Organ transplants have gradually increased worldwide. To have maintenance of appropriate potential organs, AVP is needed. Furthermore, nephrogenic DI-the potential therapeutic drugs and analysis of membrane protein stability is the topic of the next two chapters, followed by new insights into the diagnosis and management of pregnancy-related DI. The seventh chapter reports on the problems with differential diagnosis in a case of central DI in a female patient with bipolar disorder. The lithium treatment usually resulted in nephrogenic DI. Finally, over the last years, the development of MRI imaging on the pituitary gland with the stalk and hypothalamus has advanced. The final chapter interprets imaging techniques in DI in detail

Case series of breast fillers and how things may go wrong: radiology point of view

INTRODUCTION: Breast augmentation is a procedure opted by women to overcome sagging breast due to breastfeeding or aging as well as small breast size. Recent years have shown the emergence of a variety of injectable materials on market as breast fillers. These injectable breast fillers have swiftly gained popularity among women, considering the minimal invasiveness of the procedure, nullifying the need for terrifying surgery. Little do they know that the procedure may pose detrimental complications, while visualization of breast parenchyma infiltrated by these fillers is also deemed substandard; posing diagnostic challenges. We present a case series of three patients with prior history of hyaluronic acid and collagen breast injections. REPORT: The first patient is a 37-year-old lady who presented to casualty with worsening shortness of breath, non-productive cough, central chest pain; associated with fever and chills for 2-weeks duration. The second patient is a 34-year-old lady who complained of cough, fever and haemoptysis; associated with shortness of breath for 1-week duration. CT in these cases revealed non thrombotic wedge-shaped peripheral air-space densities. The third patient is a 37‐year‐old female with right breast pain, swelling and redness for 2- weeks duration. Previous collagen breast injection performed 1 year ago had impeded sonographic visualization of the breast parenchyma. MRI breasts showed multiple non- enhancing round and oval shaped lesions exhibiting fat intensity. CONCLUSION: Radiologists should be familiar with the potential risks and hazards as well as limitations of imaging posed by breast fillers such that MRI is required as problem-solving tool

Characterization of alar ligament on 3.0T MRI: a cross-sectional study in IIUM Medical Centre, Kuantan

INTRODUCTION: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female. The specific objectives are to assess the prevalence of alar ligament visualized on MRI, to describe its characteristics in term of its course, shape and signal homogeneity and to find differences in alar ligament signal intensity between male and female. This study also aims to determine the association between the heights of respondents with alar ligament signal intensity and dimensions. MATERIALS & METHODS: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. RESULTS: Alar ligament was best depicted in coronal plane, followed by sagittal and axial planes. The orientations were laterally ascending in most of the subjects (60%), predominantly oval in shaped (54%) and 67% showed inhomogenous signal. No significant difference of alar ligament signal intensity between male and female respondents. No significant association was found between the heights of the respondents with alar ligament signal intensity and dimensions. CONCLUSION: Employing a 3.0T MR scanner, the alar ligament is best portrayed on coronal plane, followed by sagittal and axial planes. However, tremendous variability of alar ligament as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury

Propaedeutics of Internal Diseases

УЧЕБНЫЕ ПОСОБИЯДИАГНОСТИКАПИЩЕВАРИТЕЛЬНОЙ СИСТЕМЫ БОЛЕЗНИ /ДИАГНОСТИКАМОЧЕПОЛОВЫЕ БОЛЕЗНИ /ДИАГНОСТИКАГЕМАТОЛОГИЧЕСКИЕ БОЛЕЗНИ /ДИАГНОСТИКАДИАГНОСТИЧЕСКИЕ МЕТОДЫ ЭНДОКРИННЫЕДИАГНОСТИЧЕСКИЕ МЕТОДЫ ПИЩЕВАРИТЕЛЬНЫЕКОСТНО-МЫШЕЧНОЙ СИСТЕМЫ БОЛЕЗНИ /ДИАГНОСТИКАТЕРАПИЯ (ДИСЦИПЛИНА)DISEASES OF THE ENDOCRINE GLANDSDISEASES OF THE MUSCULOSKELETAL SYSTEMDISEASES OF THE BLOODDISEASES OF THE URINARY TRACTDISEASES OF THE DIGESTIVE SYSTEMINTERNAL DISEASESPROPAEDEUTICS OF INTERNAL DISEASESINTERNAL MEDICINEИНОСТРАННЫЕ СТУДЕНТЫСодержит следующие разделы: обследование пациентов с заболеваниями органов систем пищеварения, мочевыделения, крови, желез внутренней секреции и опорно-двигательного аппарата. Для студентов 2 и 3 курсов, изучающих пропедевтику внутренних болезней на английском языке. It contains the following sections: examination of patients with diseases of the digestive system, urinary tract, blood, endocrine glands and musculoskeletal system