Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review

Objective: To summarize the available evidence on the use of elastography in the assessment of the masseter muscle in healthy individuals and patients with masseter muscle disorders.Methods: Systematic literature review has been performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Results: 16 of 142 studies identified were analyzed. Elastography was used in seven studies. Heterogeneity was observed in terms of study protocols, devices, patients, units of measure, and results. Elasticity values showed a correlation between the left and right masseter muscle side in healthy people, but not in patients with temporomandibular disorders (TMDs). Elasticity values increased in TMD and were correlated with the severity of TMD symptoms. Phantom studies proved the high reliability of elastography.Conclusion: Elastography is a promising tool for the assessment of the masseter muscle elasticity, but the evidence is insufficient. Studies on larger groups are needed to determine the accuracy of elastography to characterize masticatory muscle disorders.Radiolog

Adherence to guidelines aimed at preventing post-contrast acute kidney injury (PC-AKI) in radiology practices: a survey study

Background New insights into post-contrast acute kidney injury (PC-AKI) have recently led to the guidelines on the prevention of PC-AKI being updated. However, little is known about the barriers and facilitators involved in guideline adherence by radiology practices. Purpose To evaluate barriers and facilitators to the adherence of PC-AKI guidelines. Material and Methods Radiologists visiting the European Society of Urogenital Radiology (ESUR) 2018 meeting, as well as ESUR members were contacted to fill in an electronic questionnaire on the implementation of PC-AKI guidelines applying to their local radiology practices. Results Of the 145 responding radiologists representing radiology practices, 127 (88%) confirmed having a PC-AKI protocol in place in their radiology practice, of which 61 (48%) used a protocol as specified in a (inter)national guideline. The majority of radiology practices of the respondents used the ESUR guideline (40%). Barriers for not using PC-AKI prevention guidelines were related to a lack of outcome expectancy. Barriers for not using the protocol as specified were related to a lack of agreement with specific recommendations, lack of motivation, guideline-specific factors, and environmental factors. Self-reported facilitators consisted of guideline-specific factors. Conclusion Guidelines for the prevention of PC-AKI seem to be widely implemented among radiology practices, and regularly locally modified because of barriers involved in agreement and behavior. Knowledge of the barriers and facilitators of guideline adherence will aid future efforts aimed at bridging the gap between awareness and implementation of evidence-based guidelines in radiology practices.Cardiovascular Aspects of Radiolog

Identification of Gadolinium contrast enhanced regions in MS lesions using brain tissue microstructure information obtained from diffusion and T2 relaxometry MRI

International audienceA multiple sclerosis (MS) lesion at an early stage undergoes active blood brain barrier (BBB) breakdown. Identifying MS lesions in a patient which are undergoing active BBB breakdown is of critical importance for MS burden evaluation and treatment planning. However in non-contrast enhanced structural magnetic resonance imaging (MRI) the regions of the lesion undergoing active BBB breakdown cannot be distinguished from the other parts of the lesion. Hence gadolinium (Gd) contrast enhanced T1-weighted MR images are used for this task. However some side effects of Gd injection into patients have been increasingly reported recently. The BBB breakdown is reflected by the condition of tissue microstructure such as increased inflammation, presence of higher extra-cellular matter and debris. We thus propose a framework to predict enhancing regions in MS lesions using tissue microstructure information derived from T2 relaxometry and diffusion MRI (dMRI) multi-compartment models. We show that combination of the dMRI and T2 relaxometry microstructure information can distinguish the Gd enhancing lesion regions from the other regions in MS lesions