Multimodality Imaging of Helminthic Infections.

Parasitic worms (ie, helminths) encompass a broad spectrum of organisms that lead to a myriad of acute, chronic, and multisystemic disease manifestations rooted in the life cycles of helminths, their migratory paths within humans, and the immunologic reactions they provoke. Although geographic distribution is traditionally given substantial consideration in the process of diagnosing these diseases, increased world travel and migration has resulted in cases all over the world. Because physicians in areas where these organisms are nonendemic are less likely to be familiar with them, the diseases are unexpected, resulting in difficulty and delay in diagnosis and appropriate treatment of patients.

Imaging of the Uterus after Endometrial Ablation.

Endometrial ablation (EA), a therapeutic alternative to hysterectomy for the treatment of excessive uterine bleeding, is increasing in utilization and popularity among gynecologists performing this procedure and women undergoing it. The increase in utilization of this minimally invasive surgery has resulted in the growth of intentional and nonintentional imaging of the postablation uterus. Although routinely performed cross-sectional imaging modalities such as US, CT, and MRI are expected to provide optimal assessment of the post-EA uterus, often the findings are confusing as they overlap with those of other pathologic processes seen in the uterus such as endometrial cancer and adenomyosis, resulting in misinterpretation.

Gastrointestinal oncologic emergencies: a radiologists' guide.

The prevalence of cancer continues to increase both in the United States and worldwide. Oncologic emergencies are potentially life-threatening conditions in cancer patients, and these may be directly or indirectly related to the underlying malignancy. Radiologists must be well-versed not only in cancer staging, but also in potential cancer related complications and emergencies to guide prompt appropriate management.

Oncologic pitfalls and mimics in the abdomen and pelvis.

Oncological imaging in the abdomen and pelvis can be complex. Several imaging pitfalls and mimics of oncology can create diagnostic uncertainty. A pitfall is a malignancy that is missed, either not visualized or misdiagnosed as a benign finding.

US of the Neck beyond the Thyroid Gland: Parathyroid Glands.

Parathyroid imaging in hyperparathyroidism management is not solely to support the diagnosis but also to precisely localize abnormal parathyroid tissue, thus enabling minimally invasive parathyroidectomy. US offers a noninvasive and cost-effective method for identifying and characterizing parathyroid lesions. Common causes include solitary parathyroid adenoma, multiple adenomas, and parathyroid hyperplasia.

Postmortem CT: Applications in Clinical and Forensic Medicine.

Just as radiography has been used in forensic medicine since shortly after the discovery of x-rays in 1895, CT was introduced to postmortem investigation not long after its introduction to medicine in the 1970s. In recent decades, forensic radiology has declared itself as a new subspecialty capable of revolutionizing death investigation and research. A variety of postmortem imaging techniques have emerged.

Renovascular hypertension - a primer for the radiologist.

Renovascular hypertension (RVHT) is an important cause of secondary hypertension, accounting for approximately 75% of cases. This pictorial review describes the imaging modalities used to diagnose RVHT, including ultrasound, computed tomography angiography, and magnetic resonance angiography, provides their benefits and limitations, and explores the imaging findings, diagnostic criteria, and management of multiple causes of RVHT. Atherosclerosis is the most common cause of RVHT, particularly in older individuals, while fibromuscular dysplasia is more prevalent in younger females.

Ultrasound of the Upper Urinary Tract.

Ultrasound (US) plays a primary role in the assessment and diagnosis of renal and ureteral pathologies and their management. It is considered the first-line imaging modality for evaluation of urinary obstruction, nephrolithiasis, and urinary retention among other indications. US is also essential for evaluation of renal vasculature and assessment of renal transplantation.

Residual Ultrasound-Enhancing Agents Mimicking Portal Venous Gas.

Sonographic detection of mobile echogenic foci within the main portal vein and its branches or within the liver parenchyma extending along the portal triads to the periphery of the liver is an alarming finding that has been associated with portal venous gas in the setting of bowel ischemia. Ultrasound-enhancing agents (UEAs) have been widely utilized in abdominal ultrasound for evaluation of organ neoplasms and vascular patency as well as in echocardiography for the evaluation of cardiac function. The appearance of UEAs on abdominal ultrasound can resemble gas like that seen in the portal venous system and liver in patients with bowel ischemia; therefore, UEA residuals should always be a part of the differential diagnosis of echogenic foci when seen on abdominal ultrasounds with preceding recent UEA administration.

Conventional and Contrast-enhanced US of the Lung: From Performance to Diagnosis.

In recent years, lung US has evolved from a marginal tool to an integral component of diagnostic chest imaging. Contrast-enhanced US (CEUS) can improve routine gray-scale imaging of the lung and chest, particularly in diagnosis of peripheral lung diseases (PLDs). Although an underused tool in many centers, and despite inherent limitations in evaluation of central lung disease caused by high acoustic impedance between air and soft tissues, lung CEUS has emerged as a valuable tool in diagnosis of PLDs.

Renal bleeding: imaging and interventions in patients with tumors.

In patients with cancer, spontaneous renal bleeding can stem from a range of underlying factors, necessitating precise diagnostic tools for effective patient management. Benign and malignant renal tumors are among the primary culprits, with angiomyolipomas and renal cell carcinomas being the most common among them. Vascular anomalies, infections, ureteral obstructions, and coagulation disorders can also contribute to renal-related bleeding.

ACR Appropriateness Criteria® Clinically Suspected Adnexal Mass, No Acute Symptoms: 2023 Update.

Asymptomatic adnexal masses are commonly encountered in daily radiology practice. Although the vast majority of these masses are benign, a small subset have a risk of malignancy, which require gynecologic oncology referral for best treatment outcomes. Ultrasound, using a combination of both transabdominal, transvaginal, and duplex Doppler technique can accurately characterize the majority of these lesions.

Ultrasound evaluation of portal venous gas and its mimics.

Portal venous gas on abdominal ultrasound classically represents an indirect indicator of bowel ischemia, a critical condition which poses a high patient mortality and therefore warrants emergent corrective action. While the classic appearance of portal venous gas on ultrasound is well-described in the literature, the characteristic descriptors are nonspecific and may actually represent other less emergent mimics. Therefore, while radiologists should remain vigilant for the detection of findings corresponding to portal venous gas, they should also be aware of similar-appearing entities in order to provide the most accurate diagnosis.

Multimodality Imaging of Postmastectomy Breast Reconstruction Techniques, Complications, and Tumor Recurrence.

For women undergoing mastectomy, breast reconstruction can be performed by using implants or autologous tissue flaps. Mastectomy options include skin- and nipple-sparing techniques. Implant-based reconstruction can be performed with saline or silicone implants.

The Second Mountain: Climbing the Challenges of Midcareer Radiology.

A radiologist's career can be divided into the early, middle, and late phases. The midcareer phase is a particularly difficult period and has the highest rate of burnout among radiologists. Often throughout the early phase of a radiologist's career, during residency, fellowship, and while a junior faculty member, there is an abundance of support to help in personal and professional growth, but this support often wanes as radiologists gain seniority.

Grading Abdominal Trauma: Changes in and Implications of the Revised 2018 AAST-OIS for the Spleen, Liver, and Kidney.

According to the Centers for Disease Control and Prevention, trauma is the leading cause of fatal injuries for Americans aged 1-44 years old and the fourth leading overall cause of death. Accurate and early diagnosis, including grading of solid organ injuries after blunt abdominal trauma (BAT), is crucial to guide management and improve outcomes. The American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) is the most widely accepted BAT scoring system at CT both within the United States and internationally, and its uses include stratification of injury severity, thereby guiding management, and facilitation of clinical research, billing, and coding.

Biliary Duct Dilatation: Expert Panel Narrative Review.

Biliary duct dilatation is a common incidental finding in practice, but it is unlikely to indicate biliary obstruction in the absence of clinical symptoms or elevated levels on liver function tests (LFTs). However, the clinical presentation may be nonspecific, and LFTs may either be unavailable or difficult to interpret. The goal of this Expert Panel Narrative Review is to highlight a series of topics fundamental to the management of biliary duct dilatation, providing consensus recommendations in a question-and-answer format.

Delayed cancer diagnosis in the pregnant patient: navigating a complex medical and ethical dilemma.

Prompt diagnosis of cancer in pregnancy is necessary to ensure timely management and improve outcomes. However, there are a several reasons why diagnosis may be delayed in pregnancy. Three major contributors to delayed diagnosis and treatment are patient delay, provider delay, and referral delay.

Paraneoplastic Syndromes from Head to Toe: Pathophysiology, Imaging Features, and Workup.

Patients often have symptoms due to the mass effect of a neoplasm on surrounding tissues or the development of distant metastases. However, some patients may present with clinical symptoms that are not attributable to direct tumor invasion. In particular, certain tumors may release substances such as hormones or cytokines or trigger an immune cross-reactivity between malignant and normal body cells, resulting in characteristic clinical features that are broadly referred to as paraneoplastic syndromes (PNSs).

Thyroid cancer in pregnancy: diagnosis, management, and treatment.

The evaluation and management of cancer during pregnancy requires special care to assure the health and safety of both the mother and fetus. The diagnosis and treatment of thyroid cancer in the non-pregnant patient often involves radioactive iodine exposure. However, radioactive iodine is contraindicated in pregnancy and surgical interventions pose risks to both the mother and fetus.

Melanoma in pregnancy.

Melanoma is one of the most common types of cancer diagnosed during pregnancy. Patients with advanced disease require frequent staging examinations (e.g.

Imaging evaluation of lymphoma in pregnancy with review of clinical assessment and treatment options.

Lymphoma-related malignancies can be categorized as Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL) based on histologic characteristics. Although quite rare during pregnancy, HL and NHL are the fourth and fifth most common malignancies during the pregnancy period, respectively. Given the rarity of lymphoma among pregnant patients, radiologists are usually unfamiliar with the modifications required for staging and treatment of this population, even those who work at centers with busy obstetrical services.