Abdominal radiology (New York)
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Currently there is a lot of interest in the use of a "biparametric" or "abbreviated" prostate MR protocol, which usually refers to removal of the dynamic contrast-enhanced (DCE) MRI, in the detection of clinically significant prostate cancer. In this article we describe the benefits of DCE as part of the PI-RADS lexicon, with particular reference to its role in PI-RADS V2 category 3 peripheral zone lesions. We also discuss the benefits of triplanar T2-weighted images, and finally discuss how a mpMRI protocol is of benefit in prostate cancer staging, in evaluating for local disease recurrence, and as a biomarker for neoadjuvant therapy response.
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PI-RADS score 3 is recognized as equivocal likelihood of clinically significant prostate cancer (csPCa) occurrence. We aimed to develop a Radiomics machine learning (RML)-based redefining score to screen out csPCa in equivocal PI-RADS score 3 category. ⋯ Our RML models have the potential to predict csPCa in PI-RADS score 3 lesions, thus can inform the decision making process of biopsy.
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Fournier gangrene is an emergency condition that is associated with a high mortality rate. It is defined as a rapidly progressing infective necrotizing fasciitis of the perineal, perianal, and genital regions. Early diagnosis, broad-spectrum antibiotic coverage, and adequate surgical debridement are crucial and lead to better prognosis and patient survival. ⋯ In this pictorial review, we discuss the pathogenesis of Fournier gangrene and display the imaging spectrum with an emphasis on CT findings, including asymmetrical fascial thickening, soft tissue stranding, soft tissue gas, collection, and abscess formation. The infection originating from colorectal pathology, the affected anatomy, and the involvement of the abdominal wall are important predictors of mortality. The familiarity of the varied imaging appearance of Fournier gangrene is necessary to provide an accurate diagnosis, and evaluation of disease extent is crucial for optimal surgical debridement.
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To evaluate the diagnostic performance of histogram analysis of intravoxel incoherent motion (IVIM) parameters for differentiating prostate cancer (PCa) from benign prostatic hyperplasia (BPH), and compare with the monoexponential model, with in-bore MR-guided biopsy as pathological reference. ⋯ Histogram analyses of IVIM and monoexponential model were both useful methods for discriminating PCa from BPH. The diagnostic performance of IVIM model seemed to be not superior to that of monoexponential model. Combination of IVIM and monoexponential model did not add significant information to the single model alone.
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To establish measurement quality criteria for the noninvasive assessment of clinically significant portal hypertension (CSPH) in patients with cirrhosis using CT-based liver surface nodularity (LSN) measurements. ⋯ CT-based LSN measurement is highly reproducible and accurate. We suggest using at least 8 valid measurements to determine the mean LSN value for the detection of CSPH.