Radiology
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To prospectively compare the diagnostic accuracy of steady-state, high-spatial-resolution magnetic resonance (MR) angiography of the lower leg, performed with a blood pool contrast agent, with selective digital subtraction angiography (DSA) as the reference standard in patients with symptomatic peripheral arterial disease. ⋯ MR angiography performed with blood pool agents has an accuracy comparable with that of selective DSA in the lower leg but with less risk involved. Steady-state imaging performed with blood pool agents facilitates evaluation of MR angiography of infrapopliteal arteries.
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Pulmonary nodule characterization is currently being redefined as new clinical, radiologic, and pathologic data are reported, necessitating a reevaluation of the clinical management, especially of subsolid nodules. These are now known to frequently, although not invariably, fall into the spectrum of peripheral adenocarcinomas of the lung. Strong correlation between the Noguchi histologic classification and computed tomographic (CT) appearances of these lesions, in particular, has been reported. ⋯ As a consequence, recognition of the potential association between subsolid nodules and peripheral adenocarcinomas requires a review of current guidelines for the management of these lesions, further necessitated by a differential diagnosis that includes benign lesions such as focal inflammation, focal fibrosis, and organizing pneumonia. Specific issues that need to be addressed are the need for consensus regarding an appropriate CT classification, methods for precise measurement of subsolid nodules, including the extent of both ground-glass and solid components, as well as accurate assessment of the growth rates as means for predicting malignancy and prognosis. It is anticipated that interim guidelines may serve to standardize our current management of these lesions, pending further clarification of their natural history.
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Multicenter Study
Nephrogenic systemic fibrosis: change in incidence following a switch in gadolinium agents and adoption of a gadolinium policy--report from two U.S. universities.
To determine the incidence of nephrogenic systemic fibrosis (NSF) in tertiary care centers of two U.S. universities following the switch from the use of gadodiamide to gadobenate dimeglumine and gadopentetate dimeglumine, and the adoption of restrictive gadolinium-based contrast agent (GBCA) policies. ⋯ Following the switch from gadodiamide to gadobenate dimeglumine and gadopentetate dimeglumine, and the adoption of restrictive GBCA policies, no NSF cases were observed at either center.
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To analyze and compare computed tomographic (CT) bronchial measurements in patients with asthma and healthy subjects and to correlate bronchial morphometric parameters with functional data and immunohistologic markers of airway remodeling and inflammation. ⋯ Axial reconstructions with orthogonal measurements along the airways enabled by three-dimensional segmentation methods are able to demonstrate significant changes in bronchial morphometry, predicting airflow limitation in asthma, and may have a role in the noninvasive measurement of airway remodeling.
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To investigate whether default mode network (DMN) spatial properties can be directly affected by pain, with a comparison of painful and nonpainful conditions. ⋯ Study findings were in line with the impairments of the DMN reported in patients with chronic pain. They support the hypothesis that alteration of the DMN connectivity pattern localized in specific brain areas during acute pain, if repeated across time, might induce permanent changes that could disrupt the DMN functional architecture.