Current Medical Imaging - Volume 19, Issue 14, 2023

As a convenient and non-invasive diagnostic method, computed tomography (CT) has been developing continuously, and dual-energy CT imaging is one of its current research hotspots. Dualenergy CT, using two different X-ray energies for imaging, can generate spectral image sets such as virtual monoenergetic images, virtual non-contrast images, iodine density images, uric acid images, calcium inhibition images, and effective atomic number images. These images could help to increase the contrast of vascular, improve the detection rate of lesions, reduce artifacts, reduce the dose of radiation, and characterize materials. Dual-layer spectral detector CT, a detector-based dual-energy scanning device, has an X-ray tube and a dual-layer X-ray detector that can simultaneously separate lowenergy and high-energy photons from a multi-energy X-ray beam, which means excellent time registration. This paper aims to introduce the applications of dual-layer spectral detector CT in abdominal angiography, including optimizing image quality, reducing the dose of contrast agent and radiation, providing richer diagnostic information, organ perfusion, and thrombus identification.

Coronavirus (COVID-19) is a global pandemic with over 600 million cases identified. In addition to extensive pulmonary complications of COVID-19, one feature unique to many patients with severe COVID-19 infections is coagulopathy with a rising prevalence of multi-systemic thromboembolic manifestations. Global data suggests a relationship between coagulopathy and mortality. In this review, we highlight multiple COVID-19 thromboembolic complications with emphasis on pathophysiology, clinical management, and radiological manifestations.

Osteoarthritis (OA) is a bone disease that mainly affects the cartilage. Even though there are many diseases that are commonly noticed in bones, one of the most dangerous diseases is OA. The breakdown of the cartilage bone is the cause of OA. According to the survey given by the National Institute on Aging, it is revealed that most of the people in their old age are at the very advanced stage of OA. X-ray is the common imaging modality for analysing the severity of Osteoarthritis. When needed for advanced level of investigation, MRI scans and thermal images are also initialized. There are numerous methods for the analysis of OA from different modalities in the very early stage. These methods may be semi-automatic and automatic. But all the developed algorithms gave results based on the space width, and texture feature only and didn’t provide any quantitative analysis based on any standard parameters. The main aim of this work is to present major research challenges in different OA detection methods, discuss different machine learning-based OA detection methods and analyse their performance. The research gap in the existing methods such as an empirical model for the detection of OA and the standard parameters for the measurement of bone marrow is discussed in the proposed paper.

Purpose: Breast cancer is fatal if it is not diagnosed and treated promptly; consequently, early and precise diagnosis is essential. In comparison to mammography and sonography, the sensitivity of MRI to cellular changes and its ability to differentiate benign from malignant tumors make it the preferred imaging technique. Consequently, the present meta-analysis assessed the effectiveness of different imaging modalities for breast cancer detection and evaluated the diagnostic accuracy of MRI. Methods: Pertinent articles were searched in PubMed, MEDLINE, and Central databases using the appropriate keywords as per the PRISMA guidelines. Retrospective and prospective studies were included according to the predefined PICOS criteria. A meta-analysis was performed using RevMan and MedCalc software, and statistical parameters, such as odds ratio, sensitivity, specificity, likelihood ratios, and accuracy, were calculated. Publication bias was evaluated using Egger’s and Begg’s tests, and diagnostic performance was assessed using Youden’s and Bland-Altman's plots. Results: Fourteen clinical trials with 4666 breast cancer patients with perineural spread were included. The included studies used MRI for the detection of breast cancer lesions according to the BI-RADS® (Breast Imaging Reporting and Data System) guidelines and stated that it has high sensitivity and diagnostic accuracy. Similarly, the present meta-analysis found a high sensitivity of 86.12 % and a high diagnostic accuracy of 91.2%. Other than this, we obtained a specificity of 65%, a positive likelihood ratio of 2.7, and a negative likelihood ratio of 0.22. The pooled odds ratio (OR) was reported to be 1.87 (95% CI 1.42-2.46), and the pooled risk ratio value was 1.19 (95% CI 1.11-1.28). Conclusion: Present meta-analysis strongly recommends MRI as an effective imaging method for the detection of breast cancer.

Background: One of the neurodevelopmental disorders widely affecting school-aged children in recent years is attention deficit hyperactivity disorder (ADHD). In many neurodevelopmental disorders, grey matter may be used as a clinical indicator by looking at MRIs. Objective: The study aimed to segment grey matter from brain MRI using a proposed fuzzy c-means clustering-based technique for the detection of ADHD and its subtypes (ADHD-Inattentive, ADHDHyperactive, and ADHD-Combined). The grey matter volume, age, gender, and medication status of the subjects were investigated to identify ADHD subtypes. Methods: A modified fuzzy c-means with an elbow approach has been proposed to overcome the drawbacks of previous fuzzy c-means methods and improve segmentation performance. The volume of segmented grey matter was included with the phenotypic information of the ADHD-200 dataset for data analysis of typically developing (TD) and ADHD subtypes. Results: The proposed segmentation exhibited a dice similarity index of 95%. ADHD-Inattentive exhibited a loss of grey matter in the prefrontal cortex, while ADHD-hyperactive exhibited a loss of grey matter in the cerebellum when compared to TD. The analysis of ADHD subtypes based on age and gender showed that children transitioning to adolescence are mostly affected by ADHD-inattentive and female kids are less prone to ADHD-hyperactive. The whole grey matter volume of ADHD-inattentive children, on average, was found to be approximately 4% less than ADHD-combined. Furthermore, the whole grey matter volume was less in non-medication naive children. Conclusion: This study may support healthcare providers in giving appropriate occupational therapy based on the identification of different ADHD subtypes.

Objective: The presence of gastroparesis in patients with dyspepsia can be evaluated by gastric emptying scintigraphy. We aimed to evaluate gastroparesis with optimal solid gastric emptying scintigraphy and suboptimal liquid gastric emptying scintigraphy in euthyroid goiter patients with dyspepsia. Methods: We included 67 patients diagnosed with euthyroid goiter with dyspepsia complaints. The patients did not use any medication and did not have any other chronic diseases. Solid and liquid gastric emptying scintigraphy was performed on all patients. In our retrospective study; the images were reevaluated. The region of interest was plotted on the area compatible with the stomach and timeactivity curves were obtained. The correlation of solid and liquid gastric emptying test results was evaluated. Results: Twelve (18%) of the patients were male and the mean age of the patients was 64 (49-75). There is a correlation between solid and liquid gastric emptying scintigraphy (p< 0.0005, r: 0.0880). Solid gastric emptying time was prolonged in 27 patients (40%). Liquid gastric emptying was prolonged in 23 patients (34%). Solid gastric emptying was also prolonged in all patients with prolonged liquid gastric emptying. Conclusion: According to the results of the optimal gastric emptying test performed with radio-labeled solid food. The rate of gastroparesis was low in our patient group with dyspepsia complaints. However, there is a correlation between the optimal test and suboptimal gastric emptying test results in our patient group. Liquid gastric emptying scintigraphy may be preferred in specific patient groups in case of suspected gastroparesis because of its easy application and short duration.

Background: A routine ultrasound scan is used to assess a variety of renal pathological cases. Sonographers face a variety of challenges that may affect their interpretation. Understanding normal organ shapes, human anatomy, physical concepts, and artifacts is required for accurate diagnosis. Sonographers must understand how artifacts appear in ultrasound images in order to reduce errors and improve diagnosis. The purpose of this study is to assess sonographers' awareness and knowledge of artifacts in renal ultrasound scans. Methods: Participants in this cross-sectional study were asked to complete a survey containing different types of common artifacts in renal system ultrasound scans. An online questionnaire survey was used to collect the data. The questionnaire targeted radiologists, radiologic technologists, and intern students in Madinah hospitals in the ultrasound department. Results: The total number of participants was 99, with 9.1% being radiologists, 31.3% being radiology technologists, 6.1% being senior specialists, and 53.5% being intern students. There was a significant difference in the participants’ knowledge of ultrasound artifacts in the renal system with the total selection of the right artifact in senior specialists at 73% and intern students 45%. There was a direct relationship between age and years of experience in distinguishing artifacts in the renal system scan. A category of participants with the highest age and experience got 92% of the correct selection of artifacts. Conclusion: The study concluded that intern students and radiology technologists have limited knowledge of ultrasound scan artifacts, whereas senior specialists and radiologists have a high level of awareness of the artifacts.

Background: The ultrasound imaging findings and clinical treatment procedure of a case of fibrolipomatous hamartoma of the median nerve are reported in this paper. The disease diagnosis was mainly dependent on magnetic resonance, and rarely described by ultrasound. This paper introduces the imaging manifestations of median neurofibromatoid hamartoma under ultrasound. Case Presentation: This case is a middle-aged female with pituitary adenoma. Fibrolipomatous hamartoma, as a rare benign fibrofatty tumor, is characterized by the slow proliferation of mature adipocytes and fibrous tissue around and inside the peripheral nerves, eventually leading to the fusiform enlargement of nerve fiber bundles. Disscussion: This paper discusses the value and application of color doppler ultrasound in the diagnosis of FLH to provide a reference for the clinical diagnosis and treatment of this disease in the future and reviews the literature on this disease. Conclusion: Because fibrolipomatous hamartoma is very rare, it is very important to improve the understanding and diagnosis of this disease.

Introduction: Pediatric pituitary adenomas are rare, resulting in a limited amount of literature on these patients. The incidence of calcification in adult patients with pituitary adenomas is only 0.2% to 8%, while the incidence of calcification in children has not been reported. Case Report: In this paper, we report a 10-year-old girl with a calcified pituitary adenoma. Laboratory examination showed the growth hormone (GH) to be more than 50ug/L, and pituitary prolactin (PRL) was 27.42 ng/mL. Non-contrast-enhanced computed tomography (CT) scans indicated a large sellar occupation with multiple nodules of calcification. Subsequently, the patient underwent a transcranial resection. Histopathologic evaluation confirmed the diagnosis of pituitary adenoma with multiple calcifications. Conclusion: Since the management and prognosis of adenomas with calcification from other occupations of the pituitary gland differ significantly, it is important to differentiate between the two.

Background: Transcatheter arterial chemoembolization (TACE) is an effective treatment for hepatocellular carcinoma (HCC), however, the complications of TACE have gradually become a concern of clinicians. Injury to the bile duct has been the focus of many scholars. Case Presentation: HCC was diagnosed in a 51-year-old female patient, and the first TACE was performed on April 10, 2020. The second TACE was performed on October 18, 2021. After the second TACE, The patient suffered from nausea, jaundice, and body itching. Computed tomography (CT) of the abdomen showed that the lower common bile duct was obviously blocked by the solidified lipiodol accompanied by dilatation of intrahepatic and extrahepatic bile ducts on October 27, 2021. Endoscopic retrograde cholangiopancretography (ERCP) and endoscopic nasobiliary drainage (ENBD) were performed on October 29, 2021. The deposition of lipiodol in the common bile duct was significantly reduced. Conclusion: After the transcatheter arterial chemoembolization for hepatocellular carcinoma, we should be on alert for damage to the bile duct, and pay attention to the deposition of lipiodol in the common bile duct.