• Hepatic angiosarcoma manifests on CT and MR as rapidly progressive multifocal tumours • Multiphasic imaging demonstrates hypervascular foci that progressively expand and follow blood pool • Enhancement pattern can resemble cavernous haemangiomas or show a "reverse" centrifugal pattern • Lack of tumour washout of hypervascular lesions argues against multifocal hepatocellular carcinoma • Careful assessment of the cross-sectional imaging findings may suggest the diagnosis.
The pregnant trauma patient presents an important and challenging encounter for the clinical team and radiologist. In this article, we present several key aspects of the imaging workup of pregnant trauma patients, beginning with a review of the modalities that are used in this setting. Ultrasonography plays an important role in initial evaluation of the fetus but a limited role in evaluation of maternal injuries. Given that conventional radiography and computed tomography are the "workhorse" modalities for evaluation of pregnant trauma patients, radiologists must pay particular attention to radiation dose concerns. Magnetic resonance imaging can be used after the initial evaluation and for follow-up imaging, and safety concerns related to its use in pregnant patients are addressed. At imaging interpretation, radiologists must contend not only with the typical spectrum of injuries that can be seen in any trauma patient but also with pregnancy-specific injuries, such as placental abruption and uterine rupture. Particularly unusual situations, such as a ruptured ectopic pregnancy in a trauma patient, are presented. Although pregnant trauma patients are infrequently encountered, familiarity with imaging findings of injuries in these patients is essential to providing the best care for the mother and fetus.
Our study shows that microwave ablation of peridiaphragmatic hepatic tumors is safe, without incidence of diaphragmatic hernia, and can be performed with a low rate of local tumor progression.
Objective
To prospectively compare reduced-dose (RD) CT colonography (CTC) with standard-dose (SD) imaging using several reconstruction algorithms.
Methods
Following SD supine CTC, 40 patients (mean age, 57.3 years; 17 M/23 F, mean BMI, 27.2) underwent an additional RD supine examination (targeted dose reduction, 70–90%). DLP, CTDIvol, effective dose, and SSDE were compared. Several reconstruction algorithms were applied to RD series. SD-FBP served as reference standard. Objective image noise, subjective image quality and polyp conspicuity were assessed.
Results
Mean CTDIvol and effective dose for RD series was 0.89 mGy (median 0.65) and 0.6 mSv (median 0.44), compared with 3.8 mGy (median 3.1) and 2.8 mSv (median 2.3) for SD series, respectively. Mean dose reduction was 78%. Mean image noise was significantly reduced on RD-PICCS (24.3±19HU) and RD-MBIR (19±18HU) compared with RD-FBP (90±33), RD-ASIR (72±27) and SD-FBP (47±14 HU). 2D image quality score was higher with RD-PICCS, RD-MBIR, and SD-FBP (2.7±0.4/2.8±0.4/2.9±0.6) compared with RD-FBP (1.5±0.4) and RD-ASIR (1.8±0.44). A similar trend was seen with 3D image quality scores. Polyp conspicuity scores were similar between SD-FBP/RD-PICCS/RD-MBIR (3.5±0.6/3.2±0.8/3.3±0.6).
Conclusion
Sub-milliSievert CTC performed with iterative reconstruction techniques demonstrate decreased image quality compared to SD, but improved image quality compared to RD images reconstructed with FBP.
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