Role of MRI in early follow-up of patients with solid organ injuries: How and why we do it?

Iacobellis, Francesca; Serafino, Marco Di; Brillantino, Antonio; Mottola, Arianna; Giudice, S; Stavolo, Ciro; Festa, Patrizio; Patlas, Michael N.; Scaglione, Mariano; Romano, Luigia

doi:10.1007/s11547-021-01394-0

Cited by 19 publications

(18 citation statements)

References 35 publications

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“…5 By contrast, MR imaging exhibits superior soft-tissue contrast resolution and ability to identify intrauterine blood products and is a highly accurate imaging modality that can be used to identify placental abruption with sensitivity and specificity reported at near 100%. 13,14 Findings of placental abruption on MR imaging include a hematoma located along the placental margin (i.e, subchorionic; the most common location), centrally (retroplacental), or within the placental itself (intraplacental). 5,10 Hemorrhage can also be identified as layering dependently within the amniotic cavity itself 7 (Figure 1).…”

Section: Magnetic Resonance Assessment Of the Pregnant Trauma Patientmentioning

confidence: 99%

The Role of Magnetic Resonance in Evaluating Abdominopelvic Trauma - Part 2: Trauma in Pregnancy, Vascular, and Genitourinary Injuries

Rajput

Mellnick

2022

Can Assoc Radiol J

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Trauma is an important cause of mortality, particularly in the young. While computed tomography (CT) is the mainstay of body imaging in the setting of trauma, magnetic resonance (MR) imaging can be useful in stable patients. Although more commonly used in spinal and musculoskeletal trauma, MR also has a role in abdominopelvic trauma. Broadly, its uses include clarification of equivocal cases, monitoring complications of trauma, particularly with solid organ injury, or as a primary imaging modality for patients with low suspicion for injury for whom avoiding ionizing radiation is a priority—namely, in pediatric and pregnant patients. In this two-part review article, we will review clinical scenarios where this may be encountered, utilizing case examples. Our second installment will focus on the use of MR in pregnant patients and in the characterization of vascular and genitourinary trauma. Body MR can be useful in pregnant patients in characterizing injuries both specific for and not specific for pregnancy. Placental injuries and hematomas in particular may be better seen on MR relative to CT, owing to its superior contrast resolution. MR angiography can be performed either without or with contrast and can be useful to monitor low-grade traumatic aortic injuries. Renal and ureteral injuries can be followed with MR to help identify urine leaks, either in a delayed presentation or in patients who have an iodinated contrast allergy. Lastly, penile injuries are often imaged with ultrasound, but may benefit from additional imaging with MR when the tunica albuginea cannot be completely seen due to overlying hematoma.

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Section: Magnetic Resonance Assessment Of the Pregnant Trauma Patientmentioning

confidence: 99%

The Role of Magnetic Resonance in Evaluating Abdominopelvic Trauma - Part 2: Trauma in Pregnancy, Vascular, and Genitourinary Injuries

Rajput

Mellnick

2022

Can Assoc Radiol J

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“…Furthermore, in recent years a more conservative approach for traumatic injuries of parenchymatous organs has been encouraged; at present, non-operative management is considered the standard treatment [ 6 , 7 ]. Consequently, this has led to an increased number of imaging studies to monitor the healing of lesions [ 8 , 9 ]. Due to the invasiveness associated with the use of intravenous contrast medium and ionizing radiation, MDCT is not the preferred follow-up imaging method for hemodynamically stable patients or isolated, blunt, moderate-energy abdominal trauma.…”

Section: Introductionmentioning

confidence: 99%

The Technique and Advantages of Contrast-Enhanced Ultrasound in the Diagnosis and Follow-Up of Traumatic Abdomen Solid Organ Injuries

et al. 2022

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Trauma is one of the most common causes of death or permanent disability in young people, so a timely diagnostic approach is crucial. In polytrauma patients, CEUS (contrast enhanced ultrasound) has been shown to be more sensitive than US (ultrasound) for the detection of solid organ injuries, improving the identification and grading of traumatic abdominal lesions with levels of sensitivity and specificity similar to those seen with MDCT (multidetector tomography). CEUS is recommended for the diagnostic evaluation of hemodynamically stable patients with isolated blunt moderate-energy abdominal traumas and the diagnostic follow-up of conservatively managed abdominal traumas. In this pictorial review, we illustrate the advantages and disadvantages of CEUS and the procedure details with tips and tricks during the investigation of blunt moderate-energy abdominal trauma as well as during follow-up in non-operative management.

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“…Imaging plays a major role in the management of HCC from screening to post-therapy follow-up [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. In particular, ultrasonography (US) is the method of choice for tumor screening, while the role of computed tomography (CT) and magnetic resonance imaging (MRI) for HCC diagnosis and post-treatment assessment is largely consolidated in clinical practice [ 3 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ].…”

Section: Introductionmentioning

confidence: 99%

A Narrative Review on LI-RADS Algorithm in Liver Tumors: Prospects and Pitfalls

et al. 2022

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Liver cancer is the sixth most detected tumor and the third leading cause of tumor death worldwide. Hepatocellular carcinoma (HCC) is the most common primary liver malignancy with specific risk factors and a targeted population. Imaging plays a major role in the management of HCC from screening to post-therapy follow-up. In order to optimize the diagnostic-therapeutic management and using a universal report, which allows more effective communication among the multidisciplinary team, several classification systems have been proposed over time, and LI-RADS is the most utilized. Currently, LI-RADS comprises four algorithms addressing screening and surveillance, diagnosis on computed tomography (CT)/magnetic resonance imaging (MRI), diagnosis on contrast-enhanced ultrasound (CEUS) and treatment response on CT/MRI. The algorithm allows guiding the radiologist through a stepwise process of assigning a category to a liver observation, recognizing both major and ancillary features. This process allows for characterizing liver lesions and assessing treatment. In this review, we highlighted both major and ancillary features that could define HCC. The distinctive dynamic vascular pattern of arterial hyperenhancement followed by washout in the portal-venous phase is the key hallmark of HCC, with a specificity value close to 100%. However, the sensitivity value of these combined criteria is inadequate. Recent evidence has proven that liver-specific contrast could be an important tool not only in increasing sensitivity but also in diagnosis as a major criterion. Although LI-RADS emerges as an essential instrument to support the management of liver tumors, still many improvements are needed to overcome the current limitations. In particular, features that may clearly distinguish HCC from cholangiocarcinoma (CCA) and combined HCC-CCA lesions and the assessment after locoregional radiation-based therapy are still fields of research.

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Role of MRI in early follow-up of patients with solid organ injuries: How and why we do it?

Cited by 19 publications

References 35 publications

The Role of Magnetic Resonance in Evaluating Abdominopelvic Trauma - Part 2: Trauma in Pregnancy, Vascular, and Genitourinary Injuries

The Role of Magnetic Resonance in Evaluating Abdominopelvic Trauma - Part 2: Trauma in Pregnancy, Vascular, and Genitourinary Injuries

The Technique and Advantages of Contrast-Enhanced Ultrasound in the Diagnosis and Follow-Up of Traumatic Abdomen Solid Organ Injuries

A Narrative Review on LI-RADS Algorithm in Liver Tumors: Prospects and Pitfalls

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