Polyarteritis nodosa: An educational review
|
|
- Samuel Perry
- 5 years ago
- Views:
Transcription
1 Polyarteritis nodosa: An educational review Poster No.: C-3162 Congress: ECR 2010 Type: Educational Exhibit Topic: Vascular Authors: D. T. O Driscoll; Dublin/IE Keywords: polyarteritis nodosa, angiography, vasculitis DOI: /ecr2010/C-3162 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 18
2 Learning objectives 1. Review the pathophysiology of Polyarteritis Nodosa (PAN). 2. Illustrate the common imaging manifestations of Polyarteritis Nodosa. 3. Provide examples of mimics of Polyarteritis Nodosa emphasising the challenge this diagnosis presents to radiologists. Background Polyarteritis nodosa (PAN) is one of a spectrum of diseases that belongs to the pathologic category of necrotizing vasculitis. PAN is characterized by the presence of inflammatory reactions of blood vessels of medium or small caliber that lead to necrosis and destruction of the walls of vessels. The diagnosis is ideally made by means of biopsy of involved tissue in a patient with the appropriate clinical symptoms and laboratory data, but an angiogram provides the proof in some cases. Most patients with PAN have positive angiographic evidence of their disease, predominantly in the visceral arteries but also in arteries of the extremities and in small branches of the aorta. The most well-known angiographic feature is the presence of so-called microaneurysms in medium or small arteries. Arterial occlusive lesions are also a feature. In this poster, the epidemiology, pathology, clinical features, and diagnosis of PAN are presented. In addition, some of the commonest imaging features and other pathologies with image findings which mimic PAN are discussed. PAN occurs twice as frequently in men as in women, and it is found in all age groups but most commonly in the 5th-7th decades. The estimated annual frequency ranges from four to nine per million people in the general population to more than 70 per million people in the population of patients with hepatitis B virus (1). In studies reported from France (2,3), the percentage of cases of PAN attributed to hepatitis B viral infection decreased from 36% to 7% during the past decade after the development of vaccines against viral hepatitis. The cause of PAN is unknown for most patients. Viruses play a role in the pathogenesis in some cases, most notably hepatitis B virus (4,5) but also human immunodeficiency virus (6,7). PAN is a focal panmural necrotizing vasculitis in small and medium sized arteries Page 2 of 18
3 (and sometimes small veins) that can involve any organ and in varying degrees. The primary abnormal changes of the involved vessel consist of fibrinoid or hyaline necrosis of the media with simultaneous or subsequent involvement of the intima and adventitia. Secondary changes include aneurysm formation, hemorrhage, and thrombosis. The kidneys may be involved in 70%-80% of cases; the gastrointestinal tract, peripheral nerves, and skin in 50%; skeletal muscles and mesentery in 30%; and the central nervous system in 10% (8). Imaging findings OR Procedure details Recognition of PAN can be a clinical challenge given its varied spectrum of organ involvement, wide range of clinical symptoms, and variations in severity. The clinical course lasts several months to more than a year. Relapse occurs in 40% of treated patients, with a median interval of 33 months (9). The disease may be fulminant; if untreated, the 5-year survival is less than 15%. Survival increases to 80% with steroid treatment, with or without cytotoxic drugs (10,11). Most tests are nonspecific, although the erythrocyte sedimentation rate is usually elevated. Fever, malaise, and weight loss are common. Many of the clinical symptoms are related to organ ischemia secondary to arterial branch occlusions. Aneurysm rupture is a less common cause of pain. Arthralgias are noted in 50% of patients as are peripheral neuropathies (mononeuritis multiplex), which are often symptomatic early. Renal involvement including proteinuria and hypertension are found in 75% (12). Branch vessel occlusions can lead to multiple renal infarcts. Abdominal pain from ischemia or infarction secondary to occlusive lesions is the most common gastrointestinal complaint. Abdominal pain may also be caused by rupture of an aneurysm in one of the viscera: liver, kidney, or mesentery (13). Cutaneous lesions include palpable purpura, infections, and ischemic ulcers. Muscle pain and limb claudication may occur. The diagnostic criteria of PAN have been classified by the American College of Rheumatology (14). Three of the 10 criteria must be present for the diagnosis of PAN. A positive angiogram with typical findings is one of the 10 criteria. A definitive diagnosis may be made in certain clinical settings by performing tissue biopsy from a symptomatic organ site, but sampling errors and lack of disease specificity may be problematic. The role of angiography is to help confirm or support the clinical impression when a suitable biopsy site is lacking or when the biopsy results are inconclusive. In patients with generalized systemic symptoms-especially abdominal complaints, nephropathy, hypertension, or generalized malaise-angiography is a valuable diagnostic tool that can lead to the diagnosis in occult cases. High-spatial-resolution angiographic technique is important for maximizing the diagnostic potential of the procedure. The diagnostic features of PAN, such as minimal luminal irregularity or narrowing, are difficult to detect on suboptimal studies. Aneurysms may be small, difficult to detect, few in number, or isolated Page 3 of 18
4 to one organ. A complete angiographic study of the abdomen should be considered to help detect occult aneurysms. Angiographic findings are present in about 40%-90% of patients at the time clinical symptoms appear (15) and include: Aneurysms Ectasia Occlusive disease The true frequency of PAN is difficult to determine because of the nonspecificity of angiographic findings and sampling bias. Other diseases, including rheumatoid vasculitis, systemic lupus erythematosus, and Churg-Strauss syndrome, may have similar angiographic findings of aneurysms and occlusive lesions (16). Drug abuse is another accepted cause of multiple microaneurysms in various organs. Citron et al. (17) reported that the diverse clinicopathologic syndrome and angiographic findings of necrotizing angiitis associated with drug abuse were strikingly similar to those of polyarteritis nodosa with severe renal, gastrointestinal, cardiac, and neurologic involvement. Other vasculitides, such as Wegener's granulomatosis have also been reported in the literature to have multiple aneurysms similar to those of polyarteritis nodosa (18). Findings of multiple, small-sized aneurysms on angiography are pathognomonic for PAN. The aneuryms are usually multiple (most often 10 or more in any one visceral circulation) and 2-5 mm, commonly affecting the branch points of arteries. The kidney is the most frequently affected organ. Depending on the vessels involved, renal polyarteritis nodosa may present clinically as acute or chronic renal failure or nephrotic syndrome or may be manifested by perirenal hemorrhage. With renal complications, hypertension often develops rapidly. Two characteristic lesions have been described in polyarteritis nodosa when the kidney is involved: they may occur separately or together (19): Arteritis. Glomerulitis. The arteritis primarily involves the arcuate vessels and consists of fibrinoid necrosis and vascular thrombosis. Thus, multiple small renal infarcts are a prominent feature. The aneurysm, forming as a result of focal necrosis of the vessel wall, may undergo necrosis and healing with fibrosis, but occasionally will rupture and produce perirenal and retroperitoneal hemorrhage (19). Approximately one half to two thirds of patients with polyarteritis nodosa have abdominal pain, nausea, vomiting, or other gastrointestinal symptoms. The gastrointestinal lesions may take the form of ulceration, perforation, hemorrhage, or infarct and produce corresponding symptoms: Page 4 of 18
5 Gastrointestinal hemorrhage occurs in roughly 6% of cases. Bowel perforation in 5%. Bowel infarction in 1% (20,21). In the gastrointestinal tract, the jejunum appears to be most commonly involved. Generally, when the aneurysms involve the mesenteric arteries, their number and size are fewer and smaller compared with those of the kidney and liver (22). The infarcted bowel progresses into either bowel perforation or bowel obstruction caused by stricture. In addition to the genitourinary and gastrointestinal tracts, any organ in the abdomen can be involved -the liver is the most common. The vascular changes in the liver result in: Aneurysm formation. Rupture of aneurysm. Infarction. Interstitial hepatitis. Liver cirrhosis. Although the liver is commonly involved, there are few clinical signs or symptoms suggesting hepatic involvement (22). The cystic arteries are also a frequent site of developing arteritis, and subsequent acalculous cholecystitis and intracholecystic hemorrhage have been reported (23). Page 5 of 18
6 Fig.: 1. Occlusive disease in PAN. Selective right renal angiogram obtained in the arterial phase shows partial obliteration, or pruning, of the renal arteries distally. Page 6 of 18
7 Fig.: 2. Occlusive disease in PAN. Selective right renal angiogram obtained in the parenchymal phase showing multiple microaneurysms and a right lower pole infarct. Page 7 of 18
8 Fig.: 3. Diffuse involvement of the abdominal visceral arteries with PAN. Angiogram shoes multiple aneurysms of the coeliac trunk and its peripheral branches. Page 8 of 18
9 Fig.: 4. Diffuse involvement of the abdominal visceral arteries with PAN. Angiogram depicts extensive fusiform aneurysms of the superior mesenteric artery and one large saccular aneurysm of the accessory right hepatic artery. Page 9 of 18
10 Fig.: 5. Diffuse involvement of the abdominal visceral arteries with PAN. Angiogram depicts the coeliac trunk and pancreaticoduodenal arcade with extensive small fusiform microaneurysms. Page 10 of 18
11 Fig.: 6. Superior mesenteric artery involvement in PAN. Superior mesenteric artery angiogram shows multiple microaneurysms in peripheral branches of the superior mesenteric artery. Page 11 of 18
12 Fig.: 7. Superior mesenteric artery involvement in PAN. Superior mesenteric arteriogram shows multiple microaneurysms in a jejunal branch of the superior mesenteric artery. Page 12 of 18
13 Fig.: 8. Segmental arteriolar mediolysis. Multiple microaneurysms in the superior mesenteric artery (biopsy proven to be SAM) mimicking PAN. Page 13 of 18
14 Fig.: 9. Fibromuscular Dysplasia (a,b). Nonselective renal angiogram depicting classical FMD (a,b). Page 14 of 18
15 Fig.: 9. Fibromuscular Dysplasia (a,b). Nonselective renal angiogram depicting classical FMD (a,b). Conclusion As seen in this review of the spectrum of imaging findings in PAN, a variety of arterial beds may be affected and a variety of lesions may be seen. The clinical diagnosis of polyarteritis nodosa is usually made on the basis of various symptoms and signs of: abdominal pain. hypertension. arthralgia or arthritis. peripheral and central nervous system dysfunction. retinopathy. Page 15 of 18
16 cardiac involvement. respiratory involvement. hepatic involvement (24). Such protean clinical manifestations frequently present a diagnostic challenge. Findings of multiple, small-sized aneurysms on angiography are virtually pathognomonic for PAN. While the presence of aneurysms increases the specificity of the diagnosis of PAN, in their absence other arterial lesions such as luminal irregularities, stenoses, and occlusions can suggest the diagnosis. In a patient without fulminant disease but in whom clinical suspicion is firm, comprehensive angiography may lead to the diagnosis of PAN on the basis of the constellation of angiographic findings. Without angiography, the correct diagnosis is established only by obtaining a biopsy of subcutaneous nodules or skeletal muscle; however, the diagnostic success rate of the biopsy has been disappointing (20-35%) (25). Therefore, a negative biopsy does not rule out the condition. In summary, the possibility of vasculitis should be considered when multiple abdominal organs have abnormal radiologic findings; however, angiography is necessary (in the absence of a positive biopsy) for establishing a specific diagnosis of polyarteritis nodosa. Personal Information D. O Driscoll, Department of Radiology, St. James Hospital, Dublin 8, Ireland. References 1.Conn DL. Polyarteritis. Rheum Dis Clin North Am 1990; 16: Guillevin L, Le THD, Godeau P, Jais P, Wechsler B. Clinical findings and prognosis of polyarteritis nodosa and Churg-Strauss angiitis: a study in 165 patients. Br J Rheumatol 1988; 27: Guillevin L, Lhote F, Cohen P, et al. Polyarteritis nodosa related to hepatitis B virus: a prospective study with long-term observation of 41 patients. Medicine (Baltimore) 1995; 74: Page 16 of 18
17 4.Gocke DJ, Hsu K, Morgan C, Bombardieri S, Lockshin M, Christian CL. Association between polyarteritis and Australia antigen. Lancet 1970; 2: Fisher RG, Graham DY, Granmayeh M, Trabanino JG. Polyarteritis nodosa and hepatitis-b surface antigen: role of angiography in diagnosis. AJR Am J Roentgenol 1977; 129: Bardin T, Gaudouen C, Kuntz D, et al. Necrotizing vasculitis in human immunodeficiency virus infection (abstr). Arthritis Rheum 1987; 30:S Libman BS, Quismorio FP, Jr, Stimmler MM. Polyarteritis nodosa-like vasculitis in human immunodeficiency virus infection. J Rheumatol 1995; 22: Wold LE, Baggenstoss AH. Gastrointestinal lesions of periarteritis nodosa. Proc Staff Meeting Mayo Clin 1949; 24: Gordon M, Luqmani RA, Adu D, et al. Relapses in patients with a systemic vasculitis. Q J Med 1993; 86: Guillevin L, Jarrousse B, Lok C, et al. Long-term follow-up after treatment of PAN and Churg-Strauss angiitis with comparison of steroids, plasma exchange and cyclophosphamide to steroids and plasma exchange: a prospective randomized trial of 71 patients. J Rheumatol 1991; 18: Guillevin L, Fain O, Lhote F, et al. Lack of superiority of steroids plus plasma exchange to steroids alone in the treatment of polyarteritis nodosa and Churg-Strauss syndrome. Arthritis Rheum 1992; 35: Cupps TR, Fauci AS. The vasculitides Philadelphia, Pa: Saunders, Jaques PF, Parker LA, Mauro MA. Fulminant systemic necrotizing arteritis: CT findings. J Comput Assist Tomogr 1988; 12: Lightfoot RW, Jr, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990: criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990; 33: Page 17 of 18
18 15.Ewald EA, Griffin D, McCune WJ. Correlation of angiographic abnormalities with disease manifestations and disease severity in polyarteritis nodosa. J Rheumatol 1987; 14: Hekali P, Kajander H, Pajari R, Stenman S, Somer T. Diagnostic significance of angiographically observed visceral aneurysms with regard to polyarteritis nodosa. Acta Radiol 1991; 32: Citron BP, Halpern M, McCarron M, et al. Necrotizing angiitis associated with drug abuse. N Engl J Med 1970;283: Rothfield NF, McCluskey RT, Baldwin DS. Renal disease in systemic lupus erythematosus. N Engl J Med 1963;269: McClure PH, Westcott JL. Periarteritis nodosa with perirenal hemorrhage: a case report with angiographic findings. J Urol 1969;102: Travers RL, Allison DJ, Brettle RP, Hughes GRV. Polyarteritis nodosa: a clinical and angiographic analysis of 17 cases. Semin Arthritis Rheum 1979;8 : Fauci AS, Haynes BF, Katz P. The spectrum of vasculitis: clinical, pathologic, immunologic and therapeutic considerations. Ann Intern Med 1978; 89: Morway FH, Lundberg EA. The clinical manifestations of essential polyarteritis nodosa (periarteritis nodosa) with emphasis on the hepatic manifestations. Ann Int Med 1954;40: Case records of the Massachussetts General Hospital: case N Engl J Med 1938;218: Nuzum JW Jr, Nuzum JW. Polyarteritis nodosa: statistical review of 175 cases from the literature and report of a "typical" case. Arch Intern Med 1954;94: Maxeiner SR, McDonald JR, Kerklin JW. Muscle biopsy in the diagnosis of periarteritis nodosa: an evaluation. Surg Clin North Am 1952;32: Page 18 of 18
Fibromuscular Dysplasia (FMD) of the renal arteries Angiographic features and therapeutic options
Fibromuscular Dysplasia (FMD) of the renal arteries Angiographic features and therapeutic options Poster No.: C-0630 Congress: ECR 2012 Type: Educational Exhibit Authors: K. I. Ringe, B. Meyer, F. Wacker,
More informationCT evaluation of small bowel carcinoid tumors
CT evaluation of small bowel carcinoid tumors Poster No.: C-0060 Congress: ECR 2015 Type: Educational Exhibit Authors: N. V. V. P. Costa, L. Nascimento, T. Bilhim ; Estoril/PT, PT, 1 2 3 1 2 3 Lisbon/PT
More informationExtrapulmonary Manifestations of Tuberculosis: A Radiologic Review
Extrapulmonary Manifestations of Tuberculosis: A Radiologic Review Poster No.: C-1958 Congress: ECR 2014 Type: Authors: Educational Exhibit J. Isern 1, S. Llaverias Borrell 1, A. Olarte 1, E. Grive 1,
More informationAcute abdominal venous thromboses- the hyperdense noncontrast CT sign
Acute abdominal venous thromboses- the hyperdense noncontrast CT sign Poster No.: C-1095 Congress: ECR 2011 Type: Educational Exhibit Authors: M. Goldstein, K. Jhaveri; Toronto, ON/CA Keywords: Abdomen,
More informationDiffuse Alveolar Hemorrhage: Initial and Follow-up HRCT Features
Diffuse Alveolar Hemorrhage: Initial and Follow-up HRCT Features Poster No.: E-0037 Congress: ESTI 2012 Type: Authors: Keywords: Scientific Exhibit M. Y. Kim; Seoul/KR Lung, CT-High Resolution, CT, Computer
More information64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes
64-MDCT imaging of the pancreas: Scan protocol optimisation by different scan delay regimes Poster No.: C-051 Congress: ECR 2009 Type: Scientific Exhibit Topic: Abdominal and Gastrointestinal Authors:
More informationThe role of abdominal CT and MRI in detection of complications after transplantations of liver, kidney and pancreas.
The role of abdominal CT and MRI in detection of complications after transplantations of liver, kidney and pancreas. Poster No.: C-1319 Congress: ECR 2015 Type: Educational Exhibit Authors: R. Muslimov,
More informationImaging characterization of renal clear cell carcinoma
Imaging characterization of renal clear cell carcinoma Poster No.: C-0327 Congress: ECR 2011 Type: Educational Exhibit Authors: S. Ballester 1, A. Gaser 2, M. Dotta 1, M. F. CAPPA 1, F. Hammar 1 ; 1 2
More informationTreatment options for endoleaks: stents, embolizations and conversions
Treatment options for endoleaks: stents, embolizations and conversions Poster No.: C-0861 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit G. Lombardi; napoli/it Arteries / Aorta, Abdomen,
More informationCT and MR findings of systemic lupus erythematosus involving the brain: Differential diagnosis based on lesion distribution
CT and MR findings of systemic lupus erythematosus involving the brain: Differential diagnosis based on lesion distribution Poster No.: C-2723 Congress: ECR 2010 Type: Educational Exhibit Topic: Neuro
More informationCurious case of Misty Mesentery
Curious case of Misty Mesentery Poster No.: C-1385 Congress: ECR 2015 Type: Authors: Keywords: DOI: Educational Exhibit T. Simelane 1, H. Khosa 2, N. Ramesh 2 ; 1 Dublin/IE, 2 Portlaoise/IE Abdomen, Anatomy,
More informationQuantitative imaging of hepatic cirrhosis on abdominal CT images
Quantitative imaging of hepatic cirrhosis on abdominal CT images Poster No.: C-0556 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit S. Kido, A. Nakamura, Y. Hirano; Ube/JP Cirrhosis,
More informationAcute pelvic pain in female patient: Clinical and Radiological evaluation
Acute pelvic pain in female patient: Clinical and Radiological evaluation Poster No.: C-0909 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit N. Ramesh 1, T. Simelane 2 ; 1 Portlaoise/IE,
More informationAcute pelvic pain in female patient: Clinical and Radiological evaluation
Acute pelvic pain in female patient: Clinical and Radiological evaluation Poster No.: C-0909 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit N. Ramesh 1, T. Simelane 2 ; 1 Portlaoise/IE,
More informationAudit of Micturating Cystourethrograms performed over 1 year in a Children's Hospital
Audit of Micturating Cystourethrograms performed over 1 year in a Children's Hospital Poster No.: C-1773 Congress: ECR 2012 Type: Scientific Exhibit Authors: K. Lyons, J. Sorensen, E. L. Twomey, V. Donoghue,
More informationBiliary tree dilation - and now what?
Biliary tree dilation - and now what? Poster No.: C-1767 Congress: ECR 2012 Type: Educational Exhibit Authors: I. Ferreira, A. B. Ramos, S. Magalhães, M. Certo; Porto/PT Keywords: Pathology, Diagnostic
More informationAetiologies of normal CT main pulmonary arterial (PA) measurements in patients with right heart catheter (RHC) confirmed pulmonary hypertension (PH)
Aetiologies of normal CT main pulmonary arterial (PA) measurements in patients with right heart catheter (RHC) confirmed pulmonary hypertension (PH) Poster No.: C-0964 Congress: ECR 2010 Type: Scientific
More informationHow to plan a Zenith AAA stent-graft from a CTA: Basic measurements and concepts explained
How to plan a Zenith AAA stent-graft from a CTA: Basic measurements and concepts explained Poster No.: C-3077 Congress: ECR 2010 Type: Educational Exhibit Topic: Vascular Authors: D. V. Thomas; Northampton/UK
More informationAbdominal Vascular Emergencies in MDCT Imaging
Abdominal Vascular Emergencies in MDCT Imaging Poster No.: C-0913 Congress: ECR 2016 Type: Educational Exhibit Authors: K. SHIRODKAR, D. N. Dasappa, S. L. DEVARU, D. S. 1 2 2 2 2 2 1 Nandikoor, A. R. Patil,
More informationSingle cold nodule in Graves' disease: benign vs malignant
Single cold nodule in Graves' disease: benign vs malignant Poster No.: C-0073 Congress: ECR 2011 Type: Authors: Keywords: DOI: Scientific Paper L. I. Sonoda, M. Halim, K. Balan; Cambridge/UK Head and neck,
More informationLong bones manifestations of congenital syphilis
Long bones manifestations of congenital syphilis Poster No.: C-0139 Congress: ECR 2011 Type: Educational Exhibit Authors: T. F. de Souza 1, P. P. Collier 1, E. J. M. Bronzatto 1, G. L. P. Keywords: DOI:
More informationHigh density thrombi of pulmonary embolism on precontrast CT scan: Is it dangerous?
High density thrombi of pulmonary embolism on precontrast CT scan: Is it dangerous? Poster No.: C-1753 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit B. Y. Lee, H. R. KIM, J. I. Jung,
More informationPopliteal pterygium syndrome
Popliteal pterygium syndrome Poster No.: C-1816 Congress: ECR 2011 Type: Educational Exhibit Authors: L. B. S. Santos, J. L. D. O. Schiavon, O. O. Guimaraes Neto, 1 1 2 3 1 1 C. A. P. Braga, R. S. LEMOS,
More informationEvaluation of renal angiomyolipoma: correlation between Doppler ultrasound and angiography
Evaluation of renal angiomyolipoma: correlation between Doppler ultrasound and angiography Poster No.: C-2058 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Paper M. D. Stern, Z. Dotan, Y.
More informationIdiopathic dilatation of the pulmonary artery : radiographic and MDCT features in 6 cases
Idiopathic dilatation of the pulmonary artery : radiographic and MDCT features in 6 cases Poster No.: P-0075 Congress: ESTI 2014 Type: Authors: Educational Poster J. J. Woo 1, K. Y. Lee 2, Y. Cho 1, J.
More informationHyperechoic breast lesions can be malignant.
Hyperechoic breast lesions can be malignant. Poster No.: C-0041 Congress: ECR 2015 Type: Educational Exhibit Authors: G. Babu, R. bradley; Edinburgh/UK Keywords: Breast, Ultrasound, Biopsy, Cancer DOI:
More informationIdentification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine
Identification and numbering of lumbar vertebrae using various anatomical landmarks on MRI of lumbosacral spine Poster No.: C-2125 Congress: ECR 2015 Type: Authors: Scientific Exhibit S. patil 1, A. M.
More informationEthanol ablation of benign thyroid cysts and predominantly cystic thyroid nodules: factors that predict outcome.
Ethanol ablation of benign thyroid cysts and predominantly cystic thyroid nodules: factors that predict outcome. Poster No.: C-0322 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit J.
More informationVasculitis. Edward Dwyer, M.D. Division of Rheumatology. Vasculitis
Edward Dwyer, M.D. Division of Rheumatology VASCULITIS is a primary inflammatory disease process of the vasculature Determinants of the Clinical Manifestations of : Target organ involved Size of vessel
More informationThe Radiologic Features of Xanthogranulomatous Cholecystitis: An Important Mimic of Gallbladder Carcinoma
The Radiologic Features of Xanthogranulomatous Cholecystitis: An Important Mimic of Gallbladder Carcinoma Poster No.: C-0691 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit H. L. khosa
More informationSlowly growing malignant nodules and rapidly growing benign nodules: Evaluation of the value of volume doubling time
Slowly growing malignant nodules and rapidly growing benign nodules: Evaluation of the value of volume doubling time Poster No.: C-208 Congress: ECR 2009 Type: Educational Exhibit Topic: Chest Authors:
More informationAFib is the most common cardiac arrhythmia and its prevalence and incidence increases with age (Fuster V. et al. Circulation 2006).
Feasibility, image quality and radiation dose of coronary CT angiography (CCTA) in patients with atrial fibrillation using a new generation 256 multi-detector CT (MDCT) Poster No.: C-2378 Congress: ECR
More informationRadiological Investigation of Renal Colic in an Emergency Department of a Teaching Hospital
Radiological Investigation of Renal Colic in an Emergency Department of a Teaching Hospital Poster No.: C-0892 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit A. Koo; Leeds, West Yorkshire/UK
More informationBolus administration of esmolol allows for safe and effective heart rate control during coronary computed tomography angiography
Bolus administration of esmolol allows for safe and effective heart rate control during coronary computed tomography angiography Poster No.: C-1342 Congress: ECR 2013 Type: Scientific Exhibit Authors:
More informationA pictorial review of normal anatomical appearences of Pericardial recesses on multislice Computed Tomography.
A pictorial review of normal anatomical appearences of Pericardial recesses on multislice Computed Tomography. Poster No.: C-1787 Congress: ECR 2012 Type: Educational Exhibit Authors: N. Ahmed 1, G. Avery
More informationPelvic inflammatory disease - spectrum of tomodensitometric findings
Pelvic inflammatory disease - spectrum of tomodensitometric findings Poster No.: C-2451 Congress: ECR 2015 Type: Educational Exhibit Authors: E. Matos, A. T. Almeida, D. Castelo; Vila Nova de Gaia/PT Keywords:
More informationPneumo-esophageal 64-MDCT technique for gastric cancer evaluation
Pneumo-esophageal 64-MDCT technique for gastric cancer evaluation Poster No.: C-1627 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: M. Ulla, E. Gentile, E. Levy, D. Cavadas, J. Ithurralde
More informationIntra-abdominal abscesses radiology diagnostic
Intra-abdominal abscesses radiology diagnostic Poster No.: C-2320 Congress: ECR 2012 Type: Scientific Exhibit Authors: K. Viksna; Riga/LV Keywords: Abscess, Computer Applications-Detection, diagnosis,
More informationRadiological features of Legionella Pneumophila Pneumonia
Radiological features of Legionella Pneumophila Pneumonia Poster No.: E-0048 Congress: ESTI 2012 Type: Scientific Exhibit Authors: M. Vinciguerra, L. Stefanetti, E. Teti, G. Argentieri, L. G. 1 1 1 1 1
More informationGastrointestinal Angiodysplasia: CT Findings
Gastrointestinal Angiodysplasia: CT Findings Poster No.: C-1792 Congress: ECR 2012 Type: Authors: Keywords: DOI: Educational Exhibit G. Anguita Martinez, A. Fernandez Alfonso, D. C. Olivares Morello, J.
More informationARDS - a must know. Page 1 of 14
ARDS - a must know Poster No.: C-1683 Congress: ECR 2016 Type: Authors: Keywords: DOI: Educational Exhibit M. Cristian; Turda/RO Education and training, Edema, Acute, Localisation, Education, Digital radiography,
More informationCavitary lung lesion: Two different diagnosis with similar appearence
Cavitary lung lesion: Two different diagnosis with similar appearence Poster No.: P-0043 Congress: ESTI 2015 Type: Educational Poster Authors: M. Yesildag, H. Kalkan, K. Ödev; Konya/TR Keywords: Infection,
More informationPurpose. Methods and Materials. Results
Prevalence and significance of hypoattenuating hepatic lesions deemed too small to characterise: How are we following up these lesions and what are the outcomes? Poster No.: C-014 Congress: ECR 2009 Type:
More informationComputed tomography for the detection of thumb base osteoarthritis, comparison with digital radiography.
Computed tomography for the detection of thumb base osteoarthritis, comparison with digital radiography. Poster No.: C-1981 Congress: ECR 2012 Type: Scientific Exhibit Authors: M. S. Saltzherr, J. W. van
More informationThe "whirl sign". Diagnostic accuracy for intestinal volvulus.
The "whirl sign". Diagnostic accuracy for intestinal volvulus. Poster No.: C-0670 Congress: ECR 2014 Type: Scientific Exhibit Authors: M. Pire, M. Marti, A. Borobia, A. Verón; Madrid/ES Keywords: Abdomen,
More informationMDCT signs differentiating retroperitoneal and intraperitoneal lesions- diagnostic pearls
MDCT signs differentiating retroperitoneal and intraperitoneal lesions- diagnostic pearls Poster No.: C-0987 Congress: ECR 2015 Type: Educational Exhibit Authors: D. V. Bhargavi, R. Avantsa, P. Kala; Bangalore/IN
More informationWhen to suspect Wegener Granulomatosis: A radiologic review
When to suspect Wegener Granulomatosis: A radiologic review Poster No.: P-0038 Congress: ESTI 2015 Type: Educational Poster Authors: A. Tilve Gómez, R. Díez Bandera, P. Rodríguez Fernández, M. Garcia Vazquez-Noguerol,
More informationExcavated pulmonary nodule: steps to diagnosis?
Excavated pulmonary nodule: steps to diagnosis? Poster No.: C-1044 Congress: ECR 2014 Type: Authors: Keywords: DOI: Educational Exhibit W. Mnari, M. MAATOUK, A. Zrig, B. Hmida, M. GOLLI; Monastir/ TN Metastases,
More informationCierny-Mader classification of chronic osteomyelitis: Preoperative evaluation with cross-sectional imaging
Cierny-Mader classification of chronic osteomyelitis: Preoperative evaluation with cross-sectional imaging Poster No.: C-590 Congress: ECR 2009 Type: Topic: Educational Exhibit Musculoskeletal Authors:
More informationUltrasonic evaluation of superior mesenteric vein in cancer of the pancreatic head
Ultrasonic evaluation of superior mesenteric vein in cancer of the pancreatic head Poster No.: C-1430 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit E. Fisenko, N. Vetsheva, E. Pershina;
More informationA Randomized Controlled Study to Compare Image Quality between Fenestrated and Non-Fenestrated Intravenous Catheters for Cardiac MDCT
A Randomized Controlled Study to Compare Image Quality between Fenestrated and Non-Fenestrated Intravenous Catheters for Cardiac MDCT Poster No.: C-0623 Congress: ECR 2017 Type: Authors: Keywords: DOI:
More informationUltra-low dose CT of the acute abdomen: Spectrum of imaging findings
Ultra-low dose CT of the acute abdomen: Spectrum of imaging findings Poster No.: C-1452 Congress: ECR 2010 Type: Educational Exhibit Topic: GI Tract Authors: P. A. Vlachou, C. Kloeters, S. Kandel, P. Hein,
More informationScientific Exhibit. Authors: D. Takenaka, Y. Ohno, Y. Onishi, K. Matsumoto, T.
The feasibility of biphasic contrast-media-injection-protocol for chest imaging on 320-slice volume MDCT: Direct comparison of biphasic and bolus contrast-media injection protocols on 320-slice volume
More informationRetrograde dorsalis pedis and posterior tibial artery access after failed antegrade angioplasty
Retrograde dorsalis pedis and posterior tibial artery access after failed antegrade angioplasty Poster No.: C-2067 Congress: ECR 2010 Type: Topic: Authors: Keywords: DOI: Scientific Exhibit Interventional
More informationThe "filling defect" sign helps localise the site of intracranial aneurysm rupture on an unenhanced CT
The "filling defect" sign helps localise the site of intracranial aneurysm rupture on an unenhanced CT Poster No.: C-3380 Congress: ECR 2010 Type: Topic: Authors: Keywords: DOI: Educational Exhibit Neuro
More informationTHI-RADS. US differentiation of thyroid lesions.
THI-RADS. US differentiation of thyroid lesions. Poster No.: C-0864 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. N. Sencha, Y. Patrunov, M. S. Mogutov, E. Penyaeva, A. 1 1 1 2 1 1 1 2 Gruzdev,
More informationTHI-RADS. US differentiation of thyroid lesions.
THI-RADS. US differentiation of thyroid lesions. Poster No.: C-0864 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. N. Sencha, Y. Patrunov, M. S. Mogutov, E. Penyaeva, A. 1 1 1 2 1 1 1 2 Gruzdev,
More informationUrachal cyst: radiological findings and review of cases.
Urachal cyst: radiological findings and review of cases. Poster No.: C-0334 Congress: ECR 2014 Type: Scientific Exhibit Authors: I. Álvarez Silva 1, A. M. Fernández Martínez 1, T. Cuesta 1, S. Molnar Fuentes
More informationPancreatic Cancer Masquerading as Pancreatitis
Pancreatic Cancer Masquerading as Pancreatitis Poster No.: C-2553 Congress: ECR 2015 Type: Educational Exhibit Authors: A. Cahalane, Y. M. Purcell, L. Lavelle, E. R. Ryan, S. Skehan ; 1 1 2 2 2 2 2 Dublin,
More informationInfluence of pulsed fluoroscopy and special radiation risk training on the radiation dose in pneumatic reduction of ileocoecal intussusceptions.
Influence of pulsed fluoroscopy and special radiation risk training on the radiation dose in pneumatic reduction of ileocoecal intussusceptions. Poster No.: C-0599 Congress: ECR 2013 Type: Authors: Keywords:
More informationDuret hemorraghe caused by traumatic brain injury: what the radiologist should know.
Duret hemorraghe caused by traumatic brain injury: what the radiologist should know. Poster No.: C-1270 Congress: ECR 2012 Type: Educational Exhibit Authors: P. Dewachter 1, T. Vanderhasselt 1, K. De Smet
More informationLesions of the pancreaticoduodenal groove, a pictorial review
Lesions of the pancreaticoduodenal groove, a pictorial review Poster No.: C-2131 Congress: ECR 2013 Type: Educational Exhibit Authors: E. Ni Mhurchu, L. Lavelle, I. Murphy, S. Skehan ; IE, Dublin/ IE Keywords:
More informationMonophasic versus biphasic contrast application in CT of patients with head and neck tumour
Monophasic versus biphasic contrast application in CT of patients with head and neck tumour Poster No.: C-3331 Congress: ECR 2010 Type: Topic: Authors: Keywords: DOI: Scientific Exhibit Head and Neck G.
More informationSonographic and Mammographic Features of Phyllodes Tumours of the Breast: Correlation with Histological Grade
Sonographic and Mammographic Features of Phyllodes Tumours of the Breast: Correlation with Histological Grade Poster No.: C-0046 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit C. Y.
More informationVascular complications in percutaneous biliary interventions: A series of 111 procedures
Vascular complications in percutaneous biliary interventions: A series of 111 procedures Poster No.: C-0744 Congress: ECR 2013 Type: Educational Exhibit Authors: A. BHARADWAZ; AARHUS, Re/DK Keywords: Obstruction
More information128-slice dual-source CT coronary angiography using highpitch scan protocols in 102 patients
128-slice dual-source CT coronary angiography using highpitch scan protocols in 102 patients Poster No.: C-0634 Congress: ECR 2010 Type: Scientific Exhibit Topic: Cardiac Authors: Y. H. Choe, J. W. Lee,
More informationPneumatosis intestinalis, not always a surgical emergency
Pneumatosis intestinalis, not always a surgical emergency Poster No.: C-2233 Congress: ECR 2012 Type: Educational Exhibit Authors: E. Vanhoutte, M. Lefere, R. Vanslembrouck, D. Bielen, G. De 1 1 2 1 1
More informationOverview of physiological post-mortem alterations in totalbody imaging of 100 in-hospital deceased patients
Overview of physiological post-mortem alterations in totalbody imaging of 100 in-hospital deceased patients Poster No.: C-1234 Congress: ECR 2016 Type: Scientific Exhibit Authors: I. Wagensveld, W. Oosterhuis,
More informationCorrelation Between BIRADS Classification and Ultrasound -guided Tru-Cut Biopsy Results of Breast Lesions: Retrospective Analysis of 285 Patients
Correlation Between BIRADS Classification and Ultrasound -guided Tru-Cut Biopsy Results of Breast Lesions: Retrospective Analysis of 285 Patients Poster No.: C-1433 Congress: ECR 2014 Type: Scientific
More informationRole of ultrasound in the evaluation of the ileocecal valve
Role of ultrasound in the evaluation of the ileocecal valve Poster No.: C-1581 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: M. Mohammed, M. Hussain, U. Momin, S. Lakhtakia, N. D.
More informationExperience with Transradial and Transulnar Abdominal Angiography and Intervention.
Experience with Transradial and Transulnar Abdominal Angiography and Intervention. e-poster: Congress: Type: Topic: Authors: 412 SIR 2007 Original Scientific Research Poster ONOCOLOGY: / Embolization T.
More informationContrast-enhanced ultrasound (CEUS) in the evaluation and characterization of complex renal cysts
Contrast-enhanced ultrasound (CEUS) in the evaluation and characterization of complex renal cysts Poster No.: C-2812 Congress: ECR 2018 Type: Educational Exhibit Authors: J. A. Torres de Abreu Macedo,
More informationIntrahepatic cholangiocarcinoma: diffusion-weighted MR imaging findings
Intrahepatic cholangiocarcinoma: diffusion-weighted MR imaging findings Poster No.: C-1979 Congress: ECR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit S. Schmidt, A. Pomoni, F. Becce, A. Denys,
More informationCT findings of gastric and intestinal anisakiasis as cause of acute abdominal pain
CT findings of gastric and intestinal anisakiasis as cause of acute abdominal pain Poster No.: C-2258 Congress: ECR 2015 Type: Educational Exhibit Authors: S. Marcos 1, J. Gonzalez 1, L. Sarria Octavio
More informationSmall-bowel obstruction due to bezoar: CT diagnosis and characterization
Small-bowel obstruction due to bezoar: CT diagnosis and characterization Poster No.: C-1450 Congress: ECR 2013 Type: Scientific Exhibit Authors: I. lópez blasco, S. Paz Maya, R. Dosdá Muñoz, D. Soriano
More informationReliability of the pronator quadratus fat pad sign to predict the severity of distal radius fractures
Reliability of the pronator quadratus fat pad sign to predict the severity of distal radius fractures Poster No.: C-0669 Congress: ECR 2014 Type: Scientific Exhibit Authors: J. Tonak, I. Wobbe, R. L. Duschka,
More informationThe Role of Radionuclide Lymphoscintigraphy in the Diagnosis of Lymphedema of the Extremities
The Role of Radionuclide Lymphoscintigraphy in the Diagnosis of Lymphedema of the Extremities Poster No.: C-1229 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit M. Osher 1, A. Pallas
More informationClinical impact of double reading of abdominal CT scans of surgical patients
Clinical impact of double reading of abdominal CT scans of surgical patients Poster No.: B-0037 Congress: ECR 2015 Type: Scientific Paper Authors: P. Lauritzen, J.-G. Andersen, M. V. Stokke, A. L. Tennstrand,
More informationBRAIN DEATH - The contribution of cerebral angiography. A 5-years experience.
BRAIN DEATH - The contribution of cerebral angiography. A 5-years experience. Poster No.: C-1170 Congress: ECR 2011 Type: Educational Exhibit Authors: I. Georgiou 1, V. KARTSOUNI 2, G. STAINHAUER 3, N.
More informationCognitive target MRI-TRUS fusion biopsies of MRI detected PIRADS 4 and 5 lesions
Cognitive target MRI-TRUS fusion biopsies of MRI detected PIRADS 4 and 5 lesions Poster No.: B-0704 Congress: ECR 2015 Type: Scientific Paper Authors: P. P. van Westerveld, J. Vriesema, J. H. W. van den
More informationCan aortic aneurysm growth rate be predicted in clinical practice using 18-fluorodeoxyglucose positron emission tomography (18-FDG PET)?
Can aortic aneurysm growth rate be predicted in clinical practice using 18-fluorodeoxyglucose positron emission tomography (18-FDG PET)? Poster No.: C-1743 Congress: ECR 2011 Type: Authors: Keywords: DOI:
More informationContrast agents, Abdomen, CT, Contrast agent-intravenous, Cancer /ecr2015/C-1760
Can Weight-Adapted IV Contrast Media Protocols Reduce Iodine Dose and Still Produce a Diagnostic Contrast Enhancement Level in Abdomino-Pelvic CT Scans? Poster No.: C-1760 Congress: ECR 2015 Type: Authors:
More informationComputed tomography and Modified RECIST criteria for assessment of response in malignant pleural mesothelioma
Computed tomography and Modified RECIST criteria for assessment of response in malignant pleural mesothelioma Poster No.: C-0729 Congress: ECR 2013 Type: Scientific Exhibit Authors: A. Marin, I. Pozek,
More informationDiffusion-weighted MRI (DWI) "claw sign" is useful in differentiation of infectious from degenerative Modic I signal changes of the spine
Diffusion-weighted MRI (DWI) "claw sign" is useful in differentiation of infectious from degenerative Modic I signal changes of the spine Poster No.: C-0894 Congress: ECR 2012 Type: Scientific Exhibit
More informationBasic low - field MR imaging of meniscal injuries in children.
Basic low - field MR imaging of meniscal injuries in children. Poster No.: C-2365 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit A. Yakimov, M. Nikonova, E. Prokhorova, D. Vybornov,
More informationAssessment of Vasospasm and Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: Current concepts and Value of CT Perfusion and CT Angiography
Assessment of Vasospasm and Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: Current concepts and Value of CT Perfusion and CT Angiography Poster No.: C-2563 Congress: ECR 2012 Type: Educational
More informationSoft tissues lymphoma, the great pretender. MRI diagnostic keys.
Soft tissues lymphoma, the great pretender. MRI diagnostic keys. Poster No.: C-2133 Congress: ECR 2015 Type: Educational Exhibit Authors: L. Caminero, M. E. Banegas Illescas, M. L. Rozas, M. Y. Torres,
More information3D cine PCA enables rapid and comprehensive hemodynamic assessment of the abdominal aorta
3D cine PCA enables rapid and comprehensive hemodynamic assessment of the abdominal aorta Poster No.: C-1138 Congress: ECR 2013 Type: Scientific Exhibit Authors: M. Takahashi 1, Y. Takehara 2, H. Isoda
More informationRadiological and clinical characteristics of plastic bronchitis complicated with H1N1 influenza viral pneumonia in children
Radiological and clinical characteristics of plastic bronchitis complicated with H1N1 influenza viral pneumonia in children Poster No.: C-1727 Congress: ECR 2012 Type: Scientific Exhibit Authors: H. Fujisawa,
More informationSicle-cell disease and silent cerebral infarcts evaluated with magnetic resonance imaging
Sicle-cell disease and silent cerebral infarcts evaluated with magnetic resonance imaging Poster No.: C-0243 Congress: ECR 2015 Type: Educational Exhibit Authors: E. Solomou, A. Rigopoulou, P. Kraniotis,
More informationUltrasound evaluation of patients with acute abdominal pain in the emergency department
Ultrasound evaluation of patients with acute abdominal pain in the emergency department Poster No.: C-2584 Congress: ECR 2012 Type: Authors: Keywords: DOI: Educational Exhibit A. A. Falticeanu, A.-M. Alecsa-Lupu,
More informationDr Rodney Itaki Lecturer Anatomical Pathology Discipline. University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology
Vasculitis Dr Rodney Itaki Lecturer Anatomical Pathology Discipline University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology Disease Spectrum Hypersensitivity vasculitis/microscopic
More informationA pictorial essay depicting CT and MR characteristic of adrenal pathologies: Indian study
A pictorial essay depicting CT and MR characteristic of adrenal pathologies: Indian study Poster No.: C-0703 Congress: ECR 2011 Type: Educational Exhibit Authors: A. J. B. Baxi, K. L. Tourani, N. R. Thanugonda,
More informationPercutaneous transluminal angioplasty in the treatment of stenosis of hemodialysis arteriovenous fistulae: our experience
Percutaneous transluminal angioplasty in the treatment of stenosis of hemodialysis arteriovenous fistulae: our experience Poster No.: C-3355 Congress: ECR 2010 Type: Scientific Exhibit Topic: Interventional
More informationPostpancreatectomy Hemorrhage: Imaging and Interventional Radiological Treatment
Postpancreatectomy Hemorrhage: Imaging and Interventional Radiological Treatment Poster No.: C-1422 Congress: ECR 2014 Type: Educational Exhibit Authors: T. Matsuura, K. Takase, T. Hasegawa, H. Ota, K.
More informationScientific Exhibit Authors: V. Moustakas, E. Karallas, K. Koutsopoulos ; Rodos/GR, 2
Diagnosis of Acute Appendicitis: the role of Color Doppler Ultrasound as first-line imaging method and evaluation of the higher diagnostic performances of CT against its disadvantages. Poster No.: C-0708
More informationA time-honored but almost forgotten sign of COPD: sabersheath trachea as a marker of severe airflow obstruction
A time-honored but almost forgotten sign of COPD: sabersheath trachea as a marker of severe airflow obstruction Poster No.: C-0958 Congress: ECR 2013 Type: Scientific Exhibit Authors: F. Ciccarese, A.
More informationSeemingly isolated greater trochanter fractures do not exist
Seemingly isolated greater trochanter fractures do not exist Poster No.: B-0950 Congress: ECR 2012 Type: Scientific Paper Authors: D. Dunker, J. H. Göthlin, M. Geijer ; Gothenburg/SE, Lund/SE Keywords:
More informationDigital breast tomosynthesis (DBT) occult breast cancers: clinical, radiological and histopathological features.
Digital breast tomosynthesis (DBT) occult breast cancers: clinical, radiological and histopathological features. Poster No.: C-1707 Congress: ECR 2015 Type: Scientific Exhibit Authors: V. Vinci 1, A. Iqbal
More informationLusory Artery - random finding without further implications or important challenge which conditions treatment strategy.
Lusory Artery - random finding without further implications or important challenge which conditions treatment strategy. Poster No.: C-2118 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit
More information