The Experts below are selected from a list of 1275 Experts worldwide ranked by ideXlab platform
Akram M Shaaban - One of the best experts on this subject based on the ideXlab platform.
-
peripheral Hypervascularity of the corpus luteum with ovarian edema cloe may decrease false positive diagnoses of ovarian torsion
Abdominal Radiology, 2019Co-Authors: Douglas Rogers, Ragheed Aldulaimi, Maryam Rezvani, Anne Kennedy, Akram M ShaabanAbstract:In patients with pelvic pain, corpus luteum with associated ovarian edema (CLOE) may be mistaken for ovarian torsion on ultrasound or CECT. This was a multi-reader, blinded, retrospective review performed at a single academic center from 2012 to 2018. Cases of CLOE that were misdiagnosed as torsion and cases of ovarian torsion without a lead-point mass were analyzed. Evaluated ultrasound features included presence of a corpus luteum, ovarian and corpus luteum volume, Color Doppler vascularity of the corpus luteum rim compared to that of the ovarian stroma, peripheral follicular displacement, twisted vascular pedicle, and free fluid. Evaluated CT features included presence of a corpus luteum, ovarian and corpus luteum volume, corpus luteum rim enhancement, twisted vascular pedicle, and free fluid. 39 cases of CLOE and 30 cases of ovarian torsion without lead-point mass were reviewed. A corpus luteum was present in 56.7% of torsed ovaries. In CLOE cases, peripheral Hypervascularity of the corpus luteum (manifested as enhancement at CECT or flow signal at Doppler US) was present in 67.7% (21/31) of cases on ultrasound, and in 95.7% (22/23) of cases on CT. No peripheral Hypervascularity of the corpus luteum was seen in cases of torsion (p < 0.001). Torsed ovaries were significantly larger than CLOE cases. Other findings were not significantly different between the two groups. Increased blood flow in the periphery of a corpus luteum on color Doppler ultrasound or on CECT is a strong negative predictor for ovarian torsion.
-
peripheral Hypervascularity of the corpus luteum with ovarian edema cloe may decrease false positive diagnoses of ovarian torsion
Abdominal Radiology, 2019Co-Authors: Douglas Rogers, Ragheed Aldulaimi, Maryam Rezvani, Anne M Kennedy, Akram M ShaabanAbstract:INTRODUCTION In patients with pelvic pain, corpus luteum with associated ovarian edema (CLOE) may be mistaken for ovarian torsion on ultrasound or CECT. METHODS This was a multi-reader, blinded, retrospective review performed at a single academic center from 2012 to 2018. Cases of CLOE that were misdiagnosed as torsion and cases of ovarian torsion without a lead-point mass were analyzed. Evaluated ultrasound features included presence of a corpus luteum, ovarian and corpus luteum volume, Color Doppler vascularity of the corpus luteum rim compared to that of the ovarian stroma, peripheral follicular displacement, twisted vascular pedicle, and free fluid. Evaluated CT features included presence of a corpus luteum, ovarian and corpus luteum volume, corpus luteum rim enhancement, twisted vascular pedicle, and free fluid. RESULTS 39 cases of CLOE and 30 cases of ovarian torsion without lead-point mass were reviewed. A corpus luteum was present in 56.7% of torsed ovaries. In CLOE cases, peripheral Hypervascularity of the corpus luteum (manifested as enhancement at CECT or flow signal at Doppler US) was present in 67.7% (21/31) of cases on ultrasound, and in 95.7% (22/23) of cases on CT. No peripheral Hypervascularity of the corpus luteum was seen in cases of torsion (p < 0.001). Torsed ovaries were significantly larger than CLOE cases. Other findings were not significantly different between the two groups. CONCLUSION Increased blood flow in the periphery of a corpus luteum on color Doppler ultrasound or on CECT is a strong negative predictor for ovarian torsion.
Fabio Piscaglia - One of the best experts on this subject based on the ideXlab platform.
-
characterization of small nodules in cirrhosis by assessment of vascularity the problem of hypovascular hepatocellular carcinoma
Hepatology, 2005Co-Authors: Luigi Bolondi, S Gaiani, N Celli, Rita Golfieri, W F Grigioni, S Leoni, Anna Maria Venturi, Fabio PiscagliaAbstract:In a prospective study, we examined the impact of arterial Hypervascularity, as established by the European Association for the Study of the Liver (EASL) recommendations, as a criterion for characterizing small (1-3 cm) nodules in cirrhosis. A total of 72 nodules (1-2 cm, n = 41; 2.1-3 cm, n = 31) detected by ultrasonography in 59 patients with cirrhosis were included in the study. When coincidental arterial Hypervascularity was detected at contrast perfusional ultrasonography and helical computed tomography, the lesion was considered to be hepatocellular carcinoma (HCC) according to EASL criteria. When one or both techniques showed negative results, ultrasound-guided biopsy was performed. In cases with negative results for malignancy or high-grade dysplasia, biopsy was repeated when an increase in size was detected at the 3-month follow-up examination. Coincidental Hypervascularity was found in 44 of 72 nodules (61%; 44% of 1-2-cm nodules and 84% of 2-3-cm nodules). Fourteen nodules (19.4%) had negative results with both techniques (hypovascular nodules). Biopsy showed HCC in 5 hypovascular nodules and in 11 of 14 nodules with Hypervascularity using only one technique. All nodules larger than 2 cm finally resulted to be HCC. Not satisfying the EASL imaging criteria for diagnosis were 38% of HCCs 1 to 2 cm (17% hypovascular) and 16% of those 2 to 3 cm (none hypovascular). In conclusion, the noninvasive EASL criteria for diagnosis of HCC are satisfied in only 61% of small nodules in cirrhosis; thus, biopsy frequently is required in this setting. Relying on imaging techniques in nodules of 1 to 2 cm would miss the diagnosis of HCC in up to 38% of cases. Any nodule larger than 2 cm should be regarded as highly suspicious for HCC. (HEPATOLOGY 2005.)
-
characterization of small nodules in cirrhosis by assessment of vascularity the problem of hypovascular hepatocellular carcinoma
Hepatology, 2005Co-Authors: Luigi Bolondi, S Gaiani, N Celli, Rita Golfieri, W F Grigioni, S Leoni, Anna Maria Venturi, Fabio PiscagliaAbstract:In a prospective study, we examined the impact of arterial Hypervascularity, as established by the European Association for the Study of the Liver (EASL) recommendations, as a criterion for characterizing small (1-3 cm) nodules in cirrhosis. A total of 72 nodules (1-2 cm, n = 41; 2.1-3 cm, n = 31) detected by ultrasonography in 59 patients with cirrhosis were included in the study. When coincidental arterial Hypervascularity was detected at contrast perfusional ultrasonography and helical computed tomography, the lesion was considered to be hepatocellular carcinoma (HCC) according to EASL criteria. When one or both techniques showed negative results, ultrasound-guided biopsy was performed. In cases with negative results for malignancy or high-grade dysplasia, biopsy was repeated when an increase in size was detected at the 3-month follow-up examination. Coincidental Hypervascularity was found in 44 of 72 nodules (61%; 44% of 1-2-cm nodules and 84% of 2-3-cm nodules). Fourteen nodules (19.4%) had negative results with both techniques (hypovascular nodules). Biopsy showed HCC in 5 hypovascular nodules and in 11 of 14 nodules with Hypervascularity using only one technique. All nodules larger than 2 cm finally resulted to be HCC. Not satisfying the EASL imaging criteria for diagnosis were 38% of HCCs 1 to 2 cm (17% hypovascular) and 16% of those 2 to 3 cm (none hypovascular). In conclusion, the noninvasive EASL criteria for diagnosis of HCC are satisfied in only 61% of small nodules in cirrhosis; thus, biopsy frequently is required in this setting. Relying on imaging techniques in nodules of 1 to 2 cm would miss the diagnosis of HCC in up to 38% of cases. Any nodule larger than 2 cm should be regarded as highly suspicious for HCC.
-
usefulness of contrast enhanced perfusional sonography in the assessment of hepatocellular carcinoma hypervascular at spiral computed tomography
Journal of Hepatology, 2004Co-Authors: S Gaiani, N Celli, Fabio Piscaglia, L Cecilioni, Franco Losinno, F Giangregorio, Mikaela Mancini, P Pini, F Fornari, Luigi BolondiAbstract:Abstract Background/Aims Diagnosis of hepatocellular carcinoma (HCC) relies strongly on the detection of Hypervascularity in the arterial phase and, in this setting, spiral computed tomography (CT) is the most widely used method. This prospective study aimed to investigate the usefulness of low mechanical index harmonic ultrasound (US), using a second generation contrast-enhanced technique, in the assessment of vascular pattern of HCC shown to be hypervascular at spiral CT. Methods A total of 79 cirrhotic patients with 103 nodules (mean±SD 28±13 mm) with arterial Hypervascularity at spiral CT were studied. US examination was performed by perfusional sonography, using a new dedicated technology (CnTI-Esaote™), operating at low mechanical index, after injection of a second generation contrast agent (SonoVue™-Bracco), allowing detection of tumoral flow during arterial phase. Results Selective arterial enhancement on perfusional sonography was observed in 94 /103 nodules (91.3%), with a sensitivity of 66.6, 87.5, 91.7, and 97.3% in nodules ≤1 cm, >1≤2 cm, >2≤3 cm, and >3 cm respectively. Conclusions Perfusional sonography shows good diagnostic agreement with spiral CT in hypervascular HCC and may be proposed for the immediate vascular characterization of nodules detected at US and used as second imaging technique to confirm Hypervascularity in cirrhotic nodules.
Douglas Rogers - One of the best experts on this subject based on the ideXlab platform.
-
peripheral Hypervascularity of the corpus luteum with ovarian edema cloe may decrease false positive diagnoses of ovarian torsion
Abdominal Radiology, 2019Co-Authors: Douglas Rogers, Ragheed Aldulaimi, Maryam Rezvani, Anne Kennedy, Akram M ShaabanAbstract:In patients with pelvic pain, corpus luteum with associated ovarian edema (CLOE) may be mistaken for ovarian torsion on ultrasound or CECT. This was a multi-reader, blinded, retrospective review performed at a single academic center from 2012 to 2018. Cases of CLOE that were misdiagnosed as torsion and cases of ovarian torsion without a lead-point mass were analyzed. Evaluated ultrasound features included presence of a corpus luteum, ovarian and corpus luteum volume, Color Doppler vascularity of the corpus luteum rim compared to that of the ovarian stroma, peripheral follicular displacement, twisted vascular pedicle, and free fluid. Evaluated CT features included presence of a corpus luteum, ovarian and corpus luteum volume, corpus luteum rim enhancement, twisted vascular pedicle, and free fluid. 39 cases of CLOE and 30 cases of ovarian torsion without lead-point mass were reviewed. A corpus luteum was present in 56.7% of torsed ovaries. In CLOE cases, peripheral Hypervascularity of the corpus luteum (manifested as enhancement at CECT or flow signal at Doppler US) was present in 67.7% (21/31) of cases on ultrasound, and in 95.7% (22/23) of cases on CT. No peripheral Hypervascularity of the corpus luteum was seen in cases of torsion (p < 0.001). Torsed ovaries were significantly larger than CLOE cases. Other findings were not significantly different between the two groups. Increased blood flow in the periphery of a corpus luteum on color Doppler ultrasound or on CECT is a strong negative predictor for ovarian torsion.
-
peripheral Hypervascularity of the corpus luteum with ovarian edema cloe may decrease false positive diagnoses of ovarian torsion
Abdominal Radiology, 2019Co-Authors: Douglas Rogers, Ragheed Aldulaimi, Maryam Rezvani, Anne M Kennedy, Akram M ShaabanAbstract:INTRODUCTION In patients with pelvic pain, corpus luteum with associated ovarian edema (CLOE) may be mistaken for ovarian torsion on ultrasound or CECT. METHODS This was a multi-reader, blinded, retrospective review performed at a single academic center from 2012 to 2018. Cases of CLOE that were misdiagnosed as torsion and cases of ovarian torsion without a lead-point mass were analyzed. Evaluated ultrasound features included presence of a corpus luteum, ovarian and corpus luteum volume, Color Doppler vascularity of the corpus luteum rim compared to that of the ovarian stroma, peripheral follicular displacement, twisted vascular pedicle, and free fluid. Evaluated CT features included presence of a corpus luteum, ovarian and corpus luteum volume, corpus luteum rim enhancement, twisted vascular pedicle, and free fluid. RESULTS 39 cases of CLOE and 30 cases of ovarian torsion without lead-point mass were reviewed. A corpus luteum was present in 56.7% of torsed ovaries. In CLOE cases, peripheral Hypervascularity of the corpus luteum (manifested as enhancement at CECT or flow signal at Doppler US) was present in 67.7% (21/31) of cases on ultrasound, and in 95.7% (22/23) of cases on CT. No peripheral Hypervascularity of the corpus luteum was seen in cases of torsion (p < 0.001). Torsed ovaries were significantly larger than CLOE cases. Other findings were not significantly different between the two groups. CONCLUSION Increased blood flow in the periphery of a corpus luteum on color Doppler ultrasound or on CECT is a strong negative predictor for ovarian torsion.
Luigi Bolondi - One of the best experts on this subject based on the ideXlab platform.
-
characterization of small nodules in cirrhosis by assessment of vascularity the problem of hypovascular hepatocellular carcinoma
Hepatology, 2005Co-Authors: Luigi Bolondi, S Gaiani, N Celli, Rita Golfieri, W F Grigioni, S Leoni, Anna Maria Venturi, Fabio PiscagliaAbstract:In a prospective study, we examined the impact of arterial Hypervascularity, as established by the European Association for the Study of the Liver (EASL) recommendations, as a criterion for characterizing small (1-3 cm) nodules in cirrhosis. A total of 72 nodules (1-2 cm, n = 41; 2.1-3 cm, n = 31) detected by ultrasonography in 59 patients with cirrhosis were included in the study. When coincidental arterial Hypervascularity was detected at contrast perfusional ultrasonography and helical computed tomography, the lesion was considered to be hepatocellular carcinoma (HCC) according to EASL criteria. When one or both techniques showed negative results, ultrasound-guided biopsy was performed. In cases with negative results for malignancy or high-grade dysplasia, biopsy was repeated when an increase in size was detected at the 3-month follow-up examination. Coincidental Hypervascularity was found in 44 of 72 nodules (61%; 44% of 1-2-cm nodules and 84% of 2-3-cm nodules). Fourteen nodules (19.4%) had negative results with both techniques (hypovascular nodules). Biopsy showed HCC in 5 hypovascular nodules and in 11 of 14 nodules with Hypervascularity using only one technique. All nodules larger than 2 cm finally resulted to be HCC. Not satisfying the EASL imaging criteria for diagnosis were 38% of HCCs 1 to 2 cm (17% hypovascular) and 16% of those 2 to 3 cm (none hypovascular). In conclusion, the noninvasive EASL criteria for diagnosis of HCC are satisfied in only 61% of small nodules in cirrhosis; thus, biopsy frequently is required in this setting. Relying on imaging techniques in nodules of 1 to 2 cm would miss the diagnosis of HCC in up to 38% of cases. Any nodule larger than 2 cm should be regarded as highly suspicious for HCC. (HEPATOLOGY 2005.)
-
characterization of small nodules in cirrhosis by assessment of vascularity the problem of hypovascular hepatocellular carcinoma
Hepatology, 2005Co-Authors: Luigi Bolondi, S Gaiani, N Celli, Rita Golfieri, W F Grigioni, S Leoni, Anna Maria Venturi, Fabio PiscagliaAbstract:In a prospective study, we examined the impact of arterial Hypervascularity, as established by the European Association for the Study of the Liver (EASL) recommendations, as a criterion for characterizing small (1-3 cm) nodules in cirrhosis. A total of 72 nodules (1-2 cm, n = 41; 2.1-3 cm, n = 31) detected by ultrasonography in 59 patients with cirrhosis were included in the study. When coincidental arterial Hypervascularity was detected at contrast perfusional ultrasonography and helical computed tomography, the lesion was considered to be hepatocellular carcinoma (HCC) according to EASL criteria. When one or both techniques showed negative results, ultrasound-guided biopsy was performed. In cases with negative results for malignancy or high-grade dysplasia, biopsy was repeated when an increase in size was detected at the 3-month follow-up examination. Coincidental Hypervascularity was found in 44 of 72 nodules (61%; 44% of 1-2-cm nodules and 84% of 2-3-cm nodules). Fourteen nodules (19.4%) had negative results with both techniques (hypovascular nodules). Biopsy showed HCC in 5 hypovascular nodules and in 11 of 14 nodules with Hypervascularity using only one technique. All nodules larger than 2 cm finally resulted to be HCC. Not satisfying the EASL imaging criteria for diagnosis were 38% of HCCs 1 to 2 cm (17% hypovascular) and 16% of those 2 to 3 cm (none hypovascular). In conclusion, the noninvasive EASL criteria for diagnosis of HCC are satisfied in only 61% of small nodules in cirrhosis; thus, biopsy frequently is required in this setting. Relying on imaging techniques in nodules of 1 to 2 cm would miss the diagnosis of HCC in up to 38% of cases. Any nodule larger than 2 cm should be regarded as highly suspicious for HCC.
-
usefulness of contrast enhanced perfusional sonography in the assessment of hepatocellular carcinoma hypervascular at spiral computed tomography
Journal of Hepatology, 2004Co-Authors: S Gaiani, N Celli, Fabio Piscaglia, L Cecilioni, Franco Losinno, F Giangregorio, Mikaela Mancini, P Pini, F Fornari, Luigi BolondiAbstract:Abstract Background/Aims Diagnosis of hepatocellular carcinoma (HCC) relies strongly on the detection of Hypervascularity in the arterial phase and, in this setting, spiral computed tomography (CT) is the most widely used method. This prospective study aimed to investigate the usefulness of low mechanical index harmonic ultrasound (US), using a second generation contrast-enhanced technique, in the assessment of vascular pattern of HCC shown to be hypervascular at spiral CT. Methods A total of 79 cirrhotic patients with 103 nodules (mean±SD 28±13 mm) with arterial Hypervascularity at spiral CT were studied. US examination was performed by perfusional sonography, using a new dedicated technology (CnTI-Esaote™), operating at low mechanical index, after injection of a second generation contrast agent (SonoVue™-Bracco), allowing detection of tumoral flow during arterial phase. Results Selective arterial enhancement on perfusional sonography was observed in 94 /103 nodules (91.3%), with a sensitivity of 66.6, 87.5, 91.7, and 97.3% in nodules ≤1 cm, >1≤2 cm, >2≤3 cm, and >3 cm respectively. Conclusions Perfusional sonography shows good diagnostic agreement with spiral CT in hypervascular HCC and may be proposed for the immediate vascular characterization of nodules detected at US and used as second imaging technique to confirm Hypervascularity in cirrhotic nodules.
Moon-gyu Lee - One of the best experts on this subject based on the ideXlab platform.
-
Stereotactic Body Radiotherapy-Induced Arterial Hypervascularity of Non-Tumorous Hepatic Parenchyma in Patients with Hepatocellular Carcinoma: Potential Pitfalls in Tumor Response Evaluation on Multiphase Computed Tomography
2016Co-Authors: Mee Jin Park, So Yeon Kim, Sang Min Yoon, Jong Hoon Kim, Seong Ho Park, Seung Soo Lee, Yedaun Lee, Moon-gyu LeeAbstract:Purpose: To evaluate temporal changes in contrast enhancement patterns of non-tumorous hepatic parenchyma with a focus on arterial Hypervascularity on multiphase computed tomography (CT) in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT). Methods: We retrospectively identified 61 patients who had undergone multiphase contrast-enhanced CT at one, three, and six months after SBRT. Irradiated versus non-irradiated liver parenchyma was delineated by cross-correlation with the dose-volume histogram of SBRT plan. Serial changes in the contrast enhancement patterns of the irradiated versus non-irradiated liver parenchyma were evaluated by two abdominal radiologists in consensus. We compared the frequency of the contrast enhancement patterns according to the follow-up period using the Fisher-Freeman-Halton exact test. Results: The irradiated non-tumorous hepatic parenchyma showed that the prevalence of arterial Hypervascularity increased during the follow-up period (P,.01): 11.5 % (7/61) in one, 45.9 % (28/61) in three, and 54.1 % (33/61) in six months. Contrast wash-out on the delayed phase was uncommon: 1.6 % (1/61) in one, 3.3 % (2/61) in three, and 0 % in six months. Conclusion: The incidence of arterial Hypervascularity of the irradiated hepatic parenchyma gradually increased until six months after SBRT, which could interfere with the accurate evaluation of treatment response. The lack of wash-out on th
-
stereotactic body radiotherapy induced arterial Hypervascularity of non tumorous hepatic parenchyma in patients with hepatocellular carcinoma potential pitfalls in tumor response evaluation on multiphase computed tomography
PLOS ONE, 2014Co-Authors: Mee Jin Park, So Yeon Kim, Sang Min Yoon, Jong Hoon Kim, Seong Ho Park, Seung Soo Lee, Yedaun Lee, Moon-gyu LeeAbstract:Purpose To evaluate temporal changes in contrast enhancement patterns of non-tumorous hepatic parenchyma with a focus on arterial Hypervascularity on multiphase computed tomography (CT) in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT). Methods We retrospectively identified 61 patients who had undergone multiphase contrast-enhanced CT at one, three, and six months after SBRT. Irradiated versus non-irradiated liver parenchyma was delineated by cross-correlation with the dose-volume histogram of SBRT plan. Serial changes in the contrast enhancement patterns of the irradiated versus non-irradiated liver parenchyma were evaluated by two abdominal radiologists in consensus. We compared the frequency of the contrast enhancement patterns according to the follow-up period using the Fisher-Freeman-Halton exact test. Results The irradiated non-tumorous hepatic parenchyma showed that the prevalence of arterial Hypervascularity increased during the follow-up period (P<.01): 11.5% (7/61) in one, 45.9% (28/61) in three, and 54.1% (33/61) in six months. Contrast wash-out on the delayed phase was uncommon: 1.6% (1/61) in one, 3.3% (2/61) in three, and 0% in six months. Conclusion The incidence of arterial Hypervascularity of the irradiated hepatic parenchyma gradually increased until six months after SBRT, which could interfere with the accurate evaluation of treatment response. The lack of wash-out on the delayed phase in the hypervascular area would distinguish SBRT-related change from residual/recurred HCC.