Notes

Molecular epigenetic character in breast carcinogenesis.
To investigate contrast dynamics and artifacts associated with different breathing maneuvers during pulmonary computed tomography angiography (pCTA) in a prospective randomized clinical trial.

Three different breathing maneuvers (inspiration, expiration, Mueller) were randomly assigned to 146 patients receiving pCTA for suspected pulmonary embolism (PE). Contrast enhancement of central and peripheral arteries and imaging quality of lung parenchyma were compared and analyzed. Results were compared by using the analysis of variances (ANOVA) and Kruskal-Wallis-Test.

Mean enhancement in the pulmonary trunk was highest during breath-hold in inspiration (293 HU, range 195-460 HU) compared to Mueller (259 HU, range 136-429 HU, p = 0022) and expiration (267 HU, range 115-376 HU). This was similar for the right pulmonary artery (inspiration 289 HU, range 173-454 HU; Mueller 250 HU, range 119-378 HU; p = 0.007; expiration 257 HU, range 114-366 HU; p = 0.032) and left pulmonary artery (inspiration 280.3 HU, range iration with the risk of suboptimal opacification of the pulmonary arteries.Pleural effusions are associated with a variety of disease states, rendering the differential diagnosis challenging. Spondylodiscitis is an uncommon disease, and its prompt diagnosis can reduce morbidity and mortality. However, an atypical manifestation of the disease, such as pleural effusion, can result in delayed diagnosis. A 76-year-old woman presented with back pain and right pleural effusion. Magnetic resonance imaging revealed paravertebral soft tissue infiltration, with enhancement of bone marrow and intervertebral disk at the T8 and T9 levels, suggesting spondylodiscitis. In patients with exudative pleural effusion, spondylodiscitis may be the cause, so careful analysis of imaging is necessary.
Identification of clinical predictors of acute and surgical pathologies on abdominal CT in patients with non-traumatic abdominal pain (NTAP).

Retrospective chart review cohort study of adults who had abdominal CT scans for investigation of NTAP in the Emergency Department in a tertiary care center in Lebanon. Multivariate analyses were performed to identify predictors of pathologies on CT scan.

This study included 147 patients who had abdominal CT scans for NTAP. Mean age was 39.8 ± 15.1 years and 58.5 % of patients were females. Less than half (44.9 %) had normal scans. Women had significantly higher rates of normal scans compared to males. Right lower quadrant (RLQ) tenderness was associated with significantly higher odds of having acute abnormalities on CT and of having surgical diagnoses, while epigastric tenderness was negatively associated with these two outcomes. Right and left upper quadrants and diffuse abdominal tenderness, and an abnormal neutrophil count were found to be associated with surgical diagnoses on CT.

Women are less likely to have acute and surgical pathologies on CT ordered for non traumatic abdominal pain. Epigastric tenderness is negatively associated with abnormal and surgical CT results while RLQ tenderness is associated with an abnormal CT that is likely surgical in nature. These findings should help improve diagnostic accuracy of ordering providers and improve resource utilization.
Women are less likely to have acute and surgical pathologies on CT ordered for non traumatic abdominal pain. Epigastric tenderness is negatively associated with abnormal and surgical CT results while RLQ tenderness is associated with an abnormal CT that is likely surgical in nature. These findings should help improve diagnostic accuracy of ordering providers and improve resource utilization.
To assess the value of MRI obtained before and after treatment in detecting mucosal healing in patients with ileal Crohn's disease (CD) treated with anti-TNF drugs.

In this IRB approved retrospective study, 24 patients (M/F 11/13, age 34.0 ± 12.5 years, age range 19-55 years) with ileal CD who underwent anti-TNF treatment, with pre- and post-treatment MRI (mean delay between MRIs 92 ± 57 weeks) were included. All patients underwent routine MR enterography (MRE), which included diffusion-weighted imaging (DWI). Two readers evaluated qualitative features (wall thickness, presence of edema and length of involvement) in consensus and one reader measured the following quantitative variables relative contrast enhancement (RCE) and apparent diffusion coefficient (ADC) to derive the MaRIA and Clermont scores at baseline, post-treatment and their changes (ΔMaRIA, ΔClermont). Ileocolonoscopy results were used as the reference standard. Data was evaluated using Mann-Whitney
test and receiver operating characterissults need to be verified in a larger study.
Pre-treatment Clermont score as well as post-treatment MaRIA and Clermont scores, wall thickness and ΔMaRIA are significantly predictive of response to anti-TNF drugs in ileal Crohn's disease. These results need to be verified in a larger study.
The purpose of this study was to assess the differences of magnetic resonance features between tuberculous and bacterial pyomyositis.

This is a retrospective study of patients with bacterial and tuberculous pyomyositis. We excluded patients with pyomyositis caused by actinomycosis, non-tuberculous mycobacterium, fungi, unknown of causative organism, or inadequate imaging for analysis. Magnetic resonance imaging was independently reviewed by two radiologists.

Of the 136 pyomyositis patients, 71 (52.2 %) patients had bacterial pyomyositis while 65 (47.8 %) patients had tuberculous pyomyositis. Seventy-seven patients (56.6 %) had intramuscular abscess. On multivariable analysis, bacterial pyomyositis was associated with diabetes mellitus (odds ratio [OR] 3.17, 95 % confidence interval [CI] 1.30-8.24) and bone marrow involvement (OR 5.02, 95 % CI 1.21-34.4). AP-III-a4 in vitro Spinal involvement had a significantly lower likelihood of bacterial pyomyositis (OR 0.25, 95 %CI 0.11-0.54). In patients with intramuscular abscess, diabetes mellitus and hyperintense on T2-weighted images at the abscess wall had a significantly higher likelihood of bacterial pyomyositis (OR 5.21, 95 %CI 1.33-25.42 and OR 5.34, 95 %CI 1.36-24.71, respectively), whereas spinal involvement had a significantly lower likelihood of bacterial pyomyositis (OR 0.09, 95 %CI 0.02-0.30).

Magnetic resonance imaging has modest accuracy for differentiation of tuberculous and bacterial pyomyositis. Diabetes mellitus and extraspinal pyomyositis were the predictors of bacterial pyomyositis. Presence of T2 hyperintense wall of intramuscular abscess was also the predictor of bacterial pyomyositis.
Magnetic resonance imaging has modest accuracy for differentiation of tuberculous and bacterial pyomyositis. Diabetes mellitus and extraspinal pyomyositis were the predictors of bacterial pyomyositis. Presence of T2 hyperintense wall of intramuscular abscess was also the predictor of bacterial pyomyositis.
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