: Microvascular perfusion deficits and reduced arterial perfusion reserve in patients with PAD are clearly detectable with dynamic CEUS after transient arterial occlusion.

Purpose: The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). Materials and Methods: 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. Results: The overall sensitivity of LS was 49.2?%, the specificity was 93.3?%, the positive predictive value was 91?%, and the negative predictive value was 57.5?%. The overall sensitivity for vertebral fractures was 16.7?%, and the specificity was 100?%. The sensitivity was 48.7?% and the specificity 98.2?% for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS.?40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. Conclusion: The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT. Key Points: ??The overall sensitivity of LS for truncal skeleton injuries in multiple-trauma patients was

Objective: The aim of this study was to investigate the performance of the arterial enhancement fraction (AEF) in multiphasic computed tomography (CT) acquisitions to detect hepatocellular carcinoma (HCC) in liver transplant recipients in correlation with the pathologic analysis of the corresponding liver explants. Materials and Methods: Fifty-five transplant recipients were analyzed: 35 patients with 108 histologically proven HCC lesions and 20 patients with end-stage liver disease without HCC. Six radiologists looked at the triphasic CT acquisitions with the AEF maps in a first readout. For the second readout without the AEF maps, 3 radiologists analyzed triphasic CT acquisitions (group 1), whereas the other 3 readers had 4 contrast acquisitions available (group 2). A jackknife free-response reader receiver operating characteristic analysis was used to compare the readout performance of the readers. Receiver operating characteristic analysis was used to determine the optimal cutoff value of the AEF. Results: The figure of merit (θ = 0.6935) for the conventional triphasic readout was significantly inferior compared with the triphasic readout with additional use of the AEF (θ = 0.7478, P < 0.0001) in group 1. There was no significant difference between the fourphasic conventional readout (θ = 0.7569) and the triphasic readout (θ = 0.7615, P = 0.7541) with the AEF in group 2. Without the AEF, HCC lesions were detected with a sensitivity of 30.7% (95% confidence interval [CI], 25.5%-36.4%) and a specificity of 97.1% (96.0%-98.0%) by group 1 looking at 3 CT acquisition phases and with a sensitivity of 42.1% (36.2%-48.1%) and a specificity of 97.5% (96.4%-98.3%) in group 2 looking at 4 CT acquisition phases. Using the AEF maps, both groups looking at the same 3 acquisition phases, the sensitivity was 47.7% (95% CI, 41.9%-53.5%) with a specificity of 97.4% (96.4%-98.3%) in group 1 and 49.8% (95% CI, 43.9%-55.8%)/97.6% (96.6%-98.4%) in group 2. The optimal cutoff for the AEF was 50%. Conclusion: The AEF is a helpful tool to screen for HCC with CT. The use of the AEF maps may significantly improve HCC detection, which allows omitting the fourth CT acquisition phase and thus making a 25% reduction of radiation dose possible. 3 The most cost-effective strategy to screen patients with chronic liver disease for HCC is sonography with testing of the serum alpha-fetoprotein level every 6 months.4 But a low sensitivity of ultrasound for HCC detection favors screening with computed tomography (CT), especially for patients on the orthotopic liver transplantation (OLT) list. 5,6 During the last few years, there were several published papers showing an increased detectability of HCC lesions with CT perfusion. 7-10Beneath the motion artefacts, 1 major limitation for CT perfusion is the high radiation dose, especially in a setting of long-duration HCC surveillance in patients on the OLT list.11 The calculation of the arterial enhancement fraction (AEF), as introduced by Kim et al,12 allows the calculation of a quantitative colored ...

• Hepatic steatosis has high incidence in the general population and following chemotherapy. • Hypodense liver lesions can be obscured by steatotic liver parenchyma in CT. • Low kV p -CT shows no advantage in detecting hypodense lesions in steatotic livers. • Additional DECT image information does not improve visualization of hypodense lesions in steatosis. • 120 kV p -equivalent imaging yields best quantitative and qualitative image analysis results.

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Image-guided biopsy of the lung or of the mediastinum is a minimally invasive method for acquiring material for microbiologic or histologic examinations. Given careful selection and preparation of the patient, image-guided biopsy is a safe procedure with a relatively low risk of complications. The aim of this tutorial is to summarize the special aspects concerning the intervention, including evaluation, the technical needs, different kinds of access to the target, and risk and complication management.

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Eine 29-jährige Patientin in gutem Allgemeinzustand stellte sich zur sonographischen Verlaufskontrolle bekannter Angiomyolipome beider Nieren in unserer Klinik vor (. Abb. 1). Während der sonographischen Untersuchung des Abdomens klagte die Patientin über Luftnot. Zur diagnostischen Abklärung wurde ein Röntgenbild des Thorax angefertigt (. Abb. 2). Abb. 1 9 a Sonogramm der rechten Niere (Konvexschallkopf, 4 Mhz): echoreiche, glatt begrenzte Raumforderung am Oberpol der rechten Niere mit Schallschatten (Durchmesser der Raumforderung 3,5 cm, Pfeil). Innerhalb der Raumforderung sind kleinere, echoarme Anteile abgrenzbar. b In der farbkodierten Duplexsonographie ist die Raumforderung nur randständig gering vaskularisiert Abb. 2 8 Thoraxröntgen p. a. Rechtsseitiger Spannungspneumothorax mit Verlagerung des Herz-und Mediastinalschattens nach links und des Zwerchfells nach kaudal. Die linke Lunge stellt sich unauffällig dar D Wie lautet Ihre Diagnose?