Inflammatory bowel disease (IBD) is a chronic, relapsing immune-mediated inflammation of the gastrointestinal tract. IBD includes two major disease entities: Crohn disease and ulcerative colitis. Imaging plays an important role in the diagnosis and surveillance of these complex disorders. Computed tomographic and magnetic resonance enterographic techniques have been refined in recent years to provide a superb means of evaluating the gastrointestinal tract for suspected IBD. Although the intestinal imaging manifestations of IBD have been extensively discussed in the radiology literature, extraintestinal imaging manifestations of IBD have received less attention. Multiple extraintestinal manifestations may be seen in IBD, including those of gastrointestinal (hepatobiliary and pancreatic), genitourinary, musculoskeletal, pulmonary, cardiac, ocular, and dermatologic disorders. Although many associations between IBD and extraintestinal organ systems have been well established, other associations have not been fully elucidated. Some extraintestinal disorders may share a common pathogenesis with IBD. Other extraintestinal disorders may occur as a result of unintended treatment-related complications of IBD. Although extraintestinal disorders within the abdomen and pelvis may be well depicted with cross-sectional enterography, other musculoskeletal and thoracic disorders may be less evident with such examinations and may warrant further investigation with additional imaging examinations or may be readily apparent from the findings at physical examination. Radiologists involved in the interpretation of IBD imaging examinations must be aware of potential extraintestinal manifestations, to provide referring clinicians with an accurate and comprehensive profile of patients with these complex disorders. RSNA, 2017.
Purpose To validate adipose tissue magnetic resonance imaging (atMRI) for rapid, quantitative volumetry of visceral adipose tissue (VAT) and total adipose tissue (TAT). Materials and Methods Data was acquired on normal adults and clinically-overweight girls with IRB approval/parental consent using sagittal 6-echo 3D-SPGR (26-sec single-breath-hold) at 3T. Fat-fraction images were reconstructed with quantitative corrections, permitting measurement of a physiologically-based fat-fraction threshold in normals to identify adipose tissue, for automated measurement of TAT and semi-automated measurement of VAT. TAT accuracy was validated using oil phantoms and in vivo TAT/VAT measurements validated with manual segmentation. Group comparisons were performed between normals and overweight girls using TAT, VAT, VAT-TAT-ratio (VTR), body-mass-index (BMI), waist circumference, and waist-hip-ratio (WHR). Results Oil phantom measurements were highly accurate (< 3% error). The measured adipose fat-fraction threshold was 96% ± 2%. VAT and TAT correlated strongly to manual segmentation (normals r2 ≥ 0.96, overweight girls r2 ≥ 0.99). VAT segmentation required 30 ± 11 minutes/subject (14 ± 5 sec/slice) using atMRI, versus 216 ± 73 minutes/subject (99 ± 31 sec/slice) manually. Group discrimination was significant using WHR (p < 0.001) and VTR (p = 0.004). Conclusion The atMRI technique permits rapid, accurate measurements of TAT, VAT and VTR.
post-questionaire, timeliness of hand-on practice (subxiphoid view for heart, tracheal ultrasound and bilateral lung sliding sign), and satisfication. Results: There are 20 junior emergency physicians participating in this study. The accuracy of post-test questionaire is increased from 7 to 9 points. After training, good subxiphoid view for heart can be obtained in 16 seconds, tracheal ultrasound can be obtained in 14 seconds and each lung sliding sign can be in 6 seconds.The satisfication score is 9 points in a 0-10 scale. Conclusions: Junior physicians can be familiar with resuscitation skills and incorporate ultrasound into resuscitation to improve resuscitation quality and patients' care. 3 Vessel Trachea ViewObjectives: 4 chamber view of the heart can help detecting upto 60-70% of cardiac anomalies. Further addition of the 3 vessel view, and more effectively 3 vessel trachea view can help us to increase the detection rate of cardiac anomalies significantly. Methods: 3 vessel view and 3 vessel trachea view were obtained in all patients referred to us, for routine screening as well as for fetal echocardiography. Patients with positive findings were converted into full echocardiography studies. Other structures were also evaluated, and when necessary further evaluation by karyotyping or FISH technique was done.
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