Search

Purpose: To investigate the etiology of spontaneous percutaneous nephrostomy (PCN) catheter dislodgements and evaluate factors potentially associated with these dislodgements, including muscle-to-fat composition and tissue characteristics of catheter traces., Materials and Methods: Data from 92 patients (63 males, 29 females; mean age 63.9 ± 11.4 years, range 28-88) undergoing 151 PCN catheter replacements between January 2016 and June 2021 were analyzed. Patients were divided into Group 1 (prophylactic replacements every 3 months, n = 41) and Group 2 (at least one spontaneous dislodgement, n = 51). Associations were evaluated for factors including intraabdominal visceral adipose tissue index (IAVATI), subcutaneous adipose tissue index (SATI), and abdominal perimeter. Other variables assessed were Eastern Cooperative Oncology Group (ECOG) performance status scores, psoas muscle index (PMI), renal size, renal parenchymal thickness, renal cortex-to-skin distance, posterolateral abdominal wall muscle thickness, and PCN replacement frequency., Results: No significant differences were identified between Group 1 and Group 2 in IAVATI, SATI, or abdominal perimeter values (p = 0.210-0.412). A significant difference in ECOG performance status scores (p = 0.0001), PMI (p = 0.04) and lower renal size, renal parenchymal thickness, renal cortex-to-skin distance, and posterolateral abdominal muscle thickness (p = 0.0001-0.039) were observed in Group 2. PCN replacements were significantly more frequent in Group 2 (p = 0.0001). Multivariate regression identified renal parenchymal thickness and abdominal wall muscle thickness as significant independent predictors (p = 0.0001, p = 0.02). ROC analysis yielded an AUC of 0.843 (95% CI: 0.769-0.917) for renal parenchymal thickness and 0.694 (95% CI: 0.610-0.778) for abdominal wall muscle thickness. Sensitivity and specificity rates were 73.1% and 96.4% for a 16 mm cutoff in renal parenchymal thickness, and 50.7% and 79.8% for an 8 mm cutoff in abdominal wall muscle thickness., Conclusion: A significant association was identified between spontaneous PCN catheter dislodgement and both the psoas muscle index and ECOG performance status scores, while no notable relationship was observed with abdominal visceral or subcutaneous fat tissue volumes or abdominal perimeter. The risk of dislodgement was found to increase with reduced renal parenchymal and abdominal wall muscle thickness, as well as with more frequent nephrostomy replacements, suggesting these parameters may serve as useful markers for identifying patients at higher risk., Competing Interests: Declarations. Ethical approval: This study was approved by the ethics committee of Pamukkale University (Pamukkale University Ethical Committee of Non-Invasive Clinical Research, Approval number: 13/13072021). All methods were carried out by relevant guidelines and regulations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: To evaluate the Superb Microvascular Imaging (SMI) vascular patterns and vascularity index (VI) values of malignant focal liver lesions (FLLs), assess their role in differential diagnosis, and examine interobserver agreement., Materials and Methods: A total of 107 patients (52 males, 55 females; mean age 62 ± 12.8 years, range 25-87) referred to the interventional radiology clinic for FLL biopsy between April 2022 and April 2023 were analyzed. Two radiologists independently assessed the SMI vascular patterns and calculated VI values. Differences among three lesion groups - hepatocellular carcinoma (HCC, n = 16), non-HCC primary liver malignancies (n = 16), and metastases (n = 75) - were evaluated, and interobserver agreement was assessed., Results: Most metastases (88%) demonstrated hypovascular patterns, while HCCs predominantly exhibited hypervascular patterns (68.7-81.3%). Non-HCC primary malignancies showed no dominant vascular pattern. Significant differences in SMI patterns were observed among lesion types (p = 0.001-0.035). VI values for HCCs (7.53-7.73) were significantly higher than those for non-HCC malignancies (2.73-2.93) and metastases (1.35-1.36) (p = 0.0001). ROC analysis based on VI values yielded AUCs of 0.886-0.887, with a cutoff of 2.92 providing 81.3% sensitivity and 79.1-80.2% specificity for HCC diagnosis. The inter-reader agreement for SMI patterns had a kappa score of 0.634, while the intraclass correlation coefficient (ICC) for VI values was 0.959., Conclusion: HCCs displayed more hypervascular SMI patterns and significantly higher VI values compared to other malignant FLLs, emphasizing the diagnostic potential of VI in distinguishing HCC from non-HCC tumors. Although metastases primarily exhibited hypovascular patterns and low VI values, no dominant vascular pattern was identified in non-HCC primary liver malignancies. Assessing VI values provided higher interobserver agreement compared to SMI patterns, enhancing objectivity and reproducibility., Competing Interests: Declarations. Ethical approval: This study was approved by the ethics committee of Pamukkale University (Pamukkale University Ethical Committee of Non-Invasive Clinical Research, 18/03/2022, E-60116787-020-184701). All methods were carried out by relevant guidelines and regulations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period., Methods: A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours., Results: Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h., Conclusion: The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care., (© 2024 Wiley Periodicals LLC.)

Objective: This study aimed to conduct a comparative analysis of procedural efficacy, safety, and patient outcomes between 2 distinct approaches for percutaneous antegrade double-J ureteral stent (DJS) insertion: the first-hand approach and via a nephrostomy route., Methods: Electronic records of patients undergoing percutaneous antegrade ureteral DJS placement from January 2016 to 2023 were reviewed. Patients were categorized into 2 groups based on stent placement technique: the first-hand group, involving a single-stage approach without prior percutaneous nephrostomy catheter insertion, and the nephrostomy group, where stent placement occurred through a percutaneous nephrostomy tube. Clinical data, including patient demographics, primary diagnoses, procedural details, complication rates, stent placement success, and post-procedural outcomes, were collected and analysed., Results: Both approaches demonstrated high technical success rates (93.1%). However, the nephrostomy route group exhibited a comparatively higher fluoroscopy exposure rate (8.2 min) than the first-hand group (6.8 min). Moreover, the complication risk increased by 3.08 times in patients treated with the nephrostomy method (P = .047). Notably, in cases of urinary malignancies, the preference was for placing DJS via nephrostomy., Conclusion: The first-hand approach should be prioritized as the initial choice in suitable cases owing to its reduced fluoroscopy time, lower complication rate, and the single-stage nature of the procedure., Advances in Knowledge: With the exception of cases necessitating urgent drainage, such as post-renal acute renal failure and urosepsis, the first-hand method is the primary approach for inserting DJS. This is primarily due to the significantly shorter radiation time and the single-stage nature of the procedure., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Purpose: Baastrup's disease is characterized by abnormal contact between adjacent spinous processes. Our study is the first to systematically incorporate the STIR sequence, recognized for its heightened sensitivity to fluid and edema, into the MRI protocol for diagnosing Baastrup's disease in symptomatic individuals. The objective is to determine its prevalence and association with lumbar spinal degenerative changes., Materials and Methods: Lumbar spinal MRI examinations of 375 patients performed between January 2021 and 2022 were retrospectively reviewed by two radiologists. Baastrup's disease was diagnosed based on meeting any of the following criteria: lumbar interspinous bursitis, hyperintense signal changes in adjacent spinous processes, and ligaments on the STIR sequence. The study also investigated the presence of degenerative changes and interreader agreement among radiologists., Results: Baastrup's disease was found in 141 of 375 individuals (37.8%). It correlated significantly with degenerative lumbar changes such as bulging (P = 0.0012), herniation (P = 0.0033), disc degeneration (P = 0.0013), Modic changes (P = 0.034), facet osteoarthritis (P = 0.0041), spinal stenosis (P = 0.005), and anterolisthesis (P = 0.0049). No significant associations were observed with gender (P = 0.468) or retrolisthesis (P = 0.167). Its occurrence increased gradually, peaking at 87.5% in individuals aged 80 and above. Radiologists showed complete agreement with Baastrup's diagnoses., Conclusion: Baastrup's disease is more commonly observed than being considered rare, displaying an incremental occurrence with increasing age in symptomatic individuals notably discernible on the STIR sequence. Using the STIR sequence seems to promote a consensus among radiologists, irrespective of their experience levels., (© 2024. The Author(s).)

A 14-year-old boy presented with shortness of breath, cough, and mild chest pain, with a history of intermittent milder symptoms. Physical examination and initial tests showed mild iron deficiency anemia, elevated C-reactive protein, and normal vital signs. Chest radiograph revealed abnormalities in the left lower zone, leading to contrast-enhanced chest CT. The CT scan revealed bilateral intrapulmonary sequestrations, both deriving blood supply from a common trunk originating from the celiac artery. The patient's symptoms initially attributed to a pulmonary infection improved with antibiotic therapy. Pulmonary sequestration is a congenital anomaly characterized by aberrant lung tissue lacking connections to bronchial tree or pulmonary arteries. It can lead to recurrent pulmonary infections and postinfectious sequelae. This case presented a unique bilateral sequestration, both originating from the celiac artery. Radiologists should be aware of sequestration types and associated anomalies, even in atypical locations. Blood supply can originate from various arteries, not just the aorta., (© 2023 Wiley Periodicals LLC.)

Background: Due to the long acquisition time and high cost of multiparametric magnetic resonance imaging (mpMRI), biparametric and, more recently, fast prostate magnetic resonance imaging (fpMRI) protocols have been described. However, there is insufficient data about the diagnostic performance and cost of fpMRI., Purpose: To compare the diagnostic performances and cost analysis of fpMRI and mpMRI in clinically significant prostate cancer (csPCA)., Study Type: Retrospective., Population: A total of 103 patients (63 had csPCA) with a mean age of 66.83 (± 7.22) years were included., Field Strength/sequence: A 1.5-T; T1- and T2-weighted turbo spin-echo imaging (T1WI and T2WI), echo-planar diffusion-weighted images, and dynamic contrast-enhanced T1W imaging., Assessment: Three readers independently evaluated the fpMRI and mpMRI images in different sessions blinded to all patient information. Diagnostic performances of fpMRI and mpMRI were evaluated. Kappa coefficient (κ) was used to determine the interreader and intrareader agreement. A detailed cost analysis was performed for each protocol., Statistical Tests: Receiver operating characteristics analysis, area under the curve (AUC), and κ test were used. Diagnostic performance parameters were also calculated., Results: Of the 63 malignant index lesions (csPCA), 53/63 of those (84.1%) originated from the peripheral zone and 10/63 lesions (15.9%) originated from the transition zone. The AUC values for fpMRI were 0.878 for reader 1, 0.937 for reader 2, and 0.855 for reader 3. For mpMRI, the AUC values were 0.893 for reader 1, 0.94 for reader 2, and 0.862 for reader 3. Inter and intrareader agreements were moderate to substantial (κ range, 0.5-0.79). The total cost per examination was calculated as €12.39 and €30.10 for fpMRI and mpMRI, respectively., Data Conclusions: Fast MRI protocol has similar diagnostic performance with mpMRI in detecting csPCA, and fpMRI can be considered an alternative protocol that could create a lower financial burden on health-care systems., Level of Evidence: 4 TECHNICAL EFFICACY STAGE: 6., (© 2022 International Society for Magnetic Resonance in Medicine.)