| 1. |
- Jansson, K., et al.
(författare)
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Mortality related to coronary angiography
- 1996
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Ingår i: Clinical Radiology. - : Elsevier. - 0009-9260 .- 1365-229X. ; 51:12, s. 858-860
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Tidskriftsartikel (refereegranskat)abstract
- Coronary angiography is in general regarded as a safe investigation with a low risk of serious complications, Unfortunately, a risk of serious complications exists, especially in patients with left main coronary artery disease or 3-vessel disease. The mortality rate ranges in different studies between 0.10% to 0.25%. The present series, reflecting nine gears experience, shows an overall mortality of 0.16%, This figure is influenced by the relatively high mortality: rate in the first year of the study, The recent mortality: rate of 0.07% has not changed in the last 3 years and almost all deaths occurred in the patients known to be at higher risk.
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| 2. |
- Aldin, Z., et al.
(författare)
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Long-term effectiveness of transforaminal anterolateral approach CT-guided cervical epidural steroid injections for cervical radiculopathy treatment
- 2024
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Ingår i: Clinical Radiology. - : Elsevier. - 0009-9260 .- 1365-229X. ; 79:5, s. e775-e783
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the long-term clinical effectiveness of computed tomography (CT)-guided transforaminal cervical epidural steroid injection using an anterolateral approach for the treatment of cervical radiculopathy (CR) using well-established robust clinical scoring systems for neck pain and neck disability. Despite its widespread use, evidence to support the long-term benefit of routine cervical epidural steroid injection is currently very limited.Materials and methods: This study included 113 patients with magnetic resonance imaging (MRI)-confirmed CR who underwent a steroid injection at a single cervical level via a unilateral transforaminal anterolateral approach. Pain was assessed quantitatively at pre-injection, 15 minutes post-injection, 1 month, 3 months, and at 1 year. Neck disability was assessed using the Oswestry Neck Disability Index (NDI) at pre-injection, 1 month, 3 months, and 1 year time points.Results: Eighty patients completed the study. Sixty per cent reported reduced neck pain (mean pain reduction, 55%), which was clinically significant in 45% cases. Furthermore, 66% reported an improvement in neck disability (mean improvement, 51%), which was clinically significant for 56% patients. Clinically significant good outcomes in both neck pain and neck disability were evident from as early as 1-month, and importantly, were independent both of pre-treatment CR characteristics (including severity of pre-injection neck pain or disability) and of findings on pre-injection MRI imaging.Conclusion: Transforaminal anterolateral approach CT-guided epidural steroid injection resulted in a clinically significant long-term improvement in both neck pain and disability for half of the present cohort of patients with unilateral single-level CR. This improvement was independent of the severity of the initial symptoms and pre-injection MRI findings.
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| 3. |
- Bhogal, P, et al.
(författare)
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Intracranial vessel wall MRI
- 2016
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Ingår i: Clinical radiology. - : Elsevier BV. - 1365-229X .- 0009-9260. ; 71:3, s. 293-303
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Bäcklund, J, et al.
(författare)
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Is CT indicated in diagnosing sacroiliac joint degeneration?
- 2017
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Ingår i: Clinical Radiology. - : Elsevier BV. - 0009-9260 .- 1365-229X. ; 72, s. 693.e9-693.e13
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess the value of computed tomography (CT) in the diagnosis of symptomatic sacroiliac (SI) joint degeneration.MATERIALS AND METHODS: CT images from 123 patients with clinically diagnosed SI joint pain were compared to age- and gender-matched controls without chronic back pain or previous back surgery. Degeneration was graded assessing joint space narrowing, osteophytes, subchondral sclerosis, cysts, and vacuum phenomena.RESULTS: The mean total score for the patients was 9.6 and for the controls 9.7 (p=0.77). A subgroup analysis of the mean score for the SI joints that were subjected to surgery was 4.3, compared to 4.8 in the conservatively treated SI joints in the patient group (p=0.23) and 4.8 for all SI joints in the control group (p=0.25). For patients with unilateral left-sided pain (n=40), the mean score for the left side was 5.2 and for the right side 4.9 (p=0.49). For patients with right-sided pain (n=41), the mean score for the right side was 4.8 and the left side 4.7 (p=0.55).CONCLUSION: The prevalence of SI joint degeneration on CT is equal in symptomatic and non-symptomatic individuals. This study indicates that the value of CT is limited, but further studies are needed to establish if CT has a place in diagnosing SI joint degeneration.
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| 5. |
- Fisichella, Valeria A, 1974, et al.
(författare)
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Computer-aided detection (CAD) as a second reader using perspective filet view at CT colonography: effect on performance of inexperienced readers.
- 2009
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Ingår i: Clinical Radiology. - : Elsevier BV. - 1365-229X .- 0009-9260. ; 64:10, s. 972-82
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate whether computer-aided detection (CAD) as a second reader using perspective filet view [three-dimensional (3D) filet] improves the performance of inexperienced readers at computed tomography colonography (CTC) compared with unassisted 3D filet and unassisted two-dimensional (2D) CTC. MATERIAL AND METHODS: Fifty symptomatic patients underwent CTC and same-day colonoscopy with segmental unblinding. Two inexperienced readers read the CTC studies on 3D filet and 2D several weeks apart. Four months later, readers re-read the cases only evaluating CAD marks using 3D filet. Suspicious CAD marks not previously described on 3D filet were recorded. Jackknife free-response receiver operating characteristic (JAFROC-1) analysis was used to compare the observers' performances in detecting lesions with 3D filet, 2D and 3D filet with CAD. RESULTS: One hundred and three lesions > or =3mm were detected at colonoscopy with segmental unblinding. CAD alone had a sensitivity of 73% (75/103) at a mean false-positive rate per patient of 12.8 in supine and 11.4 in prone. For inexperienced readers sensitivities with 3D filet with CAD were 58% (60/103) and 48% (50/103) with an improvement of 14-16 percentage points (p<0.05) compared with 2D and of 10-11 percentage points (p<0.05) compared with 3D filet. For inexperienced readers, the false-positive rate was 25-41% and 71-200% higher with 3D filet with CAD compared with 3D filet and 2D, respectively. JAFROC-1 analysis showed no significant differences in per-lesion overall performance among reading modes (p=0.8). CONCLUSION: CAD applied as a second reader using 3D filet increased both sensitivity and the number of false positives by inexperienced readers compared with 3D filet and 2D, thus not improving overall performance, i.e., the ability to distinguish between lesions and non-lesions.
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| 6. |
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| 7. |
- Linder, Gustav, et al.
(författare)
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F-18-FDG-PET/MRI in preoperative staging of oesophageal and gastroesophageal junctional cancer
- 2019
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Ingår i: Clinical Radiology. - : W B SAUNDERS CO LTD. - 0009-9260 .- 1365-229X. ; 74:9, s. 718-725
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate integrated 2-[F-18]-fluoro-2-deoxy-D-glucose (F-18-FDG) positron-emission tomography (PET)/magnetic resonance imaging (MRI), in comparison with the standard technique, integrated F-18-FDG-PET/computed tomography (CT), in preoperative staging of oesophageal or gastroesophageal junctional cancer.MATERIALS AND METHODS: In the preoperative staging of 16 patients with oesophageal or gastroesophageal junctional cancer, F-18-FDG-PET/MRI was performed immediately following the clinically indicated F-18-FDG-PET/CT. MRI-sequences included T1-weighted fat-water separation (Dixon's technique), T2-weighted, diffusion-weighted imaging (DWI), and gadolinium contrast-enhanced T1-weighted three-dimensional (3D) imaging. PET was performed with F-18-FDG. Two separate teams of radiologists conducted structured blinded readings of F-18-FDG-PET/MRI or F-18-FDG-PET/CT, which were then compared regarding tumour measurements and characteristics as well as assessment of inter-rater agreement (Cohen's kappa) for the clinical tumour, nodal and metastatic (TNM) stage.RESULTS: There were no medical complications. Comparison of tumour measurements revealed high correlations without significant differences between modalities. The maximum standardised uptake value (SUVmax) values of the primary tumour with F-18-FDG-PET/MRI had excellent correlation to those of F-18-FDG-PET/CT (0.912, Spearman's rho). Inter-rater agreement between the techniques regarding T-stage was only fair (Cohen's kappa, 0.333), arguably owing to relative over-classification of the T-stage using F-18-FDG-PET/CT. Agreements in the assessment of N- and M-stage were substantial (Cohen's kappa, 0.849 and 0.871 respectively).CONCLUSION: Preoperative staging with F-18-FDG-PET/MRI is safe and promising with the potential to enhance tissue resolution in the area of interest. F-18-FDG-PET/MRI and F-18-FDG-PET/CT correlated well for most of the measured values and discrepancies were seen mainly in the assessment of the T-stage. These results facilitate further studies investigating the role of F-18-FDG-PET/MRI in, e.g., predicting or determining the response to neoadjuvant therapy.
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| 8. |
- Mosavi, Firas, et al.
(författare)
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Whole-body diffusion-weighted MRI and (18)F-FDG PET/CT can discriminate between different lymphoma subtypes
- 2015
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Ingår i: Clinical Radiology. - : Elsevier BV. - 0009-9260 .- 1365-229X. ; 70:11, s. 1229-1236
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine whether combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and (18)F-FDG PET/CT.MATERIALS AND METHODS: Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and (18)F-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and (18)F-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC).RESULTS: Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n=12; aggressive non-Hodgkin's lymphoma (NHL), n=29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n=9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p=0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p=0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS.CONCLUSION: ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype.
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| 9. |
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| 10. |
- Nordenskjöld, A. C., et al.
(författare)
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X-ray exposure in utero and school performance : a population-based study of X-ray pelvimetry
- 2015
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Ingår i: Clinical Radiology. - : Elsevier BV. - 0009-9260 .- 1365-229X. ; 70:8, s. 830-834
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the association between exposure to ionising radiation from pelvimetric examinations in utero and school performance. MATERIAL AND METHODS: This was a population-based cohort study comprising 46,066 children born in the county of Ostergotland, Sweden, from 1980 through 1990. Through record linkage between Swedish registers, children exposed in utero to X-ray pelvimetry examination were compared to other children born in the same county during the study period, as well as to their unexposed siblings. Outcome variable was primary school grades, expressed in centiles and calculated through linear regression. RESULTS: In the univariate analysis, children exposed to X-ray pelvimetry in utero had higher school grades compared to unexposed children (point estimate 3 centiles, 95% confidence interval [CI]: 1.5 to 4.6). When sex, mother's education and income, birth order, and birth position were included in the analysis; however, the difference was reduced and the association was no longer statistically significant (PE 1.4, 95% CI: -0.1 to 2.8). Comparing exposed children with their siblings showed no statistical difference in univariate analysis or in multivariate analysis. CONCLUSION: No suggestion was found of a negative effect on school performance from in utero exposure of diagnostic X-ray pelvimetry.
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| 11. |
- Palmér, Magnus, 1980, et al.
(författare)
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Accuracy of transvaginal ultrasound versus MRI in the PreOperative Diagnostics of low-grade Endometrial Cancer (PODEC) study: a prospective multicentre study.
- 2023
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Ingår i: Clinical radiology. - : Elsevier BV. - 0009-9260 .- 1365-229X. ; 78:1, s. 70-79
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to investigate if the diagnostic accuracy of transvaginal ultrasound (TVUS) performed by gynaecologists is sufficient for preoperative assessment of low-grade endometrial cancer (EC) compared to magnetic resonance imaging (MRI). MRI and TVUS performed by gynaecologists were assessed at the participating centres. The MRI examinations were interpreted by two radiologists at the tertiary centre. Deep myometrial and cervical stroma invasion were visually assessed and compared to postoperative histopathology. Twohundred and fiftynine patients were included. There was a statistically significant difference in specificity assessing deep myometrial invasion between MRI and TVUS (MRI 0.88, TVUS 0.68). There was no difference in sensitivity (MRI 0.73, TVUS 0.68). When assessing cervical stroma infiltration, MRI had a higher specificity (MRI 0.96, TVUS 0.90), but there was no difference in sensitivity (MRI 0.41, TVUS 0.32). MRI has higher specificity than TVUS performed by gynaecologists for assessing deep MI and CSI in low-grade EC, but similar sensitivities. The use of TVUS as a first-line test, rather than MRI, may be supported by this study in centres where access to MRI may be limited.
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| 12. |
- Petridou, Elia, et al.
(författare)
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Breast fat volume measurement in a wide-bore 3T MR: comparison of traditional mammographic density evaluation with MR density measurements using automatic segmentation.
- 2017
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Ingår i: Clinical Radiology. - : Saunders Elsevier. - 0009-9260 .- 1365-229X. ; 72:7, s. 565-572
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Tidskriftsartikel (refereegranskat)abstract
- AimTo compare magnetic resonance imaging (MRI) derived breast density measurements using automatic segmentation algorithms with radiologist estimations using the Breast Imaging Reporting and Data Systems (BI-RADS) density classification.Materials and Methods40 women undergoing mammography and dynamic breast MRI as part of their clinical management were recruited. Fat-water separated MR images derived from a 2-point Dixon technique, phase sensitive reconstruction and atlas based segmentation were obtained before and after intravenous contrast. Breast density was assessed using software from Advanced MR Analytics (AMRA), Linköping, Sweden with results compared to the widely used four-quartile quantitative BIRADS scale.ResultsThe proportion of glandular tissue of the breast on MRI was derived from the AMRA sequence. The mean unenhanced breast density was 0.31 ± 0.22 (mean ± SD) (left) and 0.29 ± 0.21 (right). Mean breast density on post-contrast images was 0.32 ± 0.19 (left) and 0.32 ± 0.2 (right). There was "almost perfect" correlation between pre and post-contrast breast density quantification: Spearman correlation rho=0.98 (95% confidence intervals (CI): 0.97-0.99) (left) and rho=0.99(CI: 0.98-0.99) (right). The 95% limits of agreement were -0.11-0.08 (left) and -0.08-0.03 (right).Interobserver reliability for BIRADS is "substantial": weighted Kappa k=0.8 (CI: 0.74- 0.87). The Spearman Correlation coefficient between BIRADs and MR breast density was rho=0.73 (CI: 0.60-0.82) (left) and rho=0.75 (CI: 0.63-0.83) (right) which is also "substantial".ConclusionThe AMRA sequence provides a fully automated, reproducible, objective assessment of fibroglandular breast tissue proportion that correlates well with mammographic assessment of breast density with the added advantage of avoidance of ionising radiation.
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| 13. |
- Rossitti, Sandro, et al.
(författare)
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Absence of the common carotid artery in a patient with a persistent trigeminal artery variant
- 2001
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Ingår i: Clinical Radiology. - : Elsevier BV. - 0009-9260 .- 1365-229X. ; 56:1, s. 79-81
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Tidskriftsartikel (refereegranskat)abstract
- We found the present case when retrospectively reviewing the files of patients with intracranial aneurysm in our institution. It concerns the coexistence of a rare developmental anomaly of the aortic arch vessels and a persistent carotid-vertebrobasilar communication variant. Since no common embryologic basis is known, this association was probably fortuitous. Each of these particular anomalies can pose unique diagnostic and therapeutic difficulties.
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| 14. |
- Skorpil, M., et al.
(författare)
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Soft-tissue fat tumours : differentiating malignant from benign using proton density fat fraction quantification MRI
- 2019
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Ingår i: Clinical Radiology. - : Saunders Elsevier. - 0009-9260 .- 1365-229X. ; 74:7, s. 534-538
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate if quantifying proton density fat fraction (PDFF) would be useful in separating lipoma, atypical lipomatous tumour (ALT) and liposarcoma in the extremities and trunk. In addition, differentiating ALT versus non-classical lipomas using magnetic resonance imaging (MRI)-based fatty acidcomposition (FAC) and three-dimensional (3D) texture analysis was tested.Material and methods: This prospective study (undertaken between 2014–2017; comprising 20 women, 21 men) was approved by the Regional Ethical Review Board and informed consent was obtained from all participants. For PDFF and FAC 3D spoiled gradient multi-echo images were acquired. PDFF was analysed in 16 lipomas (25–76 years), 14 ALTs (42–78 years) and 11 myxoid liposarcomas (31–68 years). The difference of mean PDFF was tested with one-way analysis of variance. A support vector machine algorithm was used to find the separating mean PDFF values.Results: Mean PDFF for lipomas was 90% (range 76–98%), for ALT 83% (range 62–91%), and for liposarcoma 4% (range 0–21%). The difference of mean PDFF for liposarcomas versus ALT and lipoma was significant (p=0.0001, for both), and for ALT versus lipoma (p=0.021). The optimal threshold for separating liposarcoma from ALT and lipoma was 41.5%, and for ALT and lipoma 85%. Texture analysis could not separate ALT and non-classical lipomas, while the difference for FAC unsaturation degree was significant (p=0.013).Conclusion: Measuring PDFF is a promising complement to standard MRI, to separate liposarcomas from ALT and lipomas. Lipomas that are not solely composed of fat cannot confidently be separated from ALT using PDFF, FAC, or texture analysis.
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| 15. |
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| 16. |
- von Below, Catrin, et al.
(författare)
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Validation of 3 T MRI including diffusion-weighted imaging for nodal staging of newly diagnosed intermediate- and high-risk prostate cancer
- 2016
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Ingår i: Clinical Radiology. - : Saunders Elsevier. - 0009-9260 .- 1365-229X. ; 71:4, s. 328-334
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To prospectively validate 3 T magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) for preoperative lymph node (LN) staging in a clinical setting, in intermediate- and high-risk prostate cancer (PCa) patients using laparoscopic extended LN dissection (ePLND) as the reference standard.MATERIALS AND METHODS: Between August 2011 and May 2013, 40 newly diagnosed intermediate and high-risk PCa patients underwent preoperative LN staging with 3 T MRI DWI using histopathology of ePLND as the reference standard. The sensitivity, specificity, and accuracy of MRI DWI were calculated. A subgroup analysis of proven LN-positive patients was made to investigate differences in PSA, Gleason score, number, and size of LN metastases, estimated risk of LN involvement, and if curative treatment was indicated, between the true-positive and the false-negative groups.RESULTS: A total of 728 LN were harvested from six anatomical regions per patient (external, obturator, internal) with a mean number of 18 LNs per patient (range 11-40). Twenty patients had histologically proven LN-positive disease. MRI DWI was true positive in 11 patients, false negative in nine patients, false positive in two patients, and true negative in 18 patients, resulting in 90% specificity, 55% sensitivity, and 72.5% accuracy. The true-positive patients had significantly more involved LNs (mean 6.9 versus 2.7, p=0.017), with larger diameter (mean 12.3 versus 5.2 mm, p=0.048) and fewer were treated with curative intent (six versus nine, p=0.03), compared with the false-negative group.CONCLUSION: MRI DWI LN staging has a low sensitivity but high specificity. The true-positive patients have a considerably higher burden of LN metastases compared to false-negative patients.
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| 17. |
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| 18. |
- Ekberg, Olle, et al.
(författare)
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The clinical importance of a thick-walled, tender gall-bladder without stones on ultrasonography
- 1991
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Ingår i: Clinical Radiology. - 1365-229X. ; 44:1, s. 38-41
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Tidskriftsartikel (refereegranskat)abstract
- Ultrasound examinations of 563 patients with right upper quadrant pain and a clinical suspicion of acute cholecystitis were reviewed. In 31 patients, a tender, dilated gall-bladder with a thick (more than 4 mm) partly hypoechoic wall without any detectable calculi was found on the emergency examination. This was interpreted as due to acute acalculous cholecystitis. None of the patients was critically ill. Twenty-one of the patients had follow-up studies with either oral cholecystography, cholangiography, or ultrasound. Fourteen of the 21 had gall-bladder calculi while seven did not. These seven patients presumably represent the true frequency (1.2%) of acute acalculous cholecystitis in this clinical setting. In five other patients with an initial diagnosis of acute acalculous cholecystitis the gall-bladder wall thickening probably was secondary to concomitant pancreatitis, appendicitis, hepatitis or peptic ulcer disease. A meticulous and careful search for gall-bladder calculi should be performed in the presence of a dilated, tender thick-walled gall-bladder.
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| 19. |
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