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  • Journal Highlights

    The following are highlights from the current issues of RSNA’s two peer-reviewed journals.


    July 1, 2017

    Radiology
    Stratification, Imaging, and Management of Acute Massive and Submassive Pulmonary Embolism

    Although the true incidence of pulmonary embolism (PE) remains unclear, it is recognized as a substantial cause of morbidity and mortality among hospitalized patients. While PE causes approximately 100,000-180,000 deaths per year in the U.S., mortality is restricted to patients who suffer massive or submassive pulmonary emboli.

    In a review article published in Radiology(RSNA.org/Radiology), Akhilesh K. Sista, MD, of Weill Cornell Medical College in New York, and colleagues describe the pathophysiology, clinical presentation, stratification and imaging assessment of acute PE and the medical, surgical and endovascular management of massive and submassive PE. The authors summarize the most up-to-date literature on imaging, systemic thrombolysis, surgical embolectomy and catheter-directed therapy for submassive and massive PE and give representative examples that reflect modern practice.

    Due to the high mortality associated with acute massive PE, effective treatment requires prompt risk stratification and early intervention in the form of systemic thrombolysis, surgical embolectomy and/or catheter-directed therapy (CTD).

    The authors conclude that future research on acute PE treatment should focus on the standardization of thrombolytic doses to maximize benefit while minimizing bleeding risk and the ideal method of thrombolytic administration (peripheral IV vs. CDT).

    “Although trial data for systemic thrombolysis support the notion that thrombolytic therapy may reduce long-term sequelae from PE, further studies examining the impact of low-dose CDT on long-term quality of life are needed. In addition, randomized trials should also be supported by large-scale observational data,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    Radiographics
    Beyond the Bowel: Extraintestinal Manifestations of Inflammatory Bowel Disease

    Inflammatory bowel disease (IBD) is a chronic, relapsing immune-mediated inflammation of the gastrointestinal tract. The two major subtypes of IBD are Crohn disease and ulcerative colitis. Imaging plays an important role in the detection, characterization, and surveillance of IBD.

    In the July-August issue of RadioGraphics, (RSNA.org/RadioGraphics), Jeffrey D. Olpin, MD, of the University of Utah in Salt Lake City, and colleagues describe how CT enterography and MR enterography have emerged in recent years as invaluable tools in the assessment of IBD.

    The authors discuss the various extraintestinal organ systems that can be affected in the setting of Crohn disease and ulcerative colitis, describe specific extraintestinal disorders that are associated with IBD, and discuss the roles of CT and MRI in the evaluation of patients suspected of having extraintestinal manifestations of IBD.

    “IBD and associated disorders are complex disease entities that demand an interdisciplinary approach among various subspecialties, including gastroenterology and various surgical services. Radiologists involved in the interpretation of these imaging examinations must be aware of the extraintestinal manifestations of IBD to optimize clinical management of these complex patients,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only.

    Prepare for the ABR Diagnostic Radiology Core Exam with RadioGraphics Articles

    Residents and fellows planning to take the American Board of Radiology (ABR) Diagnostic Radiology Core Exam can use RadioGraphics articles to help prepare.

    Go to RSNA.org/RadioGraphics and click on the headings to open the outline and find RSNA journal articles chosen by experts in the field as covering material particularly relevant to each section of the exam. Bookmark an article to read later using the “Add to Favorites” link on the article page.

    Residents and fellows can also access the ABR Diagnostic Radiology Core Exam Study Guide here.

    Radiology Podcasts

    Radiology Podcasts
    Radiology Podcasts

    Listen to Radiology Editor Herbert Y. Kressel, MD, deputy editors and authors discuss the following articles in the February issue of Radiology at RSNA.org/Radiology-Podcasts.

    • “Supplemental Breast MR Imaging Screening of Women with Average Risk of Breast Cancer,” Christiane K. Kuhl, MD, and colleagues.
    • “Is There Long-term Signal Intensity Increase in the Central Nervous System on T1-weighted Images after MR Imaging with the Hepatospecific Contrast Agent Gadoxetic Acid? A Cross-sectional Study in 91 Patients,” Johannes Kahn, MD, and colleagues.
    • “Transient Bone Marrow Edema Syndrome versus Osteonecrosis: Perfusion Patterns at Dynamic Contrast-enhanced MR
      Imaging with High Temporal Resolution Can Allow Differentiation,” Tobias Geith, MD, and colleagues.

    RadioGraphics Podcasts

    Radiology Podcasts

    Listen to RadioGraphics Editor Jeffrey S. Klein, MD, and authors discuss the following article in the April-May issue of RadioGraphics at pubs.RSNA.org/Page/RadioGraphics/Views.

    • “Demystifying Orbital Emergencies: A Pictorial Review,” by Viet D. Nguyen, MD, and colleagues.



    RadSista
    Depiction of catheter-directed therapy with ultrasound assistance. The dashed appearance within the infusion catheters is the radiopaque markers of the inner ultrasound filament that is thought to disperse fibrinolytic drug farther into the thrombus and disrupt fibrin strands to allow more drug-substrate binding. (Radiology 2017;284;1:5-24) © RSNA 2017. All rights reserved. Printed with permission.

    RGOI
    Axial spondyloarthropathy: spine findings in a 45-year-old man with ulcerative colitis and chronic back pain. Sagittal T1-weighted (a) and STIR (b) MR images show Romanus lesions at the anterior annular ligament attachment sites; the lesions are depicted as areas of hypointensity on the T1-weighted MR image (arrow on a) and areas of hyperintensity on the STIR MR image (arrow on b). (RadioGraphics 2017;37;4:1135-1160) © RSNA 2017. All rights reserved. Printed with permission.




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