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  • Journal Highlights - July 2013

    July 01, 2013

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

    Radiology
    MR Imaging of Cardiac Tumors and Masses: A Review of Methods and Clinical Applications

    Left ventricular thrombus

    Left ventricular thrombus in a 55-year-old man with a history of myocardial infarction. A mass was seen at transthoracic echocardiography, which prompted further evaluation with MR imaging. B, There was no uptake of contrast agent in the mass (arrow) at EGE imaging, which suggested it was avascular. The combination of an avascular mass overlying a regional wall motion abnormality with demonstrable infarction confirmed the diagnosis of left ventricular thrombus.

    (Radiology 2013;268;1:26–43) ©RSNA, 2013. All rights reserved. Printed with permission. 

    While most cardiac masses are initially detected with echocardiography, cardiac MR imaging is becoming an established method for further assessment by providing versatile imaging planes, superior tissue contrast and advanced tissue characterization.

    In an article in the July issue of Radiology (RSNA.org/Radiology), Manish Motwani, M.B.Ch.B., of the University of Leeds, England, and colleagues provide a detailed description of a core protocol for the MR assessment of cardiac masses and tumors and illustrate the different imaging characteristics of the most common types of mass, with case examples.

    Knowledge of the MR imaging features of cardiac neoplasms and other masses is important for establishing an accurate diagnosis, avoiding misinterpretation of normal variants, and staging, directing appropriate therapy and evaluating prognosis in confirmed tumors, according to the authors.

    “Cardiac MR imaging features reliably detect thrombus and have been shown to accurately differentiate between benign and malignant tumors,” the authors write. “A core protocol of MR sequences as described in this review allows the morphology, anatomy, tissue characteristics, and functional impact of a suspected tumor to be assessed in a single examination.”


    Radiographics
    Sacroiliitis Associated with Axial Spondyloarthropathy: New Concepts and the Latest Trends

    Right-sided sacroiliitis

    Right-sided sacroiliitis. Color map from computer-assisted diagnostic analysis of dynamic contrast-enhanced MR imaging data clearly depict the areas in which the ROIs were placed.

    (RadioGraphics 2013;33) ©RSNA, 2013. All rights reserved. Printed with permission. 

    MR imaging is the most recent innovation and important change with respect to the previously established classification criteria for axial spondyloarthropathy. Along with serving as a biomarker of disease activity, MR imaging allows monitoring and provides guidance for the treatment of affected patients.

    As MR imaging becomes more central to caring for these patients, familiarity with the anatomy, anatomic variants and physiologic changes of the sacroiliac joints is important for correctly interpreting findings and avoiding misdiagnosis, according to an article in the July-August issue of RadioGraphics (RSNA.org/RadioGraphics), by María Navallas, M.D., of the IDIMAR CRC Mar–Hospital del Mar, Barcelona, Spain. Specifically, the authors discuss:

    • Relevant aspects of assessment for spondyloarthritis, with an emphasis on sacroiliitis
    • Classification criteria, anatomy and imaging techniques and findings used for diagnosis and follow-up
    • MR imaging protocol, common acute and chronic findings and the definition of a positive MR imaging study
    • Different methods of monitoring disease activity, including diffusion-weighted imaging and dynamic contrast material–enhanced imaging.

    MR imaging has become the new biomarker of disease activity because of its capacity to help detect inflammatory changes, even in advanced stages in which ankylosis of the sacroiliac joint has emerged, according to the authors.

    “More important, MR imaging is able to help quantify inflammatory activity, which makes it ideal for monitoring disease activity and for guiding treatment of sacroiliitis,” the authors write.

    The article is accompanied by two invited Commentaries.

    This article meets the criteria for AMA PRA Category 1 Credit™. CME is available in print and online. 
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Honduras
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Nicaragua
Panama
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St. Vincent & Grenadines
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Angola   Guinea-Bissau   Peru
Armenia   Guyana   Phillippines
Azerbaijan   Haiti   Rwanda
Bangladesh   Honduras   Samoa
Belarus   India   Sao Tome & Principe
Belize   Indonesia   Senegal
Benin   Iran   Serbia
Bhutan   Iraq   Sierra Leone
Bolivia   Jordan   Solomon Islands
Bosnia & Herzegovina   Jamaica   Somalia
Botswana   Kenya   South Africa
Bulgaria   Kiribati   South Sudan
Burkina Faso   Korea, Dem Rep (North)   Sri Lanka
Burundi   Kosovo   St Lucia
Cambodia   Kyrgyzstan   St Vincent & Grenadines
Cameroon   Laos\Lao PDR   Sudan
Cape Verde   Lesotho   Swaziland
Central African Republic   Liberia   Syria
Chad   Macedonia   Tajikistan
China   Madagascar   Tanzania
Colombia   Malawi   Thailand
Comoros   Maldives   Timor-Leste
Congo, Dem. Rep.   Mali   Togo
Congo, Republic of   Marshall Islands   Tonga
Cote d'Ivoire   Mauritania   Tunisia
Djibouti   Micronesia, Fed. Sts.   Turkmenistan
Dominica   Moldova   Tuvalu
Domicican Republic   Mongolia   Uganda
Ecuador   Montenegro   Ukraine
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