B-mode ultrasound characteristics of carotid plaques in symptomatic and asymptomatic patients with low-grade stenosis.

Carotid plaque features assessed using B-mode ultrasound can be useful for the prediction of cerebrovascular symptoms. Therefore, the aim of this retrospective study was to determine the ability of ultrasound B-mode imaging to differentiate between carotid plaques causing less than 50% stenosis in symptomatic and asymptomatic patients. A dataset of 1,593 patients with carotid disease who underwent carotid ultrasound between 2016 and 2021 was evaluated retrospectively between January and April of 2022. A total of 107 carotid plaques from 35 symptomatic and 52 asymptomatic patients causing low-grade stenosis on B-mode images were included in the analysis. Chi-square, independent t-test and Mann-Whitney U test were used to compare the variables. There was a significant association between hypertension and the presence of cerebrovascular symptoms (p = 0.01). Predominantly hypoechoic and hyperechoic carotid plaque were significantly associated with the presence and absence of cerebrovascular symptoms, respectively (predominantly hypoechoic: p = 0.01; predominantly hyperechoic: p = 0.02). Surface irregularity was significantly associated with the presence of cerebrovascular symptoms (p = 0.02). There is was a significant difference in the carotid plaque length and area between the symptomatic and asymptomatic patients (plaque length: symptomatic median 9 mm, interquartile range [IQR] 6 mm; asymptomatic median 6 mm, IQR 4.5 mm, p = 0.01; plaque area: symptomatic median 24 mm, IQR 30 mm; asymptomatic median 14 mm, IQR 17 mm, p = 0.01); however, this difference was not significant for plaque thickness (p = 0.55), or common carotid artery intima-media thickness (p = 0.7). Our findings indicate that hypertension patients with predominantly hypoechoic carotid plaques and plaques with an irregular surface are associated with the presence of cerebrovascular symptoms. In addition, the carotid plaques in symptomatic patients were longer and larger compared to asymptomatic patients.

A qualitative study to explore opinions of Saudi Arabian radiologists concerning AI-based applications and their impact on the future of the radiology.

Objective: The aim of this study was to explore opinions and views towards radiology AI among Saudi Arabian radiologists including both consultants and trainees. Methods: A qualitative approach was adopted, with radiologists working in radiology departments in the Western region of Saudi Arabia invited to participate in this interview-based study. Semi-structured interviews (n = 30) were conducted with consultant radiologists and trainees. A qualitative data analysis framework was used based on Miles and Huberman's philosophical underpinnings. Results: Several factors, such as lack of training and support, were attributed to the non-use of AI-based applications in clinical practice and the absence of radiologists' involvement in AI development. Despite the expected benefits and positive impacts of AI on radiology, a reluctance to use AI-based applications might exist due to a lack of knowledge, fear of error and concerns about losing jobs and/or power. Medical students' radiology education and training appeared to be influenced by the absence of a governing body and training programmes. Conclusion: The results of this study support the establishment of a governing body or national association to work in parallel with universities in monitoring training and integrating AI into the medical education curriculum and residency programmes. Advances in knowledge: An extensive debate about AI-based applications and their potential effects was noted, and considerable exceptions of transformative impact may occur when AI is fully integrated into clinical practice. Therefore, future education and training programmes on how to work with AI-based applications in clinical practice may be recommended.

Artificial intelligence in radiology: Are Saudi residents ready, prepared, and knowledgeable?

OBJECTIVES: To assess the knowledge and perception of artificial intelligence (AI) among radiology residents across Saudi Arabia and assess their interest in learning about AI. METHODS: An observational cross-sectional study carried out among radiology residents enrolled in the Saudi Board of Radiology, Saudi Arabia. An anonymized, self-administered questionnaire was distributed in April 2020 and responses were collected until July 2020. RESULTS: A total of 154 residents filled the questionnaire. The top 3 aspects of AI participants wanted to learn were: clinical use of AI applications, advantages and limitations of AI applications, and technical methods. Approximately 43.5% of participants did not expect AI to affect job positions, while 42% anticipated that job positions will decrease. Approximately 53% expected a reduction in reporting workload, while 28% expected an increase in workload. CONCLUSION: Currently, the exposure of radiologists to the use of AI is inadequate. It is imperative that AI is introduced to radiology trainees and that radiologists stay updated with advances in AI to be more knowledgeable on how to benefit from it.

Superior Hypogastric Nerve Block as Post-Uterine Artery Embolization Analgesia: A Randomized and Double-Blind Clinical Trial.

Purpose To evaluate the effectiveness of superior hypogastric nerve block (SHNB) in reducing narcotic use after uterine artery embolization (UAE). Materials and Methods This study was a prospective, randomized, double-blind, parallel clinical trial in patients referred to a tertiary care university teaching hospital for UAE. Forty-four participants were enrolled (mean age, 46 years; range, 32-56 years). No consenting patient was excluded. All participants were randomized 1:1 to undergo either a sham procedure or SHNB. There were 22 participants in each group. One participant was lost to follow-up regarding home survey results. Use of narcotics and antiemetics was recorded in-hospital. Pain scores were recorded at home for 10 days with use of a visual analog scale (range, 1-10). Statistical analysis was performed by using the t test and χ2 test, with P < .05 considered indicative of a statistically significant difference. The full study protocol can be found at www.clinicaltrials.gov (NCT02270255). Results Participant demographic characteristics, fibroid volume, symptoms, and perceived sensitivity to pain were similar in both groups. Immediately after embolization, the pain score was lower in the SHNB group than in the sham group (mean, 1.0 ± 2.1 vs 2.6 ± 2.0, respectively; P = .01). The total need for fentanyl in the postanesthesia care unit was lower in the SHNB group than in the sham group (mean, 56 µg ± 67 vs 124 µg ± 91, respectively; P = .009). The morphine-equivalent dose needed was lower in the SHNB group than in the sham group (mean, 5.1 mg ± 5.8 vs 11.0 mg ± 9.0, respectively; P = .014). Of the 22 participants in the SHNB group, five (23%) needed antiemetics versus 12 of 22 participants (55%) in the sham group (P = .03). No difference in hospital admissions was observed between the two groups, and no major complications occurred from the SHNB. Conclusion Use of superior hypogastric nerve block reduces the amount of pain-related narcotics and antiemetics after uterine artery embolization. © RSNA, 2018.