Septic arthritis of the sacroiliac joint.

Septic arthritis is an inflammation of a joint caused directly by various microorganisms. It is often characterized by many unspecific symptoms. Bacteria is the most often etiological factor. We present a case report of a 76-years old woman with a unilateral septic arthritis of the sacroiliac joint. Bacterial sacroiliitis should be taken into account in patients with sacroiliitis and fever onset. Proper diagnosis can be very often difficult and delayed but fast implementation of antibiotic therapy is extremely important in the treatment process. Diagnostic imaging is crucial to the diagnosis and monitoring of septic arthritis. Magnetic resonance imaging is the most relevant tool for the detection of sacroiliitis, allowing the institution of therapeutic strategies to impede the progression of the disease.

Radiomics - the value of the numbers in present and future radiology.

Radiomics is a new concept that has been functioning in medicine for only a few years. This idea, created recently, relies on processing innumerable quantities of metadata acquired from every examination, followed by extraction thereof from relevant imaging examinations, such as computer tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) images, by means of appropriate created algorithms. The extracted results have great potential and broad possibilities of application. Thanks to these we can verify efficiency of treatment, predict locations of metastases of tumours, correlate results with histopathological examinations, or define the type of cancer more precisely. In effect, we obtain more personalised treatment for each patient, which is extremely important and highly recommendable in the tests and applicable treatment therapies conducted nowadays. Radiomics is a non-invasive and high efficiency post-processing method. This article is intended to explain the idea of radiomics, the mechanisms of data acquisition, existing possibilities, and the challenges incurred by radiologists and physicians at the stage of making diagnosis or conducting treatment.

Application of the apparent diffusion coefficient in magnetic resonance imaging in an assessment of the early response to treatment in Hodgkin's and non-Hodgkin's lymphoma - pilot study.

PURPOSE: Lymphoproliferative neoplasms are the largest and most frequently diagnosed entities in the group of haematological malignancies. The aim of the study was to assess whether apparent diffusion coefficient (ADC) measured on the first day of the second cycle of chemotherapy could be a predictor of prognosis and of the final treatment's outcome. MATERIAL AND METHODS: The study included 27 patients with diagnosed Hodgkin's and non-Hodgkin's lymphoma, who had magnetic resonance (MR) performed with diffusion weighted imaging/apparent diffusion coefficient (DWI/ADC) before and on the first day of the second cycle of chemotherapy. Imaging was performed using a 1.5 T MR scanner. ADC was measured in lymphoma infiltration in the area of the lowest signal in the ADC map and the highest signal on ß 800 images in post-treatment study. After that, the corresponding area was determined in a pre-treatment study and an ADC value was measured. RESULTS: The difference between ADC values in pre-treatment (ADC = 720 mm2/s) and post-treatment (ADC = 1059 mm2/s) studies was statistically significant (p < 0.001). Cutoff values for estimating response to treatment were established at the level of ADC 1080 mm2/s, and ADC to muscle ratio at 0.82 in post-treatment study. Patients with ADC > 752 mm2/s before treatment manifested lower probability of progression than patients with ADC < 752 mm2/s. CONCLUSIONS: ADC measurement's before treatment and on the first day of the second cycle of chemotherapy can be used as a prognostic marker in lymphoma therapy. ADC values lower than 1080 mm2/s and an increase of the ratio after the treatment can be considered as a marker of disease progression.

Trifurcation of the right common carotid artery-Case report.

Trifurcation is rare anatomical variant of the common carotid artery (CCA) termination. Knowledge of such alteration may prevent from the unintentional complications and influence on the course of various invasive medical procedures carried in the neck region. The best way to assess anatomy of neck arteries is computed tomography angiography (CTA). In this article we present a case of 64-year old male patient, who was admitted to the department with a chronic headaches and dizziness. CTA revealed a trifurcation of the right common carotid artery into: internal carotid artery and two branches of external carotid artery. The aneurysm of the proximal part of Vertebral Artery was also observed and it was considered as a cause of the symptoms which should not be related to the anatomical variety of the CCA.

Atypical Enhancement of Gd-BOPTA on the Hepatobiliary Phase in Hepatic Metastasis from Carcinoid Tumor - Case Report.

BACKGROUND Carcinoid tumor is the most frequent neuroendocrine tumor (NET) that causes liver metastases. One of the best methods to assess this type of pathology is magnetic resonance imaging with hepatocyte-specific contrast media with low molecular weight gadolinium chelate Gd-BOPTA. As these lesions do not contain hepatocytes, they present as hypointense on MRI in comparison with liver tissue which enhances this type of contrast. CASE REPORT In this article, we present a case of a 65-year-old female patient who was admitted to the Emergency Department with abdominal pain. Computed tomography revealed a single focal lesion in her liver. The patient underwent further evaluation using magnetic resonance imaging (MRI). The hepatobiliary phase MRI showed an unspecific homogenous enhancement of the hepatobiliary agent Gd-BOPTA. Since the lesion was interpreted as a non-characteristic lesion, the patient was discharged from the hospital with a recommendation for early follow-up. The follow-up MRI 6 months after discharge disclosed multiple liver metastases. CONCLUSIONS Liver metastases generally demonstrate enhancement of hepatobiliary contrast agents in the T1-weighted hepatocellular phase. Metastasis from a carcinoid tumor may also demonstrate this enhancement.

Clinical applications of spleen ultrasound elastography - a review.

In the last few years, notable technical progress has taken place in ultrasound elastography. Qualitative methods have been replaced by quantitative ones, such as: transient elastography, acoustic radiation force impulse and shear wave elastography. Owing to the fact that the spleen is superficially located, it is possible to obtain reliable measuring accuracy of its hardness using sonoelastography. Lately, many researchers have been investigating how spleen elasticity changes in patients infected with hepatitis B virus or hepatitis C virus and in patients suffering from liver fibrosis, portal hypertension, esophageal varices or myelofibrosis. In this article, we review the role and current status of accessible qualitative ultrasound elastography methods, including recent advances in the evaluation of spleen stiffness and its clinical utility. As study results demonstrate, spleen stiffness correlates with liver fibrosis and is helpful in determining the level of fibrosis in the METAVIR scoring system. In patients infected with hepatitis B virus or hepatitis C virus, spleen stiffness increases even when liver elasticity remains unaltered. Furthermore, it is useful in diagnosing portal hypertension or predicting existence of esophageal varices. Moreover, in patients suffering from biliary atresia after Kasai portoenterostomy, spleen sonoelastography may be helpful in selecting patients for liver transplantation as well as for choosing the best strategy for portal vein reconstruction before liver transplantation. In myelofibrosis, spleen stiffness correlates with bone marrow fibrosis and may be used to assess the response to treatment. Spleen sonoelastography is also useful in the monitoring of transjugular intrahepatic portosystemic shunt function.

Chest HRCT findings in patients with primary Sjögren's syndrome.

BACKGROUND: Pulmonary manifestations (PMs) in primary Sjögren's syndrome (pSS) are among the most frequent extraglandular complications, with reported prevalence varying widely (9-75%), depending on the methods of detection. OBJECTIVES: The aim of this study was to assess the incidence of PMs in pSS and to determine the factors predisposing to the occurrence of this complication. MATERIAL AND METHODS: The study group consisted of 68 patients with pSS. Among the patients who were possibly affected by PMs, chest High Resolution Computed Tomography (HRCT) was performed. RESULTS: In the group of all patients afflicted with pSS, 30 people indicated the need to expand medical imaging via chest HRCT scan. (The most frequent reason, in 80%, was persistent, dry cough periodically waking up patients at night). The chest HRCT scan revealed lung tissue changes in the course of 29% of all examined patients (of 68). No correlation was found between the occurrence of HRCT changes and the age of patients (p = 0.8), increased CRP > 5 mg/1 (p = 0.1) or ESR > 20 mm/h (p = 0.9), focus score (p = 0.8), leucopenia (p = 0.5), RF value (p = 0.3), gamma globulin value (p = 0.5), intensity of eye and oral cavity dryness (p = 0.6; 0.3) and smoking cigarettes. Additionally, no correlation was found between more frequent occurrences of antibodies anti-SSA, anti-SSB or anti-Ro52 and HRCT changes (p = 0.3; 0.07; 0.4). Pertaining to the clinical signs, HRCT changes occurred more often only in patients suffering from peripheral arthritis (p < 0.01). CONCLUSIONS: PM is a frequent symptom of pSS. A factor predisposing to the development of changes in the respiratory system was not found. Changes in HRCT occur more frequently in patients with peripheral arthritis.