Pediatric Tongue Lesions: An Often-Overlooked but Important Collection of Diagnoses.

OBJECTIVE. The purpose of this article is to discuss imaging techniques and provide a pictorial review of pediatric tongue lesions. CONCLUSION. Pediatric tongue lesions represent an often-overlooked collection of abnormalities with a variety of clinical and radiologic features. The location of these lesions places the patient at risk for airway compromise. Systematic imaging evaluation of pediatric tongue lesions can help the radiologist arrive at a correct and timely diagnosis, thus improving and expediting patient care.

Neurosurgical complications: what the radiologist needs to know.

Visits to the emergency department by patients who have recently undergone neurosurgery are a common occurrence, and these patients frequently receive emergent cross-sectional head imaging in order to evaluate for complications. Different neurosurgical approaches may have typical postoperative imaging findings that can be confused with pathology. Furthermore, particular abnormal postoperative imaging findings may signal an evolving complication. It is essential for the radiologist to understand common neurosurgical procedures and their potential complications in order to provide proper diagnostic evaluation of the postoperative neurosurgical patient. The purpose of this review is to assist radiologists in the evaluation of the postoperative neurosurgical patient and educate them on associated complications. Familiarity with common neurosurgical techniques and postoperative complications will help radiologists make the correct diagnosis, communicate effectively with the neurosurgeon, and expedite patient care.

Imaging neurological emergencies in pregnancy and puerperium.

The altered physiologic state of female patients during and just after pregnancy places them at an increased risk for several potentially life-threatening neurologic disorders. Swift diagnosis of such pathology and related complications is critical in order to reduce risk of morbidity and mortality to both the mother and the fetus. Neuroimaging plays an important role in the emergent diagnosis of pathology associated with pregnancy and puerperium, and it is critical for the radiologist to be cognizant of correlative imaging findings. Furthermore, given concerns regarding risks of neuroimaging to the fetus, it is important for the radiologist to act as an informed consultant regarding balancing fetal risks and the mother's health. The purpose of this review is to elucidate the underlying pathophysiology and neuroimaging findings associated with diagnoses that are unique to or highly associated with pregnancy and puerperium, as well as to understand the role that CT and MR play in diagnosis during and just after pregnancy, and their respective risks to the fetus.

ERG is a novel and reliable marker for endothelial cells in central nervous system tumors.

ETS-related gene (ERG) is a transcription factor that has been linked to angiogenesis. Very little research has been done to assess ERG expression in central nervous system (CNS) tumors. We evaluated 57 CNS tumors, including glioblastomas (GBMs) and hemangioblastomas (HBs), as well as two arteriovenous malformations and four samples of normal brain tissue with immunohistochemistry using a specific ERG rabbit monoclonal antibody. In addition, immunostains for CD31, CD34, and α-smooth muscle actin (α-SMA) were performed on all samples. CD31 demonstrated variable and sometimes weak immunoreactivity for endothelial cells. Furthermore, in 1 case of a GBM, CD34 stained not only endothelial cells, but also tumor cells. In contrast, we observed that ERG was only expressed in the nuclei of endothelial cells, for example, in the hyperplastic vascular complexes that comprise the glomeruloid microvascular proliferation seen in GBMs. Conversely, α-SMA immunoreactivity was identified in the abluminal cells of these hyperplastic vessels. Quantitative evaluation with automated methodology and custom Matlab 2008b software was used to calculate percent staining of ERG in each case. We observed significantly higher quantitative expression of ERG in HBs than in other CNS tumors. Our results show that ERG is a novel, reliable, and specific marker for endothelial cells within CNS tumors that can be used to better study the process of neovascularization.

A Team-Based Approach to Radiology Resident Case Conference to Improve Camaraderie Among Trainees.

INTRODUCTION: In light of increasing concerns regarding resident burnout, we developed a team-based approach (TBA) to radiology resident case conference to foster wellness by cultivating camaraderie and a positive learning environment. METHODS: Teaching faculty provided both a traditional hot-seat and a TBA format case conference. Resident perceptions of each conference format were assessed using a 16-item questionnaire, with 14 of the items utilizing a 7-point Likert scale to assess the learning environment, including measures related to wellness. A two-sided Wilcoxon rank-sum test was used to compare responses between the 2 formats of teaching conferences. RESULTS: Four paired teaching sessions were performed by 4 individual faculty. Sixty-six individual resident responses were received for the hot-seat and TBA conferences in aggregate. Residents responded "strongly agree" to positive statements more often for the TBA format compared with hot-seat for 13 out of the 14 items used to assess perceptions of the learning environment, including measures of wellness and camaraderie. The level of agreement on a 7-point Likert scale pertaining to the statement "The format of this case conference improves camaraderie among my co-residents" had a median value of 4.5 for the hot-seat format and 7 for the TBA format (P = 0.002). DISCUSSION: A TBA format for resident case conference may foster a sense of camaraderie among trainees. Residency programs may consider supplementing hot-seat conferences with the TBA method to address increasing burnout among trainees and promote resident wellbeing.

Reducing Burnout Among Radiology Trainees: A Novel Residency Retreat Curriculum to Improve Camaraderie and Personal Wellness - 3 Strategies for Success.

OBJECTIVES: To describe a residency retreat curriculum established to improve wellness and reduce burnout within a radiology residency. METHODS: A wellness retreat was created and implemented within a large academic medical center's radiology residency. The retreat curriculum was designed by a Radiology Residency Wellness Committee and was supported by departmental funding. The retreat curriculum centered on 3 strategies for success: teambuilding and bonding, Design Thinking, and guided reflection. A questionnaire was distributed at the end of the retreat, asking 12 questions in 5-point Likert format to assess resident satisfaction with different components of the retreat, as well as open-ended questions to more deeply assess the effects of the retreat on the residency experience and personal wellness in our radiology residency. Questionnaire results were summarized using frequency and percentages. Open-ended responses were qualitatively analyzed using the constant comparative method. RESULTS: Thirty-seven of 41 residents (90%) in our radiology residency participated in the retreat. Thirty-five of the 37 residents (95%) participated in the postretreat questionnaire, with 33 of 37 residents (89%) completing the entire questionnaire. Thirty-two of 33 responders (97%) anticipated the retreat would improve their residency experience, and 27 of 33 responders (82%) indicated the retreat would improve their personal wellness. Based upon the open-ended responses, improved camaraderie was the major benefit of the retreat cited by the majority of residents. CONCLUSION: A departmentally sponsored radiology residency retreat may improve personal wellness and reduce burnout.