A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran.

BACKGROUND: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. OBJECTIVES: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018-2019. RESULTS: A 50.2% increase was noted in the chest CT scan utilization in 2019-2020 compared to 2018-2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1-5 of 2019-2020, respectively. In Month 6 of 2019-2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018-2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018-19. CONCLUSION: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review.

Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS.

Assessment of the effect of radio contrast media on resistive index of renal artery by color doppler sonography.

Renal ischemia and direct toxic effect of contrast media are the main confounding causes of contrast-induced nephropathy (CIN). The effect of different contrast mediums on the resistance of renal artery is quite unclear. The aim of the present study was to assess the resistive index (RI) changes of renal segmental artery in color Doppler duplex sonography after injection of two different contrast mediums: iodixanol and iohexol. The RI of the renal segmental artery of 62 randomly chosen patients, with a normal baseline renal function, was calculated using color-coded Doppler sonography before and five minutes after bolus injection of two different contrast mediums. Thirty-one patients were administered 50 mL of iodixanol (Visipaque) and 31 patients were administered 50 mL of iohexol (Omnipaque) during intravenous urogram procedures. The RI results were analyzed and compared in two groups using two-tailed t-test. The mean RI of renal segmental artery increased significantly after administration of contrast media (mean +/- SD 0.61 +/- 0.046 vs 0.58 +/- 0.042; p< 0.001). The mean change of RI was 0.0387 +/- .00552 (mean +/- SE) in the setting of iohexol injection and 0.0216 +/- .00423 (mean +/- SE) five minutes after administration of iodixanol (p= 0.017). Both non-ionic iso-osmolar dimeric iodixanol and low-osmolar iohexol increase the renal artery resistance, but the changes are more dramatic with iohexol, suggesting better tolerance with iodixanol.