The 100 most-cited and 100 most-mentioned COVID-19-related radiological articles: a comparative bibliometric analysis.

OBJECTIVES: This study aimed to identify the 100 most-cited and 100 most-mentioned coronavirus disease-2019 (COVID-19)-related radiological articles and compare their characteristics. MATERIALS AND METHODS: We searched the Web of Science and Altmetric.com using the search terms "COVID," "COVID-19," "Coronavirus," "SARS-CoV-2," "nCoV," and "pandemic" to identify the most-cited and most-mentioned COVID-19-related articles. We identified the top 100 most-cited and 100 most-mentioned articles in the field of radiology, regardless of their publication journal. We extracted the information from the listed articles and compared the characteristics between the most-cited and most-mentioned. RESULTS: Thirty (30%) articles were featured in the lists of the most-cited and most-mentioned articles. The comparison of the 100 most-cited and most-mentioned articles on each list showed that the most frequently cited articles were published in November 2020 and before (p < .001), originated from China (p < .001), covered the topic of diagnosis of COVID-19 (p < .001), and were related to the subspecialty of pulmonary imaging (p < .001); the most frequently mentioned articles were published in December 2020 and after (p < .001), originated from the USA (p < .001), covered the topic of diagnosis of sequelae of COVID-19 (p = .013) and post-vaccination complications (p < .001), and were related to the subspecialties of cardiac imaging (p < .001) and neuroradiology (p < .013). CONCLUSION: Significant differences were observed in publication date, country of origin, topic, and subspecialty of scientific knowledge related to COVID-19 in the field of radiology, between citation and public dissemination. CLINICAL RELEVANCE STATEMENT: This bibliometric analysis compares the 100 most-cited and 100 most-mentioned COVID-19-related radiologic articles, aiming to provide valuable insights into the patterns of knowledge dissemination during the pandemic era. KEY POINTS: • Thirty articles were featured on the lists of the 100 most-cited and 100 most-mentioned COVID-19-related articles. • The 70 unique most-cited articles more frequently originated from China (48.6%), while the unique most-mentioned articles more frequently originated from the USA (51.4%) (p < 0.001). • The 70 unique most-mentioned articles were more frequently related to cardiac imaging (25.7% vs.0%, p < 0.001) and neuroradiology (15.7% vs. 1.4%, p < 0.005) compared to the unique most-mentioned articles.

Talaromyces rugulosus ventriculitis diagnosed by nanopore amplicon sequencing, 2022.

Ventriculitis has serious complications and a high mortality rate, so it is important to early identification of the pathogen for appropriate treatment. We report case of ventriculitis caused by Talaromyces rugulosus, a rare pathogen, in South Korea. Affected patient was immunocompromised. Repeated cerebrospinal fluid culture tests were negative, but the pathogen was identified by fungal internal transcribed spacer amplicon nanopore sequencing. The pathogen was detected outside the endemic area of talaromycosis.

Factors influencing mobility in community-dwelling older adults during the early COVID-19 pandemic: a cross-sectional study.

BACKGROUND: In older adults, mobility is important for maintaining their independence and quality of life, and it influences their physical, cognitive, and social health. This study aimed to identify the physical and psychosocial factors that affected the mobility of community-dwelling older adults, aged 65 years or older, who were socially isolated during the coronavirus disease 2019 (COVID-19) pandemic due to stay-at-home policies. METHODS: The participants in this study were 214 community-dwelling older adults in Korea, and a cross-sectional survey was conducted from December 2020 to January 2021. Variables included participants' general characteristics, mobility, sitting time, depression, social support, and cognitive function. RESULTS: Multiple linear regression analysis showed that the factors influencing older adults' mobility during the COVID-19 pandemic were depression (ß=-0.29, p < .001), age (65-74 years old) (ß = 0.19, p = .002), a lower level of education (ß=-0.17, p = .006), two or more comorbidities (ß=-0.18, p = .001), sitting time (ß=-0.17, p = .004), and the ability to drive a vehicle (ß = 0.14, p = .017). CONCLUSIONS: Home healthcare interventions are needed to limit psychosocial issues and improve mobility for older adults who had limited mobility during the COVID-19 pandemic.

The Effects of ICT-Based Interventions on Physical Mobility of Older Adults: A Systematic Literature Review and Meta-Analysis.

Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, p=0.005, I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = -0.40, 95% CI: -0.72 to -0.08, p < 0.001, I2 = 75.0%) and in the exergame with virtual reality (VR) group (SMD = -0.33, 95% CI: -1.01 to 0.35, p < 0.001, I2 = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = -0.19, 95% CI: -0.61 to 0.23, p=0.375, I2 = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, p=0.004, I2 = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.

Effects of grit, calling, and resilience on the retention intention of general hospital nurses.

AIM: This study aimed to determine the influence of personal factors such as grit, calling, and resilience on nurses' retention intention in South Korean general hospitals. BACKGROUND: The global shortage and high turnover rate of nurses have become significant concerns with no clear solutions for increasing retention. INTRODUCTION: Determining the factors related to the f general hospital nurses and retention intention is important for solving the problem of inadequate nursing personnel and improving the quality of nursing services. METHODS: This study was a descriptive survey of 221 nurses working at a general hospital in South Korea from July 2021 to February 2022. Data were collected using self-reported online questionnaires, with measurement tools focusing on grit, calling, resilience, and retention intention. The STROBE checklist was used for reporting this study. RESULTS: The average retention intention score was 5.35 ± 1.52 out of 8 points. Significant correlations were found between retention intention and grit, calling, and resilience. The factors influencing retention intention were job satisfaction, calling, marital status, and total career length, explaining 31.9% of the variance. CONCLUSIONS: To enhance nurses' intention to remain at general hospitals, their job satisfaction and sense of a calling should be improved. Further research should be conducted to identify factors that influence retention intention, particularly among groups with low job retention, with consideration of individual characteristics that might affect retention intention. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Increasing nurses' retention intention would alleviate the nursing shortage, help hospitals retain competent nurses, reduce turnover-related costs, and improve organizational efficiency. Resolving the nursing shortage is critical for improving patient safety and nursing service quality at general hospitals.

Development and validation of an ensemble artificial intelligence model for comprehensive imaging quality check to classify body parts and contrast enhancement.

BACKGROUND: Despite the dramatic increase in the use of medical imaging in various therapeutic fields of clinical trials, the first step of image quality check (image QC), which aims to check whether images are uploaded appropriately according to the predefined rules, is still performed manually by image analysts, which requires a lot of manpower and time. METHODS: In this retrospective study, 1669 computed tomography (CT) images with five specific anatomical locations were collected from Asan Medical Center and Kangdong Sacred Heart Hospital. To generate the ground truth, two radiologists reviewed the anatomical locations and presence of contrast enhancement using the collected data. The individual deep learning model is developed through InceptionResNetv2 and transfer learning, and we propose Image Quality Check-Net (Image QC-Net), an ensemble AI model that utilizes it. To evaluate their clinical effectiveness, the overall accuracy and time spent on image quality check of a conventional model and ImageQC-net were compared. RESULTS: ImageQC-net body part classification showed excellent performance in both internal (precision, 100%; recall, 100% accuracy, 100%) and external verification sets (precision, 99.8%; recovery rate, 99.8%, accuracy, 99.8%). In addition, contrast enhancement classification performance achieved 100% precision, recall, and accuracy in the internal verification set and achieved (precision, 100%; recall, 100%; accuracy 100%) in the external dataset. In the case of clinical effects, the reduction of time by checking the quality of artificial intelligence (AI) support by analysts 1 and 2 (49.7% and 48.3%, respectively) was statistically significant (p < 0.001). CONCLUSIONS: Comprehensive AI techniques to identify body parts and contrast enhancement on CT images are highly accurate and can significantly reduce the time spent on image quality checks.

Population-based and Personalized Reference Intervals for Liver and Spleen Volumes in Healthy Individuals and Those with Viral Hepatitis.

Background Reference intervals guiding volumetric assessment of the liver and spleen have yet to be established. Purpose To establish population-based and personalized reference intervals for liver volume, spleen volume, and liver-to-spleen volume ratio (LSVR). Materials and Methods This retrospective study consecutively included healthy adult liver donors from 2001 to 2013 (reference group) and from 2014 to 2016 (healthy validation group) and patients with viral hepatitis from 2007 to 2017. Liver volume, spleen volume, and LSVR were measured with CT by using a deep learning algorithm. In the reference group, the reference intervals for the volume indexes were determined by using the population-based (ranges encompassing the central 95% of donors) and personalized (quantile regression modeling of the 2.5th and 97.5th percentiles as a function of age, sex, height, and weight) approaches. The validity of the reference intervals was evaluated in the healthy validation group and the viral hepatitis group. Results The reference and healthy validation groups had 2989 donors (mean age ± standard deviation, 30 years ± 9; 1828 men) and 472 donors (mean age, 30 years ± 9; 334 men), respectively. The viral hepatitis group had 158 patients (mean age, 48 years ± 12; 95 men). The population-based reference intervals were 824.5-1700.0 cm3 for liver volume, 81.1-322.0 cm3 for spleen volume, and 3.96-13.78 for LSVR. Formulae and a web calculator (https://i-pacs.com/calculators) were presented to calculate the personalized reference intervals. In the healthy validation group, both the population-based and personalized reference intervals were used to classify the volume indexes of 94%-96% of the donors as falling within the reference interval. In the viral hepatitis group, when compared with the population-based reference intervals, the personalized reference intervals helped identify more patients with volume indexes outside the reference interval (liver volume, 21.5% [34 of 158] vs 13.3% [21 of 158], P = .01; spleen volume, 29.1% [46 of 158] vs 22.2% [35 of 158], P = .01; LSVR, 35.4% [56 of 158] vs 26.6% [42 of 158], P < .001). Conclusion Reference intervals derived from a deep learning approach in healthy adults may enable evidence-based assessments of liver and spleen volume in clinical practice. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Ringl in this issue.

Meta-analysis of CT and MRI for differentiation of autoimmune pancreatitis from pancreatic adenocarcinoma.

OBJECTIVES: To systematically determine the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC), with a comparison between the two imaging modalities. METHODS: Literature search was conducted using PubMed and EMBASE databases to identify original articles published between 2009 and 2019 reporting the diagnostic performance of CT and MRI for differentiating AIP from PDAC. The meta-analytic sensitivity and specificity of CT and MRI were calculated, and compared using a bivariate random effects model. Subgroup analysis for differentiating focal AIP from PDAC was performed. RESULTS: Of the 856 articles screened, 11 eligible articles are remained, i.e., five studies for CT, four for MRI, and two for both. The meta-analytic summary sensitivity and specificity of CT were 59% (95% confidence interval [CI], 41-75%) and 99% (95% CI, 88-100%), respectively, while those of MRI were 84% (95% CI, 68-93%) and 97% (95% CI, 87-99%). MRI had a significantly higher meta-analytic summary sensitivity than CT (84% vs. 59%, p = 0.02) but a similar specificity (97% vs. 99%, p = 0.18). In the subgroup analysis for focal AIP, the sensitivity for distinguishing between focal AIP and PDAC was lower than that for the overall analysis. MRI had a higher sensitivity than CT (76% vs. 50%, p = 0.28) but a similar specificity (97% vs. 98%, p = 0.07). CONCLUSION: MRI might be clinically more useful to evaluate patients with AIP, particularly for differentiating AIP from PDAC. KEY POINTS: • MRI had an overall good diagnostic performance to differentiate AIP from PDAC with a meta-analytic summary estimate of 83% for sensitivity and of 97% for specificity. • CT had a very high specificity (99%), but a suboptimal sensitivity (59%) for differentiating AIP from PDAC. • Compared with CT, MRI had a higher sensitivity, but a similar specificity.

Predicting nurses' intentions in allowing family presence during resuscitation: A cross-sectional survey.

AIMS AND OBJECTIVES: This study examined nurses' intention to allow family presence during resuscitation (FPDR) by applying the theory of planned behaviour with an extended concept. BACKGROUND: Medical institutions, including nurses and other medical professionals working in emergency and intensive care units, are reluctant to allow FPDR. However, this practice reduces the family's anxiety and stress while fostering well-being and minimises their feelings of helplessness and distress by making them believe that they have helped the patient. DESIGN: A cross-sectional descriptive design was used in this study. METHODS: The participants were 252 nurses who had been working for at least 3 months in a general hospital in South Korea. Data were collected using self-report questionnaires in April 2020 and were analysed using descriptive statistics, Pearson's correlation analysis and multiple regression analysis. The instruments were intention to allow FPDR (five constructs: intention to allow FPDR, positive attitude, negative attitude, subjective norm and perceived behavioural control), perception of FPDR and self-confidence. The STROBE checklist was used for reporting this study. RESULTS: The mean score for the intention to allow FPDR was 3.47 out of 5. The regression analysis results indicated that perception of FPDR, positive attitude and negative attitude predicted the intention to allow FPDR. CONCLUSIONS: It is necessary to develop educational programmes to change the perceptions of and attitudes towards FPDR. Additionally, written policies and protocols for FPDR in South Korea are needed to develop systematic care for patients' families during cardiopulmonary resuscitation. RELEVANCE TO CLINICAL PRACTICE: The findings of this study provide baseline data for developing FPDR policies and guidelines that could minimise the family's distress and allow them to feel that they have helped the patient.

Binding of SRSF4 to a novel enhancer modulates splicing of exon 6 of Fas pre-mRNA.

Alternative splicing of exon 6 in Fas pre-mRNA generates a membrane bound pro-apoptotic isoform or soluble anti-apoptotic isoform. SRSF4 is a member of Arginine-Serine rich (SR) protein family. Here we demonstrate that increased SRSF4 expression stimulates exon 6 inclusion, and that reduced SRSF4 expression promotes exon 6 exclusion. We also show that weaker but not stronger 5' splice-site strength of exon 6 abolishes the SRSF4 effects on exon 6 splicing. Furthermore, we identified a novel enhancer on exon 6, on which SRSF4 interacts functionally and physically. Our results illustrate a novel regulatory mechanism of Fas pre-mRNA splicing.

Social isolation and its influencing factors among age-related hearing loss patients: A cross-sectional study.

Hearing loss is considered one of the most common symptoms of aging worldwide, and age-related hearing loss is one of the three major chronic illnesses that affect older adults. This study examined social isolation among age-related hearing loss patients and its influencing factors. This cross-sectional descriptive study collected data from older adults with hearing loss from March 2019 to February 2020 at a university hospital. Social isolation, subjective hearing handicap, and communication-related life satisfaction were measured using a structured questionnaire. Objective hearing function was evaluated using an audiometer (Madsen Asterao 2). The independent t test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for reporting this study. Almost half (49.9%) of 203 age-related hearing loss patients aged 60 to 92, with a mean age of 71.6 ±â€…7.95 years, experienced social isolation. Factors predicting social isolation were communication-related life satisfaction (P < .001), religiosity (P = 001), experience using hearing aids (P = .006), and subjective hearing handicap (P = .047). The explanatory power of the model was 58.2%. Interventions to reduce social isolation among age-related hearing loss patients should be implemented in an effort to develop effective, appropriate, and comprehensive strategies targeting this high-risk group.

Global hyperperfusion after successful endovascular thrombectomy is linked to worse outcome in acute ischemic stroke.

Patients with stroke may develop hyperperfusion after a successful endovascular thrombectomy (EVT). However, the relationship between post-EVT hyperperfusion and clinical outcomes remains unclear and requires further clarification. We reviewed consecutive patients with anterior circulation occlusion who were successfully recanalized with EVT. Based on post-EVT arterial spin-labeling images, hyperperfusion was categorized as follows: global hyperperfusion (GHP), increased cerebral blood flow (CBF) in ≥ 50% of the culprit vessel territory; focal hyperperfusion (FHP), increased CBF in < 50% of the culprit vessel territory; no hyperperfusion (NHP), no discernible CBF increase. Factors associated with hyperperfusion were assessed, and clinical outcomes were compared among patients under different hyperperfusion categories. Among 131 patients, 25 and 40 patients developed GHP and FHP, respectively. Compared to other groups, the GHP group had worse National Institutes of Health Stroke Scale score (GHP vs. NHP/FHP, 18.1 ± 7.4 vs. 12.3 ± 6.0; p < 0.001), a larger post-EVT infarct volume (98.9 [42.3-132.7] vs. 13.5 [5.0-34.1] mL; p < 0.001), and a worse 90-day outcome (modified Rankin Scale, 3 [1-4] vs. 2 [0-3]; p = 0.030). GHP was independently associated with infarct volume (B = 0.532, standard error = 0.163, p = 0.001), and infarct volume was a major mediator of the association of GHP with unfavorable outcomes (total effect: ß = 0.176, p = 0.034; direct effect: ß = 0.045, p = 0.64; indirect effect: ß = 0.132, p = 0.017). Patients presenting with post-EVT GHP had poorer neurological prognosis, which is likely mediated by a large infarct volume.

Hypoxia inducible factors inhibit respiratory syncytial virus infection by modulation of nucleolin expression.

Respiratory syncytial virus (RSV) is a global healthcare problem, causing respiratory illness in young children and elderly individuals. Our knowledge of the host pathways that define susceptibility to infection and disease severity are limited. Hypoxia inducible factors (HIFs) define metabolic responses to low oxygen and regulate inflammatory responses in the lower respiratory tract. We demonstrate a role for HIFs to suppress RSV entry and RNA replication. We show that hypoxia and HIF prolyl-hydroxylase inhibitors reduce the expression of the RSV entry receptor nucleolin and inhibit viral cell-cell fusion. We identify a HIF regulated microRNA, miR-494, that regulates nucleolin expression. In RSV-infected mice, treatment with the clinically approved HIF prolyl-hydroxylase inhibitor, Daprodustat, reduced the level of infectious virus and infiltrating monocytes and neutrophils in the lung. This study highlights a role for HIF-signalling to limit multiple aspects of RSV infection and associated inflammation and informs future therapeutic approaches for this respiratory pathogen.

Impact of emotional state and suicidal intentions on suicide attempts among Korean adolescents with household financial difficulties following the outbreak of COVID-19: A cross-sectional study.

The recent prolonged coronavirus disease-2019 pandemic has brought an economic crisis to various households, leading to negative mental health such as depression, anxiety, traumatic distress, and suicide risk among adolescents. Adolescents with household financial difficulties due to the coronavirus disease-2019 pandemic show high suicidal tendencies and attempts such as suicidal ideation and plans, their suicidal ideation and plans increase the risk of suicide attempts in South Korea. The purpose of this study was to determine the effects of emotional state and suicidal tendencies on suicide attempts among adolescents with household financial difficulties in early pandemic. This was a secondary data analysis study using statistical data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey. Among 54,948 who participated in the survey, 16,839 (30.6%) adolescents who had household financial difficulties were included in final analysis. Descriptive statistics, chi-squared test, and logistic regression analysis were conducted to analyze data. The strengthening the reporting of observational studies in epidemiology checklist was used for reporting this study. 16,839 adolescents (mean age 15.68 ± 1.76 years; 8709, 51.7% male) who experienced household financial difficulties in the prior year revealed 3 percent (508) had attempted suicide. Suicide attempts differed according to several characteristics and were significantly associated with sex, residence type, drinking experience, depressive mood, perceived happiness, suicidal ideation, and suicide planning. The findings indicate high-risk adolescents with household financial difficulties need a multi-dimensional safety network, suicide screening, and emotional interventions during the pandemic.

Validation of cost-efficient EEG experimental setup for neural tracking in an auditory attention task.

When individuals listen to speech, their neural activity phase-locks to the slow temporal rhythm, which is commonly referred to as "neural tracking". The neural tracking mechanism allows for the detection of an attended sound source in a multi-talker situation by decoding neural signals obtained by electroencephalography (EEG), known as auditory attention decoding (AAD). Neural tracking with AAD can be utilized as an objective measurement tool for diverse clinical contexts, and it has potential to be applied to neuro-steered hearing devices. To effectively utilize this technology, it is essential to enhance the accessibility of EEG experimental setup and analysis. The aim of the study was to develop a cost-efficient neural tracking system and validate the feasibility of neural tracking measurement by conducting an AAD task using an offline and real-time decoder model outside the soundproof environment. We devised a neural tracking system capable of conducting AAD experiments using an OpenBCI and Arduino board. Nine participants were recruited to assess the performance of the AAD using the developed system, which involved presenting competing speech signals in an experiment setting without soundproofing. As a result, the offline decoder model demonstrated an average performance of 90%, and real-time decoder model exhibited a performance of 78%. The present study demonstrates the feasibility of implementing neural tracking and AAD using cost-effective devices in a practical environment.

Characteristics and Clinical Implication of White Matter Lesions in Patients With Adult Moyamoya Disease.

BACKGROUND AND OBJECTIVES: White matter hyperintensities (WMHs) are reportedly increased in moyamoya disease (MMD); however, their clinical importance is not well-established owing to their pathophysiologic heterogeneity by distribution. This study aimed to evaluate the burden and pattern of WMHs and its clinical implications in the MMD trajectory. METHODS: Adult patients with MMD without significant structural lesions were 1:1 propensity score-matched with healthy controls for sex and vascular risk factors. The total, periventricular, and subcortical WMH volumes were segmented and quantified fully automatically. WMH volumes were detrended by age and compared between the 2 groups. MMD severity based on Suzuki stage and future ischemic events were assessed for their association with WMH volumes. RESULTS: A total of 161 pairs of patients with MMD and controls were analyzed. MMD significantly correlated with increased total WMH volume (B [standard error], 0.126 [0.030]; p < 0.001), periventricular WMH volume (0.114 [0.027]; p < 0.001), and periventricular-to-subcortical ratio (0.090 [0.034]; p = 0.009). In the MMD subgroup (n = 187), advanced MMD had an independent association with the total WMH volume (0.120 [0.035]; p < 0.001), periventricular WMH volume (0.110 [0.031]; p < 0.001), and periventricular-to-subcortical ratio (0.139 [0.038]; p < 0.001). Periventricular WMH volume (adjusted hazard ratio [95% confidence interval], 5.12 [1.26-20.79]) and periventricular-to-subcortical ratio (3.80 [1.51-9.56]) were associated with future ischemic events in patients with medically followed up MMD. However, no demonstrable association was found between subcortical WMH volume and MMD, MMD severity, or future ischemic events. DISCUSSION: Periventricular WMHs, but not subcortical WMHs, may represent the main pathophysiology of MMD. Periventricular WMHs may be used as a marker for ischemic vulnerability in patients with MMD.

Presence of Embolic Source and Outcome in Central Retinal Artery Occlusion.

OBJECTIVES: The etiology of central retinal artery occlusion (CRAO) is unclear in approximately 50% of patients, suggesting pathomechanical heterogeneity; moreover, little is known about outcomes according to etiology. This study investigated whether the presence of an embolic source affects outcome in CRAO. METHODS: CRAO patients within 7 days of symptom onset were retrospectively enrolled. Clinical parameters, including initial and 1-month visual acuity, CRAO subtype, and brain images, were reviewed. CRAO etiology was categorized as CRAO with or without an embolic source (CRAO-E+ and CRAO-E-). Visual improvement was defined as a decrease in logarithm of the minimum angle of resolution ≥0.3 at 1 month. RESULTS: A total of 114 patients with CRAO were included. Visual improvement was noted in 40.4% of patients. Embolic sources were identified in 55.3% of patients, and visual improvement group rather than no improvement group was more commonly associated with the presence of an embolic source. In multivariable logistic regression analysis, CRAO-E+ independently predicted visual improvement (odds ratio 3.00, 95% CI 1.15-7.81, p = 0.025). DISCUSSION: CRAO-E+ was found to be associated with a better outcome. CRAO-E+ may be more prone to recanalization than that CRAO-E-.

MRI features for differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma: A systematic review and meta-analysis.

BACKGROUND AND AIMS: The accurate differential diagnosis between autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC) is clinically important. We aimed to determine significant MRI features for differentiating AIP from PDAC, including assessment of diffusion-weighted imaging (DWI). METHODS: We performed a systematic search using three databases. The pooled diagnostic odds ratio was calculated using a bivariate random effects model to determine significant MRI features for differentiating AIP from PDAC. The pooled sensitivity and specificity were calculated. The qualitative systematic review for DWI assessment was performed. RESULTS: Of nine studies (775 patients), multiple main pancreatic duct (MPD) strictures, absence of upstream marked MPD dilatation, peripancreatic rim, and duct penetration sign were significant MRI features for differentiating AIP from PDAC. Absence of MPD dilatation had the highest pooled sensitivity (87%, 95% CI=68-96%), whereas peripancreatic rim had the highest pooled specificity (100%, 95% CI=88-100%). Of 12 studies evaluating DWI, seven reported statistically significant differences in apparent diffusion coefficient (ADC) values between AIP and PDAC; however, four reported lower ADC values in AIP than in PDAC, but three reported the opposite result. CONCLUSION: The four significant MRI features can be useful to differentiate AIP from PDAC, but DWI assessment might be limited.

Comparison of gadoxetate disodium-enhanced MRI sequences for measuring hepatic observation size and its implication of LI-RADS classification.

PURPOSE: We aimed to determine the optimal image sequence for measurement of hepatic observations on gadoxetate disodium-enhanced MRI in comparison with pathologic measurement, and to evaluate its clinical impact on the Liver Imaging Reporting and Data System (LI-RADS) v2018 classification. METHODS: Two hundred and fifty-three patients (279 hepatic observations) who underwent gadoxetate disodium-enhanced MRI and subsequent hepatectomy were retrospectively included. Two radiologists independently evaluated the visualization score (five-point scale) and size of each observation on six MRI sequences (T1-weighted, T2-weighted, arterial-phase, portal venous-phase, transitional-phase [TP], and hepatobiliary-phase [HBP] images) and assigned a LI-RADS category. Correlations between MRI and pathologic measurements were evaluated using Pearson correlation coefficients. A repeated measures analysis of variance with Bonferroni post hoc comparison tests was used to compare the visualization scores and absolute differences between MRI sequences and pathologic measurements. The LI-RADS classification according the size measurement of each MRI sequence was compared using Cochran's Q test with a post hoc McNemar's test. RESULTS: Of the MRI sequences, HBP had the highest visualization score (4.1 ± 0.6) and correlation coefficient (r = 0.965). The absolute difference between MRI and pathologic measurement was lowest on TP (2.3 mm ± 2.2), followed by HBP (2.4 mm ± 2.1). In the LI-RADS classifications, HBP did not have any non-visible observations. Regarding LR-3, LR-4, and LR-5, there was no significantly different LI-RADS classification among the six MRI sequences (p ≥ 0.122). CONCLUSION: Hepatobiliary-phase images are clinically useful for measuring hepatic observations on gadoxetate disodium-enhanced MRI, especially regarding visibility and correlation with pathologic findings.