ABSTRACT
Thoracic aortic graft infections are infrequent yet grave complications of cardiovascular surgery. Risk factors include prolonged operative time, postoperative wound infections, and patient-specific risk factors like diabetes or malnutrition (Van Hemelrijck et al., Vessel Plus 6:47, 2022). In postoperative vascular scenarios, it is critical to utilize cross-sectional imaging to detect the presence of a complication, followed by describing the morphology, extent, and ancillary features. FDG-PET/CT can help differentiate between expected postoperative changes and worrisome infection by metabolic activity (FDG uptake). We present an extensive case of ascending aortic graft infection in the setting of ongoing sternal osteomyelitis. CT and PET/CT reveal chronic sternal osteomyelitic changes spreading into the retrosternal soft tissues, and a large intraluminal thrombus in the ascending aortic graft. Small mobile strands propagate toward the right brachiocephalic origin, posing a significant stroke risk. PET/CT confirmed postoperative infection by demonstrating increased FDG uptake.
Subject(s)
Blood Vessel Prosthesis Implantation , Blood Vessel Prosthesis , Fluorodeoxyglucose F18 , Osteomyelitis , Positron Emission Tomography Computed Tomography , Predictive Value of Tests , Prosthesis-Related Infections , Sternum , Humans , Osteomyelitis/diagnostic imaging , Osteomyelitis/etiology , Osteomyelitis/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis/adverse effects , Chronic Disease , Treatment Outcome , Sternum/surgery , Sternum/diagnostic imaging , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/surgery , Prosthesis-Related Infections/etiology , Male , Fluorodeoxyglucose F18/administration & dosage , Risk Factors , Aged , Anti-Bacterial Agents/therapeutic use , Radiopharmaceuticals , Aortography/methods , Middle AgedABSTRACT
ABSTRACT: The expanded application of radiologic imaging resulted in an increased incidence of renal masses in the recent decade. Clinically, it is difficult to determine the malignant potential of the renal masses, thus resulting in complex management. Image-guided biopsies are the ongoing standard of care to identify molecular variance but are limited by tumor accessibility and heterogeneity. With the evolving importance of individualized cancer therapies, radiomics has displayed promising results in the identification of tumoral mutation status on routine imaging. This article discusses how magnetic resonance imaging features can guide a radiologist toward identifying renal mass characteristics.
Subject(s)
Kidney Neoplasms , Humans , Biopsy , Image-Guided Biopsy/methods , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Magnetic Resonance ImagingABSTRACT
A wide variety of benign and malignant breast processes may generate hyperintense signal at T2-weighted magnetic resonance imaging (MRI). MRI has been traditionally used in the pre-treatment planning of breast cancer, in assessing treatment response and detecting recurrence. In this comprehensive review, we describe and illustrate the MRI features of a few common and uncommon T2 hyperintense breast lesions, with an emphasis on MRI features that help to characterize lesions based on morphological features, specific appearances on T1-and T2-weighted imaging, and enhancement characteristics on the dynamic post-contrast phase that are either diagnostic or aid in narrowing the differential diagnosis.