Publications by authors named "Ashish Chawla"

74 Publications

Pulmonary amyloidosis: A close mimic of malignancy.

Lung India 2021 May-Jun;38(3):286-288

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/lungindia.lungindia_333_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194423PMC
May 2021

Cholangiocarcinoma: Part 1, Pathological and Morphological Subtypes, Spectrum of Imaging Appearances, Prognostic Factors and Staging.

Curr Probl Diagn Radiol 2021 Mar 13. Epub 2021 Mar 13.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Republic of Singapore.

Cholangiocarcinoma (CC) is the most frequent malignant tumor of the biliary tract. The vast majority of cholangiocarcinomas are adenocarcinomas with a high proportion of fibrous stroma. Based on the macroscopic growth pattern, CC is classified as mass-forming, periductal infiltrating, or intraductal, with each type having its own characteristic imaging findings and prognostic outcome. The recently proposed pathological classification of cholangiocarcinoma into two types: perihilar large duct type and peripheral small duct and/or ductular type helps in better understanding of the morphology and the imaging appearances. Computed tomography (CT) and magnetic resonance imaging (MRI) remain the main tools of imaging. We aim to provide a comprehensive outline of the different subtypes and the rationale behind various imaging features of these subtypes. Cholangiocarcinoma is one of the more difficult tumors to treat and till date, surgery remains the only definitive curative treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1067/j.cpradiol.2021.03.008DOI Listing
March 2021

Cholangiocarcinoma - Part 2, Tumoral and Nontumoral Mimics and Imaging Features Helpful in Differentiation.

Curr Probl Diagn Radiol 2021 Feb 7. Epub 2021 Feb 7.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Republic of Singapore. Electronic address:

Each of the 3 morphological subtypes of cholangiocarcinoma has a different set of imaging differentials. Emulators of mass-forming cholangiocarcinoma include other primary and secondary hepatic malignancies, benign tumors and tumor-like mimics such as abscess, hemangioma and confluent hepatic fibrosis. Benign inflammatory biliary strictures constitute the major differential of periductal-infiltrative type and intraductal calculi are the main consideration for intraductal-growth type. CT and MRI are the standard imaging tools for characterization of cholangiocarcinoma and differentiating it from close mimics. Here we will describe the various tumoral and non-tumoral mimics of cholangiocarcinoma and discuss specific imaging features useful in differentiation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1067/j.cpradiol.2021.02.005DOI Listing
February 2021

Adaptability and responsiveness: keys to operational measures in a regional hospital radiology department during the current COVID-19 pandemic.

BJR Open 2020 19;2(1):20200017. Epub 2020 Jun 19.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

The rapid and mostly uncontrolled spread of the coronavirus disease 2019 pandemic over the past 4 months has overwhelmed many healthcare systems worldwide. In Singapore, while our public healthcare institutions were considered well prepared due to our prior experience with the SARS outbreak, there was an unexpected surge of infected patients over the recent 2 months to deal with. We describe our radiology department's experience in modifying operational practices and implementing strict infection control measures aimed at minimizing disease transmission and mitigating the potential impact of possible staff infection. From the perspective of serving a medium-sized regional hospital and limited by physical and manpower constraints, our radiology department had to adapt quickly and modify our initial responses and practices as the disease scenario changed. We have also enumerated some guidelines for planning future radiology departments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjro.20200017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7594887PMC
June 2020

Impact of sequence type and field strength (1.5, 3, and 7T) on 4D flow MRI hemodynamic aortic parameters in healthy volunteers.

Magn Reson Med 2021 02 4;85(2):721-733. Epub 2020 Aug 4.

Department of Cardiology and Nephrology, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine and HELIOS Hospital Berlin Buch, Berlin, Germany.

Purpose: 4D flow magnetic resonance imaging (4D-MRI) allows time-resolved visualization of blood flow patterns, quantification of volumes, velocities, and advanced parameters, such as wall shear stress (WSS). As 4D-MRI enters the clinical arena, standardization and awareness of confounders are important. Our aim was to evaluate the equivalence of 4D flow-derived aortic hemodynamics in healthy volunteers using different sequences and field strengths.

Methods: 4D-MRI was acquired in 10 healthy volunteers at 1.5T using three different prototype sequences, at 3T and at 7T (Siemens Healthineers). After evaluation of diagnostic quality in three segments (ascending-, descending aorta, aortic arch), peak velocity, flow volumes, and WSS were investigated. Equivalence limits for comparison of field strengths/sequences were based on the limits of Bland-Altman analyses of the intraobserver variability.

Results: Non-diagnostic quality was found in 10/144 segments, 9/10 were obtained at 7T. Apart for the comparison of forward flow between sequence 1 and 3, the differences in measurements between field strengths/sequences exceeded the range of agreement. Significant differences were found between field strengths/sequences for forward flow (1.5T vs. 3T, 3T vs. 7T, sequence 1 vs. 3, 2 vs. 3 [P < .001]), WSS (1.5T vs. 3T [P < .05], sequence 1 vs. 2, 1 vs. 3, 2 vs. 3 [P < .001]), and peak velocity (1.5T vs. 7T, sequence 1 vs. 3 [P > .001]). All parameters at all field strengths/with all sequences correlated moderately to strongly (r ≥ 0.5).

Conclusion: Data from all sequences could be acquired and resulting images showed sufficient quality for further analysis. However, the variability of the measurements of peak velocity, flow volumes, and WSS was higher when comparing field strengths/sequences as the equivalence limits defined by the intraobserver assessments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/mrm.28450DOI Listing
February 2021

Tract sealing with normal saline after percutaneous transthoracic lung biopsies.

J Med Imaging Radiat Oncol 2020 Apr 9;64(2):211-214. Epub 2020 Feb 9.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

Introduction: In the present study, we aimed to assess whether normal saline injection for sealing the biopsy track is useful in reducing the incidence of pneumothorax after computed tomography (CT)-guided percutaneous transthoracic lung biopsy (PTLB).

Methods: We retrospectively compared the incidence of pneumothorax in 100 consecutive biopsies (n = 100, group A) that had injection of saline along the track, with historical cohort of same number of consecutive patients who underwent PTLB without injection of saline along the needle track (n = 100, group B). CT-guided biopsies were performed by coaxial technique and 1-3 ml of saline was injected along the tract. Patient chjmirocteristics, lesion size, location and other baseline pjmirometers were compared. Incidence of pneumothorax and number of patients who underwent catheter drainage of pneumothorax was compared in both groups.

Results: Baseline chjmirocteristics were compjmiroble in both groups. Track sealing with saline was successful in all patients. Pneumothorax rate was 46% for patients in group B and 32% in group A (P < 0.05). Seven patients (7%) had insertion of chest drain for pneumothorax in the group B and only 1% in the group A (P < 0.05). No mortality was observed in both groups. No complications were observed in any of the patients due to saline injection.

Conclusion: Track sealing with saline is a simple and safe technique which significantly reduces the incidence of pneumothorax and chest tube insertion after PTLB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1754-9485.13002DOI Listing
April 2020

Osteosarcoma mimicking fibrous pleurisy with dystrophic calcification!!!

Lung India 2020 Jan-Feb;37(1):75-76

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/lungindia.lungindia_274_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961088PMC
January 2020

The cloud sign of mass-forming intrahepatic cholangiocarcinoma.

Abdom Radiol (NY) 2020 01;45(1):237-238

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00261-019-02328-1DOI Listing
January 2020

Dual-Source Dual-Energy CT in Submandibular Sialolithiasis: Reliability and Radiation Burden.

AJR Am J Roentgenol 2019 12 1;213(6):1291-1296. Epub 2019 Oct 1.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, National Healthcare Group, 90 Yishun Central, Singapore 768828.

This study aims to compare the diagnostic accuracy of virtual unenhanced CT images derived from dual-source dual-energy contrast-enhanced CT with that of standard unenhanced CT images for evaluation of sialolithiasis. All dual-energy CT studies of the neck performed during the preceding 5 years were reviewed for submandibular gland calculi. Only patients who had unenhanced CT and contrast-enhanced CT performed as part of the same evaluation were included in this study. This review yielded 30 patients. Virtual unenhanced CT images were derived from the dual-energy dataset and compared with the true unenhanced CT images by two separate radiologists who assessed the total number of calculi encountered, their location, the largest dimension, and the attenuation of the calculi. The radiation burden incurred for true unenhanced CT and virtual unenhanced CT and the total radiation burden were calculated. Our analysis revealed that measurements of stone size showed good interobserver agreement. The mean stone size was 7.9 ± 5.9 (SD) mm on virtual unenhanced CT and 8.4 ± 5.9 mm on true unenhanced CT (range, 2.0-31.8 mm); the difference was statistically insignificant. The mean stone attenuation differed considerably ( < 0.01) between the virtual and true unenhanced CT images (494.8 ± 187.5 HU and 924.4 ± 374.9 HU, respectively), but correlated well. The mean radiation dose for a dual-phase IV contrast-enhanced CT study was 23.13 mGy (volume CT dose index). The mean dose was 10.93 mGy for the true unenhanced CT phase, thereby suggesting a 47.25% reduction in administered radiation dose when a single-phase contrast-enhanced CT study with virtual unenhanced image reconstructions is performed. Virtual unenhanced CT images derived from dual-source dual-energy CT scans of the neck provide accurate assessment of sialolithiasis akin to that provided by conventional CT protocols but at only a fraction of the radiation dosage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2214/AJR.19.21299DOI Listing
December 2019

Reply to: underestimating the impact of erect abdominal radiographs.

J Med Radiat Sci 2019 06 10;66(2):146. Epub 2019 Apr 10.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmrs.333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545408PMC
June 2019

Sonographic assessment of musculoskeletal causes of calf pain and swelling.

Emerg Radiol 2019 Jun 13;26(3):349-359. Epub 2019 Feb 13.

Department of Diagnostic Radiology, Woodlands Health Campus, 2 Yishun Central 2, Tower E, Level 5, Singapore, 768024, Republic of Singapore.

Calf pain or swelling is a common presentation to the emergency department. The differential diagnoses are wide. Deep vein thrombosis (DVT) is often the first diagnosis to be excluded given its potentially fatal complications. Musculoskeletal causes of calf pain or swelling such as Baker's cyst, muscle or tendon tear, soft tissue infection, and inflammation are not uncommon and can often be confidently diagnosed with ultrasonography (US). Familiarity with these conditions and the sonographic findings would be useful in making timely and correct diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10140-019-01680-5DOI Listing
June 2019

Computer Vision Syndrome: Darkness Under the Shadow of Light.

Can Assoc Radiol J 2019 Feb;70(1):5-9

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun Central, Singapore.

Radiologists typically spend long hours staring at the computer monitor. This unavoidable nature of our work can lead to detrimental effects on the eyes. Moreover, there is little awareness among radiologists with regards to such potential harm. Ocular hazards, such as computer vision syndrome, are increasingly becoming more relevant to the radiology community. In this article, we discuss the ocular occupational hazards faced by radiologists and suggestions that may help in minimizing such hazards.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carj.2018.10.005DOI Listing
February 2019

Trends and implications of 24/7 interventional radiology in a newly opened acute hospital.

CVIR Endovasc 2018 29;1(1):26. Epub 2018 Oct 29.

Department of Diagnostic Radiology at Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828 Singapore.

Introduction: We aim to evaluate the frequency of use and changing practices for all out-of-hours interventional radiology (IR) procedures performed in a new hospital.

Methods: This is a 5 year retrospective review of all out-of-hours procedures performed by the Interventional Radiology team from July 2010 to June 2015. Number and category of procedures performed were identified from the RIS database.

Results: Of the 7140 procedures performed by IR over the 5 years, 764 were out-of-hours. The total number of out-of-hours cases performed annually by IR has increased by 240% from year 1 to year 5. The variety and distribution of out-of-hours work has shown a characteristic trend with rising requests for advanced procedures such as active haemorrhage control.

Conclusion: The rising number and complexity of cases for on-call IR further supports the need for a formal on-call rota, ideally 1:6, to provide a sustainable 24/7 service and optimize patient outcome in an acute hospital.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s42155-018-0033-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319518PMC
October 2018

Abdominal radiographs in the emergency department: current status and controversies.

J Med Radiat Sci 2018 Dec;65(4):250-251

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore.

This editorial is discussing about the indiscriminate use of abdominal radiographs in the emergency department in general, with focus on value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmrs.307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275266PMC
December 2018

Platelet inhibition to target reperfusion injury trial: Rationale and study design.

Clin Cardiol 2019 Jan 17;42(1):5-12. Epub 2018 Dec 17.

The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK.

Background: In ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI), current oral P2Y12 platelet inhibitors do not provide maximal platelet inhibition at the time of reperfusion. Furthermore, administration of cangrelor prior to reperfusion has been shown in pre-clinical studies to reduce myocardial infarct (MI) size. Therefore, we hypothesize that cangrelor administered prior to reperfusion in STEMI patients will reduce the incidence of microvascular obstruction (MVO) and limit MI size in STEMI patients treated with PPCI.

Methods: The platelet inhibition to target reperfusion injury (PITRI) trial, is a phase 2A, multi-center, double-blinded, randomized controlled trial, in which 210 STEMI patients will be randomized to receive either an intravenous (IV) bolus of cangrelor (30 μg/kg) followed by a 120-minute infusion (4 μg/kg/min) or matching saline placebo, initiated prior to reperfusion (NCT03102723).

Results: The study started in October 2017 and the anticipated end date would be July 2020. The primary end-point will be MI size quantified by cardiovascular magnetic resonance (CMR) on day 3 post-PPCI. Secondary endpoints will include markers of reperfusion, incidence of MVO, MI size, and adverse left ventricular remodeling at 6 months, and major adverse cardiac and cerebrovascular events.

Summary: The aim of the PITRI trial is to assess whether cangrelor administered prior to reperfusion would reduce acute MI size and MVO, as assessed by CMR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/clc.23110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436500PMC
January 2019

Antisynthetase syndrome: Initial and follow-up imaging features.

Lung India 2018 Nov-Dec;35(6):523-525

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/lungindia.lungindia_4_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219130PMC
November 2018

Clinics in diagnostic imaging (189). Acute phase cardiac sarcoidosis (CS).

Singapore Med J 2018 08;59(8):407-412

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

A 44-year-old man presented with breathlessness and episodes of palpitations for the last one year. The imaging diagnosis of cardiac sarcoidosis was made based on chest radiography and cardiac magnetic resonance (MR) imaging findings, and was further confirmed by biopsy. Cardiac sarcoidosis is an uncommon entity, yet is potentially fatal with nonspecific clinical manifestations, including sudden cardiac death. Hence, it is important to diagnose and treat this entity at an early stage to improve morbidity and mortality. Cardiac MR imaging plays a pivotal role in facilitating diagnosis and monitoring therapeutic response. We describe the MR imaging features of cardiac sarcoidosis and discuss imaging features of other cardiomyopathies that may mimic cardiac sarcoidosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11622/smedj.2018095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109831PMC
August 2018

Myocardial Extracellular Volume Fraction and Change in Hematocrit Level: MR Evaluation by Using T1 Mapping in an Experimental Model of Anemia.

Radiology 2018 07 3;288(1):93-98. Epub 2018 Apr 3.

From the Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Yonsei University Medical Center, 50 Yonsei-ro, Seodarmun-gu, Seoul 120-752, South Korea (P.K.K., Y.J.H., K.H., J.Y.L., J.H., H.J.L., Y.J.K., Y.J.S., B.W.C.); Department of Radiology, Mie University Graduate School of Medicine, Tsu, Japan (H.S.); Department of Radiology, Khoo Teck Puat Hospital, Singapore (A.C.); College of Letters and Science, University of California Berkeley, Berkeley, Calif (J.K.P.); Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Medical Center, Seoul, South Korea (C.H.P.); and Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.H.).

Purpose To evaluate the effect of changes in hematocrit level on myocardial extracellular volume (ECV) fraction, as quantified with cardiac magnetic resonance (MR) imaging in an animal model. Materials and Methods Thirteen adult male Sprague-Dawley rats underwent cardiac MR imaging before and after induction of anemia. MR imaging procedures, including unenhanced and contrast material-enhanced T1 mapping, were performed by using a saturation recovery Look-Locker sequence with a 9.4-T unit. An optimized T1 mapping sequence was established in the phantom study. Systolic function of the left ventricle (LV) was calculated from the cine images. Native and postcontrast T1 values of the LV myocardium at the midcavity level and LV blood pool, partition coefficients, and ECV were calculated. Histopathologic examination of the heart was performed after sacrifice. Intergroup comparison of variables was performed with the paired t test. Results The postanemia models exhibited lower hematocrit levels, postcontrast T1 values of the LV pool, and partition coefficients (mean, 45.7% ± 5.2 [standard deviation]; 563.8 msec ± 155.7; and 29.2 ± 3.5, respectively) than did the preanemia models (mean, 59.0% ± 4.1; 690.2 msec ± 109.7; and 38.2 ± 4.4, respectively) (P < .05 for all comparisons). There were no differences between the pre- and postanemia groups in terms of LV ejection fraction (mean, 72.7% ± 2.1 vs 73.2% ± 4.7; P = .78) and ECV (mean, 15.5% ± 2.0 vs 16.0% ± 1.9; P = .24). Conclusion Myocardial ECV measured with contrast-enhanced T1 mapping cardiac MR imaging did not significantly change despite changes in hematocrit level in anemic rat models. Extrapolation of this finding from animal models to human subjects suggests that ECV measured with MR imaging could be a robust parameter in anemic patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1148/radiol.2018171342DOI Listing
July 2018

Clinics in diagnostic imaging (184). Fat embolism syndrome (FES).

Singapore Med J 2018 03;59(3):159-162

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

A 23-year-old Indian man presented with shortness of breath and new-onset confusion along with a rash on his chest on Postoperative Day 2, following internal fixation of his femur fracture. Although computed tomography pulmonary angiography was negative for filling defects in the pulmonary vasculature, it showed mosaic attenuation changes with some interlobular septal thickening. Magnetic resonance imaging of the brain showed patchy signal abnormalities, predominantly in the grey-white matter junction region with extensive susceptibility artefacts, consistent with petechial haemorrhages. The laboratory work-up showed thrombocytopenia and anaemia. A diagnosis of fat embolism syndrome was established, based on the clinical presentation combined with laboratory and imaging findings. The clinical and imaging features of fat embolism syndrome are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11622/smedj.2018029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861340PMC
March 2018

Spontaneous rupture of hepatocellular carcinoma with tumor embolism in pulmonary arteries.

Lung India 2018 Mar-Apr;35(2):178-179

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768829, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/lungindia.lungindia_327_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846274PMC
March 2018

Unusual presentation of lung cancer as skeletal muscle and subcutaneous metastases.

Lung India 2017 Sep-Oct;34(5):485-487

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0970-2113.213820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592769PMC
September 2017

Current Techniques and Clinical Applications of Computed Tomography Urography.

Curr Probl Diagn Radiol 2018 Jul - Aug;47(4):245-256. Epub 2017 Jul 8.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun, Singapore.

From conventional radiograph to magnetic resonance urography, imaging of urinary system has evolved with variety of investigations over the past several decades with each of them having advantages and limitations of their own. In the current era, computed tomography (CT) has emerged as a preferred investigations for evaluation of the urinary tract. There are various techniques involved in performing CT urography (CTU) with triple bolus technique (TB-CTU) currently drawing a special attention because of its low radiation exposure. This article aims to discuss the current techniques, indications, and clinical applications of CTU with illustrations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1067/j.cpradiol.2017.07.002DOI Listing
September 2018

High-Resolution Computed Tomography Imaging in Conductive Hearing Loss: What to Look for?

Curr Probl Diagn Radiol 2018 Mar - Apr;47(2):119-124. Epub 2017 May 17.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun Central, Singapore.

Conductive hearing loss (CHL) is caused by the disruption of the sound conductive chain that, in turn, may be due to diseases of the external and middle ear. High-resolution computed tomography (CT) is the imaging modality of choice to evaluate CHL because of its excellent spatial resolution. Along with clinical and otoscopic findings, CT also helps in the diagnosis and preoperative planning. This pictorial review aims to illustrate the CT features of common conditions causing CHL that may arise from the external and middle ear, as well as highlights some of the key imaging features that are helpful in management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1067/j.cpradiol.2017.05.005DOI Listing
July 2018

Clinics in diagnostic imaging (178). Wünderlich syndrome and pseudoaneurysm.

Singapore Med J 2017 Jun;58(6):289-293

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

Wünderlich syndrome is a rare entity characterised by spontaneous retroperitoneal haemorrhage with renal origin. We present a case of Wünderlich syndrome secondary to clotting dyscrasia in a 64-year-old woman. The patient experienced a second Wünderlich haemorrhagic event with metachronous pseudoaneurysm formation, which was likely secondary to the large subcapsular haematoma stripping the renal capsule and tearing the cortical arteries. Selective pseudoaneurysm embolisations were successfully performed on both occasions. This clinical entity, its imaging differential diagnoses and management are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11622/smedj.2017049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474523PMC
June 2017

Magnetic resonance imaging of painful swollen legs in the emergency department: a pictorial essay.

Emerg Radiol 2017 Oct 18;24(5):577-584. Epub 2017 May 18.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.

Patients presenting with a painful swollen leg are not infrequently encountered at the emergency department and can pose a diagnostic dilemma for attending physicians. The potential causes of leg pain and swelling include trauma, infection, inflammation, and neurogenic, vascular, and iatrogenic conditions; with magnetic resonance imaging (MRI) being an important tool in evaluation. We describe the MRI features of various conditions causing painful swollen legs. We also discuss the differential diagnosis and the useful clinical and laboratory findings that radiologists should be aware of, in order to arrive at an accurate diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10140-017-1514-6DOI Listing
October 2017

Greening the Radiology Department: Not a Big Mountain to Climb.

Can Assoc Radiol J 2017 Aug 11;68(3):234-236. Epub 2017 May 11.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

An environmental-friendly radiology department should be a requirement of the future era. The aim of this article is to make radiologists aware of their responsibilities for a greener world. We have suggested a number of minor but important changes in various sections of a radiology department that can make the radiology department more environmentally friendly. These small steps require relatively little effort on our part but cumulatively, may have a huge positive impact on our environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carj.2016.10.009DOI Listing
August 2017

Severe chest pain in an elderly woman.

Emerg Med J 2017 Apr;34(4):248

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/emermed-2016-205735DOI Listing
April 2017

Epigastric pain: a life-threatening condition.

Emerg Med J 2016 Nov;33(11):829-830

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/emermed-2015-205640DOI Listing
November 2016

Dual-energy CT applications in salivary gland lesions.

Br J Radiol 2017 Jun 26;90(1074):20160859. Epub 2017 Apr 26.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Republic of Singapore.

The increasing availability of dual-energy CT (DECT) has set the stage for an exciting era in CT technology. This technique is extensively used throughout the world with numerous centres working on the applications of DECT in various radiology subspeciality areas. DECT provides many advantages over the conventional single-energy scan. Instead of a single set of images, radiologists have access to multiple sets of images from a single acquisition. The DECT workstation enables the reader to generate images, according to the clinical setting, in order to answer a specific clinical question. Radiologists should be aware of the basic concepts of DECT and the usefulness of each image data set. This article aimed to describe the basic principles, techniques and applications of DECT in the imaging of salivary gland lesions. The specific roles of each image data set, in the context of salivary gland lesions, are also discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1259/bjr.20160859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602178PMC
June 2017
-->