Publications by authors named "Christine O Menias"

252 Publications

Current update on malignant epithelial ovarian tumors.

Abdom Radiol (NY) 2021 Jun 5. Epub 2021 Jun 5.

The Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Epithelial ovarian cancer (EOC) represents the most frequently occurring gynecological malignancy, accounting for more than 70% of ovarian cancer deaths. Preoperative imaging plays an important role in assessing the extent of disease and guides the next step in surgical decision-making and operative planning. In this article, we will review the multimodality imaging features of various subtypes of EOC. We will also discuss the role of imaging in the staging, management, and surveillance of EOC.
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http://dx.doi.org/10.1007/s00261-021-03081-0DOI Listing
June 2021

The CT scout view: complementary value added to abdominal CT interpretation.

Abdom Radiol (NY) 2021 Jun 1. Epub 2021 Jun 1.

Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI, 53792, USA.

Computed tomography (CT) scout images, also known as CT localizer radiographs, topograms, or scanograms, are an important, albeit often overlooked part of the CT examination. Scout images may contain important findings outside of the scanned field of view on CT examinations of the abdomen and pelvis, such as unsuspected lung cancer at the lung bases. Alternatively, scout images can provide complementary information to findings within the scanned field of view, such as characterization of retained surgical foreign bodies. Assessment of scout images adds value and provides a complementary "opportunistic" review for interpretation of abdominopelvic CT examinations. Scout image review is a useful modern application of conventional abdominal radiograph interpretation that can help establish a diagnosis or narrow a differential diagnosis. This review discusses the primary purpose and intent of the CT scout images, addresses standard of care and bias related to scout image review, and presents a general systematic approach to assessing scout images with multiple illustrative examples, including potential pitfalls in interpreting scout images.
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http://dx.doi.org/10.1007/s00261-021-03135-3DOI Listing
June 2021

Imaging Manifestations of Genitourinary Tuberculosis.

Radiographics 2021 May 28:200154. Epub 2021 May 28.

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110 (M.N., M.Z., A.S.S., C.S.); Department of Radiology, Division of Body Imaging, University of Missouri Health System, Columbia, Mo (M.A.S.); Department of Radiology, Division of Body Imaging, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan (A.H.); Department of Imaging, Division of Body Imaging, Clinica Davila, Recoleta, Chile (C.V.); and Department of Radiology, Division of Abdominal Imaging, Mayo Clinic Arizona, Scottsdale, Ariz (C.O.M.).

The genitourinary region is one of the most common sites of extrapulmonary tuberculosis (TB) involvement. The imaging features of genitourinary TB are protean and can mimic other entities, including malignancy, and pose a diagnostic dilemma. Hematogenous seeding and lymphatic spread of mycobacteria from pulmonary, tonsillar, and nodal TB are implicated in the pathogenesis of genitourinary TB. In addition, contiguous extension from the urinary tract and sexual transmission are described as sources of genital TB. Genitourinary TB can be indolent and results in nonspecific signs and symptoms; thus, imaging has a vital role in the working diagnosis for these cases. Classic uroradiologic signs of genitourinary TB are primarily described from the era of intravenous urography and conventional radiography. Now, CT, CT urography, MRI, and US are used in the diagnosis and management. Familiarity with the imaging features of genitourinary TB may help guide the diagnosis and, in turn, lead to timely management. US has a vital role in the evaluation of scrotal and female genital TB. MRI offers superior soft-tissue contrast resolution and excellent depiction of anatomic detail. The various imaging manifestations of genitourinary TB are highlighted. RSNA, 2021.
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http://dx.doi.org/10.1148/rg.2021200154DOI Listing
May 2021

Human Gut Microbiota-associated Gastrointestinal Malignancies: A Comprehensive Review.

Radiographics 2021 May 14:200168. Epub 2021 May 14.

From the Department of Radiology, University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 (A.B., S.D., J.K., V.S.K.); University of Texas at Austin, Austin, Tex (S.K.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).

The human gastrointestinal tract houses trillions of microbes. The gut and various types of microorganisms, including bacteria, viruses, fungi, and archaea, form a complex ecosystem known as the gut microbiota, and the whole genome of the gut microbiota is referred to as the gut microbiome. The gut microbiota is essential for homeostasis and the overall well-being of a person and is increasingly considered an adjunct "virtual organ," with a complexity level comparable to that of the other organ systems. The gut microbiota plays an essential role in nutrition, local mucosal homeostasis, inflammation, and the mucosal immune system. An imbalanced state of the gut microbiota, known as dysbiosis, can predispose to development of various gastrointestinal malignancies through three speculated pathogenic mechanisms: direct cytotoxic effects with damage to the host DNA, disproportionate proinflammatory signaling inducing inflammation, and activation of tumorigenic pathways or suppression of tumor-suppressing pathways. Several microorganisms, including , Epstein-Barr virus, human papillomavirus, , , and , are associated with gastrointestinal malignancies such as esophageal adenocarcinoma, gastric adenocarcinoma, gastric mucosa-associated lymphoid tissue lymphoma, colorectal adenocarcinoma, and anal squamous cell carcinoma. Imaging plays a pivotal role in diagnosis and management of microbiota-associated gastrointestinal malignancies. Appropriate use of probiotics, fecal microbiota transplantation, and overall promotion of the healthy gut are ongoing areas of research for prevention and treatment of malignancies. RSNA, 2021.
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http://dx.doi.org/10.1148/rg.2021200168DOI Listing
May 2021

Second Malignancies after Radiation Therapy: Update on Pathogenesis and Cross-sectional Imaging Findings.

Radiographics 2021 May-Jun;41(3):876-894. Epub 2021 Apr 23.

From the Department of Radiology, University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 (L.K., A.M.P., V.S.K.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (S.R.P., S.Y., L.P.M.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (K.S., C.O.M.); and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (S.H.T.).

A wide spectrum of second cancers occur as late complications of radiation therapy (RT) used to treat various malignancies. In addition to the type and dose of radiation, lifestyle, environmental, and genetic factors are important to the development of second malignancies in cancer survivors. Typically, RT-induced malignancies (RTIMs) are biologically aggressive cancers with a variable period of 5-10 years for hematologic malignancies and 10-60 years for solid tumors between RT and the development of the second cancer. Although carcinomas and leukemias commonly develop after low-dose RT, sarcomas occur in tissues or organs that receive high-dose RT. Angiosarcomas and unclassified pleomorphic sarcomas are the two most common RT-associated sarcomas; other sarcomas include malignant peripheral nerve sheath tumors, leiomyosarcomas, osteosarcomas, chondrosarcomas, and dedifferentiated or pleomorphic liposarcomas. Select RTIMs show tumor genetic characteristics that allow accurate diagnosis. Nearly all cutaneous angiosarcomas after RT for breast cancer and 90% of RT-associated malignant peripheral nerve sheath tumors are characterized by gene amplifications and loss of H3 K27me3 expression respectively. Classic papillary thyroid carcinomas that develop after RT frequently harbor rearrangements and have a favorable prognosis, despite their advanced stage at patient presentation. Select RTIMs demonstrate characteristic imaging findings and typically develop in the prior radiation field. Imaging is essential to early diagnosis, characterization, localization, and staging of RTIMs. Familiarity of radiologists with the diverse spectrum of RTIMs is essential for early diagnosis and optimal management. RSNA, 2021.
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http://dx.doi.org/10.1148/rg.2021200171DOI Listing
April 2021

Imaging Spectrum of Granulomatous Diseases of the Abdomen and Pelvis.

Radiographics 2021 May-Jun;41(3):783-801. Epub 2021 Apr 16.

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110 (M.N., A.J.C., M.Z., D.H.B., V.M.M.); Division of Abdominal Imaging, Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (C.O.M.); and Division of Abdominal Imaging and Intervention, Department of Radiology, University of Wisconsin-Madison, Madison, Wis (P.J.P., D.H.K., M.G.L.).

A is a compact organization of mature macrophages that forms because of persistent antigenic stimulation. At the microscopic level, granulomas can undergo various morphologic changes, ranging from necrosis to fibrosis, which along with other specialized immune cells define the appearance of the granulomatous process. Accordingly, the imaging features of granulomatous diseases vary and can overlap with those of other diseases, such as malignancy, and lead to surgical excisions and biopsy. However, given the heterogeneity of granulomas as a disease group, it is often hard to make a diagnosis on the basis of the histopathologic features of granulomatous diseases alone owing to overlapping microscopic features. Instead, a multidisciplinary approach is often helpful. Radiologists need to be familiar with the salient clinical manifestations and imaging findings of granulomatous diseases to generate an appropriate differential diagnosis. RSNA, 2021.
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http://dx.doi.org/10.1148/rg.2021200172DOI Listing
April 2021

Ligament of Treitz: Anatomy, Relevance of Radiologic Findings, and Radiologic-Pathologic Correlation.

AJR Am J Roentgenol 2021 04 10;216(4):927-934. Epub 2021 Feb 10.

Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030.

The objective of this article is to discuss the anatomy, embryonic origin, normal variants, and various attachments of the ligament of Treitz. We also describe the pathologic processes that develop along the ligament of Treitz and the role of cross-sectional imaging in identifying these conditions. The ligament of Treitz, also known as the suspensory ligament of the duodenum, is an important anatomic landmark in the abdomen. It is essential that radiologists understand the anatomic attachments, normal variants, and various pathologic conditions involving the ligament of Treitz as well as the role of cross-sectional imaging in the assessment of these conditions.
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http://dx.doi.org/10.2214/AJR.20.23273DOI Listing
April 2021

The humbling hemangioma: uncommon CT and MRI imaging features and mimickers of hepatic hemangiomas.

Clin Imaging 2021 Jun 5;74:55-63. Epub 2021 Jan 5.

NYU Langone Health, Department of Radiology, United States of America.

Cavernous hemangiomas are among the most common liver lesions encountered in abdominal imaging. While classical imaging characteristics usually aid the radiologist in confidently arriving at its diagnosis, atypical hemangiomas can prove to be difficult to distinguish from other more worrisome hepatic lesions such as metastases and hepatocellular carcinoma. Furthermore, some malignant lesions can display features that simulate hemangiomas. The radiologist must be aware of these pitfalls to make an accurate diagnosis, when possible.
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http://dx.doi.org/10.1016/j.clinimag.2020.12.028DOI Listing
June 2021

Ovarian teratomas: clinical features, imaging findings and management.

Abdom Radiol (NY) 2021 Jan 4. Epub 2021 Jan 4.

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Unit 1473, 1515 Holcombe Boulevard, Houston, TX, 77030-4009, USA.

Ovarian teratomas are the most common type of germ cell tumors. There are three major subtypes of ovarian teratomas including mature, immature, and monodermal teratomas. Ultrasound, computed tomography and magnetic resonance imaging can demonstrate specific imaging findings for mature teratoma. Imaging features of immature and monodermal teratomas are less specific, but a combination of clinical features and imaging findings can help in the diagnosis. Imaging is also very helpful in guiding management. In this article, we review the epidemiology, histopathology, clinical presentation, imaging features and management of ovarian teratomas.
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http://dx.doi.org/10.1007/s00261-020-02873-0DOI Listing
January 2021

Imaging of abdominal and pelvic infections in the cancer patient.

Abdom Radiol (NY) 2021 Jan 2. Epub 2021 Jan 2.

Yale School of Medicine, New Haven, CT, USA.

Infections are the most commonly encountered complications in patients with cancer. The classical signs and symptoms of infections are often not present in this patient population, which makes the diagnosis more challenging. Host factors play a major role in the development and prognosis of infections in cancer patients; these can be related to the underlying type of malignancy (solid organ versus hematological), tumor burden, anatomic obstruction, altered integrity of barriers (skin or mucosa), treatment-related factors (from chemotherapy, radiation treatment, surgery, interventional procedures, and/or medical device placement) and the degree of immunosuppression. This article reviews common, as well as less common, imaging manifestations of infections and their potential mimics in the abdomen and pelvis in cancer patients and discusses their differentiating features, with the role of imaging in various organs in the abdomen and pelvis taking into consideration relevant clinical background information and the main risk factors.
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http://dx.doi.org/10.1007/s00261-020-02896-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778421PMC
January 2021

Hepatic Mucinous Cystic Neoplasm Versus Simple Biliary Cyst: Assessment of Distinguishing Imaging Features Using CT and MRI.

AJR Am J Roentgenol 2021 02 23;216(2):403-411. Epub 2020 Dec 23.

Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

The purpose of our study was to identify the imaging features that differentiate a hepatic mucinous cystic neoplasm (MCN) from a simple biliary cyst. Surgically resected hepatic MCNs and simple biliary cysts over a 20-year period (October 29, 1997-January 23, 2018) with preoperative CT, MRI, or both were retrospectively identified. Included cases underwent histopathologic confirmation of diagnosis based on the 2010 World Health Organization criteria and blinded imaging review. Various imaging features, including cyst shape and septal enhancement, were assessed for performance. For septate cysts, the relationship of the septation to the cyst wall-that is, arising from the wall without an indentation versus arising from an external macrolobulation-was recorded. Statistical analysis was performed for the imaging features with the chi-square test. The study group comprised 22 hepatic MCNs and 56 simple biliary cysts. A unilocular hepatic cystic lesion was highly predictive of a simple biliary cyst (positive predictive value = 95.2%). The imaging feature of septations arising only from macro-lobulations was 100% specific for a simple biliary cyst on CT ( = 0.001). The presence of septations arising from the cyst wall without indentation was 100% sensitive for hepatic MCN but was only 56.3% specific on CT. Septal enhancement reached 100% sensitivity for hepatic MCN on MRI ( = 0.018). The presence of septations, relationship of the septations to the cyst wall, and septal enhancement were sensitive imaging features in the detection of hepatic MCN. The imaging feature of septations arising only from macrolobulations in the cyst wall was specific for simple biliary cysts on CT and helped differentiate simple biliary cysts from hepatic MCNs.
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http://dx.doi.org/10.2214/AJR.20.22768DOI Listing
February 2021

Multimodality Imaging of Genitourinary Tuberculosis.

Curr Probl Diagn Radiol 2020 Nov 15. Epub 2020 Nov 15.

University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:

Tuberculosis (TB) prevalence has increased over the past few decades, especially in the developing world. The genitourinary tract is the most common extra-pulmonary location of TB. Symptoms of genitourinary TB are often vague. Diagnosis of genitourinary TB requires a high level of clinical suspicion. Healthcare providers must be familiar with genitourinary TB imaging features on different imaging modalities and how to correlate these findings with urine studies and histologic analysis to definitively diagnose genitourinary TB.
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http://dx.doi.org/10.1067/j.cpradiol.2020.10.005DOI Listing
November 2020

Cross-Sectional Imaging Evaluation of Vascular Lesions in the Gastrointestinal Tract and Mesentery.

J Comput Assist Tomogr 2020 Nov/Dec;44(6):870-881

Department of Diagnostic Radiology, University of Missouri, Columbia, MO.

Gastrointestinal (GI) tract and mesenteric vascular lesions can have various clinical presentations, of which GI bleeding is the most common. This collection of pathology is highly variable in etiology ranging from occlusive disease to vascular malformations to trauma to neoplasms which makes for a challenging workup and diagnosis. The advent of multiple imaging modalities and endoscopic techniques makes the diagnosis of these lesions more achievable, and familiarity with their various imaging findings can have a significant impact on patient management. In this article, we review the gamut of GI tract and mesenteric vascular lesions and their associated imaging findings.
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http://dx.doi.org/10.1097/RCT.0000000000001107DOI Listing
December 2020

A review of internal hernias related to congenital peritoneal fossae and apertures.

Abdom Radiol (NY) 2021 05 30;46(5):1825-1836. Epub 2020 Oct 30.

Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305-5105, USA.

Congenital-type internal hernias have the potential to cause small bowel obstruction well into adulthood. Congenital-type internal hernias include left paraduodenal, right paraduodenal, foramen of Winslow, pericecal, sigmoid mesocolon, transomental, small bowel mesentery, and broad ligament hernias. This review summarizes CT imaging features and complications of congenital internal hernias using a systematic approach based on abdominopelvic quadrants and key anatomic features. CT imaging will continue to be commonly used to evaluate abdominal pain. Anatomical landmarks and characteristic CT findings can help identify congenital internal hernias as a potential cause of abdominal pain.
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http://dx.doi.org/10.1007/s00261-020-02829-4DOI Listing
May 2021

Abdominal Imaging Manifestations of Recreational Drug Use.

Radiographics 2020 Nov-Dec;40(7):1895-1915. Epub 2020 Oct 16.

From the Department of Radiology, Saint Louis University Hospital, 3635 Vista Ave, 2nd Floor, Deslodge Tower, St Louis, MO 63103-2097 (J.M., A.U.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.M., M.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (K.S.Z., C.O.M.); and Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.H.).

Recreational drug use is a burgeoning health issue worldwide, with a variety of presenting symptoms and complications. These complications can be secondary to the toxic effects of the drug itself, drug impurities, and nonsterile injection. The abdominal radiologist is likely to encounter patients who use drugs recreationally and may be responsible for recognizing and reporting these acute conditions, which in some cases can be life threatening. Because these patients often present with an altered mental state and may deny or withhold information on drug use, the underlying cause may be difficult to determine. The most commonly used drugs worldwide include cocaine, cannabinoids, opioids, and amphetamines and their derivatives. Complications of use of these drugs that can be seen at abdominopelvic CT can involve multiple organ systems, including the soft tissue and gastrointestinal, genitourinary, vascular, and musculoskeletal systems. A diverse range of abdominal complications associated with these drugs can be seen at imaging, including disseminated infections, gastrointestinal ischemia, and visceral infarction. Radiologists should be familiar with the imaging findings of these complications to accurately diagnose these entities and help guide workup and patient treatment. RSNA, 2020.
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http://dx.doi.org/10.1148/rg.2020200048DOI Listing
October 2020

Decoding Genes: Current Update on Radiogenomics of Select Abdominal Malignancies.

Radiographics 2020 Oct;40(6):1600-1626

From the Department of Radiology, University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 (V.S.K., H.M., L.K.); Departments of Radiology (S.Y., S.R.P.) and Pathology (N.R.), University of Texas MD Anderson Cancer Center, Houston, Tex; Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (A.D.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).

Technologic advances in chromosomal analysis and DNA sequencing have enabled genome-wide analysis of cancer cells, yielding considerable data on the genetic basis of malignancies. Evolving knowledge of tumor genetics and oncologic pathways has led to a better understanding of histopathologic features, tumor classification, tumor biologic characteristics, and imaging findings and discovery of targeted therapeutic agents. Radiogenomics is a rapidly evolving field of imaging research aimed at correlating imaging features with gene mutations and gene expression patterns, and it may provide surrogate imaging biomarkers that may supplant genetic tests and be used to predict treatment response and prognosis and guide personalized treatment options. Multidetector CT, multiparametric MRI, and PET with use of multiple radiotracers are some of the imaging techniques commonly used to assess radiogenomic associations. Select abdominal malignancies demonstrate characteristic imaging features that correspond to gene mutations. Recent advances have enabled us to understand the genetics of steatotic and nonsteatotic hepatocellular adenomas, a plethora of morphologic-molecular subtypes of hepatic malignancies, a variety of clear cell and non-clear cell renal cell carcinomas, a myriad of hereditary and sporadic exocrine and neuroendocrine tumors of the pancreas, and the development of targeted therapeutic agents for gastrointestinal stromal tumors based on characteristic gene mutations. Mutations associated with aggressive phenotypes of these malignancies can sometimes be predicted on the basis of their imaging characteristics. Radiologists should be familiar with the genetics and pathogenesis of common cancers that have associated imaging biomarkers, which can help them be integral members of the cancer management team and guide clinicians and pathologists. RSNA, 2020 See discussion on this article by Luna (pp 1627-1630).
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http://dx.doi.org/10.1148/rg.2020200042DOI Listing
October 2020

Imaging Evaluation of Abdominopelvic Gunshot Trauma.

Radiographics 2020 Oct;40(6):1766-1788

From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (F.S., A.M., M.V.R.); Department of Radiology, NYU Winthrop University Hospital, Mineola, NY (D.S.K.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (M.M.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (J.S.P.); and Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, Conn (A.M.).

Firearm-related injuries, or gunshot wounds (GSWs), are among the most important worldwide public health problems, resulting in considerable annual morbidity, disability, and mortality. GSWs to the abdomen and pelvis are associated with substantial injuries to multiple organs and tissues. Imaging plays an important role in identifying these injuries, dictating nonoperative management, and determining imaging and clinical follow-up, as well as helping manage potential long-term complications. CT is the primary imaging modality used to evaluate these injuries and their complications, including use of reconstructed multiplanar volume-rendered images. The authors discuss the ballistics and mechanisms of firearm injury, CT findings, trajectory analysis, and applications of different imaging modalities above and beyond CT in evaluation of GSWs. Imaging findings and classifications of the severity of injuries to solid and hollow organs and vascular, musculoskeletal, and neurologic systems are reviewed. Key complications associated with gunshot injuries to the abdomen and pelvis are presented. The challenges of imaging in the acute trauma setting and potential pitfall mimics at imaging, particularly at CT, are also described. A step-by-step guide for thorough and comprehensive evaluation of GSWs to the abdomen and pelvis is introduced, with tips for optimizing effective communication with the clinical team. RSNA, 2020.
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http://dx.doi.org/10.1148/rg.2020200018DOI Listing
October 2020

A review of anatomy, pathology, and disease spread in the perisplenic region.

Abdom Radiol (NY) 2021 02 19;46(2):805-817. Epub 2020 Sep 19.

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

The perisplenic region is a complex anatomical area involving multiple peritoneal and subperitoneal structures, which influence the presentation and behavior of various pathologic processes. This review is a comprehensive resource for perisplenic anatomy and pathology with associated clinical presentations and imaging findings. Understanding the pathophysiologic intricacies of the perisplenic region assists the radiologist in building a helpful differential diagnosis and recognizing predictable disease patterns.
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http://dx.doi.org/10.1007/s00261-020-02736-8DOI Listing
February 2021

Iron-containing pathologies of the spleen: magnetic resonance imaging features with pathologic correlation.

Abdom Radiol (NY) 2021 03 11;46(3):1016-1026. Epub 2020 Sep 11.

Department of Diagnostic Radiology, Mayo Clinic, Scottsdale, AZ, USA.

Systemic and non-systemic pathologies that involve iron deposition within the spleen have characteristic features on MRI due to the susceptibility properties of deposited iron, or hemosiderin. These lesions will have signal loss on longer echo sequences due to the T2* effect when evaluated with dual-echo gradient-echo sequences. The pathophysiology of systemic and localized iron sequestration disease processes can elucidate an underlying diagnosis based on these imaging features in conjunction with clinical information.
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http://dx.doi.org/10.1007/s00261-020-02709-xDOI Listing
March 2021

'Fortune cookie sign': a variant of mushroom cap sign on T2 weighted MRI for deep sigmoid endometriosis.

Abdom Radiol (NY) 2021 03 11;46(3):1272-1275. Epub 2020 Sep 11.

Mayo Clinic School of Medicine, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.

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http://dx.doi.org/10.1007/s00261-020-02735-9DOI Listing
March 2021

Lessons learned from COVID-19 and 3D printing.

Am J Emerg Med 2020 Aug 16. Epub 2020 Aug 16.

MRI unit, Radiology department, HT medica, Carmelo Torres 2, 23007 Jaén, Spain. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2020.08.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428745PMC
August 2020

Imaging Evaluation of Fallopian Tubes and Related Disease: A Primer for Radiologists.

Radiographics 2020 Sep-Oct;40(5):1473-1501. Epub 2020 Aug 21.

From the Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (M.V.R.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (M.M.); Department of Radiology, NYU Winthrop University Hospital, Mineola, NY (D.S.K.); Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY (J.S.P.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (L.M.G.); and Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (C.O.M.).

A wide range of benign and malignant processes can affect one or both fallopian tubes. Familiarity with and recognition of the characteristic imaging features of these diseases and conditions are imperative for accurate diagnosis and prompt patient management. Disorders including pelvic inflammatory disease (hydrosalpinx and pyosalpinx in particular), isolated tubal torsion and ovarian torsion with fallopian tube involvement, endometriosis manifesting as hematosalpinx and adhesions, ectopic pregnancy, and malignancies are the most important entities that radiologists should be familiar with when assessing the fallopian tubes. Some fallopian tube diseases are self-limiting, while others can result in infertility or even potentially life-threatening infection or bleeding if left untreated. Therefore, correct diagnosis is important for appropriate life-saving treatment and preserving fertility. Understanding the physiologic features of the fallopian tube and the role of this organ in the pathogenesis of pelvic neoplasms is equally important. Knowledge of what to expect in a patient who has undergone uterine and fallopian tube interventions, such as uterine ablation and fallopian tube ligation, and of the potential associated complications (eg, postablation sterilization syndrome) also is pertinent. The imaging modalities used for the evaluation of fallopian tube disease and patency range from commonly used examinations such as US, CT, and MRI to other modalities such as hysterosalpingography and hysterosonography performed by using US contrast material. The ability to differentiate fallopian tube conditions from other adnexal and pelvic pathologic entities by using a variety of imaging modalities allows the radiologist to make a timely diagnosis and ensure proper clinical management. RSNA, 2020.
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http://dx.doi.org/10.1148/rg.2020200051DOI Listing
August 2020

Imaging of Renal Infections and Inflammatory Disease.

Radiol Clin North Am 2020 Sep 14;58(5):909-923. Epub 2020 Jul 14.

Mayo Clinic School of Medicine, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.

Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Diagnosis is based on clinical findings of fever, flank pain, and urinary tract infection. Computed tomography findings include renal enlargement with wedge-shaped heterogeneous areas of decreased enhancement, known as a "striated nephrogram." Imaging is primarily used to diagnose complications such as emphysematous pyelonephritis, renal abscess, and pyonephrosis. Chronic pyelonephritis can have varying appearances on imaging ranging from xanthogranulomatous pyelonephritis or, in extreme cases, renal replacement lipomatosis.
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http://dx.doi.org/10.1016/j.rcl.2020.05.004DOI Listing
September 2020

The Lesser Sac and Foramen of Winslow: Anatomy, Embryology, and CT Appearance of Pathologic Processes.

AJR Am J Roentgenol 2020 10 12;215(4):843-851. Epub 2020 Aug 12.

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030.

This article reviews the embryologic development, relevant anatomy, and imaging features, on CT, of pathologic processes involving the lesser sac and foramen of Winslow. The lesser peritoneal sac is an intricate anatomic region involved in many disease processes. It is a significant conduit for the spread of disease within the peritoneal cavity. The spectrum of pathologic processes pertaining to the lesser sac can be classified on the basis of the type of involvement, such as a fluid collection (e.g., transudate, exudate, bile, and blood), a mass (e.g., neoplastic or nonneoplastic conditions and lymphadenopathy), or an internal hernia into the lesser sac.
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http://dx.doi.org/10.2214/AJR.19.22749DOI Listing
October 2020

Multiple Endocrine Neoplasia: Spectrum of Abdominal Manifestations.

AJR Am J Roentgenol 2020 10 13;215(4):885-895. Epub 2020 Jul 13.

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030.

Multiple endocrine neoplasia (MEN) syndromes are autosomal-dominant genetic disorders that predispose two or more organs of the endocrine system to tumor development. Although the diagnosis relies on clinical and serologic findings, imaging provides critical information for surgical management with the ultimate goal of complete tumor resection. This article reviews abdominal neoplasms associated with the various subtypes of MEN syndromes, with a focus on clinical presentation and characteristic imaging features.
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http://dx.doi.org/10.2214/AJR.19.22542DOI Listing
October 2020

Update: Venous Thrombosis and Hypercoagulability in the Abdomen and Pelvis-Findings in COVID-19.

Radiographics 2020 Sep-Oct;40(5):E24-E28. Epub 2020 Jul 10.

From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792 (M.C.O., M.G.L., L.M.G., D.H.K., P.J.P.); Department of Radiology, Mayo Clinic Scottsdale, Scottsdale, Ariz (C.O.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.).

Articles in the Update section provide current knowledge to supplement or update information found in full-length articles previously published in . Authors of the previously published article provide a brief synopsis that emphasizes important new information such as technological advances, revised imaging protocols, new clinical guidelines involving imaging, or updated classification schemes. Articles in this section are published solely online and are linked to the original article.
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http://dx.doi.org/10.1148/rg.2020200119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534456PMC
September 2020

Trans-diaphragmatic Pathologies: Anatomical Background and Spread of Disease on Cross-sectional Imaging.

Curr Probl Diagn Radiol 2021 Mar-Apr;50(2):252-261. Epub 2020 Jun 1.

Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:

The diaphragm is not only a sheet of muscle separating the abdominal and thoracic cavities: it plays an essential role in ventilation and can act as a gateway for the spread of different disease processes between the abdominal and the thoracic cavity. Careful attention to the appearance of the diaphragm on various imaging modalities is essential to ensure the accurate diagnosis of diaphragmatic disorders, which may be secondary to functional or anatomical derangements.
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http://dx.doi.org/10.1067/j.cpradiol.2020.05.007DOI Listing
June 2020

Morison's pouch: anatomical review and evaluation of pathologies and disease spread on cross-sectional imaging.

Abdom Radiol (NY) 2020 08;45(8):2315-2326

Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.

The peritoneum is a complex structure. Having a better understanding of this complex anatomy will enable the radiologist to accurately assess and diagnose the wide range of intra-abdominal pathologies. In this article, we review the anatomy, boundaries, and connections of Morison's pouch. In addition, we discuss the incidence and development of common pathological conditions within Morison's pouch and the role of multiple imaging modalities in assessment and diagnosis of these conditions.
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http://dx.doi.org/10.1007/s00261-020-02597-1DOI Listing
August 2020

Acute diverticulitis: Key features for guiding clinical management.

Eur J Radiol 2020 Jul 30;128:109026. Epub 2020 Apr 30.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States.

Diverticular disease of the colon and small bowel is an important cause of pathology leading to emergency department visits and urgent gastrointestinal surgery. CT is a highly sensitive and specific modality for the diagnosis of acute diverticulitis and its complications as well as for the exclusion of alternate causes of pathology. Ultrasound, MRI and virtual CT colonoscopy have important adjunct roles for screening and workup of complications in specific patient populations. While diverticular disease most commonly involves the descending and sigmoid colon, it can also affect the proximal colon and small bowel. Acute diverticulitis may be categorized as uncomplicated or complicated according to the degree of inflammatory changes and related complications it induces, although some degree of overlap exists in clinical practice. Uncomplicated diverticulitis is classically characterized by localized inflammation surrounding a diverticulum ranging from wall thickening and phlegmonous change to the development of small, localized pericolic abscesses. Complicated forms of disease manifest with larger pericolic and distant abscesses, fistulae to adjacent organs, perforation, and peritonitis. Recurrent episodes of diverticulitis may lead to muscular hypertrophy of the bowel wall and luminal narrowing, potentially leading to bowel obstruction. Several imaging features may help to differentiate diverticulitis from colonic malignancy, however this remains a diagnostic imaging challenge that often requires further evaluation with colonoscopy. In this review, we discuss the pathophysiology and key imaging features of acute diverticulitis and its complications. We explore both common and uncommon presentations of the disease involving the colon and small bowel, acute and chronic manifestations of disease, and pitfalls to recognize when imaging alone may be insufficient to distinguish benign from malignant.
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http://dx.doi.org/10.1016/j.ejrad.2020.109026DOI Listing
July 2020