Publications by authors named "Danielle Byrne"

20 Publications

  • Page 1 of 1

Chronic Lung Allograft Dysfunction: Review of CT and Pathologic Findings.

Radiol Cardiothorac Imaging 2021 Feb 11;3(1):e200314. Epub 2021 Feb 11.

Department of Radiology, Division of Cardiothoracic Radiology (D.B., O.M.M., N.L.M., A.M.B.), Department of Medicine, Division of Respirology (R.G.N., R.D.L., C.B., J.R.S.), Department of Pathology (J.C.E.), and Department of Thoracic Surgery (J.Y.), Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1L5; and British Columbia Lung Transplant Program, Vancouver, Canada (R.G.N., J.Y., R.D.L., C.B., J.R.S.).

Chronic lung allograft dysfunction (CLAD) is the most common cause of mortality in lung transplant recipients after the 1st year of transplantation. CLAD has traditionally been classified into two distinct obstructive and restrictive forms: bronchiolitis obliterans syndrome and restrictive allograft syndrome. However, CLAD may manifest with a spectrum of imaging and pathologic findings and a combination of obstructive and restrictive physiologic abnormalities. Although the initial CT manifestations of CLAD may be nonspecific, the progression of findings at follow-up should signal the possibility of CLAD and may be present on imaging studies prior to the development of functional abnormalities of the lung allograft. This review encompasses the evolution of CT findings in CLAD, with emphasis on the underlying pathogenesis and pathologic condition, to enhance understanding of imaging findings. The purpose of this article is to familiarize the radiologist with the initial and follow-up CT findings of the obstructive, restrictive, and mixed forms of CLAD, for which early diagnosis and treatment may result in improved survival. © RSNA, 2021.
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http://dx.doi.org/10.1148/ryct.2021200314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978021PMC
February 2021

Systemic Air Embolism Complicating Computed Tomography-guided Percutaneous Transthoracic Biopsy of Cavitary Lung Lesions: A Systematic Review.

J Thorac Imaging 2021 Feb 25. Epub 2021 Feb 25.

Department of Radiology, Vancouver General Hospital Department of Radiology, University of British Columbia, Vancouver, BC, Canada.

Purpose: Cavitary lung lesions often pose a diagnostic challenge, and tissue sampling can be required to obtain a confident diagnosis. Many authors contend that a computed tomography-guided percutaneous transthoracic lung biopsy (PTLB) of a cavitary lung lesion places a patient at higher risk for systemic air embolism (SAE) compared with biopsy of a noncavitary lesion.

Materials And Methods: We reviewed the literature for studies of SAE complicating PTLB. We searched English-language articles indexed through PubMed, Embase, and Ovid Medline and included articles published up to March 31, 2020.

Results: We identified 10 case reports of SAE complicating PTLB, and 3 case-cohort studies comparing cavitary and noncavitary lesion biopsy. Among the case-cohort studies reviewed, 4 SAE occurred among 145 biopsies of cavitary lesions (2.7%), and 65 SAE occurred among 3050 biopsies of noncavitary lesions (2.1%). The pooled odds ratio of PTLB complicating SAE of cavitary lesions compared with noncavitary lesions was 1.29 (95% confidence interval: 0.47-3.60). No deaths following SAE after computed tomography-guided PTLB of cavitary lesions were reported in recent literature.

Conclusions: On the basis of available evidence, air embolism rates are similar for PTLB of cavitary and noncavitary lesions. Additional research and registry studies are necessary to better understand this topic.
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http://dx.doi.org/10.1097/RTI.0000000000000581DOI Listing
February 2021

Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference.

Can Assoc Radiol J 2020 Nov 3:846537120968919. Epub 2020 Nov 3.

Department of Radiology, 8167Vancouver General Hospital, Vancouver, British Columbia, Canada.

Purpose: The RSNA expert consensus statement and CO-RADS reporting system assist radiologists in describing lung imaging findings in a standardized manner in patients under investigation for COVID-19 pneumonia and provide clarity in communication with other healthcare providers. We aim to compare diagnostic performance and inter-/intra-observer among chest radiologists in the interpretation of RSNA and CO-RADS reporting systems and assess clinician preference.

Methods: Chest CT scans of 279 patients with suspected COVID-19 who underwent RT-PCR testing were retrospectively and independently examined by 3 chest radiologists who assigned interpretation according to the RSNA and CO-RADS reporting systems. Inter-/intra-observer analysis was performed. Diagnostic accuracy of both reporting systems was calculated. 60 clinicians participated in a survey to assess end-user preference of the reporting systems.

Results: Both systems demonstrated almost perfect inter-observer agreement (Fleiss kappa 0.871, < 0.0001 for RSNA; 0.876, < 0.0001 for CO-RADS impressions). Intra-observer agreement between the 2 scoring systems using the equivalent categories was almost perfect (Fleiss kappa 0.90-0.92, < 0.001). Positive predictive values were high, 0.798-0.818 for RSNA and 0.891-0.903 CO-RADS. Negative predictive value were similar, 0.573-0.585 for RSNA and 0.573-0.58 for CO-RADS. Specificity differed between the 2 systems, 68-73% for CO-RADS and 52-58% for RSNA with superior specificity of CO-RADS. Of 60 survey participants, the majority preferred the RSNA reporting system rather than CO-RADS for all options provided (66.7-76.7%; < 0.05).

Conclusions: RSNA and CO-RADS reporting systems are consistent and reproducible with near perfect inter-/intra-observer agreement and excellent positive predictive value. End-users preferred the reporting language in the RSNA system.
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http://dx.doi.org/10.1177/0846537120968919DOI Listing
November 2020

RSNA Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19: Interobserver Agreement Between Chest Radiologists.

Can Assoc Radiol J 2021 Feb 2;72(1):159-166. Epub 2020 Jul 2.

Department of Radiology, 8167Vancouver General Hospital, British Columbia, Canada.

Purpose: To assess the interobserver variability between chest radiologists in the interpretation of the Radiological Society of North America (RSNA) expert consensus statement reporting guidelines in patients with suspected coronavirus disease 2019 (COVID-19) pneumonia in a setting with limited reverse transcription polymerase chain reaction testing availability.

Methods: Chest computed tomography (CT) studies in 303 consecutive patients with suspected COVID-19 were reviewed by 3 fellowship-trained chest radiologists. Cases were assigned an impression of typical, indeterminate, atypical, or negative for COVID-19 pneumonia according to the RSNA expert consensus statement reporting guidelines, and interobserver analysis was performed. Objective CT features associated with COVID-19 pneumonia and distribution of findings were recorded.

Results: The Fleiss kappa for all observers was almost perfect for typical (0.815), atypical (0.806), and negative (0.962) COVID-19 appearances ( < .0001) and substantial (0.636) for indeterminate COVID-19 appearance ( < .0001). Using Cramer V analysis, there were very strong correlations between all radiologists' interpretations, statistically significant for all (typical, indeterminate, atypical, and negative) COVID-19 appearances ( < .001). Objective CT imaging findings were recorded in similar percentages of typical cases by all observers.

Conclusion: The RSNA expert consensus statement on reporting chest CT findings related to COVID-19 demonstrates substantial to almost perfect interobserver agreement among chest radiologists in a relatively large cohort of patients with clinically suspected COVID-19. It therefore serves as a reliable reference framework for radiologists to accurately communicate their level of suspicion based on the presence of evidence-based objective findings.
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http://dx.doi.org/10.1177/0846537120938328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335944PMC
February 2021

Teaching NeuroImages: An aTIPICal cause of acute neck pain.

Neurology 2020 08 30;95(8):e1112-e1113. Epub 2020 Jun 30.

From Neurology (S.G.-L.), Université Laval, Québec, Canada; Jaber Al-Ahmad Al Sabah Hospital (A.K.S.), Kuwait City, Kuwait; and Radiology (D.B., J.R.S.) and Neurology (T.S.), University of British Columbia, Vancouver, Canada.

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http://dx.doi.org/10.1212/WNL.0000000000010094DOI Listing
August 2020

Paediatric chronic fatigue syndrome patients' and parents' perceptions of recovery.

BMJ Paediatr Open 2019 2;3(1):e000525. Epub 2019 Dec 2.

Centre for Academic Child Health, University of Bristol, Bristol, UK.

Objectives: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is common in children and adolescents; however, little is known about how we should define recovery. This study aims to explore perceptions of recovery held by paediatric patients with CFS/ME and their parents.

Methods: Children with CFS/ME and their parents were recruited through a single specialist paediatric CFS/ME service. Data were collected through semistructured interviews with children and parents. The interview questions explored how participants would know if they/their child had recovered from CFS/ME. Thematic analysis was used to identify patterns within the data.

Results: Twenty-one children with CFS/ME, twenty mothers and two fathers were interviewed. Some children found it hard to define recovery as the illness had become a 'new normal'. Others thought recovery would indicate returning to pre-morbid levels of activity or achieving the same activity level as peers (socialising, education and leisure activities). Increased flexibility in routines and the absence of payback after activities were important. The interviews highlighted the concept of recovery as highly individual with wide variation in symptoms experienced, type and level of activity that would signify recovery. Parents describe how changes in mood and motivation would signify their child's recovery, but children did not reflect on this.

Conclusion: Some parents and children struggle to define what would constitute complete recovery. However, signs of recovery were more easily identifiable. Definitions of recovery went far beyond symptom reduction and were focused towards rebuilding lives.
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http://dx.doi.org/10.1136/bmjpo-2019-000525DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245384PMC
December 2019

A Review of the Applications of Dual-Energy CT in Acute Neuroimaging.

Can Assoc Radiol J 2020 Aug 28;71(3):253-265. Epub 2020 Feb 28.

Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.

Dual-energy computed tomography (CT) is a promising tool with increasing availability and multiple emerging and established clinical applications in neuroradiology. With its ability to allow characterization of materials based on their differential attenuation when imaged at two different energy levels, dual-energy CT can help identify the composition of brain, neck, and spinal components. Virtual monoenergetic imaging allows a range of simulated single energy-level reconstructions to be created with postprocessing. Low-energy reconstructions can aid identification of edema, ischemia, and subtle lesions due to increased soft tissue contrast as well as increasing contrast-to-noise ratios on angiographic imaging. Higher energy reconstructions can reduce image artifact from dental amalgam, aneurysm clips and coils, spinal hardware, dense contrast, and dense bones. Differentiating iodine from hemorrhage may help guide management of patients after thrombectomy and aid diagnosis of enhancing tumors within parenchymal hemorrhages. Iodine quantification may predict hematoma expansion in aneurysmal bleeds and outcomes in traumatic brain injury. Calcium and bone subtraction can be used to distinguish hemorrhage from brain parenchymal mineralization as well as improving visualization of extra-axial lesions and vessels adjacent to dense plaque or skull. This article reviews the basics of dual-energy CT and highlights many of its clinical applications in the evaluation of acute neurological presentations.
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http://dx.doi.org/10.1177/0846537120904347DOI Listing
August 2020

Development of a conceptual framework to underpin a health-related quality of life outcome measure in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME): prioritisation through card ranking.

Qual Life Res 2020 May 6;29(5):1169-1181. Epub 2020 Jan 6.

Centre for Academic Child Health (CACH), Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.

Purpose: Chronic fatigue syndrome (CFS)/myalgic encephalopathy (ME) is relatively common in children and is disabling at an important time in their development. This study aimed to develop a conceptual framework of paediatric CFS/ME using the patient-perspective to ensure that the content of a new outcome measure includes the outcomes most important to young people.

Methods: We developed a child-centred interactive card ranking exercise that included health-related quality of life (HRQoL) outcomes identified from a previous review of the literature as well as qualitative work. Adolescents and their parents selected and ranked the outcomes most important to them and discussed each outcome in further detail. Adolescents were purposively sampled from a single specialist paediatric CFS/ME service in England. Interviews were audio recorded and transcribed verbatim, and thematic framework analysis was used to develop the final conceptual framework.

Results: We interviewed 43 participants in which there are 21 adolescents, 12-17 years of age with mild-moderate CFS/ME and their parents (20 mothers and 2 fathers). 'Symptoms', 'tiredness', 'payback and crashing' and 'activities and hobbies' were ranked most important to improve by both children and parents. Children ranked 'school' higher than parents and parents ranked 'mood' higher than children. A youth- specific CFS/ME conceptual framework of HRQoL was produced that included 4 outcome domains and 11 subdomains: sleep, tiredness, problems concentrating, individual symptoms, fluctuation and payback, daily and general activities, participation in school, leisure and social life, mood, anxiety and self-esteem.

Conclusions: An interactive card ranking exercise worked well for adolescents aged 12-17 to elicit the most important outcomes to them and explore each domain in further detail. We developed a final conceptual framework of HRQoL that forms the basis of a new paediatric patient-reported outcome measure (PROM) in CFS/ME.
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http://dx.doi.org/10.1007/s11136-019-02399-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190584PMC
May 2020

Improvements in cardiac function detected using echocardiography in patients with hereditary haemochromatosis.

Ir J Med Sci 2020 Feb 20;189(1):109-117. Epub 2019 May 20.

Institute of Cardiovascular Science, St James Hospital, Dublin 8, Ireland.

Background: Hereditary haemochromatosis is often not diagnosed until adulthood. Iron overload cardiomyopathy initially results in diastolic dysfunction and can result in arrhythmias and irreversible cardiac failure if untreated. The aim of this study was to investigate whether patients with newly diagnosed hereditary haemochromatosis without signs of heart failure exhibit subclinical alterations of cardiac function and to determine if cardiac function improved after 1 year of venesection.

Methods: Baseline echocardiography was performed on 25 patients with newly diagnosed hereditary haemochromatosis with elevated serum ferritin levels. The test was repeated after 1 year of treatment with venesection. Tissue Doppler imaging (TDI) and deformation (strain) imaging using speckle tracking were performed. Left atrial force was measured according to the Newtonian principle, in which force (dynes) = mass × acceleration. Left atrial force was calculated by the Manning method expressed as ρ × 0.53 × mitral annular orifice area × (peak A velocity).

Results: Radial strain showed a significant improvement after 1 year of venesection (increase from 38.8 to 52.6). The LAF showed a significant decrease after 1 year of venesection (median decrease = 0.6 (IQR 0, 1.60), p = 0.0004). Iso-volumetric relaxation time (IVRT) decreased significantly in patients after 1 year of venesection (decrease from 107.4 ± 16.2 to 97.68 ± 15.4 ms, p (0.0187)).

Conclusion: Among all measurements, radial strain, IVRT and left atrial force were shown to significantly improve following a 1-year course of venesection, suggesting that these parameters could be used to identify subclinical cardiac dysfunction in patients with iron overload secondary to hereditary haemochromatosis and to guide intensification of venesection therapy.
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http://dx.doi.org/10.1007/s11845-019-02032-5DOI Listing
February 2020

Occult central pontine myelinolysis post liver transplant: A consequence of pre-transplant hyponatremia.

Ann Hepatol 2019 Jul - Aug;18(4):651-654. Epub 2019 Apr 24.

Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, Canada. Electronic address:

Rapid overcorrection of chronic hyponatremia can lead to osmotic demyelination syndrome or central pontine myelinolysis (CPM), a diagnosis often triggered by observing the characteristics of neurological abnormalities developed as a result of CPM. However, anyone with chronic hyponatremia and overcorrection of serum sodium is at risk of physiological CPM despite the lack of clinical symptoms. We report an adult patient who presented as post-op delirium, had incidental finding of CPM by magnetic resonance imaging (MRI) of the head after a liver transplant. Despite his non-typical presentation, the patient had the typical risk factors of CPM such as chronic hyponatremia, rapid overcorrection of serum sodium and cirrhosis undergoing a transplant. As hyponatremia and neurological disorder such encephalopathy simultaneously affect patients with cirrhosis, CPM may be more common than once thought in the chronic liver disease population and inappropriate hyponatremia management has important medical consequences that can go unnoticed.
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http://dx.doi.org/10.1016/j.aohep.2019.01.004DOI Listing
August 2020

Intravenous leiomyomatosis manifesting as saddle embolism.

BMJ Case Rep 2019 Mar 20;12(3). Epub 2019 Mar 20.

Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.

A 51-year-old, otherwise well woman, presented with progressive severe dyspnoea. CT pulmonary angiogram (CTPA) demonstrated a large filling defect within the right main pulmonary artery with evidence of right heart strain. She was anticoagulated and discharged home; however, was readmitted with progression of symptoms and hypotension within 1 month. Repeat CTPA demonstrated progression of the filling defect. Formal surgical thrombectomy was performed with removal of an unusual cream-coloured, rubber-like material. Histological analysis revealed intravenous leiomyomatosis (IVL). IVL is a rare benign neoplasm, characterised by smooth muscle cell proliferation in vascular structures that can act aggressively. This case describes the workup, recognition and management of IVL.
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http://dx.doi.org/10.1136/bcr-2018-228267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453327PMC
March 2019

An acute stroke CT imaging algorithm incorporating automated perfusion analysis.

Emerg Radiol 2019 Jun 1;26(3):319-329. Epub 2019 Feb 1.

Department of Radiology, Mater Misericordiae University Hospital, Whitty Building, North Circular Road, Dublin 7, Ireland.

In this paper, we propose a CT imaging algorithm for patients presenting with suspected acute stroke that incorporates automated CT perfusion (CTP) imaging. The algorithm details evaluation of the non-contrast CT (NCCT) for hemorrhage and acute ischemia, calculation of ASPECTS, with performance and interpretation of CTP if appropriate. In particular, we consider the key steps in expeditious interpretation of non-contrast CT and CT angiography in the context of suspected acute ischemic stroke. Given the recent expansion of the "imaging based" treatment window for thrombectomy from 6 to 24 h in the 2018 American Heart Association stroke guidelines, we consider the key criteria in the decision to perform CT perfusion and the patient cohorts in which this might be most helpful. We also describe how imaging findings might be incorporated into the treatment paradigm for suspected with acute ischemic stroke and we allude to some of the most frequently encountered pitfalls associated with CTP which we think will be particularly helpful for radiologists and stroke physicians who are considering adding CT perfusion to their work-up for acute stroke.
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http://dx.doi.org/10.1007/s10140-019-01675-2DOI Listing
June 2019

Adolescent's descriptions of fatigue, fluctuation and payback in chronic fatigue syndrome/myalgic encephalopathy (CFS/ME): interviews with adolescents and parents.

BMJ Paediatr Open 2018 4;2(1):e000281. Epub 2018 Dec 4.

Centre for Academic Child Health, University of Bristol, Bristol, UK.

Objective: As part of a larger qualitative study to explore outcomes important in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) and what improvements in fatigue and disability are key, interviews were undertaken with adolescents and their parents. This paper focuses on their descriptions of fatigue, fluctuation of symptoms and payback.

Design And Setting: Semistructured qualitative interviews were undertaken between December 2014 and February 2015. Adolescents and parents were interviewed separately. Participants were recruited from a single specialist paediatric chronic fatigue service. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis.

Participants: We interviewed 21 adolescents and their parents (20 mothers and 2 fathers). The adolescents were aged between 12 and 17 years of age (mean age 14.4 years), mild to moderately affected by CFS/ME (not housebound) and the majority were female (16/21).

Results: All adolescents with CFS/ME reported fatigue, a natural fluctuation of the condition, with good days and bad days as well as an increase in symptoms after activity (payback). However, adolescent's descriptions of fatigue, symptoms and the associated impact on their daily lives differed. The variations included: fatigue versus a collection of symptoms, constant versus variable symptoms and variable symptom severity. There were differences between participants in the amount of activity taken to cause payback. The impact of fatigue and symptoms on function ranged from: limiting the duration and amount of leisure activities, struggling with daily activities (eg, self-care) to no activity (sedentary).

Conclusions: Fatigue, fluctuation of the condition and payback after activity are described by all adolescents with CFS/ME in this study. However, the individual experience in terms of how they describe it and the degree and impact varies.
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http://dx.doi.org/10.1136/bmjpo-2018-000281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307594PMC
December 2018

A cause of recurrent strokes: carotid webs detected by CT angiogram.

BJR Case Rep 2018 9;4(1):20170066. Epub 2017 Nov 9.

Department of Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.

Carotid webs are an uncommon cause of recurrent ischaemic strokes. They are considered a form of fibromuscular dysplasia, possibly developmental in origin, with non-inflammatory and non-atherosclerotic features and a characteristic appearance on CT angiography. They have been described as a thin intraluminal filling defect along the posterior wall of the carotid bulb in oblique sagittal reformats and a septum on axial CT angiography. Here we summarize two cases of ischaemic strokes secondary to carotid webs with characteristic images. Detection and awareness of carotid webs and their imaging features among radiologists and physicians are important as it is associated with a high risk of recurrent cerebrovascular events.
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http://dx.doi.org/10.1259/bjrcr.20170066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159149PMC
November 2017

CT cervico-cerebral angiography in acute stroke. Can we justify aortic arch imaging?

Ir J Med Sci 2019 May 24;188(2):661-666. Epub 2018 Aug 24.

Department of Radiology, Mater Misericordiae University Hospital, Dublin 7, Ireland.

Objectives: Computed tomography cervico-cerebral angiography (CTCCA) plays a pivotal role in the evaluation of acute stroke. Currently no evidence justifies the inclusion of the upper chest in the CTCCA field of view. The aim of this study was to assess the prevalence and clinical significance of vascular findings identified on CTCCA in the head, neck, and upper chest regions in patients presenting with acute stroke symptoms.

Methods: A retrospective review of radiology images and reports of 900 consecutive patients (425 men, 475 women; mean age 63.2 years, age range 19-99 years) with a suspected acute stroke who underwent CTCCA in the emergency department between January 2011 and July 2016. Clinically significant vascular CTCCA findings were recorded for each patient within the head, neck, and upper chest regions, respectively.

Results: Of the 900 patients, clinically significant vascular CTCCA findings were identified in 404/900 (44.8%) patients. 218/900 (24.2%) were located within the head region; 174/900 (19.3%) within the neck; and 12/900 (2.4%) in the upper chest. Of the 12 vascular findings located within the upper chest, 3/900 (0.33%) were related to a clinically significant posterior circulation infarct.

Conclusions: Routine inclusion of the upper chest on CTCCA is currently difficult to justify in the evaluation of a suspected acute anterior circulation stroke, contributing significantly to total radiation dose without demonstrating significant extra-cranial vascular findings. Prospective studies adopting narrower fields of view excluding the upper chest are necessary.
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http://dx.doi.org/10.1007/s11845-018-1888-9DOI Listing
May 2019

Subtraction multiphase CT angiography: A new technique for faster detection of intracranial arterial occlusions.

Eur Radiol 2018 Apr 13;28(4):1731-1738. Epub 2017 Nov 13.

Department of Radiology, Mater Misericordiae University Hospital, North Circular Road, Dublin 7, Ireland.

Objective: To describe and evaluate a novel technical development to improve detection of intracranial vessel occlusions using multiphase CT angiography (MPCTA).

Materials And Methods: The institutional ethics committee approved the study. Fifty patients (30 consecutive distal (M2 or smaller) anterior circulation occlusions, ten M1 occlusions, ten cases without occlusion) presenting with suspected AIS who underwent MPCTA were included. Post-processing of MPCTA studies created "subtraction" and "delayed enhancement" (DE) datasets. Initially, non-contrast CT and MPCTA studies for each patient were evaluated. Readers' confidence, speed and sensitivity of detection of intracranial vessel occlusions were recorded. After an interval of at least 4 weeks, readers were provided with post-processed images and studies were re-evaluated.

Results: While the sensitivity of detection of intracranial vessel occlusions was equal for both conventional MPCTA and subMPCTA, the mean time taken to identify a vessel occlusion decreased by 64 % using subMPCTA (16 s vs. 45 s with conventional MPCTA) (p<0.001). In addition, confidence in interpretation improved (from 4.4 to 4.9) using subMPCTA (p<0.001).

Conclusion: SubMPCTA is a novel technique that aids in identifying small intracranial vessel occlusions in the suspected AIS patient. SubMPCTA increases confidence in interpretation and reduces the time taken to detect intracranial vessel occlusions.

Key Points: • SubMPCTA processes MPCTA data to better demonstrate intracranial arterial occlusions. • SubMPCTA increases confidence and speed of interpretation of MPCTA studies. • SubMPCTA may aid in rapidly differentiating acute ischaemic stroke from stroke mimics.
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http://dx.doi.org/10.1007/s00330-017-5124-1DOI Listing
April 2018

Combined intramedullary and intradural extramedullary spinal metastases in malignant melanoma.

BMJ Case Rep 2017 Mar 25;2017. Epub 2017 Mar 25.

Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.

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http://dx.doi.org/10.1136/bcr-2017-220031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747669PMC
March 2017

Child, Teacher and Parent Perceptions of the FRIENDS Classroom-Based Universal Anxiety Prevention Programme: A Qualitative Study.

School Ment Health 2016 12;8(4):486-498. Epub 2016 Mar 12.

Department for Health, University of Bath, Bath, BA2 7AY UK.

School-based mental health prevention programmes can be effective but their adoption within schools will depend on their social acceptability. We report a qualitative evaluation summarising the views of children (115), parents (20) and school staff (47) about a universal school-based anxiety prevention programme FRIENDS. This study was conducted as part of a large scale randomised controlled trial ( = 1362) involving 40 schools in the UK providing primary education to children aged 7-11. Reported overall experience of the programme was very positive, with all three major components of the cognitive behaviour therapy programme (emotional, cognitive, and behavioural) being accepted well and understood by children. The programme was considered to be enjoyable and valuable in teaching children important skills, particularly emotional regulation and coping. Children provided examples of using the skills learned during FRIENDS to manage their emotions and solve problems. However, teachers were concerned that the programme overlapped with the current school curriculum, required additional time and almost half were unable to identify any tangible changes in the children's behaviour. Whilst this paper provides evidence to support the social validity of the FRIENDS anxiety prevention programme, the concerns raised by teachers question the longer-term sustainability of the programme.
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http://dx.doi.org/10.1007/s12310-016-9187-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102957PMC
March 2016

A case of thoracic giant cell tumor of bone and discussion of radiological features and current management practices.

Radiol Case Rep 2016 Sep 25;11(3):222-6. Epub 2016 May 25.

Department of Oncology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.

Giant cell tumor of bone (GCTB) is a rare condition with distinct radiological features that aid diagnosis. We present the case of an adult female patient, with locally invasive GCTB and review important radiological and management principles. Specific radiological features include locally aggressive, lytic radiolucent lesions, which can demonstrate cortical thinning and expansile remodeling of bone and typically involve the epiphysis and metaphysis. Management is primarily surgical, and denosumab has a role in the advanced setting.
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http://dx.doi.org/10.1016/j.radcr.2016.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996899PMC
September 2016

Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

Int Wound J 2012 Apr 13;9(2):120-5. Epub 2011 Sep 13.

FFNMRCSI, Centre for Nursing and Midwifery Research, Royal College of Surgeons in Ireland, Dublin, Ireland.

Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.
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http://dx.doi.org/10.1111/j.1742-481X.2011.00851.xDOI Listing
April 2012