Use Of Contrast Media Research Articles

Synthetic Post-Contrast Imaging through Artificial Intelligence: Clinical Applications of Virtual and Augmented Contrast Media.

Contrast media are widely diffused in biomedical imaging, due to their relevance in the diagnosis of numerous disorders. However, the risk of adverse reactions, the concern of potential damage to sensitive organs, and the recently described brain deposition of gadolinium salts, limit the use of contrast media in clinical practice. In recent years, the application of artificial intelligence (AI) techniques to biomedical imaging has led to the development of 'virtual' and 'augmented' contrasts. The idea behind these applications is to generate synthetic post-contrast images through AI computational modeling starting from the information available on other images acquired during the same scan. In these AI models, non-contrast images (virtual contrast) or low-dose post-contrast images (augmented contrast) are used as input data to generate synthetic post-contrast images, which are often undistinguishable from the native ones. In this review, we discuss the most recent advances of AI applications to biomedical imaging relative to synthetic contrast media.

Hit and miss: The accuracy of intra-articular injections of the first metatarsophalangeal joint

Introduction: Therapeutic injections provide a treatment option for patients with joint and periarticular pain, those who are not surgical candidates, whom conservative treatment has failed, or those that are awaiting surgery. Injectable glucocorticoids are one of the most common therapeutic interventions in musculoskeletal healthcare and are widely used in pathologies of the first metatarsophalangeal joint. The aim of this paper is to highlight current concepts around first metatarsophalangeal joint injection injection accuracy. Anatomy: The first metatarsophalangeal joint is a condyloid synovial juncture and consists of the head of the first metatarsal, the base of the proximal phalanx, six muscles, eight ligaments and two sesamoid bones, with associated ligamentous attachments. The joint capsule is shaped like a box. Methods: To achieve the research aim, a scoping review was undertaken with a search strategy that identified evidence via the following sources: Electronic databases, Google scholar, and Reference lists. Results: The search yielded 193 articles, 48 of which appeared of potential relevance. After removing duplicate articles this total was reduced to 37 articles. After scanning the content, 27 were excluded to leave 10 articles. Twenty eight further articles were found through related author research, examination of reference lists and free text searches of Google Scholar. One reference was unobtainable. The final count of papers utilised for review was 37 which produced three themes, one of which was injection accuracy. Injection accuracy: In the long history of injection therapy, infiltrations have often been performed without image guidance, i.e., using palpation guidance, anatomical landmarks and clinical judgement to direct needle entry and advancement. Needle placement may also be confirmed by use of diagnostic imaging. Typical imaging modalities are fluoroscopy or ultrasound, used alone or in combination with contrast media. Discussion: The perceived wisdom is that if an injectate misses its target it is likely to be less effective and lead to false negative reporting of poor treatment outcomes, but the literature is not equivocal. This article discusses the recent literature in the field. Conclusions: The literature suggests that steroid injections are safe and effective for the short-term relief of joint pain. When injecting small synovial joints using palpated-guided methods, clinicians must be alert to the potential for failure of technique from the needle penetrating too far into the articulation and exiting the joint on the contralateral side from the entry point. Use of shorter needles and use of imaging, +/- the use of contrast media, might reduce the number of such failures.

Dedicated CCTA Followed by High-Pitch Scanning versus TRO-CT for Contrast Media and Radiation Dose Reduction: A Retrospective Study.

We aimed to compare dedicated coronary computed tomography angiography (CCTA) followed by high-pitch scanning and triple-rule-out computed tomography angiography (TRO-CTA) in terms of radiation dose, contrast media (CM) use, and image quality. Patients with acute chest pain were retrospectively enrolled and assigned to group A (n = 55; scanned with dedicated CCTA followed by high-pitch scanning) or group B (n = 45; with TRO-CTA). Patient characteristics, radiation dose, CM use, and quantitative parameters (CT value, image noise, signal-to-noise ratio, contrast-to-noise ratio, and image quality score) of pulmonary arteries (PAs), thoracic aortae (TAs), and coronary arteries (CAs) were compared. The total effective dose was significantly lower in group A (6.25 ± 2.94 mSv) than B (8.93 ± 4.08 mSv; p < 0.001). CM volume was significantly lower in group A (75.7 ± 8.9 mL) than B (95.0 ± 0 mL; p < 0.001). PA and TA image quality were significantly better in group B, whereas that of CA was significantly better in group A. Qualitative image scores of PA and TA scans rated by radiologists were similar, whereas that of CA scans was significantly higher in group A than B (p < 0.001). Dedicated CCTA followed by high-pitch scanning demonstrated lower radiation doses and CM volume without debasing qualities of PA, TA, and CA scans than did TRO-CTA.

Metformin Can Be Safely Used in Patients Exposed to Contrast Media: A Systematic Review and Meta-Analysis

Background: There have been few studies published on the use of contrast media (CM) in metformin-treated patients. In this study, we conducted a systematic review and meta-analysis to investigate the relationship between metformin and contrast-induced acute kidney injury (CI-AKI). Methods: A comprehensive search of the Medline, PubMed, Embase, and Web of Science databases for literature on associations between metformin use and CI-AKI incidence was conducted. The pooled odds ratio (OR), or relative risk, as well as the corresponding 95% confidence intervals (CIs), was calculated to assess the relationship between metformin and CI-AKI risk as well as the incidence of lactic acidosis (LA). Results: In total, seven studies met our eligibility criteria on associations between metformin use and CI-AKI incidence, comprising 2,325 individuals, with 279 new cases of CI-AKI exposed to CM. The pooled analysis revealed no statistically significant increase in the risk of CI-AKI development in patients who used metformin continuously (random-effects OR: 1.15, 95% CI: 0.70–1.90, p = 0.57). No cases of LA that occurred during CM exposure were reported. Conclusion: Metformin can be safely used in patients with moderate renal impairment (eGFR ≥ 30 mL/min/1.73 m²) during CM exposure.

Hand compartment syndrome secondary to contrast media extravasation: A case report

IntroductionContrast media extravasation injury is a recognized complication of contrast media use. Compartmental syndrome of the hand secondary to contrast extravasation is exceptional. We describe a case of compartment syndrome of the hand secondary to contrast media extravasation.Case presentationWe present a 47-year-old woman with a history of pulmonary embolism who was diagnosed of compartment syndrome of the left hand after injection of contrast medium during a CT scan. Whose first diagnosis was mild contrast medium extravasation injury 24 h before the compartment syndrome. Standard radiography showed an accumulation of contrast medium in the left hand. The patient underwent a fasciotomy and secondary healing. Follow-up showed good radiographic, clinical, and hand function after 2 months.DiscussionThe occurrence of hand compartment syndrome secondary to contrast media extravasation is rare. Most of the time, they are initially diagnosed as medium extravasation before the worsening of symptoms. Because of its unknown incidence, treatment is not codified. The goal of treatment is to save the limb and restore function. This can be achieved rapidly with early surgery because of the unpredictable course.ConclusionContrast media injection is not a harmless gesture. Hand compartment syndrome after contrast extravasation is rare and is a severe injury, our experience with this case suggests that early surgery helps save the limb and restore function. Always fear a compartmental syndrome in case of extravasation of contrast medium.

Impact of iodinated contrast media concentration on image quality for dual-energy CT and single-energy CT with low tube voltage settings.

Contrast-induced nephropathy (CIN) is an adverse reaction associated with the use of intravenous contrast media (CM). To investigate the impact of low tube voltage settings on single-energy computed tomography (SECT) and rapid kV switching dual-energy CT (DECT) with reduced concentrations of iodinated CM. A phantom containing four different concentrations of CM (original concentration CM, 20%, 40%, and 60% reductions) was scanned using SECT mode with varying tube voltages (70, 80, 100, and 120 kVp) and DECT mode through reconstructing monoenergetic energy (50 keV and 70 keV) images. ATCM system with different noise index (NI) settings were set, and the images were reconstructed using ASiR-V. Image quality were measured for individual phantom sizes and protocols and compared to a reference protocol for SECT of 120 kVp, NI = 18, threshold contrast enhancement ≥280 HU, and CNR ≥17. Tube voltage settings of 70 kVp together with 40% reduction in the iodinated CM is suitable for small phantom size, those of 80 kVp and 20% reduction is suitable for the medium and large sizes. This allows radiation doses to be reduced by 12%-30%. Values of CNR and contrast for DECT are better than those for SECT with the same NI setting. Diagnostic reference of image quality can be maintained by using SECT with lower tube voltage and DECT with reductions of iodinated CM concentration and radiation dose. Therefore, the NI setting can be increased when DECT is used to achieve a similar image quality.

Physiological Stress as Risk Factor for Hypersensitivity to Contrast Media: A Narrative Review of the Literature and a Proposal of Psychophysiological Tools for Its Detection

The use of contrast media in clinical diagnostic practice has increased significantly in recent years, accompanied by an increase in adverse reactions. These are the fleeting symptoms most complained about by patients: Flushing of the face, feeling of nausea, and heat lasting a few seconds, considered side effects related to the drug. Hypersensitivity reactions are rarer but dangerous and are driven by the immune system. To ensure the optimal management of adverse reactions to iodinated contrast media, various types of health specialists, such as radiologists, are looking into how to deal with the problem. While there are many suggestions in the scientific literature on what to do in the case of important reactions during or after radiological examination, unfortunately, there are no studies on primary and secondary prevention and, in particular, on psychophysical and psychophysiological influences. Some inferences could be made by observing the studies about psychophysiological stress and immune-inflammatory processes of allergies. The few studies in the literature on the analysis of processes affecting both psychophysiological stress and allergic responses have been analyzed. Finally, stress measurement methods are proposed that can highlight “hypersensitive” people with physiological characteristics capable of exacerbating or accentuating an allergic reaction to contrast media.

Iodinated Contrast Media Conservation Measures During a Global Shortage: Effect on Contrast Media Use at a Large Health System.

The aim of this study was to quantify the effect of iodinated contrast media (ICM) conservation measures implemented at a single health system during a global shortage, comparing the 12-month period before intervention and the 14-day period after intervention. The mean daily utilization of contrast-enhanced CT decreased from 112 to 44 examinations, the mean ICM volume per CECT examination decreased from 88 to 74 mL, and the mean daily ICM use decreased from 9.9 to 3.3 L.

Magnetic Resonance Imaging to Diagnose and Predict the Outcome of Diabetic Kidney Disease—Where Do We Stand?

Diabetic kidney disease (DKD) is a major public health problem and its incidence is rising. The disease course is unpredictable with classic biomarkers, and the search for new tools to predict adverse renal outcomes is ongoing. Renal magnetic resonance imaging (MRI) now enables the quantification of metabolic and microscopic properties of the kidneys such as single-kidney, cortical and medullary blood flow, and renal tissue oxygenation and fibrosis, without the use of contrast media. A rapidly increasing number of studies show that these techniques can identify early kidney damage in patients with DKD, and possibly predict renal outcome. This review provides an overview of the currently most frequently used techniques, a summary of the results of some recent studies, and our view on their potential applications, as well as the hurdles to be overcome for the integration of these techniques into the clinical care of patients with DKD.

Ultrasound Versus Fluoroscopy for Image Guidance During Percutaneous Nephrolithotomy

Introduction: Fluoroscopes are commonly used in PCNL worldwide. While ultrasound is used for screening and localization of renal stones, its role in percutaneous nephrolithotomy (PCNL) is underutilized.&#x0D; Objective: To compare the operative outcome, postoperative outcome and complications of ultrasound versus fluoroscopy guided PCNL.&#x0D; Results: The study was performed from 1st April, 2018 to 30th Sept, 2021. A total of 305 patients were enrolled in the study, with 122 cases performed under ultrasound (UG-PCNL) and 183 under fluoroscopy guidance (FG-PCNL). In the ultrasound group, the mean age was 48.65 ± 12.11 years. 45 were females and 77 were males with a mean stone burden of 754.33 ± 241.22 mm2, with the majority of renal units demonstrating moderate to gross hydronephrosis. While in the fluoroscopy group 81 were females and 102 were males with a mean age 46.28 ± 12.65 years and mean stone size of 763.54 ± 288.97mm2. Partial staghorn stones were found in approximately 25.4% in UG-PCNL while 34.4% in FG-PCNL group. Preoperative parameters including age, sex, stone laterality, stone location, stone size, and severity of hydronephrosis did not differ between each group.There was no significant difference in successful tract creation, stone clearance, operation time , hospital stay, complications and ancillary procedure between UG-PCNL and FG-PCNL. Compared to fluoroscopy, ultrasonography had shorter puncture time, higher success rate of first puncture, shorter tract dilatation time, lesser drop in hemoglobin and lesser blood transfusion requirement.&#x0D; Conclusion: Ultrasound is a safe alternative to fluoroscopy for successful percutaneous renal access and dilatation with similar stone clearance to that of fluoroscopy. The advantages of ultrasonography over fluoroscopy include shorter puncture time, higher success rate of first puncture, lower blood loss, and lower complications. It also avoids radiation exposure and use of contrast media.

All about the Pancreas

All about the Pancreas Abstract. Ultrasound has made tremendous progress with the use of contrast media and elastography, particularly in patients with small, solid pancreatic lesions (SPL) <20mm and cystic tumors (CPL) of any size. In the case of solid and cystic pancreatic lesions, the differential diagnosis must first be evaluated after detection in order to define the indications for radical surgery, strategies for preserving the pancreatic parenchyma or simply for control examinations. Contrast-enhanced transcutaneous (TUS, CEUS) and endoscopic (EUS, CE-EUS) ultrasound and elastography facilitate further characterization of SPL and ZPL. Pancreatic ductal adenocarcinomas (PDAC) show hypoenhancement in contrast-enhanced ultrasound. The majority of the important differential diagnoses, on the other hand, are multi-enhancing. PDAC are almost always harder than healthy pancreatic parenchyma. In contrast, elastographically soft SPL are - with very few exceptions - benign. This review provides an overview of the use of modern ultrasound techniques to detect and characterize solid and cystic pancreatic lesions.

OP0150 ASAS RECOMMENDATIONS FOR REQUESTING AND REPORTING IMAGING EXAMINATIONS IN PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS

BackgroundClinicians face uncertainties in their daily practice when requesting imaging examinations for patients with suspected axial spondyloarthritis (axSpA) or when producing an imaging report because the requirements and desired information of radiologists and rheumatologists / orthopedics alike are sometimes not completely known or understood.ObjectivesThis project aimed to develop practical consensus recommendations for the standardized communication around imaging of sacroiliac joints and spine for diagnostic purposes in patients with suspected axSpA or their management in clinical practice.MethodsAn international task force was established combining radiologists (n=7) and rheumatologists (n=13) from the Assessment of SpondyloArthritis international Society (ASAS), two members of Young ASAS and a patient representative. The task force defined the project’s aims and developed a project statement. Then, considering published literature and the work of other groups, two survey rounds were designed, and all ASAS members invited to respond: first, to identify items for further consideration, second, to consider the detail of information to be communicated. Finally, ASAS members discussed the recommendations proposed by the task force during the ASAS annual workshop in January 2022 and voted regarding endorsement of the recommendations.ResultsThe final set of recommendations is presented in Figure 1. Six recommendations deal with imaging requests in patients with axSpA. The first three recommendations entail clinical features, patients’ symptoms and risk factors. Recommendation 4 concerns previous imaging and reports and recommendation 5 refers to contraindications to imaging or contrast media. Recommendation 6 is about the suspected diagnosis and possible clinical differential diagnoses and the reason for the examination. Eleven additional recommendations refer to the radiology report. The first point addresses clinical information included in the report. Recommendations 2 to 4 advise on information about the technical conduct of the exam, the use of contrast media and image quality. Imaging findings that should be mentioned in the report if present are listed in recommendations 5 to 7. Finally, recommendations 8 to 11 combine advice for the conclusion, and for suggesting additional imaging or referral to a rheumatology expert if a different physician requested the imaging. The recommendations were endorsed by ASAS with approval from 73% of voting members (43 agreed, 10 rejected, 6 abstained).Figure 1.ASAS recommendations for requesting and reporting imaging in patients with suspected axial Spondyloarthritis.ConclusionThese ASAS recommendations provide guidance for requesting and reporting imaging examinations in the context of axSpA and for standardizing and enhancing communication between rheumatologists and radiologists to improve diagnosis and patient care.Disclosure of InterestsTorsten Diekhoff Paid instructor for: Novarits, Eli Lilly, MSD, Canon MS, Consultant of: Eli Lilly, Iris Eshed: None declared, Chiara Giraudo: None declared, Kay-Geert Hermann: None declared, Manouk de Hooge: None declared, Lennart Jans: None declared, Anne Grethe Jurik: None declared, Robert G Lambert: None declared, Pedro M Machado: None declared, Walter P Maksymowych: None declared, Michael Mallinson: None declared, Helena Marzo-Ortega: None declared, Victoria Navarro-Compán: None declared, Susanne Juhl Pedersen: None declared, Mikkel Østergaard: None declared, Monique Reijnierse: None declared, Martin Rudwaleit: None declared, Fernando Sommerfleck: None declared, Ulrich Weber: None declared, Xenofon Baraliakos: None declared, Denis Poddubnyy: None declared

Evaluating the Effectiveness of Pretreatment With Intravenous Fluid in Reducing the Risk of Developing Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis.

Contrast media administration to patients during cardiac events increases the risk of developing contrast-induced nephropathy (CIN). CIN is among some complications usually associated with the percutaneous coronary intervention and may result in acute renal failure. Several risk factors are associated with CIN. These risk factors include; age (elderly patients), pre-existing renal impairment, diabetes mellitus, and the use of high osmolar contrast media. Studies have shown that several measures such as using low osmolar contrast media, N-acetylcysteine, intravenous sodium bicarbonate, and hydration through oral or intravenous fluid administration play a significant role in CIN incidence reduction. Hydration using intravenous fluid, especially saline solution, has been critical in preventing CIN. Prehydration using the intravenous fluid before contrast media administration is vital.A systematic literature search with meta-analysis for relevant and original articles was carried out from 2000 to 2022 on databases such as PubMed, Cochrane Library, Google Scholar, ScienceDirect, Web of Science, and Embase. The search on the databases was based on various keywords related to intravenous fluid and CIN. The studies that met the inclusion criteria were critically analyzed, and data such as study design, interventions, participants, and outcomes of the research were retrieved.Out of the 784 results yielded during the initial search, ten articles met the eligibility criteria and were included in the study. The data analysis obtained from the included studies showed that pretreatment using intravenous fluid has conflicting results. Some studies showed that hydrating patients using intravenous fluid before contrast media administration significantly reduces the risk of CIN. In contrast, others claimed that intravenous fluid has minimal impact on preventing CIN.Despite the different investigations conducted on CIN, it remains insufficiently understood. From the analysis, most of the studies support that intravenous fluid administration decreases the occurrence of CIN in patients that receive contrast media. The analysis also has established that oral hydration is similar to intravenous fluid administration in reducing CIN incidence.

Recent study debunks the iodine allergy myth—again

Every year, an estimated 75 million people worldwide require procedures that involve the use of contrast media. Prior to these procedures, the overwhelming majority of physicians—66% to 89%—ask patients about seafood or shellfish allergies based on their perception that iodine triggers those allergies and therefore these patients may not tolerate contrast media. Despite little or no evidence to support the existence of iodine allergies or a link between seafood allergy and iodine-containing products, anywhere from 20% to 75% of physicians say they would halt orders for the radiologic procedures or order premedication of patients due to perceived iodine allergy, according to a recent study published in American Journal of Health-System Pharmacy (AJHP).

Novel Technique of Non-Intravenous Use of Ultrasound Contrast Media for Biopsy Needle Visualization

Novel Technique of Non-Intravenous Use of Ultrasound Contrast Media for Biopsy Needle Visualization

Multiparametric Functional MRI of the Kidney: Current State and Future Trends with Deep Learning Approaches.

Until today, assessment of renal function has remained a challenge for modern medicine. In many cases, kidney diseases accompanied by a decrease in renal function remain undetected and unsolved, since neither laboratory tests nor imaging diagnostics provide adequate information on kidney status. In recent years, developments in the field of functional magnetic resonance imaging with application to abdominal organs have opened new possibilities combining anatomic imaging with multiparametric functional information. The multiparametric approach enables the measurement of perfusion, diffusion, oxygenation, and tissue characterization in one examination, thus providing more comprehensive insight into pathophysiological processes of diseases as well as effects of therapeutic interventions. However, application of multiparametric fMRI in the kidneys is still restricted mainly to research areas and transfer to the clinical routine is still outstanding. One of the major challenges is the lack of a standardized protocol for acquisition and postprocessing including efficient strategies for data analysis. This article provides an overview of the most common fMRI techniques with application to the kidney together with new approaches regarding data analysis with deep learning. This article implies a selective literature review using the literature database PubMed in May 2021 supplemented by our own experiences in this field. Functional multiparametric MRI is a promising technique for assessing renal function in a more comprehensive approach by combining multiple parameters such as perfusion, diffusion, and BOLD imaging. New approaches with the application of deep learning techniques could substantially contribute to overcoming the challenge of handling the quantity of data and developing more efficient data postprocessing and analysis protocols. Thus, it can be hoped that multiparametric fMRI protocols can be sufficiently optimized to be used for routine renal examination and to assist clinicians in the diagnostics, monitoring, and treatment of kidney diseases in the future. · Multiparametric fMRI is a technique performed without the use of radiation, contrast media, and invasive methods.. · Multiparametric fMRI provides more comprehensive insight into pathophysiological processes of kidney diseases by combining functional and structural parameters.. · For broader acceptance of fMRI biomarkers, there is a need for standardization of acquisition, postprocessing, and analysis protocols as well as more prospective studies.. · Deep learning techniques could significantly contribute to an optimization of data acquisition and the postprocessing and interpretation of larger quantities of data.. · Zhang C, Schwartz M, Küstner T et al. Multiparametric Functional MRI of the Kidney: Current State and Future Trends with Deep Learning Approaches. Fortschr Röntgenstr 2022; 194: 983 - 992.

Hemorrhagic Transformation Rates following Contrast Media Administration in Patients Hospitalized with Ischemic Stroke.

Hemorrhagic transformation is a critical complication associated with ischemic stroke and has been associated with contrast media administration. The objective of our study was to use real-world in-hospital data to evaluate the correlation between contrast media type and transformation from ischemic to hemorrhagic stroke. We obtained data on inpatient admissions with a diagnosis of ischemic stroke and a record of either iso-osmolar or low-osmolar iodinated contrast media for a stroke-related diagnostic test and a treatment procedure (thrombectomy, thrombolysis, or angioplasty). We performed multivariable regression analysis to assess the relationship between contrast media type and the development of hemorrhagic transformation during hospitalization, adjusting for patient characteristics, comorbid conditions, procedure type, a threshold for contrast media volume, and differences across hospitals. Inpatient visits with exclusive use of either low-osmolar (n = 38,130) or iso-osmolar contrast media (n = 4042) were included. We observed an overall risk reduction in hemorrhagic transformation among patients who received iso-osmolar compared with low-osmolar contrast media, with an absolute risk reduction of 1.4% (P = .032), relative risk reduction of 12.5%, and number needed to prevent harm of 70. This outcome was driven primarily by patients undergoing endovascular thrombectomy (n = 9211), in which iso-osmolar contrast media was associated with an absolute risk reduction of 4.6% (P = .028), a relative risk reduction of 20.8%, and number needed to prevent harm of 22, compared with low-osmolar contrast media. Iso-osmolar contrast media was associated with a lower rate of hemorrhagic transformation compared with low-osmolar contrast media in patients with ischemic stroke.

Prognostic value of non-contrast myocardial T1 mapping in cardiovascular diseases: a systematic review and meta-analysis.

Myocardial fibrosis predisposes the development of main adverse cardiovascular events (MACEs) in various cardiac disorders. Native T1 derived from cardiac magnetic resonance allows the quantitative assessment of myocardial fibrosis without the use of contrast media. However, the prognostic value of native T1 in risk stratification remains uncertain. We searched MEDLINE®, Embase, and the Cochrane Library for cohort studies up to July 31, 2021, that reported prognostic data for native T1 in various cardiac disorders; the studies enrolling patients with myocardial iron or amyloid deposition, edema, and inflammation were excluded. A random effects meta-analysis was conducted. Heterogeneity was assessed using I2 statistic. Nineteen studies with 5,380 patients were included in this meta-analysis. Patients with MACEs had higher native T1 than those without [weighted mean difference: 27.35 (15.55-39.16), I2 = 23.2%]. The increase of native T1 per 1ms [pooled adjusted hazard ratio (HR): 1.02 (1.00-1.03), I2 = 41.8%] and per ≥ 10ms [pooled adjusted HR: 1.11 (1.07-1.16), I2 = 28.6%] was both associated with the development of MACEs; the categorical variable derived from native T1 also has the predicative value for MACEs [pooled adjusted HR: 5.97 (3.69-9.68), I2 = 0.0%].Myocardial native T1 potentially serves as a prognostic biomarker in patients with various cardiac disorders. Different variable definitions of native T1 have different positively predictive value for outcome; the categorical variable derived from native T1 may be more helpful in identifying high-risk patients.

Comparison of Abdominopelvic CT Diagnoses at Academic Teaching Hospitals in Rwanda and the United States

Purpose: The purpose of this study was to compare the disease processes encountered on abdominal and pelvic CT examinations at academic teaching hospitals in Rwanda and the United States and to highlight how these differences may impact a global radiology collaboration. Materials and Methods: In this retrospective study, we included 130 patients (mean 59 +/-17 years, range 20-91, F:M 74:56) who underwent abdominal/pelvic CT examinations between April 1st-12th, 2019. CT examinations were prospectively encountered in clinical work at the Centre Hospitalier Universitaire de Kigali or University Teaching Hospital of Kigali (CHUK) in Kigali, Rwanda, where the radiology report impression, patient age, gender, study indication, CT protocol, and clinical diagnosis were recorded when available. Abdominal/pelvic CT examinations at the Massachusetts General Hospital (MGH) in Boston, Massachusetts, United States were then retrospectively reviewed for the same information. Patient age and gender were compared using Student’s t-test and Chi-square statistic. Frequency of formal recommendations in radiology reports, available comparison of CT examinations, presence of known diagnoses, and intravenous and oral contrast media use were compared using Fisher’s exact test. Diagnostic categories were qualitatively compared. Results: A wide variety of pathology was encountered by abdominal/pelvic CT at both sites of imaging, with qualitative differences observed in cancer types, infectious agents, and how imaging guides care. Patients in Rwanda were older (p=0.0017), more likely to receive intravenous (p &lt; 0.05) and positive oral contrast (p &lt; 0.05) media and less likely to receive a formal recommendation in their radiology report (p &lt; 0.05). Patients in the United States were more likely to have an available prior abdominal/pelvic CT (p &lt; 0.05), to present for follow-up of a known diagnosis (p &lt; 0.05), and to receive a formal recommendation in their radiology report (p &lt; 0.05). Conclusion: Participation in global radiology collaborations is beneficial for radiologists by broadening exposure to pathologies and practice different from their own institution and region.

Effects of contrast medium exposure on urine albumin/creatinine ratio

Aim: Albuminuria is a direct consequence of renal glomerular injury and increases with glomerular dysfunction. Spot urine albumin/creatinine (Alb/Cr) ratio is a reasonable surrogate for 24-hour urine albumin excretion rate and certainly not without limitations. It is known that renal function can be affected following contrast agent administration. The aim of our study is to assess the changes in Alb/Cr ratio in spot urine before and after contrast agents in patients undergoing computed tomography (CT) scanning.&#x0D; Material and Method: The present study included 103 hospitalized patients aged between 18 and 75 years, who underwent contrast-enhanced CT scanning for any reason and did not develop contrast-induced nephropathy (CIN). We compared the values of Alb/Cr ratio at the 6th, 12th, 24th, 48th, and 72nd hours after the procedure (post-procedure time) with the values at pre-procedure time. &#x0D; Results: The median age of the patients were 61 years. It has been observed that there is no significant increased in microalbuminuria after the use of contrast media. When the patients were evaluated for the albuminuria level before the procedure, it has been seen that 73 patients (70.9%) had an Alb/Cr ratio of