Objectives
Determine the rate of positive extremity ultrasound exams for DVT in patients with COVID‐19 and assess for differences in laboratory values in patients with and without DVT, which could be used as a surrogate to decide the need for further evaluation with ultrasound.
Methods
Retrospective case control study with 1:2 matching of cases (COVID‐19+ patients) to controls (COVID‐19− patients) based on age, gender, and race. Laboratory values assessed were serum D‐dimer, fibrinogen, prothrombin time, international normalized ratio, and C‐reactive protein. Demographic variables, comorbidities, and clinical variables including final disposition were also evaluated. P‐values for categorical variables were calculated with the chi‐square test or Fisher's exact test. P‐values for continuous variables were compared with the use of a two‐tailed unpaired t‐test.
Results
The rate of extremity ultrasound exams positive for DVT were similar in patients with (14.7%) and without (19.3%) COVID‐19 (P = .423). No significant difference was observed in laboratory values including the D‐dimer level in COVID‐19 patients without (mean 9523.9 ng/mL (range 339 to >60,000)) or with DVT (mean 13,663.7 ng/mL (range 1193–>60,000)) (P = .475). No differences were found in demographic variabilities or co‐morbidities among COVID‐19 patients with and without extremity DVT.
Conclusions
We found no statistically significant difference in rate of positive DVT studies between COVID‐19+ and COVID‐19− patients. D‐dimer levels are elevated, in some cases markedly, in COVID‐19 patients with and without DVTs and therefore these data do not support their use as a surrogate when assessing the need for ultrasound evaluation.
by
Thomas A. Hope;
Marc J. Gollub;
Supreeta Arya;
David D. B. Bates;
Dhakshinamoorthy Ganeshan;
Mukesh Harisinghani;
Kartik S. Jhaveri;
Zahra Kassam;
David H. Kim;
Elena Korngold;
Neeraj Lalwani;
Courtney Moreno;
Stephanie Nougaret;
Victoriya Paroder;
Raj M. Paspulati;
Jennifer S. Golia Pernicka;
Iva Petkovska;
Perry J. Pickhardt;
Gaiane M. Rauch;
Michael H. Rosenthal;
Shannon P. Sheedy;
Natally Horvat
Standardized terminology is critical to providing consistent reports to referring clinicians. This lexicon aims to provide a reference for terminology frequently used in rectal cancer and reflects the consensus of the Society of Abdominal Radiology Disease Focused Panel in Rectal cancer. This lexicon divided the terms into the following categories: primary tumor staging, nodal staging, treatment response, anal canal anatomy, general anatomy, and treatments.
Primary hepatic malignancies are less common than metastatic diseases, but a recognition of these lesions is important for diagnosis and treatment planning. Magnetic resonance imaging (MRI) provides the most imaging information to diagnose lesions noninvasively and to narrow differential diagnoses. This paper reviews the imaging findings of chronic liver disease and primary hepatic malignancies, including hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (CCA), epithelioid hemangioendothelioma, hepatic angiosarcoma, and primary hepatic lymphoma. Clinical and MRI features are reviewed to improve the readers' recognition of these tumors, allowing for a narrower differential diagnosis when liver masses are encountered on abdominal imaging.
by
Courtney Moreno;
Judy Yee;
Firas S. Ahmed;
Matthew A. Barish;
Cecelia Brewington;
Abraham H. Dachman;
Marc J. Gollub;
David H. Kim;
Elizabeth McFarland;
Perry J. Pickhardt;
Syam Reddy;
Michael Zalis;
Kevin J. Chang
Purpose
To describe the favorable procedural profile of CT colonography (CTC) during the COVID-19 pandemic.
Conclusion
Postponement of cancer screening due to COVID-19 has resulted in a backlog of individuals needing to undergo structural examination of the colon. The experience during the initial COVID-19 surge with urgent evaluation of the colon for transplant patients prior to transplant suggests that CTC can be done in a lower risk manner as compared to other structural examinations. The procedural profile of CTC is advantageous during this pandemic as maintaining social distancing and preserving healthcare supplies including PPE are of paramount importance. CTC is an important option to utilize in the screening armamentarium to allow effective screening of average risk asymptomatic individuals in the COVID-19 era.
Assess the added value of nonenhanced computed tomography (NECT) to contrast-enhanced CT (CECT) of the abdomen for characterization of hypervascular liver metastases and incidental findings. Institutional review board approved, Health Insurance Probability and Accountability Act compliant, retrospective study of patients with melanoma, neuroendocrine tumor, or thyroid cancer. First available triphasic abdomen CT after initial diagnosis was reviewed by 3 radiologists. The 3 most suspicious lesions were characterized on the CECT as benign or malignant and then recharacterized after reviewing the NECT with CECT. Incidental renal and adrenal lesions were characterized similarly. Diagnostic performance of CECT vs its combination with NECT was assessed. Statistical significance level was set at P < 0.05. A total of 81 patients were included (mean age = 55 years; 52% male; 64% with liver lesions; 27% and 11% with incidental renal and adrenal lesions, respectively). Percentage area under the curve and 95% CI of CECT vs combination with NECT for characterization of liver metastases was 98(94-100) vs 99(96-100) for reviewer 1 (P = 0.35), 93(86-100) vs 94(87-100) for reviewer 2 (P = 0.23), and 96(90-100) vs 99(97-100) for reviewer 3 (P = 0.32). Mean difference in area under the curve and 95% CI between 2 protocols for characterization of liver, renal, and adrenal lesions were −0.007(−0.05 to 0.04) (P = 0.63), −0.09(−0.25 to 0.07) (P = 0.22), and −0.01(−0.05 to 0.02) (P = 0.27), respectively. After addition of NECT, confidence level for lesion characterization increased 4%-15% for liver metastases, 18%-59% and 33%-67% for renal and adrenal lesions, respectively. In conclusion, while addition of NECT to CECT improved radiologist’ confidence, there was no statistically significant change in characterization of hypervascular liver metastases or incidental renal and adrenal lesions.