Springer Science and Business Media LLC

Radiological examinations of COVID-19 positive patients play a vital role in early diagnosis and assessment of disease course, as most COVID-19 infected patients were diagnosed with pneumonia and characteristic CT imaging patterns. Asymptomatic infected individuals, called “asymptomatic carrier or transmitter”, who are the infectious sources of SARS-CoV-2, and some of them progress rapidly, even resulting in acute respiratory distress syndrome (ARDS) with a high case-fatality rate. Our study is a prospective study and aims to be familiar with the CT imaging features of asymptomatic cases with COVID-19 pneumonia. A total of 44 asymptomatic cases with COVID-19 pneumonia between March 20, 2020 and May 23, 2020 were enrolled. All patients had a history of exposure to SARS-CoV-2 or recent travel history. All patients had no symptoms. The predominant feature of CT findings in this cross-sectional study was ground-glass opacity (GGO) (41, 93%) with peripheral (34, 77.3%) distribution, bilateral location (20, 45.5%) with lower lobe predominance (left lower lobe 72% and right lower lobe 50%). CT imaging of asymptomatic cases with COVID-19 pneumonia has highly characteristics findings. Since asymptomatic patients are the asymptomatic transmitter, and some patients can progress rapidly in the short term, it is essential to early diagnose asymptomatic patients with COVID-19. CT scan has great sensitivity in screening and detecting patients with COVID-19 pneumonia.

As newer technologies in the field of medical imaging continue to expand, development of unique techniques for optimizing image quality and minimizing radiation dose becomes very necessary for improve diagnosis of pathologies and patient safety. Different types of medical imaging devices have been developed for specific diagnostic purposes. This article provides a brief overview on the need for co-registration of some medical images into a single image (image fusion), advantages of some nanoparticle contrast agents in medical imaging, and a discussion of present and future role of integrating image fusion with nanoparticle contrast agents in diagnosis. The use of nanoparticle contrast agents together with image fusion is a promising technique in future medical imaging as is likely to reveal pathologies of ≤ 1 nm sizes.

Lateral epicondylitis (LE) is a common non-traumatic condition. The diagnosis of LE is typically made clinically. Some lateral epicondylitis patients can profit from supplementary imaging for a precise differential diagnosis. Recently, shear wave elastography has been increasingly attracting public attention in evaluation of tendon pathology and tissue elasticity quantitatively. The purpose of our study was to prove that shear wave elastography can be utilized in the diagnosis and follow-up of lateral epicondylitis. This cross-sectional analytic study involved 42 patients with unilateral lateral epicondylitis (30 males, 12 females with age range: 30–50 years, mean age: 39.9 ± 6 SD). The patients were reviewed by two radiologists with experience of more than 10 years, blinded to each other's results. Lateral epicnodylitis was diagnosed based on clinical criteria. The thickness of common extensor tendon and shear wave speed (SWS) were acquired in elbows bilaterally, along with values of the involved elbows in pre- and post-treatment phases. The comparison between examined groups, inter-rater and intra-rater concordance, and the diagnostic performance have been investigated with paired t-test, an intraclass correlation coefficients (ICCs), and a receiver operator characteristic curve, respectively. The patients with lateral epicondylitis showed a significantly decreased value of shear wave speed on affected side in comparison to the healthy side (P value: 0.000). The shear wave speed of diseased elbows has increased significantly following non-operative management than before therapy. The inter-rater and intra-rater concordance showed both excellent values (ICCs ranged from 0.939 to 1.000) for shear wave speed measurements. Furthermore, a 10.72 m/s cutoff limit of mean SWS (shear wave speed) for differentiating lateral epicondylitis elbows from healthy elbows showed a sensitivity and specificity of 90.5% for both. Shear wave elastography can be of value as a technique with proper reproducibility and proper diagnostic performance for evaluation and monitoring the therapeutic effect in patients with lateral epicondylitis.

A retrospective study was conducted on 71 consecutive patients with suspected prostate cancer (PCa) with a mean age of 56 years and underwent mp-MRI of the prostate at 3 Tesla MRI. Two readers recognized all prostatic lesions, and each lesion had a score according to Prostate Imaging–Reporting and Data System version 2 (PI-RADS-v2). To evaluate the interobserver agreement of PI-RADS-v2 in characterization of prostatic lesions using multiparametric MRI (mp-MRI) at 3 Tesla MRI. The overall interobserver agreement of PI-RADS-v2 for both zones was excellent (k = 0.81, percent agreement = 94.9%). In the peripheral zone (PZ) lesions are the interobserver agreement for PI-RADS II (k = 0.78, percent agreement = 83.9%), PI-RADS III (k = 0.66, percent agreement = 91.3 %), PI-RADS IV (k = 0.69, percent agreement = 93.5%), and PI-RADS V (k = 0.91, percent agreement = 95.7 %). In the transitional zone (TZ) lesions are the interobserver agreement for PI-RADS I (k = 0.98, percent of agreement = 96%), PI-RADS II (k = 0.65, percent agreement = 96%), PI-RADS III (k = 0.65, percent agreement = 88%), PI-RADS IV (k = 0.83, percent agreement = 96%), and PI-RADS V (k = 0.82, percent agreement = 92%). We concluded that PI-RADS-v2 is a reliable and a reproducible imaging modality for the characterization of prostatic lesions and detection of PCa.

Scurvy is a nutritional vitamin C deficiency disease which shows classical signs on radiographs most commonly along long bones with subperiosteal hemorrhage being a classical finding. Primary presentation of scurvy with orbital hemorrhage presenting as proptosis is however uncommon. We report an unusual primary presentation of scurvy in a 4-year-old boy with West syndrome and global developmental delay who presented to the emergency with complaints of bilateral proptosis and eyelid swelling (right > left) which on examination revealed bluish discolouration of bilateral eyelids. On further multimodality imaging investigation, orbital subperiosteal hemorrhages were identified as the cause, along with classical radiographic features of scurvy in bilateral lower limb long bones. The diagnosis was further bolstered by rapid resolution of periorbital ecchymosis after initiating oral vitamin C supplementation. To the best of our knowledge, primary presentation of scurvy in the form of bilateral proptosis due to orbital hemorrhages although uncommon can still be a manifestation of scurvy in addition to the more routinely detected subperiosteal hemorrhages along long bones. The significance of establishing the aetiology in such cases of orbital hemorrhage cannot be overemphasised, in view of drastic clinical recovery after starting vitamin C therapy.