Faculty Bibliography

Endometrial abnormalities develop in female patients of all ages. Symptoms related to endometrial pathologies are among the most common causes of gynecologist office visits, with the radiologists playing an important role in endometrial evaluation. In some instances, the radiologist may be the first physician to note endometrial pathology. In this article, we will provide a comprehensive review of radiologic modalities utilized in the evaluation of the endometrium, as well as the imaging appearance of various endometrial disease processes.

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. Online supplemental material is available for this article.^©RSNA, 2020.

Maternal serum alpha-fetoprotein is a valuable laboratory test used in pregnant women as an indicator to detect certain clinical abnormalities. These can be grouped into four main categories: fetal factors, pregnancy complications, placental abnormalities, and maternal factors. Imaging is an invaluable tool to investigate the various etiologies leading to altered maternal serum alpha-fetoprotein. By reading this article, the radiologist, sonologist, or other health care practitioner should be able to define the probable pathology leading to the laboratory detected abnormal maternal serum levels, thus helping the clinician to appropriately manage the pregnancy and counsel the patient.

The purpose of this article is to describe arterial and venous thromboembolism in the abdomen, pelvis, and lower extremities. Eight-two COVID patients with abdominal ultrasound or CT were retrospectively compared with non-COVID patients for thromboembolism and solid-organ infarction. Nine (11%) COVID-19 patients had thromboembolic findings with medium to large-sized arterial thrombi in 5/82. One non-COVID patient had known portal vein thrombus on CT. Thromboembolic findings occurred more frequently in patients with than without COVID-19 (p=0.02).

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. Online supplemental material is available for this article.^©RSNA, 2020.

OBJECTIVE. The purpose of this study is to report unanticipated lung base findings on abdominal CT in 23 patients concerning for coronavirus disease (COVID-19). In these patients, who were not previously suspected of having COVID-19, abdominal pain was the most common indication for CT (n = 19), and 11 patients had no extrapulmonary findings. Seventeen patients underwent polymerase chain reaction testing, which returned positive results for all 17. CONCLUSION. Unsuspected coronavirus disease may be strongly suggested on the basis of lung findings on abdominopelvic CT.

RATIONALE AND OBJECTIVE/OBJECTIVE:To review response rates published in medical imaging journals, and to analyze potential factors which contributed to a low response rate. MATERIALS AND METHODS/METHODS:A literature search was performed in MEDLINE and Embase to identify and assess published medical imaging survey studies. Variables assessed were response rate, incentives such as reminders and remuneration, and rationales provided for a potential low response rate. Statistical significance was calculated using unpaired t tests, ANOVA, Mann-Whitney, and Kruskal-Wallis tests. RESULTS:Three hundred and fifty-six unique surveys were included for analysis. The mean survey response rate in the current age of predominately electronic surveys was 45%. Factors which statistically significantly demonstrated a difference in response rate were survey location (European countries: 52%, Canada: 47%, United States: 42%; p < 0.05), survey topic (musculoskeletal: 69%, nuclear medicine: 64%, and education: 47%; p < 0.05), survey delivery method (telephone: 76%, email: 41%; p < 0.0001), and survey question type (short answer: 62%, multiple choice: 43%; p < 0.01). Statistically significant linear correlations were observed between the response rate compared to the number of reminders sent (r = 0.27; p < 0.01) and the number of participants (r = -0.26; p < 0.0001). CONCLUSION/CONCLUSIONS:The survey response rate serves as a surrogate marker for nonresponse bias. Survey response controlled for intrinsic nonadjustable characteristics offer achievable research goals. Adjustable factors to low response, including survey delivery method, question type, and number of reminders demonstrated statistical difference in response rate, and can be utilized by researchers to prospectively minimize nonresponse bias.

OBJECTIVE. The purpose of this article is to describe the imaging findings associated with complex fetal abdominal wall defects and provide an algorithmic method for arriving at a final diagnosis. CONCLUSION. Fetal ventral abdominal wall defects are a complex group of conditions with a broad spectrum of associated multisystem anomalies and manifestations. Correct characterization and classification of these defects require not only familiarity with imaging findings but also a systematic approach to avoid diagnostic confusion.