"Undiagnosed aortic coarctation with 2 simultaneous acute aortic syndromes: Intramural hematoma and mycotic aneurysm" [Case Report]
Murali, Sowmiya; Wang, Sherry S; Grenier, Michelle A; Revels, Jonathan W
Acute aortic syndrome can be a fatal pathology if not diagnosed and managed early. Although acute aortic syndrome is more often a diagnosis of adulthood, it may occasionally afflict the pediatric patients. We herein present a case of a 5-year-old female that was discovered to have multiple acute and congenital aortic abnormalities after presenting to the emergency department with infectious symptoms and lower extremity pain. Acute aortic syndrome may not be a top differential consideration in children with acute chest pain; however, it is important to consider because delayed diagnosis and management can have fatal implications.
Provocative thoughts from COVID-19: physician-centric solutions to physician burnout [Editorial]
Wang, Sherry S; Weaver, Jennifer S; Revels, Jonathan W
Clinical Manifestations and Medical Imaging of Osteogenesis Imperfecta: Fetal Through Adulthood
Weaver, Jennifer S; Revels, Jonathan W; Elifritz, Jamie M; Whitlow, Benjamin; Retrouvey, Michele; Wang, Sherry S
The aim of this paper is to describe the varying clinical and imaging manifestations of Osteogenesis Imperfecta (OI) in the fetus, the child, and the adult. OI is a genetic disorder with mutation of Type 1 and non-type 1 collagen genes that results in disruption of multiple collagen based organ systems, most notably bones, often leading to "brittle bones". Additional features such as blue sclera, dentinogenesis imperfecta, joint and ligamentous hyperlaxity, hearing loss and cardiac defects may be present. Currently, there are at least 30 recognized genetic forms of OI. Given the multiple genes involved, variable genetic inheritance, and the wide range in phenotype, diagnosis can be challenging. While OI may sometimes be diagnosed in the fetus, patients with mild forms of OI may be diagnosed in childhood or even in adulthood. Imaging, including ultrasound, radiography, computed tomography, and magnetic resonance imaging, plays an important role in the diagnoses of OI in the fetus, the child, and the adult. Imaging is also crucial in identifying the many multisystem manifestations of OI. In particular, imaging can help differentiate manifestations of OI from injuries sustained in non-accidental trauma. Age, severity and manner of presentation of OI vary broadly depending on the specific genetic mutation involved, mode of inheritance, and age of the patient. Successful diagnosis of OI hinges on a detailed knowledge of the variable presentation and complications that may be encountered with this disease. CONCLUSION: In conclusion, OI comprises a heterogeneous group of genetic disorders responsible for bone fragility and additional connective tissue disorders, which can result in specific clinical and imaging findings in the fetus, the child, and the adult.
The role of CT in planning percutaneous structural heart interventions: Where to measure and why
Revels, Jonathan W; Wang, Sherry S; Gharai, Leila R; Febbo, Jennifer; Fadl, Shaimaa; Bastawrous, Sarah
As research continues to demonstrate successes in the use of percutaneous trans-vascular techniques in structural heart intervention, both the subspecialty trained and non-subspecialty trained cardiac imager find themselves performing and reporting larger amounts of information regarding cardiovascular findings. It is therefore imperative that the imager gains understanding and appreciation for how these various measurements are obtained, as well as their implication in a patient's care. Cardiac gated computed tomography (CT) has solidified its role and ability at providing high resolution images that can be used to obtain the key measurements used in structural heart intervention planning. This manuscript aims to provide an overview of what measurements are necessary to report when interpreting CT examinations purposed for structural heart intervention. This includes a review on indications and brief discussion on complications related to these procedures.
"The bagel and blob signs in tubal ectopic pregnancy" [Case Report]
Lima, Dustin; Revels, Jonathan W; Mattinson, Ty; Wang, Sherry S
An ectopic pregnancy carries the potential for disastrous maternal complications. Early first trimester pelvic ultrasound examinations are frequently obtained in cases of pelvic pain and vaginal bleeding to assess for such diagnoses. The "bagel sign" and the "blob sign" described two sonographic appearances of tubal ectopic pregnancy with positive predictive values of > 95%. Current ectopic pregnancy consensus statements differ in the interpretation of these findings; however, radiologists should have familiarity with the appearances of these findings so as to best educate ordering providers on the potential for presence of a tubal ectopic pregnancy and need for very close patient surveillance.
Unilateral axillary lymphadenopathy following COVID-19 vaccination: A case report and imaging findings [Case Report]
Dominguez, Jennifer Ledezma; Eberhardt, Steven C; Revels, Jonathan W
As more people receive coronavirus disease 2019 (COVID-19) vaccinations, the side effects of the vaccines will become more apparent. One reported side effect that has come to light is unilateral axillary lymphadenopathy ipsilateral to the vaccination site. In general, unilateral axillary lymphadenopathy has a broad differential including malignancy, infection, autoimmune disorder, and iatrogenic etiologies. We present a case of a previously healthy 38-year-old woman who received her first dose of Pfizer COVID-19 vaccination 3 days prior to presenting to the emergency department complaining of 2 weeks of abdominal pain and 20-pound unintentional weight loss. Unilateral axillary lymphadenopathy, ipsilateral to the vaccination site, was found on a contrast-enhanced computed tomography examination of the chest, abdomen, and pelvis. Subsequent diagnostic mammograms did not demonstrate evidence of malignancy; however, axillary ultrasound again revealed nonspecific lymphadenopathy. A short-term follow-up axillary ultrasound was recommended, rather than a lymph node biopsy, given the history of recent vaccination. At clinical follow-up, the patient's abdominal pain resolved and no further weight loss was noted. This case report discusses the key components and workup recommendation of unilateral axillary lymphadenopathy in the setting of COVID-19 vaccination.
Multimodality Imaging Review of Multiple Endocrine Neoplasia
Ali, Arafat; Revels, Jonathan; Wang, David T; Wang, Lily L; Wang, Sherry S
A comprehensive radiologic review of abdominal and pelvic torsions
Bonney, Richard; Revels, Jonathan W; Wang, Sherry S; Lussier, Rick; Dey, Courtney B; Katz, Douglas S; Moshiri, Mariam
The clinical manifestations of abdominal and pelvic organ torsion can often be non-specific and can affect a wide range of ages and demographic groups. Radiologists have a key role in not only establishing the diagnosis of organ torsion, but also in the assessment of potential complications. As multiple imaging modalities may be utilized in the evaluation of abdominal and pelvic pain, recognizing the various appearances of organ torsion is important to ensure early diagnosis and thereby reducing patient morbidity and mortality, particularly since abdominal and pelvic organ torsion may not be clinically suspected at the time of initial patient presentation.
Partial Anomalous Left Pulmonary Artery: Pseudo-Pulmonary Sling
Revels, Jonathan W; Wang, Sherry S; Grenier, Michelle A; Richards, Allyson A
The RSNA Pulmonary Embolism CT Dataset
Colak, Errol; Kitamura, Felipe C; Hobbs, Stephen B; Wu, Carol C; Lungren, Matthew P; Prevedello, Luciano M; Kalpathy-Cramer, Jayashree; Ball, Robyn L; Shih, George; Stein, Anouk; Halabi, Safwan S; Altinmakas, Emre; Law, Meng; Kumar, Parveen; Manzalawi, Karam A; Nelson Rubio, Dennis Charles; Sechrist, Jacob W; Germaine, Pauline; Lopez, Eva Castro; Amerio, Tomas; Gupta, Pushpender; Jain, Manoj; Kay, Fernando U; Lin, Cheng Ting; Sen, Saugata; Revels, Jonathan Wesley; Brussaard, Carola C; Mongan, John