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World Journal of Orthopedics 2015年第6期6卷 498-504页

作者： Avneesh Chhabra Shaun Nordeck vibhor wadhwa Sai Madhavapeddi William J Robertson Department of Radiology University of Texas Southwestern Medical Center Department of Orthopaedics University of Texas Southwestern Medical Center

Femoroacetabular impingement is uncommonly associated with a large rim fragment of bone along the superolateral acetabulum. We report an unusual case of femoroacetabular impingement(FAI) with chronic acetabular rim fracture. Radiographic, 3D computed tomography, 3D magnetic resonance imaging and arthroscopy correlation is presented with discussion of relative advantages and disadvantages of various modalities in the context of FAI.

关键词： 3D computed tomography 3D magnetic resonance imaging Femoroacetabular impingement Rim fracture

COVID-19 imaging:Diagnostic approaches,challenges,and evolving advances

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World Journal of Radiology 2021年第6期13卷 171-191页

作者： Dante L Pezzutti vibhor wadhwa Mina S Makary Department of Radiology The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Radiology Weill Cornell Medical CenterNew York CityNY 10065United States

The role of radiology and the radiologist have evolved throughout the coronavirus disease-2019(COVID-19)pandemic.Early on,chest computed tomography was used for screening and diagnosis of COVID-19;however,it is now indicated for high-risk patients,those with severe disease,or in areas where polymerase chain reaction testing is sparsely available.Chest radiography is now utilized mainly for monitoring disease progression in hospitalized patients showing signs of worsening clinical status.Additionally,many challenges at the operational level have been overcome within the field of radiology throughout the COVID-19 pandemic.The use of teleradiology and virtual care clinics greatly enhanced our ability to socially distance and both are likely to remain important mediums for diagnostic imaging delivery and patient care.Opportunities to better utilize of imaging for detection of extrapulmonary manifestations and complications of COVID-19 disease will continue to arise as a more detailed understanding of the pathophysiology of the virus continues to be uncovered and identification of predisposing risk factors for complication development continue to be better understood.Furthermore,unidentified advancements in areas such as standardized imaging reporting,point-of-care ultrasound,and artificial intelligence offer exciting discovery pathways that will inevitably lead to improved care for patients with COVID-19.

关键词： COVID-19 Coronavirus Pandemic Diagnostic imaging Radiography Computed tomography Outcomes Future trends

Metastatic disease to the liver:Locoregional therapy strategies and outcomes

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World Journal of Clinical Oncology 2021年第9期12卷 725-745页

作者： Kylie E Zane Jordan M Cloyd Khalid S Mumtaz vibhor wadhwa Mina S Makary Department of Radiology The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Radiology Weill Cornell Medical CenterNew York CityNY 10065United States

Secondary cancers of the liver are more than twenty times more common than primary tumors and are incurable in most cases.While surgical resection and systemic chemotherapy are often the first-line therapy for metastatic liver disease,a majority of patients present with bilobar disease not amenable to curative local resection.Furthermore,by the time metastasis to the liver has developed,many tumors demonstrate a degree of resistance to systemic chemotherapy.Fortunately,catheter-directed and percutaneous locoregional approaches have evolved as major treatment modalities for unresectable metastatic disease.These novel techniques can be used for diverse applications ranging from curative intent for small localized tumors,downstaging of large tumors for resection,or locoregional control and palliation of advanced disease.Their use has been associated with increased tumor response,increased disease-free and overall survival,and decreased morbidity and mortality in a broad range of metastatic disease.This review explores recent advances in liver-directed therapies for metastatic liver disease from primary colorectal,neuroendocrine,breast,and lung cancer,as well as uveal melanoma,cholangiocarcinoma,and sarcoma.Therapies discussed include bland transarterial embolization,chemoembolization,radioembolization,and ablative therapies,with a focus on current treatment approaches,outcomes of locoregional therapy,and future directions in each type of metastatic disease.

关键词： Metastatic liver cancer Transarterial embolization Chemoembolization Radioembolization Ablation Transarterial chemoembolization Transarterial radioembolization

3T magnetic resonance neurography of pudendal nerve with cadaveric dissection correlation

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World Journal of Radiology 2016年第7期8卷 700-706页

作者： Avneesh Chhabra Courtney A McKenna vibhor wadhwa Gaurav K Thawait John A Carrino Gary P Lees A Lee Dellon Musculoskeletal Radiology University of Texas Southwestern Medical Center the Russell H.Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Department of Art As Applied to Medicine Johns Hopkins University Department of Radiology University of Arkansas for Medical Sciences Department of Radiology and Imaging Hospital for Special Surgery Department of Plastic Surgery and Neurosurgery Johns Hopkins University School of Medicine

AIM: To evaluate the pudendal nerve segments that could be identified on magnetic resonance neurography(MRN) before and after surgical marking of different nerve segments.METHODS: The hypothesis for this study was that pudendal nerve and its branches would be more easily seen after the surgical nerve marking. Institutional board approval was obtained. One male and one female cadaver pelvis were obtained from the anatomy board and were scanned using 3 Tesla MRI scanner using MR neurography sequences. All possible pudendal nerve branches were identified. The cadavers were then sent to the autopsy lab and were surgically dissected by a peripheral nerve surgeon and an anatomist to identify the pudendal nerve branches. Radiological markers were placed along the course of the pudendal nerve and its branches. The cadavers were then closed and rescanned using the same MRN protocol as the premarking scan. The remaining pudendal nerve branches were attempted to be identified using the radiological markers. All scans were read by an experienced musculoskeletal radiologist.RESULTS: The pre-marking MR Neurography scans clearly showed the pudendal nerve at its exit from the lumbosacral plexus in the sciatic notch, at the level of the ischial spine and in the Alcock's Canal in both cadavers. Additionally, the right hemorrhoidal branch could be identified in the male pelvis cadaver. The perineal and distal genital branches could not be identified. On post-marking scans, the markers were used as identifiable structures. The location of the perineal branch, the hemorroidal branch and the dorsal nerve to penis(in male cadaver)/clitoris(in female cadaver) could be seen. However, the visualization of these branches was suboptimal. The contralateral corresponding nerves were poorly seen despite marking on the surgical side. The nerve was best seen on axial T1W and T2W SPAIR images. The proximal segment could be seen well on 3D DW PSIF sequence. T2W SPACE was not very useful in visualization of this small nerve or its branches.CONCLUSI

关键词： Pudendal nerve Cadaver Magnetic resonance neurography Chronic pelvic pain

Incremental value of magnetic resonance neurography of Lumbosacral plexus over non-contributory lumbar spine magnetic resonance imaging in radiculopathy: A prospective study

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World Journal of Radiology 2016年第1期8卷 109-116页

作者： Avneesh Chhabra Sahar J Farahani Gaurav K Thawait vibhor wadhwa Allan J Belzberg John A Carrino Musculoskeletal Radiology University of Texas Southwestern Medical Center The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Department of Radiology University of Arkansas for Medical Sciences Department of Neurosurgery Johns Hopkins University School of Medicine Department of Radiology and Imaging Hospita for Special Surgery

AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; mean age54 year and range 22-74 year) with unilateral lumbar radiculopathy and with previous non-contributory lumbar spine MRI underwent lumbosacral(LS) plexus MRN over a period of one year. Lumbar spine MRI performed as part of the MRN LS protocol as well as bilateral L4-S1 nerves,sciatic,femoral and lateral femoral cutaneous nerves were evaluated in each subject for neuropathy findings on both anatomic(nerve signal,course and caliber alterations) and diffusion tensor imaging(DTI)tensor maps(nerve signal and caliber alterations).Minimum fractional anisotropy(FA) and mean apparent diffusion coeffcient(ADC) of L4-S2 nerve roots,sciatic and femoral nerves were recorded.RESULTS: All anatomic studies and 80% of DTI imaging received a good-excellent imaging quality grading. In a blinded evaluation,all 10 examinations demonstrated neural and/or neuromuscular abnormality corresponding to the site of radiculopathy. A number of contributory neuropathy findings including double crush syndrome were observed. On DTI tensor maps,nerve signal and caliber alterations were more conspicuous. Although individual differences were observed among neuropathic appearing nerve(lower FA and increased ADC) as compared to its contralateral counterpart,there were no significant mean differences on statistical comparison of LS plexus nerves,femoral and sciatic nerves(P > 0.05).CONCLUSION: MRN of LS plexus is useful modality for the evaluation of patients with non-contributory MRI of lumbar spine as it can incrementally delineate the etiology and provide direct objective and non-invasive evidence of neuromuscular pathology.

关键词： Magnetic resonance imaging Neurography Lumbosacral plexus Radiculopathy