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World Journal of Hepatology 2024年第3期16卷 316-330页

作者： Ramesh Kumar Rishabh Patel Rajeev Nayan Priyadarshi Ruchika Narayan Tanmoy Maji Utpal Anand Jinit R Soni department of Gastroenterology All India Institute of Medical SciencesPatna 801507India department of radiodiagnosis All India Institute of Medical SciencesPatna 801507India department of Surgical Gastroenterology All India Institute of Medical SciencesPatna 801507India

Amebic liver abscess(ALA)is still a common problem in the tropical world,where it affects over three-quarters of patients with liver *** is caused by an anaerobic protozoan Entamoeba hystolytica,which primarily colonises the *** is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular *** of the male gender,during their reproductive years,are most prone to ALA,and this appears to be due to a poorly mounted immune response linked to serum testosterone *** is more common in the right lobe of the liver,is strongly associated with alcohol consumption,and can heal without the need for *** majority of ALA patients have an uncomplicated course,a number of complications have been described,including rupture into abdomino-thoracic structures,biliary fistula,vascular thrombosis,bilio-vascular compression,and secondary bacterial *** on clinico-radiological findings,a classification system for ALA has emerged recently,which can assist clinicians in making treatment *** research has revealed the role of venous thrombosis-related ischemia in the severity of *** years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited *** has been the drug of choice for ALA patients for many ***,concerns over the resistance and adverse effects necessitate the creation of new,safe,and potent antiamebic *** the indication of the drainage of uncomplicated ALA has become more clear,high-quality randomised trials are still necessary for robust *** drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis,for whom surgery represents a significant risk of *** regard to all of the aforementioned issues,this article intends to present an u

关键词： Amebic liver abscess Amebiasis Ruptured liver abscess Percutaneous drainage Metronidazole

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Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

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World Journal of Radiology 2024年第6期16卷 221-231页

作者： Himanshu Surya Ramesh Kumar Rajeev Nayan Priyadarshi Sabbu Surya Prakash Sudhir Kumar department of Gastroenterology All India Institute of Medical SciencesPatna 801507India department of radiodiagnosis All India Institute of Medical SciencesPatna 801507India

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular *** To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high *** This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with *** association of RRI with AKI was *** receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI *** analysis was conducted to determine the predictors of high *** The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of ***,AKI was present in 129(64.5%)*** mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-*** mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)*** demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

关键词： Renal resistive index Cirrhosis Acute kidney injury Hepatorenal syndrome Renal Doppler

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Vascular complications of liver abscess: A literature review

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World Journal of Meta-Analysis 2024年第3期12卷 17-29页

作者： Rahul Arya Ramesh Kumar Rajeev N Priyadarshi Ruchika Narayan Utpal Anand department of Gastroenterology All India Institute of Medical SciencesPatna 801507BiharIndia department of radiodiagnosis All India Institute of Medical SciencesPatna 801507BiharIndia department of Surgical Gastroenterology All India Institute of Medical SciencesPatna 801507India

Extensive vascular network and proximity to the gastrointestinal tract make the liver susceptible to abscess *** pyogenic liver abscesses account for the majority of liver abscesses in the Western world,amebic liver abscesses are more prevalent in tropical and developing *** liver abscesses heal without ***,various vascular complications can occur in these patients,including compression of the inferior vena cava,thrombosis of the portal vein and/or hepatic veins,hepatic artery pseudoaneurysm,direct rupture into major vessels or the pericardium,and biliovascular *** compli-cations can present significant clinical challenges due to the potential for hae-morrhage,ischemia,and systemic embolism,thereby increasing the risk of morbidity and *** compression,flow stasis,inflammation,endothelial injury,and direct invasion are some of the proposed mechanisms that can cause vascular complications in the setting of a liver *** the diag-nosis,thorough assessment,and therapeutic planning of vascular complications,more sophisticated imaging techniques such as multidetector computed tomo-graphy angiography or magnetic resonance angiography may be *** most vascular complications resolve with abscess treatment alone,additional interventions may be required based on the nature,severity,and course of the *** article aims to provide a systematic update on the spectrum of vascular complications of liver abscesses,offering insights into their pathogenesis,diagnosis,and management strategies.

关键词： Liver abscess Pylephlebitis Venous thrombosis Pseudoaneurysm Portal cavernoma Inferior vena cava obstruction

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Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 699-715页

作者： Ankit Agarwal Sagnik Biswas Shekhar Swaroop Arnav Aggarwal Ayush Agarwal Gautam Jain Anshuman Elhence Arun Vaidya Amit Gupte Ravi Mohanka Ramesh Kumar Ashwani Kumar Mishra Shivanand Gamanagatti Shashi Bala Paul Subrat Kumar Acharya Akash Shukla Shalimar department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew Delhi 110029DelhiIndia department of Gastroenterology Seth Gordhandas Sunderdas Medical College and KEM HospitalMumbai 400012MaharashtraIndia department of Gastroenterology Sir HN Reliance Foundation HospitalMumbai 400004India department of Liver Transplant and HPB Sir HN Reliance Foundation HospitalMumbai 400004India department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Professor of Biostatistics National Drug Dependence Treatment Centre(NDDTC)All India Institute of Medical SciencesNew Delhi 110029India department of radiodiagnosis All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

BACKGROUND There is scant literature on hepatocellular carcinoma(HCC)in patients with Budd-Chiari syndrome(BCS).AIM To assess the magnitude,clinical characteristics,feasibility,and outcomes of treatment in *** A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were *** prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were *** In the New Delhi cohort of 35 BCS-HCC patients,18 had HCC at index presentation(prevalence 1.99%),and 17 developed HCC over a follow-up of 4601 person-years,[incidence 0.36(0.22-0.57)per 100 person-years].BCS-HCC patients were older when compared to patients with BCS alone(P=0.001)and had a higher proportion of inferior vena cava block,cirrhosis,and long-segment vascular *** median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up(13029 ng/mL vs 500 ng/mL,P=0.01).Of the 35 BCS-HCC,26(74.3%)underwent radiological interventions for BCS,and 22(62.8%)patients underwent treatment for HCC[transarterial chemoembolization in 18(81.8%),oral tyrosine kinase inhibitor in 3(13.6%),and transarterial radioembolization in 1(4.5%)].The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo(P=0.0001).In contrast to the New Delhi cohort,the Mumbai cohort of BCS-HCC patients were predominantly males,presented with a more advanced HCC[Barcelona Clinic Liver Cancer C and D],and 2 patients underwent liver *** HCC is not uncommon in patients with *** interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

关键词： Budd chiari syndrome Cancer Cirrhosis Thrombosis Liver Varices Transarterial chemoembolization Hepatic venous outflow tract obstruction

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Characterization of tumors of jaw:Additive value of contrast enhancement and dual-energy computed tomography

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World Journal of Radiology 2024年第4期16卷 82-93页

作者： Deepak Justine Viswanathan Ashu Seith Bhalla Smita Manchanda Ajoy Roychoudhury Deepika Mishra Asit Ranjan Mridha department of radiodiagnosis and Interventional Radiology All India Institute of Medical SciencesNew Delhi 110029India department of Oral and Maxillofacial Surgery All India Institute of Medical SciencesNew Delhi 110029India department of Oral Pathology and Microbiology All India Institute of Medical SciencesNew Delhi 110029India department of Pathology All India Institute of Medical SciencesAnsari NagarNew Delhi 110029India

BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the *** is a paucity of literature on the enhancement characteristics of jaw *** is mainly because,even though computed tomography(CT)is used to evaluate these lesions,they are often imaged without intravenous *** study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT,therefore improving the ability to differentiate between various *** To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw *** Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy *** analysis of the tumor,including the enhancing solid component,was done,followed by quantitative analysis of iodine concentration(IC),water concentration(WC),HU,and normalized *** study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma(CGCG),ameloblastoma,odontogenic keratocyst(OKC),and other jaw tumors.A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for nonparametric variables were *** significant differences were found,a series of independent t-tests or Mann-Whitney U tests were *** Ameloblastoma was the most common pathology(n=20),followed by CGCG(n=11)and *** showed a higher mean concentration of all quantitative parameters than ameloblastomas(P<0.05).An IC threshold of 31.35×100μg/cm^(3) had the maximum sensitivity(81.8%)and specificity(65%).Between ameloblastomas and OKC,the former showed a higher mean concentration of all quantitative parameters(P<0.001),however when comparing unilocular ameloblastomas with OKCs,the latter showed

关键词： Jaw neoplasms Ameloblastomas Dual-energy computed tomography Iodine quantification Mandibular neoplasms Maxillary neoplasms

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Ensemble for evaluating diagnostic efficacy of non-invasive indices in predicting liver fibrosis in untreated hepatitis C virus population

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World Journal of Methodology 2024年第3期14卷 90-105页

作者： Navneet Kaur Gitanjali Goyal Ravinder Garg Chaitanya Tapasvi Umit Demirbaga department of Biochemistry Guru Gobind Singh Medical College and HospitalFaridkot 151203PunjabIndia department of Biochemistry All India Institute of Medical SciencesBathinda 151005PunjabIndia department of Medicine Guru Gobind Singh Medical College and HospitalBaba Farid University of Health SciencesFaridkot 151203PunjabIndia department of radiodiagnosis Guru Gobind Singh Medical College and HospitalBaba Farid University of Health SciencesFaridkot 151203India department of Computer Engineering Bartin UniversityBartin 74100Türkiye department of Medicine University of CambridgeCambridge CB20QQUnited Kingdom European Bioinformatics Institute Wellcome GenomeCambridge CB101SDUnited Kingdom

BACKGROUND Hepatitis C virus(HCV)infection progresses through various phases,starting with inflammation and ending with hepatocellular *** are several invasive and non-invasive methods to diagnose chronic HCV *** invasive methods have their benefits but are linked to morbidity and ***,it is important to analyze the potential of non-invasive methods as an *** wave elastography(SWE)is a non-invasive imaging tool widely validated in clinical and research studies as a surrogate marker of liver *** fibrosis determination by invasive liver biopsy and non-invasive SWE agree closely in clinical studies and therefore both are gold *** To analyzed the diagnostic efficacy of non-invasive indices[serum fibronectin,aspartate aminotransferase to platelet ratio index(APRI),alanine aminotransferase ratio(AAR),and fibrosis-4(FIB-4)]in relation to *** have used an Artificial Intelligence method to predict the severity of liver fibrosis and uncover the complex relationship between non-invasive indices and fibrosis *** We have conducted a hospital-based study considering 100 untreated patients detected as HCV positive using a quantitative Real-Time Polymerase Chain Reaction *** performed statistical and probabilistic analyses to determine the relationship between non-invasive indices and the severity of *** also used standard diagnostic methods to measure the diagnostic accuracy for all the *** The results of our study showed that fibronectin is a highly accurate diagnostic tool for predicting fibrosis stages(mild,moderate,and severe).This was based on its sensitivity(100%,92.2%,96.2%),specificity(96%,100%,98.6%),Youden’s index(0.960,0.922,0.948),area under receiver operating characteristic curve(0.999,0.993,0.922),and Likelihood test(LR+>10 and LR-200),AAR(>1),APRI(>3),and FIB-4(>4)were all strongl

关键词： Hepatitis C virus Non-invasive biomarkers Shear wave elastography Fibronectin Bayesian network Machine learning Liver fibrosis

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Radiation Dose from CT-Scan of Childhood’s Head: Results of the First Ivorian Survey in a Single Study Site

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Journal of Applied Mathematics and Physics 2024年第5期12卷 1725-1732页

作者： Koutoua Joseph Anouan Adjoua Sonia Dje Idrissa Garba Yoh Esther Soro Nuclear Physics and Radiation Protection Team Training and Research Unit&#8212Sciences of the Structures of Matter and Technology University F&#233lix Houphouet-Boigny of Abidjan Abidjan C&#244te d&#8217Ivoire department of Medical Pediatrics and Specialties University Hospital of Angr&#233 Abidjan C&#244te d&#8217Ivoire department of radiodiagnosis and Medical Imaging University Hospital of Angr&#233 Abidjan C&#244te d&#8217Ivoire

Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDIvol) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDIvol and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDIvol and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.

关键词： Radiation Protection Computed Tomography Imaging Childhood Diagnostic Reference Levels

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Advances in the imaging of gastroenteropancreatic neuroendocrine neoplasms

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World Journal of Gastroenterology 2022年第26期28卷 3008-3026页

作者： Anupama Ramachandran Kumble Seetharama Madhusudhan department of radiodiagnosis and Interventional Radiology All India Institute of Medical SciencesNew Delhi 110029India

Gastroenteropancreatic neuroendocrine neoplasms comprise a heterogeneous group of tumors that differ in their pathogenesis,hormonal syndromes produced,biological behavior and consequently,in their requirement for and/or response to specific chemotherapeutic agents and molecular targeted *** imaging techniques are available for functional and morphological evaluation of these neoplasms and the selection of investigations performed in each patient should be customized to the clinical ***,with the increased availability of cross sectional imaging,these neoplasms are increasingly being detected incidentally in routine radiology *** article is a review of the various imaging modalities currently used in the evaluation of neuroendocrine neoplasms,along with a discussion of the role of advanced imaging techniques and a glimpse into the newer imaging horizons,mostly in the research stage.

关键词： Neuroendocrine tumor Gastroenteropancreatic Intravoxel incoherent motion Diffusion weighted imaging Perfusion imaging Dual energy computed tomography

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Pulmonary infarct masquerading as community-acquired pneumonia in the COVID-19 scenario: A case report

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World Journal of Respirology 2024年第1期13卷 1-6页

作者： K K Mujeeb Rahman Gopal Durgeshwar Prasanta R Mohapatra Manoj Kumar Panigrahi Siladitya Mahanty Pulmonary Critical Care and Sleep Medicine All India Institute of Medical SciencesBhubaneswarBhubaneswar 751019India department of radiodiagnosis All India Institute of Medical SciencesBhubaneswar 751019India

BACKGROUND Pulmonary embolism(PE)requires a high degree of clinical suspicion for its diagnosis and can mimic pneumonia due to its clinical,radiological,and laboratory ***-existence of PE and pneumonia can also occur,which is surprisingly more common than *** SUMMARY Here,we report a case of a young male who initially presented during the peak of the coronavirus disease 2019 pandemic with features of *** was kept under observation and was later diagnosed and treated for a right main pulmonary artery embolism without any identifiable source of *** PE and pneumonia share common clinical,radiological,and laboratory findings that may delay the diagnosis of *** disproportionate to the extent of radiological involvement could be an indicator of an underlying PE.

关键词： Pneumonia Pulmonary embolism Deep vein thrombosis Pulmonary infarct Case report

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Drainage of pancreatic fluid collections in acute pancreatitis:A comprehensive overview

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World Journal of Clinical Cases 2022年第20期10卷 6769-6783页

作者： Akash Bansal Pankaj Gupta Anupam K Singh Jimil Shah Jayanta Samanta Harshal S Mandavdhare Vishal Sharma Saroj Kant Sinha Usha Dutta Manavjit Singh Sandhu Rakesh Kochhar department of radiodiagnosis Postgraduate Institute of Medical Education and ResearchChandigarh 160012India department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

Moderately severe and severe acute pancreatitis is characterized by local and systemic *** complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the *** fluid collections represent the most important local *** of these collections is indicated in the setting of infection,persistent or new onset organ failure,compressive or pressure symptoms,and intraabdominal ***,endoscopic,and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and *** methods are often *** this minireview,we discuss the indications,timing,and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter *** also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage.

关键词： Pancreatitis,Acute necrotizing Drainage Catheters Stents Therapeutic irrigation Debridement Collections

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