CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings

Hypothenar hammer syndrome: outcomes after ulnar artery reconstruction with autologous vein graft

The most common surgical procedure for the treatment of hypothenar hammer syndrome (HHS) is resection of the pathological segment followed by arterial reconstruction using a venous bypass. Bypass thrombosis occurs in 30% of cases, with various clinical consequences, ranging from no symptoms to reappearance of the preoperative clinical symptoms. We reviewed 19 patients with HHS who underwent bypass graft, to assess clinical outcomes and graft patency, with a minimum follow-up of 12 months. Objective and subjective clinical evaluation and ultrasound exploration of the bypass were carried out. Clinical results were compared according to bypass patency. At a mean follow-up of 7 years, 47% of patients had complete resolution of symptoms; symptoms were improved in 42% of cases, and unchanged in 11%. Mean QuickDASH and CISS scores were 20.45/100 and 28/100, respectively. Bypass patency rate was 63%. Patients with patent bypass had shorter follow-up (5.7 vs 10.4 years; p = 0.037) and a better CISS score (20.3 vs 40.6; p = 0.038). There were no significant differences between groups for age (48.6 and 46.7 years; p = 0.899), bypass length (6.1 and 9.9 cm; p = 0.081) or QuickDASH score (12.1 and 34.7; p = 0.084). Arterial reconstruction gave good clinical results, with the best results in case of patent bypass. Level of evidence: IV.

Imaging techniques for assessment of vascular involvement in systemic sclerosis

PURPOSE OF REVIEW

Vascular assessment in systemic sclerosis (SSc) is included in classification criteria for this disease, thus routinely used in the evaluation of patients in which this diagnosis is being considered. In this review, imaging techniques for assessment of vascular involvement in SSc hands and skin are discussed.

RECENT FINDINGS

Longitudinal use of imaging techniques has important implications for understanding the progressive vasculopathy and fibrotic transition in SSc. Nailfold and oral capillaroscopy as well as laser speckle contrast analysis are established techniques for vascular functional assessment, but longitudinal use is challenged by equipment costs and clinical time constraints. Ultrasound techniques are well described but require technical training. Advances in mobile infrared thermography and optical coherence tomography could potentially provide a point-of-care, quantitative outcome measure in clinical trials and practice.

SUMMARY

The equipment cost, technical training, data standardization, and invasiveness of vascular assessment techniques that quantify morphological (microangiopathy) and functional (blood flow reduction) are critical for implementation into SSc clinical trials and practice to understand progressive vasculopathy, such as wound development.

MRI Diagnosis and Pathological Examination of Axillary Lymph Node Metastasis in Breast Cancer Patients

In order to explore the characteristics and diagnostic value of magnetic resonance imaging (MRI) in axillary lymph node metastasis of breast cancer, a total of 200 breast cancer patients diagnosed and treated from January 2021 to January 2022 are selected as the study subjects, and 200 patients are divided into an axillary lymph node metastasis group and a simple breast cancer group according to pathological results. The pathological results are used as the gold standard to determine the accuracy and diagnostic efficacy of MRI results. A multivariate logistic regression method is used to analyze the influencing factors of MRI image characteristics of breast cancer axillary lymph node metastasis. The experimental results show that MRI has high application values in diagnosing axillary lymph node metastasis of breast cancer, which is worthy of clinical promotion and application.

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

The motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

Thumb Injuries and Instabilities. Part 1: Anatomy, Kinesiology, and Imaging Techniques of the Thumb

The unique anatomical characteristics of the thumb offer a broad range of motion and the ability to oppose thumb and finger, an essential function for grasping. The motor function of the thumb and its orientation make it particularly vulnerable to trauma. Pathologic lesions encountered in this joint are varied, and imaging techniques play a crucial role in injury detection and characterization. Despite advances in diagnostic accuracy, acute thumb injuries pose a challenge for the radiologist. The complex and delicate anatomy requires meticulous and technically flawless image acquisition. Standard radiography and ultrasonography are currently the most frequently used imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations, and magnetic resonance imaging may be useful in equivocal cases. In this article, we present the relevant anatomy and imaging techniques of the thumb.

Quantitative and Comparative Analysis of Effectivity and Robustness for Enhanced and Optimized Non-Local Mean Filter Combining Pixel and Patch Information on MR Images of Musculoskeletal System

In the area of musculoskeletal MR images analysis, the image denoising plays an important role in enhancing the spatial image area for further processing. Recent studies have shown that non-local means (NLM) methods appear to be more effective and robust when compared with conventional local statistical filters, including median or average filters, when Rician noise is presented. A significant limitation of NLM is the fact that thy have the tendency to suppress tiny objects, which may represent clinically important information. For this reason, we provide an extensive quantitative and objective analysis of a novel NLM algorithm, taking advantage of pixel and patch similarity information with the optimization procedure for optimal filter parameters selection to demonstrate a higher robustness and effectivity, when comparing with NLM and conventional local means methods, including average and median filters. We provide extensive testing on variable noise generators with dynamical noise intensity to objectively demonstrate the robustness of the method in a noisy environment, which simulates relevant, variable and real conditions. This work also objectively evaluates the potential and benefits of the application of NLM filters in contrast to conventional local-mean filters. The final part of the analysis is focused on the segmentation performance when an NLM filter is applied. This analysis demonstrates a better performance of tissue identification with the application of smoothing procedure under worsening image conditions.