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06:30 CET
VoE 2 - Polish
General Radiology
Wednesday, February 28, 10:00 - 11:00
Moderator: T. J. Popiela (Krakow/PL)


C-0246
10:00
Renal arteries of horseshoe kidneys - do they differ in comparison to renal arteries of typical kidneys? CT Angiography based study.
M. Majos1, M. Polguj1, Z. Szemraj-Rogucka1, A. Arazińska2, L. Stefanczyk1; 1Lodz/PL 2Łódź/PL

Aims and objectives:
The aim of this study was to determine the number of renal arteries and the level at which they branched off their parental vessels in individuals with horseshoe kidney and in persons with normal kidneys.
Methods and materials:
The study was based on a retrospective analysis of the images stored at PACS archiving system at the Department of Radiology, University Clinical Hospital No. 1 in Łódź. The analysis included the images from all consecutive patients in whom computed tomography (CT) angiography of the abdominal aorta[...]
Results:
A total of 379 renal arteries were identified in the horseshoe kidney group, with 4.57±1.39 arteries per subject on average. Overall number of the renal arteries identified in the control group amounted to 598, with a mean number of 2.4±0.43 arteries per subject. The study groups differed significan[...]
Conclusion:
The vascular system of HSK was considerably different in comparison to SK in the height of origin and a number of renal arteries. What is more, in HSK group diameter of arterial vessels strongly depended on the level of origin.
Personal information:
References:
1. Shah HU, Ojili V Multimodality imaging spectrum of complications of horseshoe kidney. Indian J Radiol Imaging. 2017 Apr-Jun;27(2):133-140. doi: 10.4103/ijri.IJRI_298_16. 2. Taghavi K, Kirkpatrick J, Mirjalili SA The horseshoe kidney: Surgical anatomy and embryology. J Pediatr Urol. [...]

C-0762
10:07
Towards problems hampering the use 3D models in everyday practice - a radiologist as a missing element.
E. Staniszewska, T. Smektala, A. Gołąb, K. Sporniak- Tutak; Szczecin/PL

Aims and objectives:
The use of 3D physical models has been documented in urology, maxillofacial surgery, orthopaedics and cardiac surgery [1-3]. The benefits of their use are reduction of surgery time and increase in surgical accuracy [1,4]. Unfortunately, despite advantages, daily use of 3D physical models is hampered[...]
Methods and materials:
Classic workflow of 3D model preparation requires the reference of the patient for a CT/MRI, sending the obtained data to external supplier and waiting to receive the model (Fig. 1). Proposed workflow is based on the assumption that for the preparation of virtual three-dimensional model is responsib[...]
Results:
Between February 2016 and September 2017 the 648 3D models have been prepared. The average, minimal, maximal and standard deviation times and cost are presented in Table 1. Additionally, to segmentation, we have separately calculated values for hard and soft tissue segmentation because of their sign[...]
Conclusion:
Presented workflow reduced the time and costs associated with production of 3D models and allowed their successful utilization in everyday practice with participating departments. To make this possible it is necessary for the radiologist to have the skills in image segmentation process and physician[...]
Personal information:
E. Staniszewska, MD. Department of Radiology and Diagnostic Imaging, Voivodeship Specialized Hospital in Szczecin. Poland Arkońska 4, 71-455 Szczecin Phone: 91 813 93 01 Fax: 91 813 93 09 e-mail: staniszewska.e@wp.pl
References:
1. Diment LE, Thompson MS, Bergmann JHM. Clinical efficacy and effectiveness of 3D printing: a systematic review. BMJ Open. 2017 Dec 21;7:e016891 2. Golab A, Smektala T, Krolikowski M, Slojewski M. Percutaneous Nephrolithotomy Using an Individual 3-Dimensionally Printed Surgical Guide. Urol Int. 20[...]

C-0771
10:14
Evaluation of appropriateness level of imaging exams ordered in emergency department
K. A. Bekalarek; Kalisz/PL

Aims and objectives:
To assess the appropriateness level of imaging exams ordered in emergency department in one polyclinical hospital in Poland using iGuide - clinical decision support system.
Methods and materials:
A total of 613 patient paper-form medical records from emergency department (ED) of one polyclinical hospital from 7-day period were manually and retrospectively reviewed. From that group 272 patients which did not have performed any radiological examination during the stay at emergency department w[...]
Results:
In entire group after iGuide appropriateness evaluation the following results were obtained: 51 exams (13,67%) were categorised in group 1 - not appropriate, 92 (24,67%) in group 2 - may be appropriate, 230 (61,66%) in group 3 - appropriate (Fig. 2). In analysed 373 exams there were: 247 (66%) XRAY [...]
Conclusion:
In performed study exams categorised in groups 1 - not appropriate and 2 - may be appropriate together counted 38,34%. In other studies performed on general hospital patients groups that percentage were lower - approximately 25%. There could be various reasons of that difference: specificity of emer[...]
Personal information:
K. A. Bekalarek Kalisz/Poland kamil.bekalarek@gmail.com
References:
[1] L. Donoso1, B. Brkljacic2; 1Universidad de Barcelona Barcelona/ES, 2Medical School, University of Zagreb Zagreb/HR ESR iGuide - Clinical Decision Support for European Imaging Referral Guidelines EuroSafe Imaging 2017 / ESI-0023 [2] H. Stahlbrandt1, L. Lindeberg2; 1Radiologiska Kliniken Eksjo/S[...]

C-1476
10:21
Typical and atypical radiological manifestations of thoracic sarcoidosis with their pathologic correlation.
J. Wakulinski, A. Lewandowska, M. Szołkowska, I. Bestry, R. Langfort, J. Kuś; Warsaw/PL

Learning objectives:
1. Describe typical and atypical radiological features of sarcoidosis in chest radiograph and CT and their pathological correlation. 2. Perform differential diagnosis of pulmonary sarcoidosis to establish diagnostic approach. 3. Perform sarcoidosis staging on the basis of t[...]
Background:
Sarcoidosis is a systemic granulomatous disease of unknown aetiology. Although it may involve any organ, thoracic manifestation is most common and is responsible for most of mortality and morbidity[1]. Despite high prevalence of pulmonary involvement, most patients are asymptomatic or present with n[...]
Findings and procedure details:
Diagnosis of Sarcoidosis In general, according to the international 1999 consensus, sarcoidosis should be diagnosed on the basis of correlating clinical symptoms as well as histologic and radiologic findings. Biopsy should be obtained whenever possible. Usually transbronchial biopsy is recommended a[...]
Conclusion:
Sarcoidosis is often asymptomatic and clinical presentation in majority of cases is not specific thus a radiologist plays a vital role in its diagnosis. Sarcoidosis can manifest in a variety of different patterns, it is necessary to recognize both typical and atypical presentations. Similar radiol[...]
Personal information:
References:
(1999) Statement on sarcoidosis. Am J Resp Crit Care 160(2):736–55. Valeyre D, Prasse A, Nunes H, et al. (2014) Sarcoidosis. Lancet. 383(9923):1155–67.55. Webb WR, Higgins CB. (2017) Thoracic Imaging: Pulmonary and Cardiovascular Radiology. Lippincott Williams & Wilkins. Scadding JG. (1961) Prog[...]

C-1851
10:28
Magnetic resonance imaging in urethral strictures with a special focus on spongiofibrosis - from image to a 3D-print. Joint radiological and urological perspective.
K. Markiet, M. frankiewicz, M. belka, O. W. Kozak, M. Matuszewski, E. Szurowska; Gdansk/PL

Learning objectives:
1. To illustrate the anatomy of male urethra in magnetic resonance imaging (MRI). 2. To emphasize the role of MRI in evaluating urethral strictures and preoperative planning especially associated with assessment of the extent of spongiofibrosis. 3. To discuss imaging technique and examination pr[...]
Background:
Urethral stricture is the most common indication for imaging of the urethra [1]. Anterior urethral strictures result from trauma or inflammation and are usually associated with scarring in the surrounding corpus spongiosum (spongiofibrosis). The mechanism of posterior urethral strictures is complete[...]
Findings and procedure details:
Normal anatomy of male urethra at MRI Male urethra is approximately 17.5–20 cm long and runs from the bladder to the external urethral meatus. It divides into posterior and anterior portions, each of which is subdivided into two parts. Posterior urethra: Extends from the bladder neck to the [...]
Conclusion:
MRU is a promising tool for defining anterior and posterior male urethral strictures as an alternative to traditional radiographic methods [4]. With exclusion of generally known contra-indications to examintaion, MRI provides excellent soft tissue contrast, adds extra information than conventional m[...]
Personal information:
References:
[1] Yekeler E, Suleyman E, Tunaci A, Tunaci M, Balci NC, Onem K, Tunc M, Acunas G. Contrast-enhanced 3D MR voiding urethrography: preliminary results. Magn Reson Imaging. 2004 Nov;22(9):1193-9. [2] El-Ghar MA, Osman Y, Elbaz E, Refiae H, El-Diasty T. MR urethrogram versus combined retrograde urethro[...]

C-2051
10:35
Assessment of PSA/predicted-PSA ratio ability to determine insignificant/significant prostate cancer in the Grade Groups system - methodological considerations.
O. W. Kozak, J. Pienkowska, K. Markiet, A. M. Szymańska-Dubowik, M. Studniarek; Gdansk/PL

Aims and objectives:
Multiparametric Magnetic Resonance Imaging (mpMRI) is a widely used tool in the assessment of prostate cancer. Standardized interpretation and reporting of prostate imaging are based on PI-RADS system. Images obtained using a multiparametric technique including T2 weighted images (T2W), and diffusio[...]
Methods and materials:
We have retrospectively analyzed the preoperative MRI-3T examinations of 91 Caucasian males who underwent prostatectomy and their PSA serum blood levels. The MRI examinations were held on 3T Philips Achieva 3.0T TX (Philips Healthcare, Best, Netherlands) with the use of the 32-channel cardiac coil.[...]
Results:
The mean PSA/pPSA ratio in indolent PCa patients was 1,56 ± 1,1 compared to 2,5 ± 1,6 in significant PCa patients. U Man-Withney test showed: PSA is significantly higher in Grade Groups ≥ 2 (U=212,5, p=0,001) PSA/pPSA ratio is significantly higher in Grade Groups ≥ 2 (U=283, p=0,011) there is no[...]
Conclusion:
The results showed statistically significant differences in PSA/pPSA ratio between the Grade Group = 1 and Grade Groups ≥ 2. The PSA/predicted-PSA ratio could help in differentiating those groups of patients on the basis of simply available parameters, especially in doubtful cases (i.e. PI-RADS 3). [...]
Personal information:
References:
[1] Barentsz JO, Weinreb JC, Verma S et al.: Synopsis of the PI-RADS v2 Guidelines for Multiparametric Prostate Magnetic Resonance Imaging and Recommendations for Use, Eur Urol, 2016 Jan;69(1):41-9. [2] Panebianco V, Barchetti F, Barentsz JO et al.: Pitfalls in Interpreting mp-MRI of the Prostate: A[...]

C-2306
10:42
Spinal epidural venous plexuses enlargement as a cause of neurologic symptoms – vascular anatomy and MRI findings
E. Wnuk, E. Maj, A. Podlecka-Piętowska, T. Dziedzic, K. Rowińska-Berman, O. Rowinski; Warsaw/PL

Learning objectives:
1. To demonstrate normal MRI anatomy of the vertebral veins. 2. To present imaging characteristics and differential diagnosis of the dilated spinal epidural veins. 3. To highlight the impact of proper diagnosis on treatment.
Background:
1. Dilated epidural veins are an uncommon cause of neurologic symptoms such as back pain and radiculopathy [1,2,3,4]. 2. The differential diagnosis of dilated epidural veins most often include intervertebral disc herniation, followed by hematoma, abscess and tumour [1,3,5,6]. 3. The spinal venous [...]
Findings and procedure details:
ANATOMY OF THE VERTEBRAL VEINS The vertebral venous plexus was described by Batson in 1940 and is traditionally called Batson plexus [8]. The vertebral venous system is a network of sinusoidal, valveless veins which contribute to the spinal cord veins and drain into systemic veins. This system is[...]
Conclusion:
Understanding the spinal vascular anatomy and knowledge of the differential diagnosis of flow voids in the epidural space is essential for providing an accurate diagnosis which result in proper treatment.
Personal information:
E. Wnuk, E. Maj, K. Rowińska-Berman, O. Rowiński - 2nd Department of Clinical Radiology, A. Podlecka-Piętowska- Department of Neurology, T. Dziedzic - Department of Neurosurgery, Medical University of Warsaw, Banacha 1A, Warsaw, Poland. Address for correspondence and reprints: Emilia Wnuk, 2nd Dep[...]
References:
1. Zimmerman GA, Weingarten K, Lavyne MH. Symptomatic lumbar epidural varices. Report of 2 cases. J Neurosurg. 1994;80:914-918. 2. Paksoy Y, Gormus N. Epidural venous plexus enlargements presenting with radiculopathy and back pain in patients with inferior vena cava obstruction or occlusion. Spine [...]

C-3227
10:49
Does hypertension affect the aging of white matter? - insights from DTI.
A. Sabisz1, P. Naumczyk1, A. Marcinkowska1, B. Graff1, A. M. Konarzewska2, K. Jodzio1, D. Gąsecki1, E. Szurowska1, K. Narkiewicz1; 1Gdansk/PL 2Gdynia/PL

Aims and objectives:
In the hypertensive patients’ population WM microstructure differences derived from DTI studies were reported in the corpus callosum. [Gons 2012, Maillard 2012] Additionally the SBP was linearly correlated with decreased regional FA and increased MD, especially in anterior corpus callosum, the infer[...]
Methods and materials:
One hundred forty six participants took part in the study : the control group (CON) of 61 healthy individuals and the subjects group (SUB) of 85 hypertensive patients. Age categories were as follows: - group I - aged to 47 (CON N=22, SUB N=24) ; - group II - aged from 48 to 56 years (CON N=19, SUB N[...]
Results:
The two-way ANOVA of diffusion coefficients of the nerve pathways, showed an age-related main effect in most of the cases (Fig. 2). In contrast, tracts such as: left and right anterior thalamic radiation (in MD, RD, AD) (Fig. 3), corticospinal tract R (in MD, AD), left cingulum cingulate gyrus (in M[...]
Conclusion:
On the basis of our results, a model of brain aging different between the hemispheres emerges. Healthy and hypertensive individuals have different aging patterns. Hypertension and age independently affected diffusion parameters in projection pathways, whereas in association fibers an additional spat[...]
Personal information:
References:
Gons, R. A. R., van Oudheusden, L. J. B., de Laat, K. F., van Norden, A. G. W., van Uden, I. W. M., Norris, D. G., … de Leeuw, F.-E. (2012). Hypertension is Related to the Microstructure of the Corpus Callosum: The RUN DMC Study. Journal of Alzheimer’s Disease, 32(3), 623–631. https://doi.org/10.323[...]

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