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Overview of the arterial system

Procedural and diagnostic vascular ultrasound applications are essential in the intensive care unit (ICU). This chapter presents a synopsis of arterial disorders, whereas evaluation of venous thrombosis and ultrasound-guided vascular procedures are presented in Chapter 9, Chapter 10, Chapter 11, Chapter 12, Chapter 13, Chapter 14, Chapter 15, Chapter 16, Chapter 17, Chapter 18 . The arterial system The left-sided aorta couples the left ventricle to…

General chest ultrasound in neurocritical care

Overview Neurocritical care patients often require hemodynamic monitoring to optimize cerebral blood flow and brain tissue oxygen delivery. Hemodynamic monitoring also aids in the management of usual coexisting disorders, such as acute lung injury and acute respiratory distress syndrome (ARDS), as well as shock states. General chest ultrasound (see Chapter 1 ), which consists of cardiovascular and lung ultrasound, is a noninvasive bedside tool that facilitates…

Ocular ultrasound in the intensive care unit: (CONSULTANT LEVEL EXAMINATION)

Overview Multipurpose ultrasound systems offer a variety of eye and orbit imaging techniques relevant to critical care. Bedside ocular ultrasound can be used for the following purposes: (1) timely identification of threats to ocular health and vision and prevention of vision-related disability in trauma, (2) assessment of nontraumatic acute change in vision and the need for immediate ophthalmologic consultation, (3) measurement of the diameter of the…

Use of transcranial doppler ultrasonography in the pediatric intensive care unit: (CONSULTANT LEVEL EXAMINATION)

Overview As mentioned in preceding chapters, transcranial Doppler (TCD) ultrasonography is a noninvasive technique that uses low-frequency transducers for real-time evaluation of cerebral arteries in adults and in children with a closed anterior fontanelle. TCD has been increasingly used for cerebral circulation monitoring in the pediatric intensive care unit (PICU), and it has become an essential tool for managing sickle cell disease in children. , Two…

Transcranial doppler in the diagnosis of cerebral circulatory arrest: (CONSULTANT LEVEL EXAMINATION)

Overview The role of transcranial color coded Doppler (TCCD) in neurocritical monitoring has been illustrated in previous chapters. We will here focus on its use as a confirmatory test in the diagnosis of brain death (BD). The concept of death in Western civilization has been linked to the cessation of breathing and heart beat, irrespective of cultural and religious variability. Advances in medical technology after the…

Transcranial doppler in aneurysmal subarachnoid hemorrhage : (CONSULTANT LEVEL EXAMINATION)

Overview The management of aneurysmal subarachnoid hemorrhage (aSAH) and its accompanying sequelae integrates transcranial Doppler (TCD) ultrasonography for the surveillance of the emergence and course of vasospasm (VS) and delayed cerebral ischemia. TCD surveillance of patients after aSAH has been advocated by the two most recent aSAH treatment guidelines, and practice standards for its use are published. This disease is complex to manage, and TCD has…

Transcranial doppler ultrasound in neurocritical care

Overview In 1982, Aaslid et al authored a paper with the title “Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries,” describing the successful insonation and blood flow velocity (FV) measurement of the basal cerebral arteries with a range-gated Doppler transducer. These authors located an “ultrasonic window” above the zygomatic arch and 1 to 5 cm anterior to the ear, through which a…

Fundamentals: Essential technology, concepts, and capability

Christian Doppler was born in Salzburg, Austria on November 29, 1803 and lived a short and deprived life, like many scientists of his time. In an 1842 session of the Science Section of the Royal Bohemian Society in Prague, he presented a thesis entitled “Concerning the colored light of double stars and other celestial constellations.” Other milestones relevant to this chapter include the discovery of piezoelectric…

Radiomics and artificial intelligence

Introduction Positron emission tomography/magnetic resonance imaging (PET/MRI) is an innovative imaging technology that simultaneously acquires PET and MRI, allowing the integration of sensitive metabolic and functional information with precise structural and anatomical characterization of tissues ( ). PET/MRI has shown great potential in tumor diagnosis, treatment planning, and follow-up ( ). In addition to the qualitative image evaluation, PET/MRI may potentially provide several imaging biomarkers for…

Gastrointestinal imaging

Abbreviations ADC apparent diffusion coefficient AUC area under the curve CAPIRINHA Controlled aliasing in parallel imaging results in higher acceleration CD Crohn disease CE contrast-enhanced CRC colorectal cancer CT computed tomography DWI diffusion-weighted imaging EUS endoscopic ultrasound FDG [18F]fluorodeoxyglucose FSE fast spin echo GI gastrointestinal HASTE Half-Fourier acquisition single-shot turbo spin echo IBD inflammatory bowel disease M metastasis MRI magnetic resonance imaging N node PET positron…

Gynecologic imaging

Introduction Gynecologic malignancies are a considerable source of morbidity and mortality, accounting for nearly 672,000 deaths globally in 2020 ( ). Imaging complements surgical and clinical gynecologic cancer staging. Pelvic contrast-enhanced magnetic resonance imaging (CE-MRI) is commonly used in clinical practice to evaluate gynecologic tumor size and local extent due to its exceptional soft tissue contrast ( ). Other advantages of MRI include the availability of…

Genitourinary imaging

Introduction The use of positron emission tomography (PET) in the evaluation of genitourinary malignancies has traditionally been hampered by low tumor uptake and the masquerading effect of excreted radiopharmaceutical activity in the urinary collecting system ( ; ; ; ). However, the advent of positron emission tomography/magnetic resonance imaging (PET/MRI) and new radiopharmaceuticals has mitigated these shortcomings, leading to an expanded utilization of PET in the…

Hepatobiliary and pancreatic imaging

Introduction Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is an emerging technology with promising applications in cancer evaluation ( ). The main advantage of these systems is that both anatomic and functional MRrI sequences are jointly acquired with metabolic PET data, resulting in high sensitivity for lesion detection and excellent soft tissue contrast resolution. Preliminary studies suggest that PET/MRI may improve whole-body assessment of soft…

Breast imaging

Acknowledgments Funding was provided in part by the 2020–Research and Innovation Framework Program PHC-11-2015 Nr. 667211, Jubiläumsfonds of the Austrian National Bank # Nr: 18207and seed grants from Novomed Austria and Guerbet France. Katja Pinker is funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748 and the Breast Cancer Research Foundation. Introduction Breast cancer is a heterogeneous disease, presenting with specific molecular patterns…

Hematologic imaging

Introduction Blood malignancies account for approximately 10% of newly diagnosed malignant tumors in the United States. While a large number of different blood cancer entities exist, three main groups are generally recognized: 1. Lymphoma, which is responsible for almost 50% of new cases 2. Leukemia which accounts for 35% of new cases 3. Myeloma, which accounts for 18% of new cases. Due to their unique biological…

Musculoskeletal imaging

Primary bone and soft tissue malignancies Primary bone and soft tissue malignancies are a heterogeneous group of relatively rare tumors, most of them deriving from mesenchymal tissue (sarcomas). The reported international annual incidence for sarcomas ranges from 1.8 to 5 cases per 100,000 individuals ( ). They can occur anywhere in the body but most commonly in the extremities (31.9%) followed by the trunk (21.8%) and…

Thoracic imaging

Clinical management of malignancies of the chest Lung cancer Lung cancer is the leading cause of cancer deaths in men and women worldwide with a 5-year survival of only around 20% ( ). Cigarette smoking is the single most common risk factor for the development of lung cancer, but air quality, residential radon, and occupational exposures such as asbestos rank among the other major factors (…

Pediatrics imaging

Acknowledgments This work was in part supported by a grant from the National Cancer Institute, grant number R01CA269231, and the Sarcoma Foundation of America. We thank Mehdi Khalighi, Dawn Holley, and Kim Halbert from the PET/MRI Metabolic Service Center for their assistance with the acquisition of PET/MRI scans at the Lucas Research Center at Stanford. Introduction Children and adolescents with cancer are referred to specific staging…

Cardiovascular imaging

Acknowledgments We would like to thank Sabine Frank, Susan Notohamiprodjo and Alberto Villagran for their assistance preparing this chapter. Introduction In recent years, numerous imaging modalities have been developed to diagnose cardiac disease noninvasively and to measure structural, functional, and bio chemical performance of cardiac tissue. Especially, applications of imaging procedures to assess myocardial perfusion under rest and stress conditions have substantially added to noninvasive diagnosis…

Neurologic imaging

Acknowledgments VG has received funding from the Swiss National Science Foundation (project n. 185028, 188355 and 169876), the Velux Foundation, the Schmidheiny Foundation and research/teaching support through her institution from Siemens Healthineers, GE Healthcare, Roche, Merck, Cerveau Technologies and Life Molecular Imaging. Introduction Neurologic disorders encompass a wide range of pathologies which overall are the leading cause of disability and second leading cause of death worldwide…