Applied Radiology
LOGIN TO YOUR MYAR CE ACCOUNT
Forgot Your Password? Register Submit
Applied Radiology is pleased to offer you a selection of free SA-CME accredited courses to choose from, as part of your free subscription to AR.
SA-CME
Accreditation/Designation Statement
The Institute for Advanced Medical Education (IAME) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Institute for Advanced Medical Education (IAME) designates these Journal-based activities for a maximum of 1 AMA PRA Category 1 Credit™ each. Physicians should only claim credit commensurate with the extent of their participation in the activity.
These credits qualify as SA-CME credits.
Imaging in Stroke Diagnosis and Treatment: An Update
Steven Benitez, MD; Ryan Holland, MD; Richard Zampolin, MD; Andrew Brook, BA, MS; Joshua Hirsch, MD; Allan L Brook, MD, Deepak Khatri, MD
Estimated time for completion: 1 hour   •   Date of release and review: September 1, 2021   •   Expiration Date: August 31, 2023
As thrombectomy has become the standard of care for large vessel/arterial occlusions, the indications are initiated by proper imaging and understanding of the brain blood flow physiology. This two-part series examines the standard of care for acute stroke imaging and the latest techniques. The second part of this activity on stroke intervention will appear in the November-December issue of Applied Radiology.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Ovarian Masses and O-RADS: A Systematic Approach to Evaluating and Characterizing Adnexal Masses with MRI
Ana Mitchell, MD; Austin Kwong, MD; Simran Sekhon, MD; John P McGahan, MD, FACR
Estimated time for completion: 1 hour   •   Date of release and review: July 1, 2021   •   Expiration Date: June 30, 2023
Given that ovarian and adnexal masses are commonly encountered in daily clinical practice, it is important to be able to recognize worrisome features on MRI. Once these are identified, it is important to accurately classify ovarian masses according to criteria ranging from low-risk to high-risk lesions. Recognizing and categorizing ovarian masses is important for determining that no further treatment or imaging is required for benign or low-risk lesions. Similarly, recognition of a worrisome feature and proper classification of high-risk masses are necessary to permit appropriate referral of these patients to a surgical oncologist.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Elbow Effusion: Utility and Limitations of Radiography in Pediatric Injuries
Sachin S Kumbhar, MD
Estimated time for completion: 1 hour   •   Date of release and review: May 1, 2021   •   Expiration Date: April 30, 2023
Fractures of the elbow are one of the commonest pediatric injuries. Some of these fractures can be occult on initial radiographs, an elbow effusion being the only initial finding. Elbow effusion can be detected on an adequately obtained lateral radiographic projection of the elbow by identifying the visibility and shape of the anterior and posterior fat pads. To maximize the accuracy of detecting elbow effusions, radiologists should be aware of conditions that can affect the visibility of these fat pads.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Acquired Pericardial Pathologies: Imaging Features, Clinical Significance, and Management
Pegah Khoshpouri, MD; Mahdie Hosseini, MD; Arya M Iranmanesh, MD; Bahar Mansoori, MD; Arash Bedayat, MD; Holman P McAdams, MD; Hamid Chalian, MD
Estimated time for completion: 1 hour   •   Date of release and review: March 1, 2021   •   Expiration Date: February 28, 2023
There are several acquired diseases involving the pericardium. The clinical signs and symptoms of most of the pericardial disease are similar. This underscores the importance of medical imaging in identification of specific pericardial diseases.
Unfortunately, there are also similarities between the imaging features of several pericardial diseases. Therefore, familiarity with imaging features of different pericardial diseases is very important in the proper management of these patients. It is also of great importance that radiologists understand the clinical significance and management of different pericardial diseases so that they can better communicate with referring clinicians.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
An Overview of Acute Mesenteric Ischemia
Arash Mirrahimi, MD, MSc; Charlotte Gallienne, MD; Hournaz Ghandehari, MD, FRCPC
Estimated time for completion: 1 hour   •   Date of release and review: January 1, 2021   •   Expiration Date: December 31, 2023
Acute mesenteric ischemia (AMI) is a true surgical emergency and a rare life-threatening condition, accounting for 0.01% of hospital admissions, with extremely high mortality rates (up to 69%). Poor outcomes remain prevalent despite advances in both diagnostic and treatment options over the last two decades
Early diagnosis and management are particularly important given that the highest incidence of AMI occurs in the elderly population, who often have multiple comorbidities leading to a worse prognosis. Biphasic contrast enhanced multidetector computed tomography (MDCT) images have become the mainstay and standard of care for investigation and timely diagnosis of AMI.
As such, the importance of recognizing imaging features of AMI and timely communication of findings with the referring physicians is of utmost importance for diagnostic radiologists and always a worthwhile topic for review. We have therefore endeavored to provide a brief summary of the presentation of AMI, its causes, relevant anatomy, and most importantly, illustrated review of CT findings that delineate ischemic changes of the bowel and mesentery.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Contrast-enhanced Ultrasound of Renal Masses
Jack Bennett, Cynthia Peterson, MPH, RDMS, RVT; Richard G. Barr MD, PhD
Estimated time for completion: 1 hour   •   Date of release and review: November 1, 2020   •   Expiration Date: October 31, 2022
Ultrasound (US) is often the initial imaging modality for evaluation of renal diseases. Non-enhanced US faces limitations in the assessment of focal renal masses and complex cysts. Contrast-enhanced ultrasound (CEUS) on the kidneys can overcome these shortcomings.
There are several advantages of CEUS over contrast-enhanced CT or contrast-enhanced MRI. These include the fact that the narrow US beam allows for improved visualization of vascularity in small structures such as septations or small mural nodules; high temporal resolution with real time assessment of vascularity; lack of radiation; and no renal impairment.
Excluding inflammatory masses, vascular abnormalities and pseudotumors, most solid enhancing renal masses are malignant. Complicated cystic lesions with enhancing soft tissue components, excluding the actual cyst wall, are malignant. Using enhancement pattern, renal masses can be characterized with high sensitivity and specificity
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Pregnancy-associated Breast Cancer and Other Breast Disease: A Radiologic Review
Andrew Ong, MD; Lisa A Mullen, MD; Susan C. Harvey, MD
Estimated time for completion: 1 hour   •   Date of release and review: September 1, 2020   •   Expiration Date: August 31, 2022
Pregnancy associated breast cancer (PABC) is a subset of breast cancer that is typically diagnosed at more advanced stages and carries a worse prognosis. The physiological breast changes that occur during pregnancy and lactation can often make clinical and radiological evaluation difficult.
Ultrasound is the primary imaging modality in the evaluation of pregnancy associated breast lesions with high sensitivity and lack of radiation. Mammography is generally considered safe during pregnancy and lactation and may also be used to assess for PABC. Dynamic contrast enhanced breast MRI is not recommended during pregnancy; however, it may safely be performed in lactating women to evaluate extent of disease or for high risk screening.
This article reviews appropriate imaging evaluation of the pregnant or lactating woman, and showcases the imaging features of benign and malignant lesions occurring during pregnancy and lactation. Many benign lesions, including fibroadenoma and lactating adenoma, can mimic malignancy. New or growing solid masses occurring during pregnancy and lactation should be further evaluated with imaging and biopsy, to avoid a delay in a potential cancer diagnosis.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
MRI Screening for Hepatocellular Carcinoma
Courtney C Moreno, MD; Thuy-Van P Hang, MD; Joel P Wedd, MD, MPH
Estimated time for completion: 1 hour   •   Date of release and review: July 1, 2020   •   Expiration Date: June 30, 2022
Screening for hepatocellular carcinoma (HCC) has been shown to improve overall survival by detecting earlier stage, more treatable disease. For some patients with HCC, liver transplant is the preferred treatment. However, donor livers are a scarce resource. Accurate identification and description of HCC with MRI is important in the determination of which patients will receive a liver transplant.
This article reviews background information about cirrhosis and hepatocellular carcinoma, the role of screening, transplant priority determination, and diagnostic criteria for HCC.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Imaging Acute Face and Neck Infections
Blair A Winegar, MD; Ethan A Neufeld, MD; Wayne S Kubal, M
Estimated time for completion: 1 hour   •   Date of release and review: March 1, 2020   •   Expiration Date: February 28, 2022
Many acute infectious conditions of the face and neck resulting from common sources, such as pharyngitis, dental infection, and penetrating trauma, are evaluated in the emergency department. The clinical features of these conditions overlap, and clinical evaluation is often insufficient to localize or determine the extent of infection within the deep spaces of the neck.
This article showcases the classic imaging features and locations of a variety of acute face and neck infections encountered in the emergency department. In addition, the imaging findings of potentially life-threatening complications, such as mediastinitis resulting from retropharyngeal abscess and septic pulmonary emboli resulting from Lemierre syndrome, are described.
In the emergency setting, the radiologist’s ability to correctly identify and categorize acute face and neck infections and their complications is paramount to direct appropriate surgical and medical management.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
A Multimodality Approach to Imaging the Mediastinum and Pleura: Pearls and Pitfalls
Leonid Roshkovan, MD; Sharyn I. Katz, MD, MTR
Estimated time for completion: 1 hour   •   Date of release and review: March 1, 2020   •   Expiration Date: February 28, 2022
Diagnostic interpretation of cross-sectional imaging of the mediastinum and pleura presents unique and significant challenges even to the experienced radiologist. The mediastinum is anatomically complex, comprising numerous structures ar-ranged into multiple anatomic compartments that can give rise to a wide range of pathologies. The pleural space is thin and multi-planar, which can confound evaluation and quantification of pleural abnormalities.
In this article, we will review imaging approaches to the mediastinum and pleura and present imaging pearls and pitfalls that can assist radiologic interpretation. This will include common masses that present in routine imaging of the chest and key imaging features that help to distinguish them using CT, MRI and FDG-PET/CT.
The knowledge of common mediastinal and pleural pa-thologies present on cross-sectional imaging will enable the radiologist to make informed diagnostic radiologic interpreta-tions and guide appropriate intervention and surveillance.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Anterior Cruciate Ligament and Meniscal Tears: A Multi-modality Review
Matthew Schwenke, MD; Manu Singh, MD; and Bernard Chow, MD
Estimated time for completion: 1 hour   •   Date of release and review: January 1, 2020   •   Expiration Date: December 31, 2022
Injuries to the anterior cruciate ligament (ACL) are increasing over time, with younger women at elevated risk. Meniscal tears are also a significant source of morbidity in both the younger and older populations. Surgical repair of both conditions may alleviate symptoms and allow resumption of athletic activities. Understanding of the pathogenesis, associated findings, and appearance of these injuries on all imaging modalities is critical to their accurate diagnosis and timely treatment. Radiographs may show indirect signs of ACL and meniscal injuries. Ultrasonography is being utilized more often in the workup of these conditions as an adjunct to physical exam and as an initial screening tool. Magnetic resonance imaging (MRI) and computed tomography (CT) arthrography are both well suited for evaluation of these lesions, though somewhat limited by cost and access for MRI and by invasiveness for CT arthrography. ACL and meniscal tears can also be graded and classified according to their appearance on imaging which helps guide the surgeon during arthroscopy.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)
Imaging Brachial Plexus Pathology
James Thomas Patrick Decourcy Hallinan, MBChB; Mini N. Pathria, MD; and Brady K. Huang, MD
Estimated time for completion: 1 hour   •   Date of release and review: November 1, 2019   •   Expiration Date: October 31, 2021
Brachial plexus disorders are a diagnostic challenge due to the complex anatomy and nonspecific symptomatology. MRI remains the best modality for assessing the brachial plexus (BP), due to its superior soft-tissue contrast compared to CT or ultrasound. Traumatic lesions are the most common cause of BP dysfunction, closely followed by neoplastic infiltration. Infection, inflammation and iatrogenic causes are less common
This review article will provide an overview of anatomy and practical, up-to-date BP imaging techniques for general radiologists, followed by a step-wise discussion of common pathology. Clinically relevant advances such as dynamic tho-racic outlet MRI will also be discussed.
To View Supplement Click Here
To complete the Post-Exam and claim SA-CME credits select Profession below.
(Site Registration/Login Required)