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Sample records for abdominal ct examinations

  1. Abdominal CT scan

    MedlinePlus

    ... results may also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal ... Livingstone; 2014:chap 4. Read More Abdominal aortic aneurysm Abdominal aortic aneurysm repair - open Abscess Acute cholecystitis ...

  2. Abdominal CT scan

    MedlinePlus

    ... tumors, including cancer Infections or injury Kidney stones Appendicitis ... also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal artery stenosis ...

  3. ASSESSMENT OF CLINICAL IMAGE QUALITY IN PAEDIATRIC ABDOMINAL CT EXAMINATIONS: DEPENDENCY ON THE LEVEL OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION (ASiR) AND THE TYPE OF CONVOLUTION KERNEL.

    PubMed

    Larsson, Joel; Båth, Magnus; Ledenius, Kerstin; Caisander, Håkan; Thilander-Klang, Anne

    2016-06-01

    The purpose of this study was to investigate the effect of different combinations of convolution kernel and the level of Adaptive Statistical iterative Reconstruction (ASiR™) on diagnostic image quality as well as visualisation of anatomical structures in paediatric abdominal computed tomography (CT) examinations. Thirty-five paediatric patients with abdominal pain with non-specified pathology undergoing abdominal CT were included in the study. Transaxial stacks of 5-mm-thick images were retrospectively reconstructed at various ASiR levels, in combination with three convolution kernels. Four paediatric radiologists rated the diagnostic image quality and the delineation of six anatomical structures in a blinded randomised visual grading study. Image quality at a given ASiR level was found to be dependent on the kernel, and a more edge-enhancing kernel benefitted from a higher ASiR level. An ASiR level of 70 % together with the Soft™ or Standard™ kernel was suggested to be the optimal combination for paediatric abdominal CT examinations. PMID:26922785

  4. Multidetector CT of blunt abdominal trauma.

    PubMed

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  5. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  6. COMPARISON OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION (ASIR™) AND MODEL-BASED ITERATIVE RECONSTRUCTION (VEO™) FOR PAEDIATRIC ABDOMINAL CT EXAMINATIONS: AN OBSERVER PERFORMANCE STUDY OF DIAGNOSTIC IMAGE QUALITY.

    PubMed

    Hultenmo, Maria; Caisander, Håkan; Mack, Karsten; Thilander-Klang, Anne

    2016-06-01

    The diagnostic image quality of 75 paediatric abdominal computed tomography (CT) examinations reconstructed with two different iterative reconstruction (IR) algorithms-adaptive statistical IR (ASiR™) and model-based IR (Veo™)-was compared. Axial and coronal images were reconstructed with 70 % ASiR with the Soft™ convolution kernel and with the Veo algorithm. The thickness of the reconstructed images was 2.5 or 5 mm depending on the scanning protocol used. Four radiologists graded the delineation of six abdominal structures and the diagnostic usefulness of the image quality. The Veo reconstruction significantly improved the visibility of most of the structures compared with ASiR in all subgroups of images. For coronal images, the Veo reconstruction resulted in significantly improved ratings of the diagnostic use of the image quality compared with the ASiR reconstruction. This was not seen for the axial images. The greatest improvement using Veo reconstruction was observed for the 2.5 mm coronal slices. PMID:26873711

  7. CT of acute abdominal aortic disorders.

    PubMed

    Bhalla, Sanjeev; Menias, Christine O; Heiken, Jay P

    2003-11-01

    Aortic aneurysm rupture, aortic dissection, PAU, acute aortic occlusion, traumatic aortic injury, and aortic fistula represent acute abdominal aortic conditions. Because of its speed and proximity to the emergency department, helical CT is the imaging test of choice for these conditions. MR imaging also plays an important role in the imaging of aortic dissection and PAU, particularly when the patient is unable to receive intravenous contrast material. In this era of MDCT, conventional angiography is used as a secondary diagnostic tool to clarify equivocal findings on cross-sectional imaging. Ultrasound is helpful when CT is not readily available and the patient is unable or too unstable to undergo MR imaging. PMID:14661663

  8. Abdominal organ motion measured using 4D CT

    SciTech Connect

    Brandner, Edward D.; Wu, Andrew . E-mail: andrew.wu@jefferson.edu; Chen, Hungcheng; Heron, Dwight; Kalnicki, Shalom; Komanduri, Krishna; Gerszten, Kristina; Burton, Steve; Ahmed, Irfan; Shou, Zhenyu

    2006-06-01

    Purpose: To measure respiration-induced abdominal organ motion using four-dimensional computed tomography (4D CT) scanning and to examine the organ paths. Methods and Materials: During 4D CT scanning, consecutive CT images are acquired of the patient at each couch position. Simultaneously, the patient's respiratory pattern is recorded using an external marker block taped to the patient's abdomen. This pattern is used to retrospectively organize the CT images into multiple three-dimensional images, each representing one breathing phase. These images are analyzed to measure organ motion between each phase. The displacement from end expiration is compared to a displacement limit that represents acceptable dosimetric results (5 mm). Results: The organs measured in 13 patients were the liver, spleen, and left and right kidneys. Their average superior to inferior absolute displacements were 1.3 cm for the liver, 1.3 cm for the spleen, 1.1 cm for the left kidney, and 1.3 cm for the right kidney. Although the organ paths varied among patients, 5 mm of superior to inferior displacement from end expiration resulted in less than 5 mm of displacement in the other directions for 41 of 43 organs measured. Conclusions: Four-dimensional CT scanning can accurately measure abdominal organ motion throughout respiration. This information may result in greater organ sparing and planning target volume coverage.

  9. Patient doses from CT examinations in Turkey

    PubMed Central

    Ataç, Gökçe Kaan; Parmaksız, Aydın; İnal, Tolga; Bulur, Emine; Bulgurlu, Figen; Öncü, Tolga; Gündoğdu, Sadi

    2015-01-01

    PURPOSE We aimed to establish the first diagnostic reference levels (DRLs) for computed tomography (CT) examinations in adult and pediatric patients in Turkey and compare these with international DRLs. METHODS CT performance information and examination parameters (for head, chest, high-resolution CT of the chest [HRCT-chest], abdominal, and pelvic protocols) from 1607 hospitals were collected via a survey. Dose length products and effective doses for standard patient sizes were calculated from the reported volume CT dose index (CTDIvol). RESULTS The median number of protocols reported from the 167 responding hospitals (10% response rate) was 102 across five different age groups. Third quartile CTDIvol values for adult pelvic and all pediatric body protocols were higher than the European Commission standards but were comparable to studies conducted in other countries. CONCLUSION The radiation dose indicators for adult patients were similar to those reported in the literature, except for those associated with head protocols. CT protocol optimization is necessary for adult head and pediatric chest, HRCT-chest, abdominal, and pelvic protocols. The findings from this study are recommended for use as national DRLs in Turkey. PMID:26133189

  10. [Normal abdominal ultrasound anatomy. Examination procedure].

    PubMed

    Salcedo Joven, I; Segura Grau, A; Rodríguez Lorenzo, A; Segura Cabral, J M

    2014-01-01

    To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region. PMID:24746380

  11. Chronic osteomyelitis examined by CT

    SciTech Connect

    Wing, V.W.; Jeffrey, R.B. Jr.; Federle, M.P.; Helms, C.A.; Trafton, P.

    1985-01-01

    CT examination of 25 patients who had acute exacerbations of chronic osteomyelitis allowed for the correct identification of single or multiple sequestra in 14 surgical patients. Plain radiographs were equivocal for sequestra in seven of these patients, because the sequestra were too small or because diffuse bony sclerosis was present. CT also demonstrated a foreign body and five soft tissue abscesses not suspected on the basis of plain radiographs. CT studies, which helped guide the operative approach, were also useful in treating those patients whose plain radiographs were positive for sequestra. The authors review the potential role of CT in evaluating patients with chronic osteomyelitis.

  12. Fully automated adipose tissue measurement on abdominal CT

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Sussman, Daniel L.; Summers, Ronald M.

    2011-03-01

    Obesity has become widespread in America and has been associated as a risk factor for many illnesses. Adipose tissue (AT) content, especially visceral AT (VAT), is an important indicator for risks of many disorders, including heart disease and diabetes. Measuring adipose tissue (AT) with traditional means is often unreliable and inaccurate. CT provides a means to measure AT accurately and consistently. We present a fully automated method to segment and measure abdominal AT in CT. Our method integrates image preprocessing which attempts to correct for image artifacts and inhomogeneities. We use fuzzy cmeans to cluster AT regions and active contour models to separate subcutaneous and visceral AT. We tested our method on 50 abdominal CT scans and evaluated the correlations between several measurements.

  13. FDG PET/CT Findings in Abdominal Fat Necrosis After Treatment for Lymphoma.

    PubMed

    Dubreuil, Julien; Moreau, Aurélie; Sarkozy, Clémentine; Traverse-Glehen, Alexandra; Skanjeti, Andrea; Salles, Gilles; Giammarile, Francesco

    2016-05-01

    FDG PET/CT is now validated in non-Hodgkin lymphoma for response assessment in interim and posttreatment lymphoma. We report the case of a 62-year-old man followed by FDG PET/CT for a diffuse large B-cell lymphoma, with initial stage III. The interim FDG PET/CT examination concluded in complete metabolic and morphological response of subdiaphragmatic lymphadenopathy but a persistent abnormal subdiaphragmatic uptake (SUVmax at 9 and Deauville 5-point scale at 5). Therefore, an abdominal biopsy of the corresponding nodules was conducted with a final diagnosis of diffuse fat necrosis. PMID:26825213

  14. Spleen volume on CT and the effect of abdominal trauma.

    PubMed

    Cruz-Romero, Cinthia; Agarwal, Sheela; Abujudeh, Hani H; Thrall, James; Hahn, Peter F

    2016-08-01

    The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p = 0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p < 0.006) and 163 vs 191 mL in females(p < 0.04). Spleen volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p < 0.01). Variation in reproducibility and repeatability was acceptable at 1.5 and 4.9 %, respectively. Reader variation was 1.7 and 4.6 % for readers 1 and 2, respectively. The mean spleen volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic. PMID:27166964

  15. Dosimetric Quantities for Computed Tomography Examinations of Paediatric Patients on the Thoracic and Abdominal Regions

    SciTech Connect

    Flores-M, E.; Gamboa de Buen, I.; Buenfil, A. E.; Ruiz-Trejo, C.; Dies, P.

    2010-12-07

    Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at ''Hospital Infantil de Mexico Federico Gomez'' in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used was a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (C{sub w}), the volumetric dose index (C{sub vol}) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the C{sub w}(31.1 mGy) and C{sub vol}(11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for C{sub w} and 5.5 mGy for C{sub vol}. However, this protocol presented the highest value for P{sub KL,CT}(282.2 mGy cm) when considering the average clinical length of the examinations.

  16. Dosimetric Quantities for Computed Tomography Examinations of Paediatric Patients on the Thoracic and Abdominal Regions

    NASA Astrophysics Data System (ADS)

    Flores-M, E.; Buenfil, A. E.; Dies, P.; Gamboa-deBuen, I.; Ruiz-Trejo, C.

    2010-12-01

    Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at "Hospital Infantil de México Federico Gómez" in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used was a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (Cw), the volumetric dose index (Cvol) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the Cw (31.1 mGy) and Cvol (11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for Cw and 5.5 mGy for Cvol. However, this protocol presented the highest value for PKL,CT (282.2 mGy cm) when considering the average clinical length of the examinations.

  17. Evaluation of five image registration tools for abdominal CT: pitfalls and opportunities with soft anatomy

    NASA Astrophysics Data System (ADS)

    Lee, Christopher P.; Xu, Zhoubing; Burke, Ryan P.; Baucom, Rebeccah; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Image registration has become an essential image processing technique to compare data across time and individuals. With the successes in volumetric brain registration, general-purpose software tools are beginning to be applied to abdominal computed tomography (CT) scans. Herein, we evaluate five current tools for registering clinically acquired abdominal CT scans. Twelve abdominal organs were labeled on a set of 20 atlases to enable assessment of correspondence. The 20 atlases were pairwise registered based on only intensity information with five registration tools (affine IRTK, FNIRT, Non-Rigid IRTK, NiftyReg, and ANTs). Following the brain literature, the Dice similarity coefficient (DSC), mean surface distance, and Hausdorff distance were calculated on the registered organs individually. However, interpretation was confounded due to a significant proportion of outliers. Examining the retrospectively selected top 1 and 5 atlases for each target revealed that there was a substantive performance difference between methods. To further our understanding, we constructed majority vote segmentation with the top 5 DSC values for each organ and target. The results illustrated a median improvement of 85% in DSC between the raw results and majority vote. These experiments show that some images may be well registered to some targets using the available software tools, but there is significant room for improvement and reveals the need for innovation and research in the field of registration in abdominal CTs. If image registration is to be used for local interpretation of abdominal CT, great care must be taken to account for outliers (e.g., atlas selection in statistical fusion).

  18. Computer-aided kidney segmentation on abdominal CT images.

    PubMed

    Lin, Daw-Tung; Lei, Chung-Chih; Hung, Siu-Wan

    2006-01-01

    In this paper, an effective model-based approach for computer-aided kidney segmentation of abdominal CT images with anatomic structure consideration is presented. This automatic segmentation system is expected to assist physicians in both clinical diagnosis and educational training. The proposed method is a coarse to fine segmentation approach divided into two stages. First, the candidate kidney region is extracted according to the statistical geometric location of kidney within the abdomen. This approach is applicable to images of different sizes by using the relative distance of the kidney region to the spine. The second stage identifies the kidney by a series of image processing operations. The main elements of the proposed system are: 1) the location of the spine is used as the landmark for coordinate references; 2) elliptic candidate kidney region extraction with progressive positioning on the consecutive CT images; 3) novel directional model for a more reliable kidney region seed point identification; and 4) adaptive region growing controlled by the properties of image homogeneity. In addition, in order to provide different views for the physicians, we have implemented a visualization tool that will automatically show the renal contour through the method of second-order neighborhood edge detection. We considered segmentation of kidney regions from CT scans that contain pathologies in clinical practice. The results of a series of tests on 358 images from 30 patients indicate an average correlation coefficient of up to 88% between automatic and manual segmentation. PMID:16445250

  19. Computer-aided diagnosis of splenic enlargement using wave pattern of spleen in abdominal CT images

    NASA Astrophysics Data System (ADS)

    Seong, Won; Cho, June-Sik; Noh, Seung-Moo; Park, Jong Won

    2006-03-01

    It is known that the spleen accompanied by liver cirrhosis is hypertrophied or enlarged. We have examined a wave pattern at the left boundary of spleen on the abdominal CT images having liver cirrhosis, and found that they are different from those on the images having a normal liver. It is noticed that the abdominal CT images of patient with liver cirrhosis shows strong bending in the wave pattern. In the case of normal liver, the images may also have a wave pattern, but its bends are not strong. Therefore, the total waving area of the spleen with liver cirrhosis is found to be greater than that of the spleen with a normal liver. Moreover, we found that the waves of the spleen from the image with liver cirrhosis have the higher degree of circularity compared to the normal liver case. Based on the two observations above, we propose an automatic method to diagnose splenic enlargement by using the wave pattern of the spleen in abdominal CT images. The proposed automatic method improves the diagnostic performance compared with the conventional process based on the size of spleen.

  20. Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

    NASA Astrophysics Data System (ADS)

    Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

    2007-03-01

    Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

  1. Radiation dose reduction in pediatric abdominal CT scanning

    SciTech Connect

    Kamel, I.R.

    1993-01-01

    A clinical trial was designed to test whether a significantly lower radiation dose technique could be used for pediatric abdominal CT scanning without loss of diagnostic image quality. The study included pediatric patients referred to radiology from the Children's Hospital and clinics at The University of Michigan. Seventy-eight cases were included in the study, 36 cases in the experimental group and 42 in the control group. Patient characteristics in both groups were comparable in every respect except for the technical factors used to expose the pelvis. Patients in the experimental group were scanned with a technique using 80 mAs while those in the control group were scanned with the conventional technique of 240 mAs. Therefore, the radiation dose to the pelvis was three times higher in the control group than in the experimental group. Scans were evaluated by two experienced pediatric radiologists who assessed anatomical details, image resolution and the degree of confidence in reaching a diagnosis. The low-mAs technique did not result in reduction of diagnostic image quality or the confidence in reaching a diagnosis. In conclusion, the radiation dose resulting from pediatric CT of the pelvis may be reduced by a factor of three with equivalent medical benefit.

  2. Immersive virtual reality for visualization of abdominal CT

    NASA Astrophysics Data System (ADS)

    Lin, Qiufeng; Xu, Zhoubing; Li, Bo; Baucom, Rebeccah; Poulose, Benjamin; Landman, Bennett A.; Bodenheimer, Robert E.

    2013-03-01

    Immersive virtual environments use a stereoscopic head-mounted display and data glove to create high fidelity virtual experiences in which users can interact with three-dimensional models and perceive relationships at their true scale. This stands in stark contrast to traditional PACS-based infrastructure in which images are viewed as stacks of two dimensional slices, or, at best, disembodied renderings. Although there has substantial innovation in immersive virtual environments for entertainment and consumer media, these technologies have not been widely applied in clinical applications. Here, we consider potential applications of immersive virtual environments for ventral hernia patients with abdominal computed tomography imaging data. Nearly a half million ventral hernias occur in the United States each year, and hernia repair is the most commonly performed general surgery operation worldwide. A significant problem in these conditions is communicating the urgency, degree of severity, and impact of a hernia (and potential repair) on patient quality of life. Hernias are defined by ruptures in the abdominal wall (i.e., the absence of healthy tissues) rather than a growth (e.g., cancer); therefore, understanding a hernia necessitates understanding the entire abdomen. Our environment allows surgeons and patients to view body scans at scale and interact with these virtual models using a data glove. This visualization and interaction allows users to perceive the relationship between physical structures and medical imaging data. The system provides close integration of PACS-based CT data with immersive virtual environments and creates opportunities to study and optimize interfaces for patient communication, operative planning, and medical education.

  3. Effects of Dual-Energy CT with Non-Linear Blending on Abdominal CT Angiography

    PubMed Central

    Wang, Chaoqin; Jiang, Xiaochen; Xu, Ge

    2014-01-01

    Objective To determine whether non-linear blending technique for arterial-phase dual-energy abdominal CT angiography (CTA) could improve image quality compared to the linear blending technique and conventional 120 kVp imaging. Materials and Methods This study included 118 patients who had accepted dual-energy abdominal CTA in the arterial phase. They were assigned to Sn140/80 kVp protocol (protocol A, n = 40) if body mass index (BMI) < 25 or Sn140/100 kVp protocol (protocol B, n = 41) if BMI ≥ 25. Non-linear blending images and linear blending images with a weighting factor of 0.5 in each protocol were generated and compared with the conventional 120 kVp images (protocol C, n = 37). The abdominal vascular enhancements, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose were assessed. Statistical analysis was performed using one-way analysis of variance test, independent t test, Mann-Whitney U test, and Kruskal-Wallis test. Results Mean vascular attenuation, CNR, SNR and subjective image quality score for the non-linear blending images in each protocol were all higher compared to the corresponding linear blending images and 120 kVp images (p values ranging from < 0.001 to 0.007) except for when compared to non-linear blending images for protocol B and 120 kVp images in CNR and SNR. No significant differences were found in image noise among the three kinds of images and the same kind of images in different protocols, but the lowest radiation dose was shown in protocol A. Conclusion Non-linear blending technique of dual-energy CT can improve the image quality of arterial-phase abdominal CTA, especially with the Sn140/80 kVp scanning. PMID:25053901

  4. Patient doses in abdominal aortogram and aorta femoral runoff examinations.

    PubMed

    Chu, R Y; Parry, C; Thompson, W; Loeffler, C

    1998-11-01

    Radiation doses to adult male patients from abdominal aortogram and aorta femoral runoff examinations in a medical center were determined with the help of a dose-area product meter. The abdominal aortogram and aorta femoral runoff examination consisted of scout radiographs, fluoroscopy (to position a catheter near the area of interest), and serial films (to record the flow of contrast media). Measurements were converted to effective doses with the help of published results from Monte Carlo simulation calculations. Data from 19 male adult patients weighing 53 to 86 kg were analyzed. The resulting total effective dose had a value of 14.0 +/- 4A mSv (mean and standard deviation). The percent contribution by fluoroscopy was 18.5 +/- 9.9%. The fluoroscopy effective dose had a stronger correlation with the dose-area product (correlation coefficient of 0.97) than with duration of exposure (correlation coefficient of 0.84). Most of the radiation exposure in the observed abdominal aortogram and aorta femoral runoff examination was attributed to radiography. PMID:9790557

  5. Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association

    PubMed Central

    CHEN, JINGJING; WU, ZENGJIE; SUN, BINBIN; LI, DACHENG; WANG, ZHENGUANG; LIU, FANGJUN; HUA, HUI

    2016-01-01

    Desmoplastic small round cell tumors (DSRCTs) are rare and aggressive malignant tumors. The aim of the present study was to analyze computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT imaging features of intra-abdominal desmoplastic DSRCT, and investigate the association of these features with histopathological results. The present study was a retrospective investigation of 4 patients with DSRCT. All patients underwent CT and dynamic CT, and 1 additionally underwent FDG-PET/CT scanning. Following a tumor resection, routine hematoxylin and eosin staining, and immunostaining, were performed and evaluated. Multiple large abdominopelvic masses were identified in all 4 patients; however, no indications of their site of origin were demonstrated. CT revealed soft-tissue masses with patchy foci of hypodense lesions. Contrast-enhanced CT revealed slightly or moderately heterogeneous enhancement of the lesions. Other observations from these patients included calcification (n=2), peritoneal seeding (n=3), hepatic metastasis (n=3), retroperitoneal lymphadenopathy (n=3) and ascites (n=2). FDG-PET/CT revealed multiple nodular increased FDG uptake in the abdominopelvic masses, and in the liver and peritoneum in 1 case. Intra-abdominal DSRCT demonstrated significant diagnostic characteristics on plain and contrast-enhanced CT. Multiple, bulky soft-tissue masses inside the peritoneal cavity, particularly in male adolescents and young adults, should be considered as potential cases of DSRCT. FDG-PET/CT techniques may be utilized to aid the staging of tumors. PMID:27123106

  6. Computed tomography (CT) of bowel and mesenteric injury in blunt abdominal trauma: a pictorial essay.

    PubMed

    Hassan, Radhiana; Abd Aziz, Azian; Mohamed, Siti Kamariah Che

    2012-08-01

    Computed tomography (CT) is currently the diagnostic modality of choice in the evaluation of clinically stable patients with blunt abdominal trauma, including the assessment of blunt bowel and mesenteric injuries. CT signs of bowel and/or mesenteric injuries are bowel wall defect, free air, oral contrast material extravasation, extravasation of contrast material from mesenteric vessels, mesenteric vascular beading, abrupt termination of mesenteric vessels, focal bowel wall thickening, mesenteric fat stranding, mesenteric haematoma and intraperitoneal or retroperitoneal fluid. This pictorial essay illustrates CT features of bowel and/or mesenteric injuries in patients with blunt abdominal trauma. Pitfalls in interpretation of images are emphasized in proven cases. PMID:23082464

  7. Intracranial CT angiography obtained from a cerebral CT perfusion examination

    SciTech Connect

    Gratama van Andel, H. A. F.; Venema, H. W.; Majoie, C. B.; Den Heeten, G. J.; Grimbergen, C. A.; Streekstra, G. J.

    2009-04-15

    CT perfusion (CTP) examinations of the brain are performed increasingly for the evaluation of cerebral blood flow in patients with stroke and vasospasm after subarachnoid hemorrhage. Of the same patient often also a CT angiography (CTA) examination is performed. This study investigates the possibility to obtain CTA images from the CTP examination, thereby possibly obviating the CTA examination. This would save the patient exposure to radiation, contrast, and time. Each CTP frame is a CTA image with a varying amount of contrast enhancement and with high noise. To improve the contrast-to-noise ratio (CNR) we combined all 3D images into one 3D image after registration to correct for patient motion between time frames. Image combination consists of weighted averaging in which the weighting factor of each frame is proportional to the arterial contrast. It can be shown that the arterial CNR is maximized in this procedure. An additional advantage of the use of the time series of CTP images is that automatic differentiation between arteries and veins is possible. This feature was used to mask veins in the resulting 3D images to enhance visibility of arteries in maximum intensity projection (MIP) images. With a Philips Brilliance 64 CT scanner (64x0.625 mm) CTP examinations of eight patients were performed on 80 mm of brain using the toggling table technique. The CTP examination consisted of a time series of 15 3D images (2x64x0.625 mm; 80 kV; 150 mAs each) with an interval of 4 s. The authors measured the CNR in images obtained with weighted averaging, images obtained with plain averaging, and images with maximal arterial enhancement. The authors also compared CNR and quality of the images with that of regular CTA examinations and examined the effectiveness of automatic vein masking in MIP images. The CNR of the weighted averaged images is, on the average, 1.73 times the CNR of an image at maximal arterial enhancement in the CTP series, where the use of plain averaging

  8. Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance

    SciTech Connect

    Yamakado, Koichiro Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

    2010-02-15

    This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 {+-} 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 {+-} 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

  9. Multidetector CT in emergency radiology: acute and generalized non-traumatic abdominal pain.

    PubMed

    Paolantonio, Pasquale; Rengo, Marco; Ferrari, Riccardo; Laghi, Andrea

    2016-05-01

    Multidetector CT (MDCT) is an imaging technique that provides otherwise unobtainable information in the diagnostic work-up of patients presenting with acute abdominal pain. A correct working diagnosis depends essentially on understanding the individual patient's clinical data and laboratory findings. In haemodynamically stable patients with acute severe and generalized abdominal pain, MDCT is now the preferred imaging test and gives invaluable diagnostic information, also in unstable patients after stabilization. In this descriptive review, we focus our attention on acute, severe and generalized or undifferentiated non-traumatic abdominal pain. The main differential diagnoses are acute pancreatitis, gastrointestinal perforation, ruptured abdominal aneurysm and acute mesenteric ischaemia. We will provide radiologist readers with a technical guide to optimize MDCT imaging protocols and list the major CT signs essential to reach a correct diagnosis and guide the best treatment. PMID:26689097

  10. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report

    PubMed Central

    Ito, Eisaku; Yoshida, Masashi; Nakashima, Keigo; Suzuki, Norihiko; Imakita, Tomonori; Tsutsui, Nobuhiro; Ohdaira, Hironori; Kitajima, Masaki; Suzuki, Yutaka

    2016-01-01

    Introduction Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a complication. To avoid ECF, we used computed tomography (CT) woundgraphy to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT. Case presentation Following a laparoscopic intersphincteric resection for low rectal neuroendocrine tumor and covering ileostomy, a 59-year-old woman underwent stoma closure. Six days after surgery, we diagnosed SSI. We suspected ECF, because the wound was deep and the pus resembled enteric fluid. However, CT woundgraphy showed that the wound was separated from the abdominal cavity and the intestine by the abdominal rectus muscle. Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty-three days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized. Discussion Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment. One good method is CT woundgraphy, which evaluates wound extent and depth, closure of muscle fascia, and the relationship between the wound and the intestine. Conclusion We report a case of CT woundgraphy before NPWT for abdominal SSI. CT woundgraphy is a good candidate for evaluating wound condition. PMID:27002290

  11. Comparative analysis of the radiation shield effect in an abdominal CT scan

    NASA Astrophysics Data System (ADS)

    Kim, Seon-Chil; Kim, Young-Jae; Lee, Joon-Seok; Dong, Kyung-Rae; Chung, Woon-Kwan; Lim, Chang-Seon

    2014-03-01

    This study measured and compared the dose on the eyeballs and the thyroid with and without the use of a shield by applying the abdominal examination protocol used in an actual examination to a 64-channel computed tomography (CT) scan. A dummy phantom manufactured from acryl was used to measure the dose to the eyeballs and the thyroid of a patient during a thoraco-abdominal CT scan. The dose was measured using three dosimeters (optically-stimulated luminescence dosimeter (OSLD), thermoluminescence dosimeter (TLD) and photoluminescence dosimeter (PLD)) attached to the surfaces of three parts (left and right eyeballs and thyroid) in a phantom with and without the use of a shield for the eyeballs and the thyroid. Two types of shields (1-mm barium shielding sheet and 1-mm tungsten shielding sheet) were used for the measurements. The goggles and the lead shield, which are normally used in clinical practice, were used to compare the shield ratios of the shields. According to the results of the measurements made by using the OSLD, the shield ratios of the barium and the tungsten sheets were in the range of 34-36%. The measurements made by using the TLD showed that the shield ratio of the barium sheet was 6.25% higher than that of the tungsten sheet. When the PLD was used for the measurement, the shield ratio of the barium sheet was 33.34%, which was equivalent to that of the tungsten sheet. These results confirmed that the cheap barium sheet had a better shielding effect than the expensive tungsten sheet.

  12. A reappraisal of adult thoracic and abdominal surface anatomy via CT scan in Chinese population.

    PubMed

    Shen, Xin-Hua; Su, Bai-Yan; Liu, Jing-Juan; Zhang, Gu-Muyang; Xue, Hua-Dan; Jin, Zheng-Yu; Mirjalili, S Ali; Ma, Chao

    2016-03-01

    Accurate surface anatomy is essential for safe clinical practice. There are numerous inconsistencies in clinically important surface markings among and within contemporary anatomical reference texts. The aim of this study was to investigate key thoracic and abdominal surface anatomy landmarks in living Chinese adults using computed tomography (CT). A total of 100 thoracic and 100 abdominal CT scans were examined. Our results indicated that the following key surface landmarks differed from current commonly-accepted descriptions: the positions of the tracheal bifurcation, azygos vein termination, and pulmonary trunk bifurcation (all below the plane of the sternal angle at vertebral level T5-T6 in most individuals); the superior vena cava formation and junction with the right atrium (most often behind the 1st and 4th intercostal spaces, respectively); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T10 and T11, respectively). The renal arteries were most commonly at L1; the midpoint of the renal hila was most frequently at L2; the 11th rib was posterior to the left kidney in only 29% of scans; and the spleen was most frequently located between the 10th and 12th ribs. A number of significant sex- and age-related differences were noted. The Chinese population was also compared with western populations on the basis of published reports. Reappraisal of surface anatomy using modern imaging tools in vivo will provide both quantitative and qualitative evidence to facilitate the clinical application of these key surface landmarks. Clin. Anat. 29:165-174, 2016. © 2015 Wiley Periodicals, Inc. PMID:26032163

  13. Reliability and Validity of Modified Algometer in Abdominal Examination

    PubMed Central

    Ko, Seok-Jae; Kim, Honggeol; Kim, Seul-Ki; Park, Kyungmo; Lee, Jeungchan; Lee, Beom-Joon; Oh, Jayoung; Lee, Kyungjin; Park, Jae-Woo

    2016-01-01

    Objective. Abdominal examination (AE) is one of the essential diagnostic methods in traditional Korean medicine that has been widely used for deciding treatment, cause, and prognosis of the disease. AE majorly depends on the experience of practitioners; therefore, standardization and quantification of AE are desperately needed. However, few studies have tried to objectify AE and established its standard. We assessed the reliability and validity of newly developed diagnostic device for AE called modified algometer (MA). Methods. Thirty-six subjects with functional dyspepsia were allocated into one of 2 groups according to gold standard of AE: epigastric discomfort without tenderness (n = 23) group or epigastric discomfort with tenderness (n = 13) group. Pressure pain threshold was evaluated at participants' epigastric region with algometer and MA. We assessed reliability and validity (sensitivity and specificity) and calculated optimal cutoff value. Results. MA showed high intertrial reliability (ICC 0.849; 0.703–0.923; P < 0.000) and validity (sensitivity: 76.92%; specificity: 60.87%), and cutoff value was 330.0 mmHg. Algometer and MA showed moderate correlation (r = 0.583, P ≤ 0.000). Conclusion. MA can be reliable and valid diagnostic device for AE and has the possibility of practical use for quantification and standardization of AE. PMID:27073401

  14. Emerging Techniques for Dose Optimization in Abdominal CT

    PubMed Central

    Platt, Joel F.; Goodsitt, Mitchell M.; Al-Hawary, Mahmoud M.; Maturen, Katherine E.; Wasnik, Ashish P.; Pandya, Amit

    2014-01-01

    Recent advances in computed tomographic (CT) scanning technique such as automated tube current modulation (ATCM), optimized x-ray tube voltage, and better use of iterative image reconstruction have allowed maintenance of good CT image quality with reduced radiation dose. ATCM varies the tube current during scanning to account for differences in patient attenuation, ensuring a more homogeneous image quality, although selection of the appropriate image quality parameter is essential for achieving optimal dose reduction. Reducing the x-ray tube voltage is best suited for evaluating iodinated structures, since the effective energy of the x-ray beam will be closer to the k-edge of iodine, resulting in a higher attenuation for the iodine. The optimal kilovoltage for a CT study should be chosen on the basis of imaging task and patient habitus. The aim of iterative image reconstruction is to identify factors that contribute to noise on CT images with use of statistical models of noise (statistical iterative reconstruction) and selective removal of noise to improve image quality. The degree of noise suppression achieved with statistical iterative reconstruction can be customized to minimize the effect of altered image quality on CT images. Unlike with statistical iterative reconstruction, model-based iterative reconstruction algorithms model both the statistical noise and the physical acquisition process, allowing CT to be performed with further reduction in radiation dose without an increase in image noise or loss of spatial resolution. Understanding these recently developed scanning techniques is essential for optimization of imaging protocols designed to achieve the desired image quality with a reduced dose. © RSNA, 2014 PMID:24428277

  15. Interaction of expanding abdominal aortic aneurysm with surrounding tissue: Retrospective CT image studies

    PubMed Central

    Kwon, Sebastian T.; Burek, William; Dupay, Alexander C.; Farsad, Mehdi; Baek, Seungik; Park, Eun-Ah; Lee, Whal

    2015-01-01

    Objectives Abdominal aortic aneurysms (AAA) that rupture have a high mortality rate. Rupture occurs when local mechanical stress exceeds the local mechanical strength of an AAA, so stress profiles such as those from finite element analysis (FEA) are useful. The role and effect of surrounding tissues, like the vertebral column, which have not been extensively studied, are examined in this paper. Methods Longitudinal CT scans from ten patients with AAAs were studied to see the effect of surrounding tissues on AAAs. Segmentation was performed to distinguish the AAA from other tissues and we studied how these surrounding tissues affected the shape and curvature of the AAA. Previously established methods by Veldenz et al. were used to split the AAA into 8 sections and examine the specific effects of surrounding tissues on these sections [1]. Three-dimensional models were created to better examine these effects over time. Registration was done in order to compare AAAs longitudinally. Results The vertebral column and osteophytes were observed to have been affecting the shape and the curvature of the AAA. Interaction with the spine caused focal flattening in certain areas of the AAA. In 16 of the 41 CT scans, the right posterior dorsal section (section 5), had the highest radius of curvature, which was by far the section that had the maximum radius for a specified CT scan. Evolution of the growing AAA showed increased flattening in this section when comparing the last CT scan to the first scan. Conclusion Surrounding tissues have a clear influence on the geometry of an AAA, which may in turn affect the stress profile of AAA. Incorporating these structures in FEA and G&R models will provide a better estimate of stress. Clinical Relevance Currently, size is the only variable considered when deciding whether to undergo elective surgery to repair AAA since it is an easy enough measure for clinicians to utilize. However, this may not be the best indicator of rupture risk

  16. Assessing the prevalence and clinical relevance of positive abdominal and pelvic CT findings in senior patients presenting to the emergency department.

    PubMed

    Alabousi, Abdullah; Patlas, Michael N; Meshki, Malek; Monteiro, Sandra; Katz, Douglas S

    2016-04-01

    The purpose of our study was to retrospectively evaluate the prevalence and clinical relevance of positive abdominal and pelvic CT findings for patients 65 years of age and older, when compared with all other scanned adult Emergency Department (ED) patients, at a single tertiary care hospital. Our hypothesis was that there is an increased prevalence and clinical relevance of positive abdominal/pelvic CT findings in senior patients. A research ethics board-approved retrospective review of all adult patients who underwent an emergency CT of the abdomen and pelvis for acute nontraumatic abdominal and/or pelvic signs and symptoms was performed. Two thousand one hundred two patients between October 1, 2011, and September 30, 2013, were reviewed. Six hundred thirty-one patients were included in the <65 group (298 men and 333 women; mean age 46, age range 18-64), and 462 were included in the >65 group (209 men and 253 women; mean age 77.6, age range 65-99). Overall, there were more positive CT findings for patients <65 (389 positive cases, 61.6 %) compared with the >65 group (257 positive cases, 55.6 %), which was a statistically significant difference (p < 0.03). Moreover, with the exception of complicated appendicitis cases, which were more common in the >65 group, there were no statistically significant differences in the clinical/surgical relevance of the positive CT findings between the two groups. The findings of our retrospective study therefore refute our hypothesis that there is an increased prevalence of positive abdominal CT findings in patients >65. This may be related to ED physicians at our institution being more hesitant to order CT examinations for the younger population, presumably due to radiation concerns. However, older patients in our series were more likely to present with complicated appendicitis, and a lower threshold for ordering CT examinations of the abdomen and pelvis in this patient population should therefore be considered. PMID

  17. Computer-Aided Diagnosis of Splenic Enlargement Using Wave Pattern of Spleen in Abdominal CT Images: Initial Observations

    NASA Astrophysics Data System (ADS)

    Seong, Won; Cho, June-Sik; Noh, Seung-Moo; Park, Jong-Won

    In general, the spleen accompanied by abnormal abdomen is hypertrophied. However, if the spleen size is originally small, it is hard to detect the splenic enlargement due to abnormal abdomen by simply measure the size. On the contrary, the spleen size of a person having a normal abdomen may be large by nature. Therefore, measuring the size of spleen is not a reliable diagnostic measure of its enlargement or the abdomen abnormality. This paper proposes an automatic method to diagnose the splenic enlargement due to abnormality, by examining the boundary pattern of spleen in abdominal CT images.

  18. Evaluation of organ doses in CT examinations with an infant anthropomorphic phantom.

    PubMed

    Fujii, K; Akahane, K; Miyazaki, O; Horiuchi, T; Shimada, A; Nagmatsu, H; Yamauchi, M; Yamauchi-Kawaura, C; Kawasaki, T

    2011-09-01

    The aim of this study is to evaluate organ doses in infant CT examinations with multi-detector row CT scanners. Radiation doses were measured with radiophotoluminescence glass dosemeters set in various organ positions within a 1-y-old child anthropomorphic phantom and organ doses were evaluated from the measurement values. Doses for tissues or organs within the scan range were 28-36 mGy in an infant head CT, 3-11 mGy in a chest CT, 5-11 mGy in an abdominal-pelvic CT and 2-14 mGy in a cardiac CT. The doses varied by the differences in the types of CT scanners and scan parameters used at each medical facility. Compared with those for children of various ages, the doses in an infant CT protocol were found to be similar to or slightly smaller than those in a paediatric CT for 5- or 6-y-old children. PMID:21743079

  19. Incidentalomas associated with abdominal and pelvic CT angiograms for abdominal-based breast free flap reconstruction.

    PubMed

    Ho, Olivia A; Bagher, Shaghayegh; Jaskolka, Jeff; Tan, Marcus; Butler, Kate; O'Neill, Anne C; Zhong, Toni; Hofer, Stefan O

    2016-05-01

    Computed tomography angiography (CTA) is routinely performed prior to breast reconstruction using deep inferior epigastric perforator (DIEP) flaps to provide better surgical planning and improve preoperative decision making. These investigations occasionally result in unexpected findings in otherwise asymptomatic women. Unexpected findings on imaging in a population of women with previous breast cancer or strong breast cancer risk factors can lead to undue stress and anxiety. The aim of this study is to determine the incidence of unexpected findings in preoperative CT angiograms and to correlate these with patient and breast cancer characteristics. A retrospective chart review from May 2008 to December 2012 was performed reviewing all patients who underwent DIEP flap breast reconstruction. Radiology reports of their preoperative CT angiograms, details of unexpected findings, patients' past medical and cancer history, additional radiological investigations, outcomes, and interventions were reviewed. In total, 360 patients met the inclusion criteria for the study. Sixty-four percent of the patients who underwent CTA imaging had incidental findings. Further imaging was suggested in 48% of this group. The most common incidentalomas were hepatic (47%), bone (24%), and renal (20%). "Incidentalomas" were associated with patients' underlying comorbidities (p = 0.001) and age (p = 0.01). "Radiographically suspicious incidentalomas" were associated with the underlying comorbidities (p = 0.001). The radiologists most commonly suggested investigation methods such as ultrasound (41%), another CT (28%), bone scan (21%), and magnetic resonance imaging (MRI; 14%). No incidentalomas were found to be malignant on further recommended investigation in this study and no breast cancer reconstruction was delayed as a result of the discovery of incidentalomas or their subsequent investigations. It is important to counsel patients of the possibility of incidental findings and the

  20. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

    PubMed

    Scheinfeld, Meir H; Mahadevia, Soham; Stein, Evan G; Freeman, Katherine; Rozenblit, Alla M

    2010-09-01

    We sought to determine whether laboratory parameters could be found, predictive of a negative abdominal CT scan in young adults with nontraumatic abdominal pain. Following institutional review board approval, we evaluated CT reports of 522 patients, aged 21-35 years old, who presented to the Emergency Department with nontraumatic abdominal pain. Bivariate analyses relating ten laboratory parameters to whether the CT detected a cause for abdominal pain were conducted. A multivariate logistic regression model was then derived, with all variables in the final model significant at p < 0.05. Variables were dichotomized to yield odds ratios and 95% confidence intervals. Of the 522 patients meeting inclusion criteria, 45% had a cause for pain demonstrated by CT. Predictors of a negative CT in men were normal hematocrit and negative urine blood (p = 0.045, p = 0.016, respectively), and in women normal hematocrit, granulocyte percent, and alkaline phosphatase (p = 0.023, p = 0.039, p < 0.0001, respectively). When standard normal values were used to calculate descriptive statistics, only granulocyte percent in women had a significant confidence interval (odds ratio 2.5, confidence interval 1.6-4.0). Among the 208 women with normal granulocyte percent, the final clinical diagnosis was appendicitis, cholecystitis, and diverticulitis, in three, three, and two cases, respectively (4% combined). In summary, no laboratory test was sufficient to offer reassurance that a CT is not necessary in a young adult patient with nontraumatic abdominal pain. Alternative strategies should be considered to decrease the use of CT, and its associated radiation exposure, in young adults with nontraumatic abdominal pain. PMID:20306104

  1. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    SciTech Connect

    Moon, K.L. Jr.; Federle, M.P.; Abrams, D.I.; Volberding, P.; Lewis, B.J.

    1984-02-01

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease.

  2. [Application of computed tomography (CT) examination for forensic medicine].

    PubMed

    Urbanik, Andrzej; Chrzan, Robert

    2013-01-01

    The aim of the study is to present a own experiences in usage of post mortem CT examination for forensic medicine. With the help of 16-slice CT scanner 181 corpses were examined. Obtained during acquisition imaging data are later developed with dedicated programmes. Analyzed images were extracted from axial sections, multiplanar reconstructions as well as 3D reconstructions. Gained information helped greatly when classical autopsy was performed by making it more accurate. A CT scan images recorded digitally enable to evaluate corpses at any time, despite processes of putrefaction or cremation. If possible CT examination should precede classical autopsy. PMID:23944089

  3. CT Hounsfield Numbers of Soft Tissues on Unenhanced Abdominal CT Scans: Variability Between Two Different Manufacturers’ MDCT Scanners

    PubMed Central

    Lamba, Ramit; McGahan, John P.; Corwin, Michael T.; Li, Chin-Shang; Tran, Tien; Seibert, J. Anthony; Boone, John M.

    2016-01-01

    OBJECTIVE The purpose of this study is to determine whether Hounsfield numbers of soft tissues on unenhanced abdominal CT of the same patient vary on repeat scans done on two different manufacturers’ MDCT scanners. MATERIALS AND METHODS A database search was performed to identify patients older than 18 years who underwent unenhanced CT of the abdomen and pelvis performed both on a Volume CT (GE Healthcare) and a Definition AS Plus (Siemens Healthcare) 64-MDCT scanner within 12 months of each other. After excluding those patients for whom Hounsfield unit measurements would be affected by mitigating factors, 48 patients (mean age, 58.8 years) were identified. Hounsfield unit measurements were obtained in nine different soft-tissue anatomic locations on each scan, and the location of these sites was kept identical on each scan pair. Data were analyzed to evaluate Hounsfield unit differences between these scanners. RESULTS In general, there was a low consistency in the Hounsfield unit measurements for each of these sites on scans obtained by the two scanners, with the subcutaneous fat in the left posterolateral flank showing the lowest correlation (intraclass correlation coefficient, 0.198). There were differences in the Hounsfield unit measurements obtained in all anatomic sites on scans obtained by both scanners. Mean Hounsfield unit measurements obtained on the Definition AS Plus scanner were lower than those obtained on the Volume CT scanner, with the intriguing exception of the anterior midline subcutaneous fat Hounsfield unit measurements, which were higher on the Definition AS Plus scanner. All differences were statistically significant (p < 0.05). CONCLUSION Hounsfield unit measurements for unenhanced abdominal soft tissues of the same patient vary between scanners of two common MDCT manufacturers. PMID:25341139

  4. Radiation dose reduction with application of non-linear adaptive filters for abdominal CT

    PubMed Central

    Singh, Sarabjeet; Kalra, Mannudeep K; Sung, Mi Kim; Back, Anni; Blake, Michael A

    2012-01-01

    AIM: To evaluate the effect of non-linear adaptive filters (NLAF) on abdominal computed tomography (CT) images acquired at different radiation dose levels. METHODS: Nineteen patients (mean age 61.6 ± 7.9 years, M:F = 8:11) gave informed consent for an Institutional Review Board approved prospective study involving acquisition of 4 additional image series (200, 150, 100, 50 mAs and 120 kVp) on a 64 slice multidetector row CT scanner over an identical 10 cm length in the abdomen. The CT images acquired at 150, 100 and 50 mAs were processed with the NLAF. Two radiologists reviewed unprocessed and processed images for image quality in a blinded randomized manner. CT dose index volume, dose length product, patient weight, transverse diameters, objective noise and CT numbers were recorded. Data were analyzed using Analysis of Variance and Wilcoxon signed rank test. RESULTS: Of the 31 lesions detected in abdominal CT images, 28 lesions were less than 1 cm in size. Subjective image noise was graded as unacceptable in unprocessed images at 50 and 100 mAs, and in NLAF processed images at 50 mAs only. In NLAF processed images, objective image noise was decreased by 21% (14.4 ± 4/18.2 ± 4.9) at 150 mAs, 28.3% (15.7 ± 5.6/21.9 ± 4) at 100 mAs and by 39.4% (18.8 ± 9/30.4 ± 9.2) at 50 mAs compared to unprocessed images acquired at respective radiation dose levels. At 100 mAs the visibility of smaller structures improved from suboptimal in unprocessed images to excellent in NLAF processed images, whereas diagnostic confidence was respectively improved from probably confident to fully confident. CONCLUSION: NLAF lowers image noise, improves the visibility of small structures and maintains lesion conspicuity at down to 100 mAs for abdominal CT. PMID:22328968

  5. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

    PubMed Central

    Miano, Danielle I.; Silvis, Renee M.; Popp, Jill M.; Culbertson, Marvin C.; Campbell, Brendan; Smith, Sharon R.

    2015-01-01

    Introduction Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US) or computed tomography (CT) studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods We conducted a retrospective chart review including emergency department (ED) and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4]) compared to those without (57%, 95% CI [52.9,61.0]). Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7]) and those without (13%, 95% CI [10.3,15.7]). The proportion of children with a

  6. CT-SPECT fusion to correlate radiolabeled monoclonal antibody uptake with abdominal CT findings

    SciTech Connect

    Kramer, E.L.; Noz, M.E.; Sanger, J.J.; Megibow, A.J.; Maguire, G.Q. )

    1989-09-01

    To enhance the information provided by computed tomography (CT) and single photon emission computed tomography (SPECT) performed with radiolabeled, anti-carcinoembryonic antigen monoclonal antibody (MoAb), the authors performed fusion of these types of images from eight subjects with suspected colorectal adenocarcinoma. Section thickness and pixel size of the two studies were matched, coordinates of corresponding points from each study were identified, and CT sections were translated, rotated, and reprojected to match the corresponding SPECT scans. The CT-SPECT fusion enabled identification of anatomic sites of tumor-specific MoAb accumulation in four cases, showed non-specific MoAb accumulation in two, and helped confirm information only suggested by the two studies separately in one.

  7. Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports

    PubMed Central

    Andersen, Jack Gunnar; Stokke, Mali Victoria; Tennstrand, Anne Lise; Aamodt, Rolf; Heggelund, Thomas; Dahl, Fredrik A; Sandbæk, Gunnar; Hurlen, Petter

    2016-01-01

    Background Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Consultant radiologists in Norwegian hospitals frequently request second reads by colleagues in real time. Our objective was to estimate the frequency of clinically important changes to radiology reports produced by these prospectively obtained double readings. Methods We retrospectively compared the preliminary and final reports from 1071 consecutive double-read abdominal CT examinations of surgical patients at five public hospitals in Norway. Experienced gastrointestinal surgeons rated the clinical importance of changes from the preliminary to final report. The severity of the radiological findings in clinically important changes was classified as increased, unchanged or decreased. Results Changes were classified as clinically important in 146 of 1071 reports (14%). Changes to 3 reports (0.3%) were critical (demanding immediate action), 35 (3%) were major (implying a change in treatment) and 108 (10%) were intermediate (requiring further investigations). The severity of the radiological findings was increased in 118 (81%) of the clinically important changes. Important changes were made less frequently when abdominal radiologists were first readers, more frequently when they were second readers, and more frequently to urgent examinations. Conclusion A 14% rate of clinically important changes made during double reading may justify quality assurance of radiological interpretation. Using expert second readers and a targeted selection of urgent cases and radiologists reading outside their specialty may increase the yield of discrepant cases. PMID:27013638

  8. A 54-Year-Old Man Presenting With an Abnormal Abdominal CT Scan 8 Months After Double Lung Transplant.

    PubMed

    Mistrot, Daniel P; Gemma, Vincent A; Gagliano, Ronald A; Omar, Ashraf; Panchabhai, Tanmay S

    2016-05-01

    A 54-year-old man who had undergone bilateral sequential lung transplant for idiopathic pulmonary fibrosis was admitted to the hospital for further evaluation of an abnormal abdominal CT scan. Three months previously a gastrojejunostomy tube had been placed after he was found to have evidence of silent aspiration with oral intake. At a recent clinic visit, he denied abdominal pain or problems with the feeding tube. He described frequent diarrhea since placement of the feeding tube. PMID:27157231

  9. Pancreas segmentation from 3D abdominal CT images using patient-specific weighted subspatial probabilistic atlases

    NASA Astrophysics Data System (ADS)

    Karasawa, Kenichi; Oda, Masahiro; Hayashi, Yuichiro; Nimura, Yukitaka; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Rueckert, Daniel; Mori, Kensaku

    2015-03-01

    Abdominal organ segmentations from CT volumes are now widely used in the computer-aided diagnosis and surgery assistance systems. Among abdominal organs, the pancreas is especially difficult to segment because of its large individual differences of the shape and position. In this paper, we propose a new pancreas segmentation method from 3D abdominal CT volumes using patient-specific weighted-subspatial probabilistic atlases. First of all, we perform normalization of organ shapes in training volumes and an input volume. We extract the Volume Of Interest (VOI) of the pancreas from the training volumes and an input volume. We divide each training VOI and input VOI into some cubic regions. We use a nonrigid registration method to register these cubic regions of the training VOI to corresponding regions of the input VOI. Based on the registration results, we calculate similarities between each cubic region of the training VOI and corresponding region of the input VOI. We select cubic regions of training volumes having the top N similarities in each cubic region. We subspatially construct probabilistic atlases weighted by the similarities in each cubic region. After integrating these probabilistic atlases in cubic regions into one, we perform a rough-to-precise segmentation of the pancreas using the atlas. The results of the experiments showed that utilization of the training volumes having the top N similarities in each cubic region led good results of the pancreas segmentation. The Jaccard Index and the average surface distance of the result were 58.9% and 2.04mm on average, respectively.

  10. Is clinical examination an accurate indicator of raised intra-abdominal pressure in critically injured patients?

    PubMed Central

    Kirkpatrick, Andrew W.; Brenneman, Frederick D.; McLean, Richard F.; Rapanos, Theodore; Boulanger, Bernard R.

    2000-01-01

    Objectives To determine the rate of elevated intra-abdominal pressure (IAP) and to evaluate the accuracy of clinical abdominal examination in the assessment of IAP in the critically injured trauma patient. Design A prospective blinded study. Setting The medical-surgical critical care unit of a university-affiliated regional adult trauma centre. Patients Forty-two adult blunt trauma victims, who had a mean injury severity score of 36. Interventions Urinary bladder pressure was measured daily and classified as normal (10 mm Hg or less), elevated (more than 10 mm Hg) or significantly elevated (more than 15 mm Hg). A blinded clinical assessment of abdominal pressure was concurrently performed and recorded as elevated or normal. Main outcome measures The sensitivity, specificity and accuracy and the positive and negative predictive values of the 2 interventions in identifying elevated IAP. Results Twenty-one patients (50%) had an elevated IAP at some point during the study. Of the 147 bladder pressure measurements done in these 42 patients, 47 (32%) were more than 10 mm Hg and 16 (11%) were more than 15 mm Hg. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical abdominal examination for identifying elevated IAP were 40%, 94%, 76%, 77% and 77%, respectively. Clinical abdominal examination had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 56%, 87%, 35%, 94% and 84% respectively, for significantly elevated IAP. Conclusions Urinary bladder pressure was commonly elevated among our population of critically injured adults. Compared with bladder pressure measurements, clinical abdominal assessment showed poor sensitivity and accuracy for elevated IAP. These findings suggest that more routine measurements of bladder pressure in patients at risk for intra-abdominal hypertension should be performed. PMID:10851415

  11. Development of automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans

    NASA Astrophysics Data System (ADS)

    Mensink, Sanne D.; Spliethoff, Jarich W.; Belder, Ruben; Klaase, Joost M.; Bezooijen, Roland; Slump, Cornelis H.

    2011-03-01

    This contribution describes a novel algorithm for the automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans of patients referred for colorectal resection. Visceral and subcutaneous adipose tissue volumes can accurately be measured with errors of 1.2 and 0.5%, respectively. Also the reproducibility of CT measurements is good; a disadvantage is the amount of radiation. In this study the diagnostic CT scans in the work - up of (colorectal) cancer were used. This implied no extra radiation. For the purpose of segmentation alone, a low dose protocol can be applied. Obesity is a well known risk factor for complications in and after surgery. Body Mass Index (BMI) is a widely accepted indicator of obesity, but it is not specific for risk assessment of colorectal surgery. We report on an automated method to quantify visceral and subcutaneous adipose tissue volumes as a basic step in a clinical research project concerning preoperative risk assessment. The outcomes are to be correlated with the surgery results. The hypothesis is that the balance between visceral and subcutaneous adipose tissue together with the presence of calcifications in the major bloodvessels, is a predictive indicator for post - operatieve complications such as anastomotic leak. We start with four different computer simulated humanoid abdominal volumes with tissue values in the appropriate Hounsfield range at different dose levels. With satisfactory numerical results for this test, we have applied the algorithm on over a 100 patient scans and have compared results with manual segmentations by an expert for a smaller pilot group. The results are within a 5% difference. Compared to other studies reported in the literature, reliable values are obtained for visceral and subcutaneous adipose tissue areas.

  12. Efficient Abdominal Segmentation on Clinically Acquired CT with SIMPLE Context Learning

    PubMed Central

    Xu, Zhoubing; Burke, Ryan P.; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-01-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining. PMID:25914506

  13. Efficient abdominal segmentation on clinically acquired CT with SIMPLE context learning

    NASA Astrophysics Data System (ADS)

    Xu, Zhoubing; Burke, Ryan P.; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining.

  14. Abdominal Kaposiform Hemangioendothelioma Associated With Lymphangiomatosis Involving Mesentery and Ileum: A Case Report of MRI, CT, and 18F-FDG PET/CT Findings.

    PubMed

    Dong, Aisheng; Zhang, Ling; Wang, Yang; He, Tianlin; Zuo, Changjing

    2016-02-01

    Kaposiform hemangioendothelioma (KH) is a rare vascular tumor of intermediate malignancy that occurs mainly in the childhood. Adult patients with KH are rare. Imaging findings of KH have rarely been reported before. We present magnetic resonance imaging (MRI), computed tomography (CT), and fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/CT findings in an adult patient with KH associated with lymphangiomatosis involving mesentery and ileum.A 22-year-old female complained of a 9-month history of intermittent melena, weakness, and palpitation. Laboratory tests revealed anemia and hypoproteinemia. Fecal occult blood test was positive. Abdominal enhanced MRI and CT showed a large abdominal mass involving mesentery and ileum. On enhanced MRI, there were many hypervascular nodules in the mass. On FDG PET/CT, the mass and the nodules showed slight FDG uptake. Small bowel capsule endoscopy showed numerous grape-shaped red nodules in the luminal wall of the involved ileum. The patient underwent resection of the abdominal mass and a segment of the ileum invaded by the abdominal mass. KH arising within lymphangiomatosis involving mesentery and ileum was confirmed by pathology. After surgery, the patient's symptoms improved.This is the first case of KH associated with lymphangiomatosis involving mesentery and ileum. In this case, the lymphangiomatosis overshadowed the small tumor nodules resulting in unusual imaging findings. Familiarity with these imaging findings is helpful for diagnosis and differential diagnosis of KH. PMID:26871848

  15. CFD Modelling of Abdominal Aortic Aneurysm on Hemodynamic Loads Using a Realistic Geometry with CT

    PubMed Central

    Ng, E. Y. K.; Loong, T. H.; Bordone, Maurizio; Pua, Uei; Narayanan, Sriram

    2013-01-01

    The objective of this study is to find a correlation between the abdominal aortic aneurysm (AAA) geometric parameters, wall stress shear (WSS), abdominal flow patterns, intraluminal thrombus (ILT), and AAA arterial wall rupture using computational fluid dynamics (CFD). Real AAA 3D models were created by three-dimensional (3D) reconstruction of in vivo acquired computed tomography (CT) images from 5 patients. Based on 3D AAA models, high quality volume meshes were created using an optimal tetrahedral aspect ratio for the whole domain. In order to quantify the WSS and the recirculation inside the AAA, a 3D CFD using finite elements analysis was used. The CFD computation was performed assuming that the arterial wall is rigid and the blood is considered a homogeneous Newtonian fluid with a density of 1050 kg/m3 and a kinematic viscosity of 4 × 10−3 Pa·s. Parallelization procedures were used in order to increase the performance of the CFD calculations. A relation between AAA geometric parameters (asymmetry index (β), saccular index (γ), deformation diameter ratio (χ), and tortuosity index (ε)) and hemodynamic loads was observed, and it could be used as a potential predictor of AAA arterial wall rupture and potential ILT formation. PMID:23864906

  16. A new method for detecting colonic polyps based on local intensity structure analysis from 3D abdominal CT images

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Nakada, Yuichi; Kitasaka, Takayuki; Mori, Kensaku; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru

    2007-03-01

    This paper presents a new method for detecting colonic polyps from abdominal CT images based on Hessian matrix analysis. Recently, virtual colonoscopy (VC) has widely received attention as a new and less-invasive colon diagnostic method. A physician diagnoses the inside of the colon using a virtual colonoscopy system. However, since the colon has many haustra and its shape is long and convoluted, a physician has to change viewpoints and viewing directions of the virtual camera many times while diagnosing. Lesions behind haustra may be overlooked. Thus this paper proposes an automated colonic polyp detection method from 3D abdominal CT images. Colonic polyps are located on the colonic wall, and their CT values are higher than colonic lumen regions. In addition, CT values inside polyps tend to gradually increase from outward to inward (blob-like structure). We employ a blob structure enhancement filter based on the eigenvalues of a Hessian matrix to detect polyps with the above blob-shaped characteristics. For reducing FPs, we eliminate polyp candidate regions in which the maximum output value of the blob structure enhancement filter is smaller than given threshold values. Also small regions are removed from candidates. We applied the proposed method to 23 cases of abdominal CT images. Overall, 74.4% of the polyps were detected with 3.8 FPs per case.

  17. Abdominal Imaging with Contrast-enhanced Photon-counting CT: First Human Experience.

    PubMed

    Pourmorteza, Amir; Symons, Rolf; Sandfort, Veit; Mallek, Marissa; Fuld, Matthew K; Henderson, Gregory; Jones, Elizabeth C; Malayeri, Ashkan A; Folio, Les R; Bluemke, David A

    2016-04-01

    Purpose To evaluate the performance of a prototype photon-counting detector (PCD) computed tomography (CT) system for abdominal CT in humans and to compare the results with a conventional energy-integrating detector (EID). Materials and Methods The study was HIPAA-compliant and institutional review board-approved with informed consent. Fifteen asymptomatic volunteers (seven men; mean age, 58.2 years ± 9.8 [standard deviation]) were prospectively enrolled between September 2 and November 13, 2015. Radiation dose-matched delayed contrast agent-enhanced spiral and axial abdominal EID and PCD scans were acquired. Spiral images were scored for image quality (Wilcoxon signed-rank test) in five regions of interest by three radiologists blinded to the detector system, and the axial scans were used to assess Hounsfield unit accuracy in seven regions of interest (paired t test). Intraclass correlation coefficient (ICC) was used to assess reproducibility. PCD images were also used to calculate iodine concentration maps. Spatial resolution, noise-power spectrum, and Hounsfield unit accuracy of the systems were estimated by using a CT phantom. Results In both systems, scores were similar for image quality (median score, 4; P = .19), noise (median score, 3; P = .30), and artifact (median score, 1; P = .17), with good interrater agreement (image quality, noise, and artifact ICC: 0.84, 0.88, and 0.74, respectively). Hounsfield unit values, spatial resolution, and noise-power spectrum were also similar with the exception of mean Hounsfield unit value in the spinal canal, which was lower in the PCD than the EID images because of beam hardening (20 HU vs 36.5 HU; P < .001). Contrast-to-noise ratio of enhanced kidney tissue was improved with PCD iodine mapping compared with EID (5.2 ± 1.3 vs 4.0 ± 1.3; P < .001). Conclusion The performance of PCD showed no statistically significant difference compared with EID when the abdomen was evaluated in a conventional scan mode. PCD provides

  18. Three-Dimensional Ultrasound-Based Navigation Combined with Preoperative CT During Abdominal Interventions: A Feasibility Study

    SciTech Connect

    Kaspersen, J.H. Sjolie, E.; Wesche, J.; Asland, J.; Lundbom, J.; Odegard, A.; Lindseth, F.; Nagelhus Hernes, T.A.

    2003-08-15

    Purpose: Three-dimensional (3D)intraoperative ultrasound may be easier to interpret when used in combination with less noisy preoperative image data such as CT. The purpose of this study was to evaluate the use of preoperative image data in a 3D ultrasound-based navigation system specially designed for minimally invasive abdominal surgery. A prototype system has been tested in patients with aortic aneurysms undergoing clinical assessment before and after abdominal aortic stent-graft implantation. Methods: All patients were first imaged by spiral CT followed by 3D ultrasound scanning. The CT volume was registered to the patient using fiducial markers. This enabled us to compare corresponding slices from 3D ultrasound and CT volumes. The accuracy of the patient registration was evaluated both using the external fiducial markers (artificial landmarks glued on the patient's skin) and using intraoperative 3D ultrasound as a measure of the true positioning of anatomic landmarks inside the body. Results: The mean registration accuracy on the surface was found to be 7.1 mm, but increased to 13.0 mm for specific landmarks inside the body. CT and ultrasound gave supplementary information of surrounding structures and position of the patient's anatomy. Fine-tuning the initial patient registration of the CT data with a multimodal CT to intraoperative 3D ultrasound registration (e.g., mutual information), as well as ensuring no movements between this registration and image guidance, may improve the registration accuracy. Conclusion: Preoperative CT in combination with 3D ultrasound might be helpful for guiding minimal invasive abdominal interventions.

  19. Abdominal and pancreatic motion correlation using 4D CT, 4D transponders, and a gating belt.

    PubMed

    Betancourt, Ricardo; Zou, Wei; Plastaras, John P; Metz, James M; Teo, Boon-Keng; Kassaee, Alireza

    2013-01-01

    The correlation between the pancreatic and external abdominal motion due to respiration was investigated on two patients. These studies utilized four dimensional computer tomography (4D CT), a four dimensional (4D) electromagnetic transponder system, and a gating belt system. One 4D CT study was performed during simulation to quantify the pancreatic motion using computer tomography images at eight breathing phases. The motion under free breathing and breath-hold were analyzed for the 4D electromagnetic transponder system and the gating belt system during treatment. A linear curve was fitted for all data sets and correlation factors were evaluated between the 4D electromagnetic transponder system and the gating belt system data. The 4D CT study demonstrated a modest correlation between the external marker and the pancreatic motion with R-square values larger than 0.8 for the inferior-superior (inf-sup). Then, the relative pressure from the belt gating system correlated well with the 4D electromagnetic transponder system's motion in the anterior-posterior (ant-post) and the inf-post directions. These directions have a correlation value of -0.93 and 0.76, while the lateral only had a 0.03 correlation coefficient. Based on our limited study, external surrogates can be used as predictors of the pancreatic motion in the inf-sup and the ant-post directions. Although there is a low correlation on the lateral direction, its motion is significantly shorter. In conclusion, an appropriate treatment delivery can be used for pancreatic cancer when an internal tracking system, such as the 4D electromagnetic transponder system, is unavailable. PMID:23652242

  20. Computerized organ localization in abdominal CT volume with context-driven generalized Hough transform

    NASA Astrophysics Data System (ADS)

    Liu, Jing; Li, Qiang

    2014-03-01

    Fast localization of organs is a key step in computer-aided detection of lesions and in image guided radiation therapy. We developed a context-driven Generalized Hough Transform (GHT) for robust localization of organ-of-interests (OOIs) in a CT volume. Conventional GHT locates the center of an organ by looking-up center locations of pre-learned organs with "matching" edges. It often suffers from mislocalization because "similar" edges in vicinity may attract the prelearned organs towards wrong places. The proposed method not only uses information from organ's own shape but also takes advantage of nearby "similar" edge structures. First, multiple GHT co-existing look-up tables (cLUT) were constructed from a set of training shapes of different organs. Each cLUT represented the spatial relationship between the center of the OOI and the shape of a co-existing organ. Second, the OOI center in a test image was determined using GHT with each cLUT separately. Third, the final localization of OOI was based on weighted combination of the centers obtained in the second stage. The training set consisted of 10 CT volumes with manually segmented OOIs including liver, spleen and kidneys. The method was tested on a set of 25 abdominal CT scans. Context-driven GHT correctly located all OOIs in the test image and gave localization errors of 19.5±9.0, 12.8±7.3, 9.4±4.6 and 8.6±4.1 mm for liver, spleen, left and right kidney respectively. Conventional GHT mis-located 8 out of 100 organs and its localization errors were 26.0±32.6, 14.1±10.6, 30.1±42.6 and 23.6±39.7mm for liver, spleen, left and right kidney respectively.

  1. Classification of CT examinations for COPD visual severity analysis

    NASA Astrophysics Data System (ADS)

    Tan, Jun; Zheng, Bin; Wang, Xingwei; Pu, Jiantao; Gur, David; Sciurba, Frank C.; Leader, J. Ken

    2012-03-01

    In this study we present a computational method of CT examination classification into visual assessed emphysema severity. The visual severity categories ranged from 0 to 5 and were rated by an experienced radiologist. The six categories were none, trace, mild, moderate, severe and very severe. Lung segmentation was performed for every input image and all image features are extracted from the segmented lung only. We adopted a two-level feature representation method for the classification. Five gray level distribution statistics, six gray level co-occurrence matrix (GLCM), and eleven gray level run-length (GLRL) features were computed for each CT image depicted segment lung. Then we used wavelets decomposition to obtain the low- and high-frequency components of the input image, and again extract from the lung region six GLCM features and eleven GLRL features. Therefore our feature vector length is 56. The CT examinations were classified using the support vector machine (SVM) and k-nearest neighbors (KNN) and the traditional threshold (density mask) approach. The SVM classifier had the highest classification performance of all the methods with an overall sensitivity of 54.4% and a 69.6% sensitivity to discriminate "no" and "trace visually assessed emphysema. We believe this work may lead to an automated, objective method to categorically classify emphysema severity on CT exam.

  2. Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study.

    PubMed

    Turgut, Ahmet Tuncay; Sönmez, Iclal; Cakıt, Burcu Duyur; Koşar, Pınar; Koşar, Uğur

    2008-06-01

    The goal of this cross-sectional observational study was to assess the possible impact of pineal gland calcification upon the intervertebral disc degeneration and abdominal aorta atherosclerosis in subjects with low back pain, and to investigate the course of these processes with aging. The study was carried out on 81 (66 women and 15 men) subjects: younger than 45 years (group X, n=22), 45-65 years of age (group Y, n=45), and older than 65 years (group Z, n=14). In addition to clinical data, computed tomography (CT) scan of the brain as well as X-ray and CT examination of the lumbar spine were recorded in this study. The degree of disc degeneration and calcification rates of aortic wall and pineal gland were independently determined by two radiologists. Both ratio of calcified pineal gland and density of pineal calcification increased progressively with aging. Also, both the degree of aortic wall calcification and disc degeneration score increased with advancing age. On CT scan, a positive correlation between degree of aortic wall calcification and disc degeneration score was found (r=0.306, p<0.01). Importantly, there was a positive association between calcification of the pineal gland and degenerative disc disease in X-ray or CT study (r=0.378 and r=0.295, p<0.005 and p<0.01, respectively), as well as between abdominal aorta atherosclerosis and pineal calcification (r=0.634, p<0.001). Our findings suggest that there is a significant interaction between pineal gland calcification and lumbar intervertebral disc degeneration and also abdominal aorta atherosclerosis. However, further studies with a larger subject cohorts are needed. PMID:18215511

  3. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT.

    PubMed

    Zhou, Yifang; Scott, Alexander; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-10-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution's standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R^2  >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented. PMID:26389637

  4. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT

    NASA Astrophysics Data System (ADS)

    Zhou, Yifang; Scott, Alexander, II; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-10-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution’s standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R^2  >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented.

  5. The Use of CT Scan in Hemodynamically Stable Children with Blunt Abdominal Trauma: Look before You Leap.

    PubMed

    Nellensteijn, David R; Greuter, Marcel J; El Moumni, Moustafa; Hulscher, Jan B

    2016-08-01

    We set out to determine the diagnostic value of computed tomographic (CT) scans in relation to the radiation dose, tumor incidence, and tumor mortality by radiation for hemodynamically stable pediatric patients with blunt abdominal injury. We focused on the changes in management because of new information obtained by CT. CT scans for suspected pediatric abdominal injury performed in our accident and emergency department were retrieved from the radiology registry and analyzed for: injury and hemodynamic parameters, changes in therapy, and radiological interventions. The dose length product (DLP) was used to calculate the effective dose (ED) and with the BEIR VII report we calculated the estimated induced lifetime tumor and mortality risk. Seventy-two patients underwent abdominal CT scanning for suspicion of abdominal injury and eight patients were excluded for hemodynamic instability, leaving 64 hemodynamically stable patients. Four patients died (6%). On the remaining 60 patients, only one laparotomy was performed for suspicion of duodenal perforation. Only in three out of the 64 hemodynamically stable cases (5%), a CT scan brought forward an indication for intervention or change in management. One patient was suspected of a duodenal perforation and underwent a laparotomy. A grade II hepatic laceration, but no duodenal, injury was found. Two patients underwent embolization of the splenic artery. One for an arterial blush caused by splenic laceration as was observed on the contrast enhanced-CT. Patient remained stable and during the angiogram the blush had disappeared. The second patient underwent (prophylactic) selective arterial embolization for having sustained a grade V splenic injury. The median radiation dosage was 11.43 mSv (range 1.19-23.76 mSv) in our patients. The use of the BEIR VII methodology results in an estimated increase in the lifetime tumor incidence of 0.17% (range, 0.05-0.67%) and an estimated increase in lifetime tumor incidence of 0.08% (0

  6. Automated extraction of radiation dose information for CT examinations.

    PubMed

    Cook, Tessa S; Zimmerman, Stefan; Maidment, Andrew D A; Kim, Woojin; Boonn, William W

    2010-11-01

    Exposure to radiation as a result of medical imaging is currently in the spotlight, receiving attention from Congress as well as the lay press. Although scanner manufacturers are moving toward including effective dose information in the Digital Imaging and Communications in Medicine headers of imaging studies, there is a vast repository of retrospective CT data at every imaging center that stores dose information in an image-based dose sheet. As such, it is difficult for imaging centers to participate in the ACR's Dose Index Registry. The authors have designed an automated extraction system to query their PACS archive and parse CT examinations to extract the dose information stored in each dose sheet. First, an open-source optical character recognition program processes each dose sheet and converts the information to American Standard Code for Information Interchange (ASCII) text. Each text file is parsed, and radiation dose information is extracted and stored in a database which can be queried using an existing pathology and radiology enterprise search tool. Using this automated extraction pipeline, it is possible to perform dose analysis on the >800,000 CT examinations in the PACS archive and generate dose reports for all of these patients. It is also possible to more effectively educate technologists, radiologists, and referring physicians about exposure to radiation from CT by generating report cards for interpreted and performed studies. The automated extraction pipeline enables compliance with the ACR's reporting guidelines and greater awareness of radiation dose to patients, thus resulting in improved patient care and management. PMID:21040869

  7. Detection of necrosis of the gastric fundus after blunt abdominal trauma by PET-CT.

    PubMed

    Hofer, A; Kratochwill, H; Pentsch, A; Gabriel, M

    2015-02-01

    Positron emission tomography with [(18)F]-fluorodeoxyglucose provides functional and anatomic information by visualising the uptake of radiolabelled glucose in tumour and inflammatory cells. We report delayed diagnosis of necrosis of the gastric fundus after blunt abdominal trauma in a 73-year-old man. After a car accident with head-on collision, the patient was stabilised in our emergency room. His femur was treated by internal fixation, his ellbow was stabilised by a fixateur externe. During surgery his status deteriorated. The patient was in need of high dosage of inotrops during the following days. He had a biventricular pacemaker implanted because of ischemic myocardiopathy, and he suffered from renal insufficiency. Over the next days, his haemodynamics improved. A central venous line had to be removed because of ensuing septic fever. The patient complained of upper abdominal pain and nausea. A sonography and computer tomography without contrast medium were performed with negative result. Because of contamination of the central venous line with Staphylococcus epidermidis the pacemaker was evaluated for infection by transoesophageal echocardiography, again without any findings. Because of ongoing fever and positive inflammatory markers a positron emission tomography was indicated, as a contrast examination and a magnetic resonance examination were not feasible because of the renal insufficiency and the pacemaker, respectively. Prophylactic removal of the pacemaker would have been a substantial risk for the patient due to his underlying myocardiopathy. Positron emission tomography showed an increased tracer uptake in the gastric fundus, which turned out to be necrotic by endoscopy. A laparoscopic resection followed, and drainage of an abscess, which had evolved subsequently between stomach and spleen stopped the inflammatory process. This case report demonstrates that positron emission tomography may be an alternative to computer tomography with contrast medium

  8. A Novel Multiinstance Learning Approach for Liver Cancer Recognition on Abdominal CT Images Based on CPSO-SVM and IO

    PubMed Central

    Yi, Dehui

    2013-01-01

    A novel multi-instance learning (MIL) method is proposed to recognize liver cancer with abdominal CT images based on instance optimization (IO) and support vector machine with parameters optimized by a combination algorithm of particle swarm optimization and local optimization (CPSO-SVM). Introducing MIL into liver cancer recognition can solve the problem of multiple regions of interest classification. The images we use in the experiments are liver CT images extracted from abdominal CT images. The proposed method consists of two main steps: (1) obtaining the key instances through IO by texture features and a classification threshold in classification of instances with CPSO-SVM and (2) predicting unknown samples with the key instances and the classification threshold. By extracting the instances equally based on the entire image, the proposed method can ignore the procedure of tumor region segmentation and lower the demand of segmentation accuracy of liver region. The normal SVM method and two MIL algorithms, Citation-kNN algorithm and WEMISVM algorithm, have been chosen as comparing algorithms. The experimental results show that the proposed method can effectively recognize liver cancer images from two kinds of cancer CT images and greatly improve the recognition accuracy. PMID:24368931

  9. The Value of Restaging With Chest and Abdominal CT/MRI Scan After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

    PubMed

    Liu, Guo-Chen; Zhang, Xu; Xie, E; An, Xin; Cai, Pei-Qiang; Zhu, Ying; Tang, Jing-Hua; Kong, Ling-Heng; Lin, Jun-Zhong; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-11-01

    Little was known with regard to the value of preoperative systemic restaging for patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT). This study was designed to evaluate the role of chest and abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI) on preoperative restaging in LARC after neoadjuvant CRT and to assess the impact on treatment strategy.Between January 2007 and April 2013, 386 newly diagnosed consecutive patients with LARC who underwent neoadjuvant CRT and received restaging with chest and abdominal CT/MRI scan were included. Imaging results before and after CRT were analyzed.Twelve patients (3.1%) (6 liver lesions, 2 peritoneal lesions, 2 distant lymph node lesions, 1 lung lesions, 1 liver and lung lesions) were diagnosed as suspicious metastases on the restaging scan after radiotherapy. Seven patients (1.8%) were confirmed as metastases by pathology or long-term follow-up. The treatment strategy was changed in 5 of the 12 patients as a result of restaging CT/MRI findings. Another 10 patients (2.6%) who present with normal restaging imaging findings were diagnosed as metastases intra-operatively. The sensitivity, specificity accuracy, negative predictive value, and positive predictive values of restaging CT/MRI was 41.4%, 98.6%, 58.3%, and 97.3%, respectively.The low incidence of metastases and minimal consequences for the treatment plan question the clinical value of routine restaging of chest and abdomen after neoadjuvant CRT. Based on this study, a routine restaging CT/MRI of chest and abdomen in patients with rectal cancer after neoadjuvant CRT is not advocated, carcino-embryonic antigen (CEA) -guided CT/MRI restaging might be an alternative. PMID:26632714

  10. Automated matching and segmentation of lymphoma on serial CT examinations

    SciTech Connect

    Yan Jiayong; Zhao Binsheng; Curran, Sean; Zelenetz, Andrew; Schwartz, Lawrence H.

    2007-01-15

    In patients with lymphoma, identification and quantification of the tumor extent on serial CT examinations is critical for assessing tumor response to therapy. In this paper, we present a computer method to automatically match and segment lymphomas in follow-up CT images. The method requires that target lymph nodes in baseline CT images be known. A fast, approximate alignment technique along the x, y, and axial directions is developed to provide a good initial condition for the subsequent fast free form deformation (FFD) registration of the baseline and the follow-up images. As a result of the registration, the deformed lymph node contours from the baseline images are used to automatically determine internal and external markers for the marker-controlled watershed segmentation performed in the follow-up images. We applied this automated registration and segmentation method retrospectively to 29 lymph nodes in 9 lymphoma patients treated in a clinical trial at our cancer center. A radiologist independently delineated all lymph nodes on all slices in the follow-up images and his manual contours served as the ''gold standard'' for evaluation of the method. Preliminary results showed that 26/29 (89.7%) lymph nodes were correctly matched; i.e., there was a geometrical overlap between the deformed lymph node from the baseline and its corresponding mass in the follow-up images. Of the matched 26 lymph nodes, 22 (84.6%) were successfully segmented; for these 22 lymph nodes, several metrics were calculated to quantify the method's performance. Among them, the average distance and the Hausdorff distance between the contours generated by the computer and those generated by the radiologist were 0.9 mm (stdev. 0.4 mm) and 3.9 mm (stdev. 2.1 mm), respectively.

  11. Contrast-Enhanced Abdominal Angiographic CT for Intra-abdominal Tumor Embolization: A New Tool for Vessel and Soft Tissue Visualization

    SciTech Connect

    Meyer, Bernhard Christian Frericks, Bernd Benedikt; Albrecht, Thomas; Wolf, Karl-Juergen; Wacker, Frank Klaus

    2007-07-15

    C-Arm cone-beam computed tomography (CACT), is a relatively new technique that uses data acquired with a flat-panel detector C-arm angiography system during an interventional procedure to reconstruct CT-like images. The purpose of this Technical Note is to present the technique, feasibility, and added value of CACT in five patients who underwent abdominal transarterial chemoembolization procedures. Target organs for the chemoembolizations were kidney, liver, and pancreas and a liposarcoma infiltrating the duodenum. The time for patient positioning, C-arm and system preparation, CACT raw data acquisition, and data reconstruction for a single CACT study ranged from 6 to 12 min. The volume data set produced by the workstation was interactively reformatted using maximum intensity projections and multiplanar reconstructions. As part of an angiography system CACT provided essential information on vascular anatomy, therapy endpoints, and immediate follow-up during and immediately after the abdominal interventions without patient transfer. The quality of CACT images was sufficient to influence the course of treatment. This technology has the potential to expedite any interventional procedure that requires three-dimensional information and navigation.

  12. [Gas-containing gallstones: value of the "Mercedes-Benz" sign at CT examination].

    PubMed

    Delabrousse, E; Bartholomot, B; Narboux, Y; Barrali, E; Chirouze, C; Kastler, B

    2000-11-01

    Gas-containing gallstones are well-known in vitro. The typical triradiate arrangement of fissures filled with gas, first described on abdominal plain films, was named by Meyers the "Mercedes-Benz" sign. This sign is absent of the recent literature. We report a case where gas was the only CT sign suggesting the presence of gallstones in the gallbladder. PMID:11104980

  13. Comparative assessment of three image reconstruction techniques for image quality and radiation dose in patients undergoing abdominopelvic multidetector CT examinations

    PubMed Central

    Desai, G S; Thabet, A; Elias, A Y A; Sahani, D V

    2013-01-01

    Objective To compare image quality and radiation dose of abdominal CT examinations reconstructed with three image reconstruction techniques. Methods In this Institutional Review Board-approved study, contrast-enhanced (CE) abdominopelvic CT scans from 23 patients were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR) and iterative reconstruction in image space (IRIS) and were reviewed by two blinded readers. Subjective (acceptability, sharpness, noise and artefacts) and objective (noise) measures of image quality were recorded for each image data set. Radiation doses in CT dose index (CTDI) dose–length product were also calculated for each examination type and compared. Imaging parameters were compared using the Wilcoxon signed rank test and a paired t-test. Results All 69 CECT examinations were of diagnostic quality and similar for overall acceptability (mean grade for ASiR, 3.9±0.3; p=0.2 for Readers 1 and 2; IRIS, 3.9±0.4, p=0.2; FBP, 3.8±0.9). Objective noise was considerably lower with both iterative techniques (p<0.0001 and 0.0016 for ASiR and IRIS). Recorded mean radiation dose, i.e. CTDIvol, was 24% and 10% less with ASiR (11.4±3.4 mGy; p<0.001) and IRIS (13.5±3.7 mGy; p=0.06), respectively, than with FBP: 15.0±3.5 mGy. Conclusion At the system parameters used in this study, abdominal CT scans reconstructed with ASiR and IRIS provide diagnostic images with reduced image noise and 10–24% lower radiation dose than FBP. Advances in knowledge CT images reconstructed with FBP are frequently noisy on lowering the radiation dose. Newer iterative reconstruction techniques have different approaches to produce images with less noise; ASiR and IRIS provide diagnostic abdominal CT images with reduced image noise and radiation dose compared with FBP. This has been documented in this study. PMID:23255538

  14. Abdominal multi-organ CT segmentation using organ correlation graph and prediction-based shape and location priors.

    PubMed

    Okada, Toshiyuki; Linguraru, Marius George; Hori, Masatoshi; Summers, Ronald M; Tomiyama, Noriyuki; Sato, Yoshinobu

    2013-01-01

    The paper addresses the automated segmentation of multiple organs in upper abdominal CT data. We propose a framework of multi-organ segmentation which is adaptable to any imaging conditions without using intensity information in manually traced training data. The features of the framework are as follows: (1) the organ correlation graph (OCG) is introduced, which encodes the spatial correlations among organs inherent in human anatomy; (2) the patient-specific organ shape and location priors obtained using OCG enable the estimation of intensity priors from only target data and optionally a number of untraced CT data of the same imaging condition as the target data. The proposed methods were evaluated through segmentation of eight abdominal organs (liver, spleen, left and right kidney, pancreas, gallbladder, aorta, and inferior vena cava) from 86 CT data obtained by four imaging conditions at two hospitals. The performance was comparable to the state-of-the-art method using intensity priors constructed from manually traced data. PMID:24505771

  15. Helical CT Angiography of Abdominal Aortic Aneurysms Treated with Suprarenal Stent Grafting: A Pictorial Essay

    SciTech Connect

    Sun Zhonghua

    2003-06-15

    The endovascular repair of abdominal aorticaneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating patients with inappropriate aneurysm necks.Unlike open repair, the success of endoluminal repair cannot be ascertained by means of direct examination and thus relies on imaging results. The use of conventional angiography for arterial imaging has become less dominant, while helical computed tomography angiography(CTA) has become the imaging modality of choice for both preoperative assessment and postoperative followup after treatment with stent graft implants. There is an increasing likelihood that radiologists will become more and more involved in the procedure of aortic stent grafting and in giving the radiological report on these patients treated with stent grafts. It is necessary for radiologists to be familiar with the imaging findings, including common and uncommon appearances following aortic stent grafting. The purpose of this pictorial essay is to describe and present normal and abnormal imaging appearances following aortic stent grafting based on helical CTA.

  16. Use of a web-based image reporting and tracking system for assessing abdominal imaging examination quality issues in a single practice.

    PubMed

    Rosenkrantz, Andrew B; Johnson, Evan; Sanger, Joseph J

    2015-10-01

    This article presents our local experience in the implementation of a real-time web-based system for reporting and tracking quality issues relating to abdominal imaging examinations. This system allows radiologists to electronically submit examination quality issues during clinical readouts. The submitted information is e-mailed to a designate for the given modality for further follow-up; the designate may subsequently enter text describing their response or action taken, which is e-mailed back to the radiologist. Review of 558 entries over a 6-year period demonstrated documentation of a broad range of examination quality issues, including specific issues relating to protocol deviation, post-processing errors, positioning errors, artifacts, and IT concerns. The most common issues varied among US, CT, MRI, radiography, and fluoroscopy. In addition, the most common issues resulting in a patient recall for repeat imaging (generally related to protocol deviation in MRI and US) were identified. In addition to submitting quality problems, radiologists also commonly used the tool to provide recognition of a well-performed examination. An electronic log of actions taken in response to radiologists' submissions indicated that both positive and negative feedback were commonly communicated to the performing technologist. Information generated using the tool can be used to guide subsequent quality improvement initiatives within a practice, including continued protocol standardization as well as education of technologists in the optimization of abdominal imaging examinations. PMID:26182885

  17. Radiation Exposure of Ovarian Cancer Patients: Contribution of CT Examinations Performed on Different MDCT (16 and 64 Slices) Scanners and Image Quality Evaluation

    PubMed Central

    Rizzo, Stefania; Origgi, Daniela; Brambilla, Sarah; De Maria, Federica; Foà, Riccardo; Raimondi, Sara; Colombo, Nicoletta; Bellomi, Massimo

    2015-01-01

    Abstract The objective of this study is to compare radiation doses given to ovarian cancer patients by different computed tomographies (CTs) and to evaluate association between doses and subjective and objective image quality. CT examinations included were performed either on a 16-slice CT, equipped with automatic z-axis tube current modulation, or on a 64-slice CT, equipped with z-axis, xy-axis modulation, and adaptive statistical iterative algorithm (ASIR). Evaluation of dose included the following dose descriptors: volumetric CT dose index (CTDIvol), dose length product (DLP), and effective dose (E). Objective image noise was evaluated in abdominal aorta and liver. Subjective image quality was evaluated by assessment of image noise, spatial resolution and diagnostic acceptability. Mean and median CTDIvol, DLP, and E; correlation between CTDIvol and DLP and patients’ weight; comparison of objective noise for the 2 scanners; association between dose descriptors and subjective image quality. The 64-slice CT delivered to patients 24.5% lower dose (P < 0.0001) than 16-slice CT. There was a significant correlation between all dose descriptors (CTDIvol, DLP, E) and weight (P < 0.0001). Objective noise was comparable for the 2 CT scanners. There was a significant correlation between dose descriptors and image noise for the 64-slice CT, and between dose descriptors and spatial resolution for the 16-slice CT. Current dose reduction systems may reduce radiation dose without significantly affecting image quality and diagnostic acceptability of CT exams. PMID:25929914

  18. Radiation exposure of ovarian cancer patients: contribution of CT examinations performed on different MDCT (16 and 64 slices) scanners and image quality evaluation: an observational study.

    PubMed

    Rizzo, Stefania; Origgi, Daniela; Brambilla, Sarah; De Maria, Federica; Foà, Riccardo; Raimondi, Sara; Colombo, Nicoletta; Bellomi, Massimo

    2015-05-01

    The objective of this study is to compare radiation doses given to ovarian cancer patients by different computed tomographies (CTs) and to evaluate association between doses and subjective and objective image quality.CT examinations included were performed either on a 16-slice CT, equipped with automatic z-axis tube current modulation, or on a 64-slice CT, equipped with z-axis, xy-axis modulation, and adaptive statistical iterative algorithm (ASIR). Evaluation of dose included the following dose descriptors: volumetric CT dose index (CTDIvol), dose length product (DLP), and effective dose (E). Objective image noise was evaluated in abdominal aorta and liver. Subjective image quality was evaluated by assessment of image noise, spatial resolution and diagnostic acceptability.Mean and median CTDIvol, DLP, and E; correlation between CTDIvol and DLP and patients' weight; comparison of objective noise for the 2 scanners; association between dose descriptors and subjective image quality.The 64-slice CT delivered to patients 24.5% lower dose (P < 0.0001) than 16-slice CT. There was a significant correlation between all dose descriptors (CTDIvol, DLP, E) and weight (P < 0.0001). Objective noise was comparable for the 2 CT scanners. There was a significant correlation between dose descriptors and image noise for the 64-slice CT, and between dose descriptors and spatial resolution for the 16-slice CT.Current dose reduction systems may reduce radiation dose without significantly affecting image quality and diagnostic acceptability of CT exams. PMID:25929914

  19. Studies on the application of a low-voltage peak to the postsurgical follow-up CT scan in abdominal cancer patients in order to reduce the exposure of patients to radiation

    NASA Astrophysics Data System (ADS)

    Cho, J. H.; Lee, H. K.; Kim, H. J.; Dong, K. R.; Chung, W. K.

    2012-10-01

    This study examined the radiation dose, computed tomography (CT) number, contrast and image quality of patients requiring periodic follow-up abdominal CT examinations at various tube voltages. The subjects were divided into two groups. One group consisted of patients who underwent a clinical analysis and the other group was a phantom one. Somatom Sensation 16 (Siemens, Erlangen, Germany) was used. Twenty patients who underwent a periodic follow-up examination by CT were selected randomly. The tube current was fixed to 150 mA, and the tube voltage was adjusted according to the appropriate value of each examination. The computed tomography dose index (CTDI) values were measured. The CT number of each organ was measured by setting up a 1 cm diameter return on investment (ROI) in the abdominal organs at the same height of the first lumbar vertebra using images of the arterial phase. Two radiologists in consensus graded the quality of the abdominal images into three groups. An abdomen-shaped acrylic phantom was used in the phantom study. An ion chamber was inserted into the holes located at the center and periphery of the phantom, where the radiation dose was automatically displayed on the reader. Tube voltages of 80, 100, 120 and 140 kVp were applied to the phantom (diluted contrast medium with water at 1:10 ratio) and the phantom was scanned. The CT number was measured from a 1 cm diameter ROI at the center of the image. The CTDI value decreased by 36% at 100 kVp (7.50 mGy) compared with that at 120 kVp (11.70 mGy). According to the radiologists' evaluation, there were 17 equivalent, 3 acceptable and 0 unacceptable levels in the group of 20 subjects. The radiation dose in the phantom study decreased with increasing tube voltages from 80 to 140 kVp. The peripheral and central doses decreased by 38% and 41%, respectively. The CT numbers at 80, 100, 120 and 140 kVp were 1365.9±4.4, 1046.1±3.7, 862.8±3.2 and 737.5±3.0 HU, respectively. In conclusion, in a follow

  20. CT in ovarian cancer staging: how to review and report with emphasis on abdominal and pelvic disease for surgical planning.

    PubMed

    Sahdev, Anju

    2016-01-01

    CT of the abdomen and pelvis is the first line imaging modality for staging, selecting treatment options and assessing disease response in ovarian cancer. The staging CT provides disease distribution, disease burden and is the imaging surrogate for surgico-pathological FIGO staging. Optimal cyto-reductive surgery offers patients' the best chance for disease control or cure, but sub-optimal resection confers no advantage over chemotherapy and adversely increases the risk of post surgical complications. Although there is extensive literature comparing performance of CT against laparoscopy and surgery, for the staging abdominal and pelvic CT, there are currently no accepted guidelines for interpretation or routinely used minimum data set templates for reporting these complex CT scans often with extensive radiological findings. This review provides a systematic approach for identifying the important radiological findings and highlighting important sites of disease within the abdomen and pelvis, which may alter or preclude surgery at presentation or after adjuvant chemotherapy. The distribution of sites and volume of disease can be used to categorize patients as suitable, probably suitable or not suitable for optimal cyto-reductive surgery. This categorization can potentially assist oncological surgeons and oncologists as a semi objective assessment tool useful for selecting patient treatment, streamlining multi disciplinary discussion and improving the reproducibility and correlation of CT with surgical findings. The review also highlights sites of disease and complications of ovarian cancer which should be included as part of the radiological report as these may require additional surgical input from non gynaecological surgeons or influence treatment selection. PMID:27484100

  1. Automated segmentation of upper digestive tract from abdominal contrast-enhanced CT data using hierarchical statistical modeling of organ interrelations

    NASA Astrophysics Data System (ADS)

    Hirayama, S.; Otake, Y.; Okada, T.; Hori, M.; Tomiyama, N.; Sato, Y.

    2016-03-01

    We have been studying the automatic segmentation of multi-organ region from abdominal CT images. In previous work, we proposed an approach using a hierarchical statistical modeling using a relationship between organs. In this paper, we have proposed automatic segmentation of the upper digestive tract from abdominal contrast-enhanced CT using previously segmented multiple organs. We compared segmentation accuracy of the esophagus, stomach and duodenum between our proposed method using hierarchical statistical modeling and a conventional statistical atlas method. Additionally, preliminary experiment was performed which added the region representing gas to the candidate region at the segmentation step. The segmentation results were evaluated quantitatively by Dice coefficient, Jaccard index and the average symmetric surface distance of the segmented region and correct region data. Percentage of the average of Dice coefficient of esophagus, stomach and duodenum were 58.7, 68.3, and 38.6 with prediction-based method and 23.7, 51.1, and 24.4 with conventional atlas method.

  2. Effect of Reducing Abdominal Compression during Prone CT Colonography on Ascending Colonic Rotation during Supine-to-Prone Positional Change

    PubMed Central

    Jang, Jong Keon; Lee, Jong Seok; Kim, Hyun Jin; Kim, Ah Young; Ha, Hyun Kwon

    2016-01-01

    Objective To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). Materials and Methods Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps ≥ 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (°) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180° and +180° (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. Results Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22° to 61° (median, 13.9°) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10°. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. Conclusion Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position. PMID:26798215

  3. An Abdominal CT may be Safe in Selected Hypotensive Trauma Patients with Positive FAST Exam

    PubMed Central

    Cook, Mackenzie R.; Holcomb, John B.; Rahbar, Mohammad H.; Alarcon, Louis H.; Bulger, Eileen M.; Brasel, Karen J.; Schreiber, Martin A.

    2016-01-01

    Background Positive Focused Assessment with Sonography in Trauma (FAST) and hypotension often indicates urgent surgery. An abdomen/pelvis CT (apCT) may allow less invasive management but the delay may be associated with adverse outcomes. Methods Patients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive FAST (HF+) who underwent a CT (apCT+) were compared to those who did not. Results Of the 92 HF+ identified, 32(35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation, OR 0.11 95% CI (0.001–0.116) and increased odds of angiographic intervention, OR 14.3 95% CI (1.5–135). There was no significant difference in 30 day mortality or need for dialysis. Conclusion An apCt in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information. PMID:25805456

  4. Pearls and pitfalls in interpretation of abdominal and pelvic PET-CT.

    PubMed

    Blake, Michael A; Singh, Ajay; Setty, Bindu N; Slattery, James; Kalra, Mannudeep; Maher, Michael M; Sahani, Dushyant V; Fischman, Alan J; Mueller, Peter R

    2006-01-01

    The interpretation of images obtained in the abdomen and pelvis can be challenging, and the coregistration of positron emission tomographic (PET) and computed tomographic (CT) scans may be especially valuable in the evaluation of these anatomic areas. PET-CT represents a major technologic advance, consisting of generally complementary modalities whose combined strength tends to overcome their respective weaknesses. However, this combined functional-structural imaging approach raises a number of controversial questions and presents some unique interpretative challenges. Accurate PET-CT scan interpretation requires awareness of the various pitfalls associated with the imaging components, both individually and in combination. The results of recent PET-CT studies have been very encouraging, but larger prospective studies will be needed to establish optimal hybrid scanning protocols. Applying sound imaging principles, paying attention to detail, and staying abreast of advances in this exciting new modality are necessary for harnessing the full diagnostic power of abdominopelvic PET-CT. PMID:16973768

  5. Segmenting the thoracic, abdominal and pelvic musculature on CT scans combining atlas-based model and active contour model

    NASA Astrophysics Data System (ADS)

    Zhang, Weidong; Liu, Jiamin; Yao, Jianhua; Summers, Ronald M.

    2013-03-01

    Segmentation of the musculature is very important for accurate organ segmentation, analysis of body composition, and localization of tumors in the muscle. In research fields of computer assisted surgery and computer-aided diagnosis (CAD), muscle segmentation in CT images is a necessary pre-processing step. This task is particularly challenging due to the large variability in muscle structure and the overlap in intensity between muscle and internal organs. This problem has not been solved completely, especially for all of thoracic, abdominal and pelvic regions. We propose an automated system to segment the musculature on CT scans. The method combines an atlas-based model, an active contour model and prior segmentation of fat and bones. First, body contour, fat and bones are segmented using existing methods. Second, atlas-based models are pre-defined using anatomic knowledge at multiple key positions in the body to handle the large variability in muscle shape. Third, the atlas model is refined using active contour models (ACM) that are constrained using the pre-segmented bone and fat. Before refining using ACM, the initialized atlas model of next slice is updated using previous atlas. The muscle is segmented using threshold and smoothed in 3D volume space. Thoracic, abdominal and pelvic CT scans were used to evaluate our method, and five key position slices for each case were selected and manually labeled as the reference. Compared with the reference ground truth, the overlap ratio of true positives is 91.1%+/-3.5%, and that of false positives is 5.5%+/-4.2%.

  6. Postherpetic pseudohernia: delayed onset of paresis of abdominal muscles due to herpes zoster causing an ipsilateral abdominal bulge.

    PubMed

    Ohno, Shunsuke; Togawa, Yasuhiro; Chiku, Tsuyoshi; Sano, Wataru

    2016-01-01

    Postherpetic pseudohernia causes an abdominal bulge as well as an abdominal wall herniation. This disease is one of the neurological complications of herpes zoster and essentially consists of paresis of ipsilateral abdominal muscles. Postherpetic pseudohernia may be mistaken for abdominal wall herniation because it is not well known. We describe two cases presenting an abdominal bulge. The ipsilateral abdominal bulge appeared after recovery from abdominal zoster. Abdominal CT showed no evidence of a herniation or mass. We diagnosed a postherpetic pseudohernia. One of the patients recovered spontaneously 4 months after the onset, and the other partially recovered after 2 months. This disease can be expected to disappear spontaneously, unlike abdominal herniation requiring surgery. It has been reported that 79.3% of patients eventually recovered spontaneously. For surgeons and general practitioners, it is beneficial to keep this disease in mind when examining a patient presenting an abdominal bulge. PMID:27229900

  7. Maximizing Iodine Contrast-to-Noise Ratios in Abdominal CT Imaging through Use of Energy Domain Noise Reduction and Virtual Monoenergetic Dual-Energy CT1

    PubMed Central

    Leng, Shuai; Yu, Lifeng; Fletcher, Joel G.; McCollough, Cynthia H.

    2015-01-01

    Purpose To determine the iodine contrast-to-noise ratio (CNR) for abdominal computed tomography (CT) when using energy domain noise reduction and virtual monoenergetic dual-energy (DE) CT images and to compare the CNR to that attained with single-energy CT at 80, 100, 120, and 140 kV. Materials and Methods This HIPAA-compliant study was approved by the institutional review board with waiver of informed consent. A syringe filled with diluted iodine contrast material was placed into 30-, 35-, and 45-cm-wide water phantoms and scanned with a dual-source CT scanner in both DE and single-energy modes with matched scanner output. Virtual monoenergetic images were generated, with energies ranging from 40 to 110 keV in 10-keV steps. A previously developed energy domain noise reduction algorithm was applied to reduce image noise by exploiting information redundancies in the energy domain. Image noise and iodine CNR were calculated. To show the potential clinical benefit of this technique, it was retrospectively applied to a clinical DE CT study of the liver in a 59-year-old male patient by using conventional and iterative reconstruction techniques. Image noise and CNR were compared for virtual monoenergetic images with and without energy domain noise reduction at each virtual monoenergetic energy (in kiloelectron volts) and phantom size by using a paired t test. CNR of virtual monoenergetic images was also compared with that of single-energy images acquired with 80, 100, 120, and 140 kV. Results Noise reduction of up to 59% (28.7/65.7) was achieved for DE virtual monoenergetic images by using an energy domain noise reduction technique. For the commercial virtual monoenergetic images, the maximum iodine CNR was achieved at 70 keV and was 18.6, 16.6, and 10.8 for the 30-, 35-, and 45-cm phantoms. After energy domain noise reduction, maximum iodine CNR was achieved at 40 keV and increased to 30.6, 25.4, and 16.5. These CNRs represented improvement of up to 64% (12.0/18.6) with

  8. Segmentation of abdominal organs from CT using a multi-level, hierarchical neural network strategy.

    PubMed

    Selver, M Alper

    2014-03-01

    Precise measurements on abdominal organs are vital prior to the important clinical procedures. Such measurements require accurate segmentation of these organs, which is a very challenging task due to countless anatomical variations and technical difficulties. Although, several features with various classifiers have been designed to overcome these challenges, abdominal organ segmentation via classification is still an emerging field in order to reach desired precision. Recent studies on multiple feature-classifier combinations show that hierarchical systems outperform composite feature-single classifier models. In this study, how hierarchical formations can translate to improved accuracy, when large size feature spaces are involved, is explored for the problem of abdominal organ segmentation. As a result, a semi-automatic, slice-by-slice segmentation method is developed using a novel multi-level and hierarchical neural network (MHNN). MHNN is designed to collect complementary information about organs at each level of the hierarchy via different feature-classifier combinations. Moreover, each level of MHNN receives residual data from the previous level. The residual data is constructed to preserve zero false positive error until the last level of the hierarchy, where only most challenging samples remain. The algorithm mimics analysis behaviour of a radiologist by using the slice-by-slice iteration, which is supported with adjacent slice similarity features. This enables adaptive determination of system parameters and turns into the advantage of online training, which is done in parallel to the segmentation process. Proposed design can perform robust and accurate segmentation of abdominal organs as validated by using diverse data sets with various challenges. PMID:24480371

  9. What is the preferred strength setting of the sinogram-affirmed iterative reconstruction algorithm in abdominal CT imaging?

    PubMed

    Hardie, Andrew D; Nelson, Rachel M; Egbert, Robert; Rieter, William J; Tipnis, Sameer V

    2015-01-01

    Our primary objective in this study was to determine the preferred strength setting for the sinogram-affirmed iterative reconstruction algorithm (SAFIRE) in abdominal computed tomography (CT) imaging. Sixteen consecutive clinical CT scans of the abdomen were reconstructed by use of traditional filtered back projection (FBP) and 5 SAFIRE strengths: S1-S5. Six readers of differing experience were asked to rank the images on preference for overall diagnostic quality. The contrast-to-noise ratio was not significantly different between SAFIRE S1 and FBP, but increased with increasing SAFIRE strength. For pooled data, S2 and S3 were preferred equally but both were preferred over all other reconstructions. S5 was the least preferred, with FBP the next least preferred. This represents a marked disparity between the image quality based on quantitative parameters and qualitative preference. Care should be taken to factor in qualitative in addition to quantitative aspects of image quality when one is optimizing iterative reconstruction images. PMID:25164978

  10. SU-E-I-23: A General KV Constrained Optimization of CNR for CT Abdominal Imaging

    SciTech Connect

    Weir, V; Zhang, J

    2015-06-15

    Purpose: While Tube current modulation has been well accepted for CT dose reduction, kV adjusting in clinical settings is still at its early stage. This is mainly due to the limited kV options of most current CT scanners. kV adjusting can potentially reduce radiation dose and optimize image quality. This study is to optimize CT abdomen imaging acquisition based on the assumption of a continuous kV, with the goal to provide the best contrast to noise ratio (CNR). Methods: For a given dose (CTDIvol) level, the CNRs at different kV and pitches were measured with an ACR GAMMEX phantom. The phantom was scanned in a Siemens Sensation 64 scanner and a GE VCT 64 scanner. A constrained mathematical optimization was used to find the kV which led to the highest CNR for the anatomy and pitch setting. Parametric equations were obtained from polynomial fitting of plots of kVs vs CNRs. A suitable constraint region for optimization was chosen. Subsequent optimization yielded a peak CNR at a particular kV for different collimations and pitch setting. Results: The constrained mathematical optimization approach yields kV of 114.83 and 113.46, with CNRs of 1.27 and 1.11 at the pitch of 1.2 and 1.4, respectively, for the Siemens Sensation 64 scanner with the collimation of 32 x 0.625mm. An optimized kV of 134.25 and 1.51 CNR is obtained for a GE VCT 64 slice scanner with a collimation of 32 x 0.625mm and a pitch of 0.969. At 0.516 pitch and 32 x 0.625 mm an optimized kV of 133.75 and a CNR of 1.14 was found for the GE VCT 64 slice scanner. Conclusion: CNR in CT image acquisition can be further optimized with a continuous kV option instead of current discrete or fixed kV settings. A continuous kV option is a key for individualized CT protocols.

  11. Clinical examination for abdominal aortic aneurysm in general practice: report from the Medical Research Council's General Practice Research Framework.

    PubMed Central

    Zuhrie, S R; Brennan, P J; Meade, T W; Vickers, M

    1999-01-01

    At the time of the 1992-1994 annual reviews in the thrombosis prevention trial, general practitioners (GPs) carried out clinical examination for aneurysms by abdominal palpation in 4171 men. When an aneurysm was suspected, the patient was referred to hospital for further investigation. Aneurysm was suspected in 60 men (1.4%) and confirmed in 25 (0.6%), the mean diameter of confirmed aneurysms being 5.0 cm (range = 3.1-8.0 cm). Of the 25 men in whom aneurysm was confirmed, 10 (40%) underwent elective surgery and one died while under investigation. Examination by abdominal palpation for aortic aneurysm, which is not widely used in either general practice or in hospital practice, other than vascular surgery, is clinically worthwhile even though not all aneurysms will be detected by this means. PMID:10756617

  12. CT-guided brachytherapy of prostate cancer: reduction of effective dose from X-ray examination

    NASA Astrophysics Data System (ADS)

    Sanin, Dmitriy B.; Biryukov, Vitaliy A.; Rusetskiy, Sergey S.; Sviridov, Pavel V.; Volodina, Tatiana V.

    2014-03-01

    Computed tomography (CT) is one of the most effective and informative diagnostic method. Though the number of CT scans among all radiographic procedures in the USA and European countries is 11% and 4% respectively, CT makes the highest contribution to the collective effective dose from all radiographic procedures, it is 67% in the USA and 40% in European countries [1-5]. Therefore it is necessary to understand the significance of dose value from CT imaging to a patient . Though CT dose from multiple scans and potential risk is of great concern in pediatric patients, this applies to adults as well. In this connection it is very important to develop optimal approaches to dose reduction and optimization of CT examination. International Commission on Radiological Protection (ICRP) in its publications recommends radiologists to be aware that often CT image quality is higher than it is necessary for diagnostic confidence[6], and there is a potential to reduce the dose which patient gets from CT examination [7]. In recent years many procedures, such as minimally invasive surgery, biopsy, brachytherapy and different types of ablation are carried out under guidance of computed tomography [6;7], and during a procedures multiple CT scans focusing on a specific anatomic region are performed. At the Clinics of MRRC different types of treatment for patients with prostate cancer are used, incuding conformal CT-guided brachytherapy, implantation of microsources of I into the gland under guidance of spiral CT [8]. So, the purpose of the study is to choose optimal method to reduce radiation dose from CT during CT-guided prostate brachytherapy and to obtain the image of desired quality.

  13. Evaluation of the robustness of the preprocessing technique improving reversible compressibility of CT images: Tested on various CT examinations

    SciTech Connect

    Jeon, Chang Ho; Kim, Bohyoung; Gu, Bon Seung; Lee, Jong Min; Kim, Kil Joong; Lee, Kyoung Ho; Kim, Tae Ki

    2013-10-15

    Purpose: To modify the preprocessing technique, which was previously proposed, improving compressibility of computed tomography (CT) images to cover the diversity of three dimensional configurations of different body parts and to evaluate the robustness of the technique in terms of segmentation correctness and increase in reversible compression ratio (CR) for various CT examinations.Methods: This study had institutional review board approval with waiver of informed patient consent. A preprocessing technique was previously proposed to improve the compressibility of CT images by replacing pixel values outside the body region with a constant value resulting in maximizing data redundancy. Since the technique was developed aiming at only chest CT images, the authors modified the segmentation method to cover the diversity of three dimensional configurations of different body parts. The modified version was evaluated as follows. In randomly selected 368 CT examinations (352 787 images), each image was preprocessed by using the modified preprocessing technique. Radiologists visually confirmed whether the segmented region covers the body region or not. The images with and without the preprocessing were reversibly compressed using Joint Photographic Experts Group (JPEG), JPEG2000 two-dimensional (2D), and JPEG2000 three-dimensional (3D) compressions. The percentage increase in CR per examination (CR{sub I}) was measured.Results: The rate of correct segmentation was 100.0% (95% CI: 99.9%, 100.0%) for all the examinations. The median of CR{sub I} were 26.1% (95% CI: 24.9%, 27.1%), 40.2% (38.5%, 41.1%), and 34.5% (32.7%, 36.2%) in JPEG, JPEG2000 2D, and JPEG2000 3D, respectively.Conclusions: In various CT examinations, the modified preprocessing technique can increase in the CR by 25% or more without concerning about degradation of diagnostic information.

  14. SU-F-18C-12: On the Relationship of the Weighted Dose to the Surface Dose In Abdominal CT - Patient Size Dependency

    SciTech Connect

    Zhou, Y; Scott, A; Allahverdian, J

    2014-06-15

    Purpose: It is possible to measure the patient surface dose non-invasively using radiolucent dosimeters. However, the patient size specific weighted dose remains unknown. We attempted to study the weighted dose to surface dose relationship as the patient size varies in abdominal CT. Methods: Seven abdomen phantoms (CIRS TE series) simulating patients from an infant to a large adult were used. Size specific doses were measured with a 100 mm CT chamber under axial scans using a Siemens Sensation 64 (mCT) and a GE 750 HD. The scanner settings were 120 kVp, 200 mAs with fully opened collimations. Additional kVps (80, 100, 140) were added depending on the phantom sizes. The ratios (r) of the weighted CT dose (Dw) to the surface dose (Ds) were related to the phantom size (L) defined as the diameter resulting the equivalent cross-sectional area. Results: The Dw versus Ds ratio (r) was fitted to a linear relationship: r = 1.083 − 0.007L (R square = 0.995), and r = 1.064 − 0.007L (R square = 0.953), for Siemens Sensation 64 and GE 750 HD, respectively. The relationship appears to be independent of the scanner specifics. Conclusion: The surface dose to the weighted dose ratio decreases linearly as the patient size increases. The result is independent of the scanner specifics. The result can be used to obtain in vivo CT dosimetry in abdominal CT.

  15. Repeatability of Radiotracer Uptake in Normal Abdominal Organs with 111In-Pentetreotide Quantitative SPECT/CT

    PubMed Central

    Rowe, Steven P.; Vicente, Esther; Anizan, Nadège; Wang, Hao; Leal, Jeffrey P.; Lodge, Martin A.; Frey, Eric C.; Wahl, Richard L.

    2015-01-01

    With an increasing emphasis on quantitation of SPECT imaging and its use in dosimetry to guide therapies, it is desirable to understand the repeatability in normal-organ SPECT uptake values (SPECT-UVs). We investigated the variability of normal abdominal organ uptake in repeated 111In-pentetreotide SPECT studies. Methods Nine patients with multiple 111In-pentetreotide SPECT/CT studies for clinical purposes were evaluated. Volumes of interest were drawn for the abdominal organs and applied to SPECT-UVs. The variability of those values was assessed. Results The average SPECT-UV for the liver (1.7 ± 0.6) was much lower than for the kidneys (right, 8.0 ± 2.4; left, 7.5 ± 1.7). Interpatient and intrapatient variability was similar (intraclass correlation coefficients, 0.40–0.59) for all organs. The average coefficients of variation for each organ for each patient were obtained and averaged across all patients (0.26 for liver, 0.22 for right kidney, and 0.20 for left kidney). The coefficients of variation for the organs across all scans were 0.33 (liver), 0.30 (right kidney), and 0.22 (left kidney). Conclusion Variability across all patients and all scans for the liver was higher than reported with 18F-FDG PET, though left kidney variability was similar to PET liver variability and left kidney uptake may be able to serve as an internal metric for determining the quantifiability of an 111In-pentetreotide SPECT study. PMID:25977467

  16. Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

    SciTech Connect

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-06-15

    Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed

  17. Association of Intraluminal Thrombus, Hemodynamic Forces, and Abdominal Aortic Aneurysm Expansion Using Longitudinal CT Images.

    PubMed

    Zambrano, Byron A; Gharahi, Hamidreza; Lim, ChaeYoung; Jaberi, Farhad A; Choi, Jongeun; Lee, Whal; Baek, Seungik

    2016-05-01

    While hemodynamic forces and intraluminal thrombus (ILT) are believed to play important roles on abdominal aortic aneurysm (AAA), it has been suggested that hemodynamic forces and ILT also interact with each other, making it a complex problem. There is, however, a pressing need to understand relationships among three factors: hemodynamics, ILT accumulation, and AAA expansion for AAA prognosis. Hence this study used longitudinal computer tomography scans from 14 patients and analyzed the relationship between them. Hemodynamic forces, represented by wall shear stress (WSS), were obtained from computational fluid dynamics; ILT accumulation was described by ILT thickness distribution changes between consecutives scans, and ILT accumulation and AAA expansion rates were estimated from changes in ILT and AAA volume. Results showed that, while low WSS was observed at regions where ILT accumulated, the rate at which ILT accumulated occurred at the same rate as the aneurysm expansion. Comparison between AAAs with and without thrombus showed that aneurysm with ILT recorded lower values of WSS and higher values of AAA expansion than those without thrombus. Findings suggest that low WSS may promote ILT accumulation and submit the idea that by increasing WSS levels ILT accumulation may be prevented. PMID:26429788

  18. Classification of visual signs in abdominal CT image figures in biomedical literature

    NASA Astrophysics Data System (ADS)

    Xue, Zhiyun; You, Daekeun; Antani, Sameer; Long, L. Rodney; Demner-Fushman, Dina; Thoma, George R.

    2014-03-01

    "Imaging signs" are a critical part of radiology's language. They not only are important for conveying diagnosis, but may also aid in indexing radiology literature and retrieving relevant cases and images. Here we report our work towards representing and categorizing imaging signs of abdominal abnormalities in figures in the radiology literature. Given a region-of-interest (ROI) from a figure, our goal was to assign a correct imaging sign label to that ROI from the following seven: accordion, comb, ring, sandwich, small bowel feces, target, or whirl. As training and test data, we created our own "gold standard" dataset of regions containing imaging signs. We computed 2997 feature attributes to represent imaging sign characteristics for each ROI in training and test sets. Following feature selection they were reduced to 70 attributes and were input to a Support Vector Machine classifier. We applied image-enhancement methods to compensate for variable quality of the images in radiology articles. In particular we developed a method for automatic detection and removal of pointers/markers (arrows, arrowheads, and asterisk symbols) on the images. These pointers/markers are valuable for approximately locating ROIs; however, they degrade the classification because they are often (partially) included in the training ROIs. On a test set of 283 ROIs, our method achieved an overall accuracy of 70% in labeling the seven signs, which we believe is a promising result for using imaging signs to search/retrieve radiology literature. This work is also potentially valuable for the creation of a visual ontology of biomedical imaging entities.

  19. Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT.

    PubMed

    Coulier, Bruno; Gogoase, Monica; Ramboux, Adrien; Pierard, Frederic

    2012-12-01

    Extra-abdominal abscesses of gastrointestinal origin developing within the lumbar subcutaneous tissues are extremely rare. We report two cases of retroperitoneal bowel perforation presenting spontaneously at admission with a lumbar abscess trespassing the lumbar triangle of Petit, a classical "locus of minus resistencia" of the posterior abdominal wall. The first case was caused by perforation of a retrocecal appendicitis--being concomitantly responsible of a necrotizing fasciitis of the thigh--and in the second case perforation was caused by left colonic diverticulitis. In both cases, the full diagnosis was made with abdominal CT. The patients were threatened by a two-step surgical approach comprising a direct posterior percutaneous drainage of the abscess followed by classical laparotomy. PMID:22270582

  20. Radiation dose evaluation in 64-slice CT examinations with adult and paediatric anthropomorphic phantoms

    PubMed Central

    Fujii, K; Aoyama, T; Yamauchi-Kawaura, C; Koyama, S; Yamauchi, M; Ko, S; Akahane, K; Nishizawa, K

    2009-01-01

    The objective of this study was to evaluate the organ dose and effective dose to patients undergoing routine adult and paediatric CT examinations with 64-slice CT scanners and to compare the doses with those from 4-, 8- and 16-multislice CT scanners. Patient doses were measured with small (<7 mm wide) silicon photodiode dosemeters (34 in total), which were implanted at various tissue and organ positions within adult and 6-year-old child anthropomorphic phantoms. Output signals from photodiode dosemeters were read on a personal computer, from which organ and effective doses were computed. For the adult phantom, organ doses (for organs within the scan range) and effective doses were 8–35 mGy and 7–18 mSv, respectively, for chest CT, and 12–33 mGy and 10–21 mSv, respectively, for abdominopelvic CT. For the paediatric phantom, organ and effective doses were 4–17 mGy and 3–7 mSv, respectively, for chest CT, and 5–14 mGy and 3–9 mSv, respectively, for abdominopelvic CT. Doses to organs at the boundaries of the scan length were higher for 64-slice CT scanners using large beam widths and/or a large pitch because of the larger extent of over-ranging. The CT dose index (CTDIvol), dose–length product (DLP) and the effective dose values using 64-slice CT for the adult and paediatric phantoms were the same as those obtained using 4-, 8- and 16-slice CT. Conversion factors of DLP to the effective dose by International Commission on Radiological Protection 103 were 0.024 mSv⋅mGy−1⋅cm−1 and 0.019 mSv⋅mGy−1⋅cm−1 for adult chest and abdominopelvic CT scans, respectively. PMID:19934069

  1. Radiation dose evaluation in 64-slice CT examinations with adult and paediatric anthropomorphic phantoms.

    PubMed

    Fujii, K; Aoyama, T; Yamauchi-Kawaura, C; Koyama, S; Yamauchi, M; Ko, S; Akahane, K; Nishizawa, K

    2009-12-01

    The objective of this study was to evaluate the organ dose and effective dose to patients undergoing routine adult and paediatric CT examinations with 64-slice CT scanners and to compare the doses with those from 4-, 8- and 16-multislice CT scanners. Patient doses were measured with small (<7 mm wide) silicon photodiode dosemeters (34 in total), which were implanted at various tissue and organ positions within adult and 6-year-old child anthropomorphic phantoms. Output signals from photodiode dosemeters were read on a personal computer, from which organ and effective doses were computed. For the adult phantom, organ doses (for organs within the scan range) and effective doses were 8-35 mGy and 7-18 mSv, respectively, for chest CT, and 12-33 mGy and 10-21 mSv, respectively, for abdominopelvic CT. For the paediatric phantom, organ and effective doses were 4-17 mGy and 3-7 mSv, respectively, for chest CT, and 5-14 mGy and 3-9 mSv, respectively, for abdominopelvic CT. Doses to organs at the boundaries of the scan length were higher for 64-slice CT scanners using large beam widths and/or a large pitch because of the larger extent of over-ranging. The CT dose index (CTDI(vol)), dose-length product (DLP) and the effective dose values using 64-slice CT for the adult and paediatric phantoms were the same as those obtained using 4-, 8- and 16-slice CT. Conversion factors of DLP to the effective dose by International Commission on Radiological Protection 103 were 0.024 mSvmGy(-1)cm(-1) and 0.019 mSvmGy(-1)cm(-1) for adult chest and abdominopelvic CT scans, respectively. PMID:19934069

  2. Low kV settings CT angiography (CTA) with low dose contrast medium volume protocol in the assessment of thoracic and abdominal aorta disease: a feasibility study

    PubMed Central

    Talei Franzesi, C; Fior, D; Bonaffini, P A; Minutolo, O; Sironi, S

    2015-01-01

    Objective: To assess the diagnostic quality of low dose (100 kV) CT angiography (CTA), by using ultra-low contrast medium volume (30 ml), for thoracic and abdominal aorta evaluation. Methods: 67 patients with thoracic or abdominal vascular disease underwent multidetector CT study using a 256 slice scanner, with low dose radiation protocol (automated tube current modulation, 100 kV) and low contrast medium volume (30 ml; 4 ml s−1). Density measurements were performed on ascending, arch, descending thoracic aorta, anonymous branch, abdominal aorta, and renal and common iliac arteries. Radiation dose exposure [dose–length product (DLP)] was calculated. A control group of 35 patients with thoracic or abdominal vascular disease were evaluated with standard CTA protocol (automated tube current modulation, 120 kV; contrast medium, 80 ml). Results: In all patients, we correctly visualized and evaluated main branches of the thoracic and abdominal aorta. No difference in density measurements was achieved between low tube voltage protocol (mean attenuation value of thoracic aorta, 304 HU; abdominal, 343 HU; renal arteries, 331 HU) and control group (mean attenuation value of thoracic aorta, 320 HU; abdominal, 339; renal arteries, 303 HU). Radiation dose exposure in low tube voltage protocol was significantly different between thoracic and abdominal low tube voltage studies (490 and 324 DLP, respectively) and the control group (thoracic DLP, 1032; abdomen, DLP 1078). Conclusion: Low-tube-voltage protocol may provide a diagnostic performance comparable with that of the standard protocol, decreasing radiation dose exposure and contrast material volume amount. Advances in knowledge: Low-tube-voltage-setting protocol combined with ultra-low contrast agent volume (30 ml), by using new multidetector-row CT scanners, represents a feasible diagnostic tool to significantly reduce the radiation dose delivered to patients and to preserve renal function

  3. Can Surgeons Assess CT Suitability for Endovascular Repair (EVAR) in Ruptured Abdominal Aortic Aneurysm? Implications for a Ruptured EVAR Trial

    SciTech Connect

    Rayt, Harjeet Lambert, Kelly; Bown, Matthew; Fishwick, Guy; Morgan, Robert; McCarthy, Mark; London, Nick; Sayers, Robert

    2008-09-15

    The purpose of this study was to determine whether surgeons without formal radiological training are able to assess suitability of patients with ruptured abdominal aortic aneurysms (AAA) for EVAR. The CT scans of 20 patients with AAA were reviewed under timed conditions by six vascular surgeons. Twenty minutes was allocated per scan. They were asked to determine if each aneurysm would be treatable by EVAR in the emergency setting and, if so, to measure for device selection. The results were then compared with those of a vascular radiologist. Six surgeons agreed on the suitability of endovascular repair in 45% of cases (95% CI, 23.1-68.5%; 9/20 scans; {kappa} = 0.41 [p = 0.01]) and concurred with the radiologist in eight of these. Individually, agreement ranged from 13 to 16 of the 20 scans, 65-80% between surgeons. The kappa value for agreement between all the surgeons and the radiologist was 0.47 (p = 0.01, moderate agreement). For the individual surgeons, this ranged from 0.3 to 0.6 (p = 0.01). In conclusion, while overall agreement was moderate between the surgeons and the radiologist, it is clear that if surgeons are to assess patients for ruptured EVAR in the future, focused training of surgical trainees is required.

  4. Value of a probabilistic atlas in medical image segmentation regarding non-rigid registration of abdominal CT scans

    NASA Astrophysics Data System (ADS)

    Park, Hyunjin; Meyer, Charles R.

    2012-10-01

    A probabilistic atlas provides important information to help segmentation and registration applications in medical image analysis. We construct a probabilistic atlas by picking a target geometry and mapping other training scans onto that target and then summing the results into one probabilistic atlas. By choosing an atlas space close to the desired target, we construct an atlas that represents the population well. Image registration used to map one image geometry onto another is a primary task in atlas building. One of the main parameters of registration is the choice of degrees of freedom (DOFs) of the geometric transform. Herein, we measure the effect of the registration's DOFs on the segmentation performance of the resulting probabilistic atlas. Twenty-three normal abdominal CT scans were used, and four organs (liver, spinal cord, left and right kidneys) were segmented for each scan. A well-known manifold learning method, ISOMAP, was used to find the best target space to build an atlas. In summary, segmentation performance was high for high DOF registrations regardless of the chosen target space, while segmentation performance was lowered for low DOF registrations if a target space was far from the best target space. At the 0.05 level of statistical significance, there were no significant differences at high DOF registrations while there were significant differences at low DOF registrations when choosing different targets.

  5. Measuring abdominal circumference and skeletal muscle from a single cross-sectional CT image: a step-by-step guide for clinicians using National Institutes of Health ImageJ

    PubMed Central

    Gomez-Perez, Sandra L.; Haus, Jacob M; Sheean, Patricia; Patel, Bimal; Mar, Winnie; Chaudhry, Vivek; McKeever, Liam; Braunschweig, Carol

    2015-01-01

    Diagnostic computed tomography (CT) scans provide numerous opportunities for body composition analysis including quantification of abdominal circumference, abdominal adipose tissues (subcutaneous, visceral and intermuscular) and skeletal muscle (SM). CT scans are commonly performed for diagnostic purposes in clinical settings and methods for estimating abdominal circumference and whole-body SM mass from them have been reported. A supine abdominal circumference is a valid measure of waist circumference (WC). The valid correlation between a single cross sectional CT image (slice) at third lumbar (L3) for abdominal SM and whole body SM is also well established. Sarcopenia refers to the age-associated decreased in muscle mass and function. A single dimensional definition of sarcopenia using CT images that includes only assessment of low whole body SM has been validated in clinical populations and significantly associated with negative outcomes. However, despite the availability and precision of SM data from CT scans and the relationship between these measurements and clinical outcomes, they have not become a routine component of clinical nutrition assessment. Lack of time, training, and expense are potential barriers that prevent clinicians from fully embracing this technique. This tutorial presents a systematic, step-by-step guide to quickly quantify abdominal circumference as a proxy for WC and SM using a cross-sectional CT image from a regional diagnostic CT scan for clinical identification of sarcopenia. Multiple software options are available, however this tutorial utilizes ImageJ, a free public domain software developed by the National Institutes of Health (NIH). PMID:26392166

  6. Ultrasonography and computed tomography of inflammatory abdominal wall lesions

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-09-01

    Twenty-four patients with inflammatory lesions of the abdominal wall were examined by ultrasonography. Nine of these patients underwent computed tomographic (CT) scanning as well. Both ultrasonography and CT clearly delineated the exact location and extent of abdominal wall abscesses. Abscesses were easily differentiated from cellulitis or phlegmon with ultrasound. The peritoneal line was more clearly delineated on ultrasonograms than on CT scans; abscesses were also more distinct on the ultrasonograms because of their low echogenicity compared with the surrounding structures. Gas bubbles, fat density with specific low attenuation values, and underlying inflamed bowel loops in obese patients with Crohn's disease were better delineated by CT.

  7. Diagnostic value of CT compared to ultrasound in the evaluation of acute abdominal pain in children younger than 10 years old.

    PubMed

    Simanovsky, Natalia; Dola, Tamar; Hiller, Nurith

    2016-02-01

    To assess the diagnostic value of ultrasound compared to CT in evaluating acute abdominal pain of different causes in children 10 years of age and under, hospital records and imaging files of 4052 patients under age of 10 who had imaging for abdominal pain were reviewed. One-hundred-thirty-two patients (3 %), (74 males/58 females) who underwent ultrasound and CT within 24 h were divided by age: group I, ages 0-48 months (25 patients); group II, 49-84 months (53 patients); and group III, 85-120 months (54 patients). Diagnoses at ultrasound, CT, and discharge were compared. Cases of a change in diagnosis following CT and impact of the changed diagnosis on patient management were assessed. Non-diagnostic ultrasound or a diagnostic conundrum was present in a small percentage (3 %) of our patients. In the group of patients imaged with two modalities, CT changed the diagnosis in 73/132 patients (55.3 %). Patient management changed in 63/132 patients (47.7 %). CT changed the diagnosis in 46/64 patients with surgical conditions (71.8 %, p < 0.001). Among patients with surgical conditions, the difference between ultrasonography (US) and CT diagnoses was significant in groups 2 (p = 0.046) and 3 (p =  .001). The impact of the change in diagnosis in surgical patients imaged with two modalities was significant in the group as a whole and in each age group separately. Non-diagnostic or equivocal US in a small percentage of patients is probably sufficient to justify the additional radiation burden. PMID:26453370

  8. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    PubMed Central

    Servaes, Sabah; Naranjo, Arlene; Geller, James I.; Ehrlich, Peter F.; Gow, Kenneth W.; Perlman, Elizabeth J.; Dome, Jeffrey S.; Gratias, Eric; Mullen, Elizabeth A.

    2015-01-01

    Background CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. Objective To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. Materials and methods The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. Results The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P=0.73), while specificity was 86.5% and 83.8% (P=1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P=0.22), and specificity was 90.4% and 92.3% (P=1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. Conclusion CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco–regional staging of pediatric renal tumors. PMID:25135711

  9. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

    NASA Astrophysics Data System (ADS)

    Dhalisa, H.; Mohamad, A. S.; Rafidah, Z.

    2016-01-01

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia.

  10. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    SciTech Connect

    Park, Joon Young Kim, Shin Jung Kim, Hyoung Ook; Kim, Yong Tae; Lim, Nam Yeol Kim, Jae Kyu; Chung, Sang Young Choi, Soo Jin Na Lee, Ho Kyun

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  11. Population exposure to ionising radiation from CT examinations in Aosta Valley between 2001 and 2008

    PubMed Central

    Catuzzo, P; Aimonetto, S; Zenone, F; Fanelli, G; Marchisio, P; Meloni, T; Pasquino, M; Tofani, S

    2010-01-01

    Recent and continuous advances in CT, such as the development of multislice CT, have promoted a rapid increase in its clinical application. Today, CT accounts for approximately 10% of the total number of medical radiographic procedures worldwide. However, the growing performance of the new CT generations have increased not only the diagnostic opportunities, but also the radiation dose to the patient. The relative contribution to the collective radiation dose is now estimated to be approximately 50%. Several papers have been published concerning the intensive use of CT and its contribution to the collective dose. However, most of the literature concerns the years 1997–2003 and the dosimetric evaluations are generally limited to the main standard protocols (chest, head and abdomen), deriving the effective dose by the simple application of the diagnostic reference levels. Only specific dosimetric analyses of single and innovative procedures have been published recently. Moreover, few data comes from Italian radiology departments. This paper aims to bridge these gaps. Firstly, it characterises in terms of measured CT dose index (CTDI) two last-generation scanners of the Radiological Department of Aosta Hospital. Secondly, it evaluates the effective dose from most of the CT examinations performed from 2001 to 2008 to compare protocols and technologies in line with the suggestions of the 2007 Recommendations of the International Commission on Radiological Protection, Publication 103. Finally, it estimates the collective dose to the population. PMID:21088089

  12. Automatic detection and segmentation of liver metastatic lesions on serial CT examinations

    NASA Astrophysics Data System (ADS)

    Ben Cohen, Avi; Diamant, Idit; Klang, Eyal; Amitai, Michal; Greenspan, Hayit

    2014-03-01

    In this paper we present a fully automated method for detection and segmentation of liver metastases on serial CT examinations (portal phase) given a 2D baseline segmentation mask. Our database contains 27 CT scans, baselines and follow-ups, of 12 patients and includes 22 test cases. Our method is based on the information given in the baseline CT scan which contains the lesion's segmentation mask marked manually by a radiologist. We use the 2D baseline segmentation mask to identify the lesion location in the follow-up CT scan using non-rigid image registration. The baseline CT scan is also used to locate regions of tissues surrounding the lesion and to map them onto the follow-up CT scan, in order to reduce the search area on the follow-up CT scan. Adaptive region-growing and mean-shift segmentation are used to obtain the final lesion segmentation. The segmentation results are compared to those obtained by a human radiologist. Compared to the reference standard our method made a correct RECIST 1.1 assessment for 21 out of 22 test cases. The average Dice index was 0.83 +/- 0.07, average Hausdorff distance was 7.85+/- 4.84 mm, average sensitivity was 0.87 +/- 0.11 and positive predictive value was 0.81 +/- 0.10. The segmentation performance and the RECIST assessment results look promising. We are pursuing the methodology further with expansion to 3D segmentation while increasing the dataset we are collecting from the CT abdomen unit at Sheba medical center.

  13. Discrete Event Simulation Models for CT Examination Queuing in West China Hospital

    PubMed Central

    Luo, Li; Tang, Shijun; Shi, Yingkang; Guo, Huili

    2016-01-01

    In CT examination, the emergency patients (EPs) have highest priorities in the queuing system and thus the general patients (GPs) have to wait for a long time. This leads to a low degree of satisfaction of the whole patients. The aim of this study is to improve the patients' satisfaction by designing new queuing strategies for CT examination. We divide the EPs into urgent type and emergency type and then design two queuing strategies: one is that the urgent patients (UPs) wedge into the GPs' queue with fixed interval (fixed priority model) and the other is that the patients have dynamic priorities for queuing (dynamic priority model). Based on the data from Radiology Information Database (RID) of West China Hospital (WCH), we develop some discrete event simulation models for CT examination according to the designed strategies. We compare the performance of different strategies on the basis of the simulation results. The strategy that patients have dynamic priorities for queuing makes the waiting time of GPs decrease by 13 minutes and the degree of satisfaction increase by 40.6%. We design a more reasonable CT examination queuing strategy to decrease patients' waiting time and increase their satisfaction degrees. PMID:27547237

  14. Discrete Event Simulation Models for CT Examination Queuing in West China Hospital.

    PubMed

    Luo, Li; Liu, Hangjiang; Liao, Huchang; Tang, Shijun; Shi, Yingkang; Guo, Huili

    2016-01-01

    In CT examination, the emergency patients (EPs) have highest priorities in the queuing system and thus the general patients (GPs) have to wait for a long time. This leads to a low degree of satisfaction of the whole patients. The aim of this study is to improve the patients' satisfaction by designing new queuing strategies for CT examination. We divide the EPs into urgent type and emergency type and then design two queuing strategies: one is that the urgent patients (UPs) wedge into the GPs' queue with fixed interval (fixed priority model) and the other is that the patients have dynamic priorities for queuing (dynamic priority model). Based on the data from Radiology Information Database (RID) of West China Hospital (WCH), we develop some discrete event simulation models for CT examination according to the designed strategies. We compare the performance of different strategies on the basis of the simulation results. The strategy that patients have dynamic priorities for queuing makes the waiting time of GPs decrease by 13 minutes and the degree of satisfaction increase by 40.6%. We design a more reasonable CT examination queuing strategy to decrease patients' waiting time and increase their satisfaction degrees. PMID:27547237

  15. Whole-body CT in polytrauma patients: The effect of arm position on abdominal image quality when using a human phantom

    NASA Astrophysics Data System (ADS)

    Jeon, Pil-Hyun; Kim, Hee-Joung; Lee, Chang-Lae; Kim, Dae-Hong; Lee, Won-Hyung; Jeon, Sung-Su

    2012-06-01

    For a considerable number of emergency computed tomography (CT) scans, patients are unable to position their arms above their head due to traumatic injuries. The arms-down position has been shown to reduce image quality with beam-hardening artifacts in the dorsal regions of the liver, spleen, and kidneys, rendering these images non-diagnostic. The purpose of this study was to evaluate the effect of arm position on the image quality in patients undergoing whole-body CT. We acquired CT scans with various acquisition parameters at voltages of 80, 120, and 140 kVp and an increasing tube current from 200 to 400 mAs in 50 mAs increments. The image noise and the contrast assessment were considered for quantitative analyses of the CT images. The image noise (IN), the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), and the coefficient of variation (COV) were evaluated. Quantitative analyses of the experiments were performed with CT scans representative of five different arm positions. Results of the CT scans acquired at 120 kVp and 250 mAs showed high image quality in patients with both arms raised above the head (SNR: 12.4, CNR: 10.9, and COV: 8.1) and both arms flexed at the elbows on the chest (SNR: 11.5, CNR: 10.2, and COV: 8.8) while the image quality significantly decreased with both arms in the down position (SNR: 9.1, CNR: 7.6, and COV: 11). Both arms raised, one arm raised, and both arms flexed improved the image quality compared to arms in the down position by reducing beam-hardening and streak artifacts caused by the arms being at the side of body. This study provides optimal methods for achieving higher image quality and lower noise in abdominal CT for trauma patients.

  16. CT Findings of Axillary Tuberculosis Lymphadenitis: A Case Detected by Breast Cancer Screening Examination

    PubMed Central

    Tanada, Yasuko; Yoshida, Kouichi; Adachi, Yasuko; Matsui, Kazuhiro

    2016-01-01

    We report the first description of CT findings of axillary tuberculous lymphadenitis confirmed by the pathological specimen. The breast cancer screening examination is one of the prime methods of detection of axillary tuberculous lymphadenitis. The most common site of axillary tuberculous lymphadenitis is the deep axilla. Screening mammography often fails to cover the whole axilla. The presence on the contrast-enhanced CT of unilateral multiple circumscribed dense nodes, some of which have large and dotted calcifications, might suggest tuberculous lymphadenitis in axillary region. PMID:27379192

  17. Influence of z overscanning on normalized effective doses calculated for pediatric patients undergoing multidetector CT examinations

    SciTech Connect

    Tzedakis, Antonis; Damilakis, John; Perisinakis, Kostas; Karantanas, Apostolos; Karabekios, Spiros; Gourtsoyiannis, Nicholas

    2007-04-15

    The purpose of this study was to evaluate the effect of z overscanning on normalized effective dose for pediatric patients undergoing multidetector-computed tomography (CT) examinations. Five commercially available mathematical anthropomorphic phantoms representing newborn, 1-, 5-, 10-, and 15-year-old patients and the Monte Carlo N-Particle (MCNP, version 4C2) radiation transport code were employed in the current study to simulate pediatric CT exposures. For all phantoms, axial and helical examinations at 120 kV tube voltage were simulated. Scans performed at 80 kV were also simulated. Sex-specific normalized effective doses were estimated for four standard CT examinations i.e., head-neck, chest, abdomen-pelvis, and trunk, for all pediatric phantoms. Data for both axial and helical mode acquisition were obtained. In the helical mode, z overscanning was taken into account. The validity of the Monte Carlo results was verified by comparison with dose data obtained using thermoluminescence dosimetry and a physical pediatric anthropomorphic phantom simulating a 10-year-old child. In all cases normalized effective dose values were found to increase with increasing z overscanning. The percentage differences in normalized data between axial and helical scans may reach 43%, 70%, 36%, and 26% for head-neck, chest, abdomen-pelvis, and trunk studies, respectively. Normalized data for female pediatric patients was in general higher compared to male patients for all ages, examined regions, and z overscanning values. For both male and female children, the normalized effective dose values were reduced as the age was increased. For the same typical exposure conditions, dose values decreased when lower tube voltage was used; for a 1-year-old child, for example, the effective dose was 3.8 times lower when 80 kV instead of 120 kV was used. Normalized data for the estimation of effective dose to pediatric patients undergoing standard axial and helical CT examinations on an

  18. Influence of z overscanning on normalized effective doses calculated for pediatric patients undergoing multidetector CT examinations.

    PubMed

    Tzedakis, Antonis; Damilakis, John; Perisinakis, Kostas; Karantanas, Apostolos; Karabekios, Spiros; Gourtsoyiannis, Nicholas

    2007-04-01

    The purpose of this study was to evaluate the effect of z overscanning on normalized effective dose for pediatric patients undergoing multidetector-computed tomography (CT) examinations. Five commercially available mathematical anthropomorphic phantoms representing newborn, 1-, 5-, 10-, and 15-year-old patients and the Monte Carlo N-Particle (MCNP, version 4C2) radiation transport code were employed in the current study to simulate pediatric CT exposures. For all phantoms, axial and helical examinations at 120 kV tube voltage were simulated. Scans performed at 80 kV were also simulated. Sex-specific normalized effective doses were estimated for four standard CT examinations i.e., head-neck, chest, abdomen-pelvis, and trunk, for all pediatric phantoms. Data for both axial and helical mode acquisition were obtained. In the helical mode, z overscanning was taken into account. The validity of the Monte Carlo results was verified by comparison with dose data obtained using thermoluminescence dosimetry and a physical pediatric anthropomorphic phantom simulating a 10-year-old child. In all cases normalized effective dose values were found to increase with increasing z overscanning. The percentage differences in normalized data between axial and helical scans may reach 43%, 70%, 36%, and 26% for head-neck, chest, abdomen-pelvis, and trunk studies, respectively. Normalized data for female pediatric patients was in general higher compared to male patients for all ages, examined regions, and z overscanning values. For both male and female children, the normalized effective dose values were reduced as the age was increased. For the same typical exposure conditions, dose values decreased when lower tube voltage was used; for a 1-year-old child, for example, the effective dose was 3.8 times lower when 80 kV instead of 120 kV was used. Normalized data for the estimation of effective dose to pediatric patients undergoing standard axial and helical CT examinations on an

  19. Intraoperative DynaCT Detection and Immediate Correction of a Type 1a Endoleak Following Endovascular Repair of Abdominal Aortic Aneurysm

    SciTech Connect

    Biasi, Lukla; Ali, Tahir; Hinchliffe, Robert; Morgan, Rob; Loftus, Ian; Thompson, Matt

    2009-05-15

    Reintervention following endovascular aneurysm repair (EVAR) is required in up to 10% of patients at 30 days and is associated with a demonstrable risk of increased mortality. Completion angiography cannot detect all graft-related anomalies and computed tomographic angiography is therefore mandatory to ensure clinical success. Intraoperative angiographic computed tomography (DynaCT; Siemens, Germany) utilizes cone beam reconstruction software and flat-panel detectors to generate CT-like images from rotational angiographic acquisitions. We report the intraoperative use of this novel technology in detecting and immediately treating a proximal anterior type Ia endoleak, following an endovascular abdominal aortic repair, which was not seen on completion angiography. Immediate evaluation of cross-sectional imaging following endograft deployment may allow for on-table correction of clinically significant stent-related complications. This should both improve technical success and minimize the need for early secondary intervention following EVAR.

  20. Iterative ct reconstruction from few projections for the nondestructive post irradiation examination of nuclear fuel assemblies

    NASA Astrophysics Data System (ADS)

    Abir, Muhammad Imran Khan

    The core components (e.g. fuel assemblies, spacer grids, control rods) of the nuclear reactors encounter harsh environment due to high temperature, physical stress, and a tremendous level of radiation. The integrity of these elements is crucial for safe operation of the nuclear power plants. The Post Irradiation Examination (PIE) can reveal information about the integrity of the elements during normal operations and off?normal events. Computed tomography (CT) is a tool for evaluating the structural integrity of elements non-destructively. CT requires many projections to be acquired from different view angles after which a mathematical algorithm is adopted for reconstruction. Obtaining many projections is laborious and expensive in nuclear industries. Reconstructions from a small number of projections are explored to achieve faster and cost-efficient PIE. Classical reconstruction algorithms (e.g. filtered back projection) cannot offer stable reconstructions from few projections and create severe streaking artifacts. In this thesis, conventional algorithms are reviewed, and new algorithms are developed for reconstructions of the nuclear fuel assemblies using few projections. CT reconstruction from few projections falls into two categories: the sparse-view CT and the limited-angle CT or tomosynthesis. Iterative reconstruction algorithms are developed for both cases in the field of compressed sensing (CS). The performance of the algorithms is assessed using simulated projections and validated through real projections. The thesis also describes the systematic strategy towards establishing the conditions of reconstructions and finds the optimal imaging parameters for reconstructions of the fuel assemblies from few projections.

  1. Staging of Primary Abdominal Lymphomas: Comparison of Whole-Body MRI with Diffusion-Weighted Imaging and 18F-FDG-PET/CT

    PubMed Central

    Stecco, Alessandro; Buemi, Francesco; Quagliozzi, Martina; Lombardi, Mariangela; Santagostino, Alberto; Sacchetti, Gian Mauro; Carriero, Alessandro

    2015-01-01

    Background. The purpose of this study was to compare the accuracy of whole-body MRI with diffusion-weighted sequences (WB-DW-MRI) with that of 18F-FDG-PET/CT in the staging of patients with primary gastrointestinal lymphoma. Methods. This retrospective study involved 17 untreated patients with primary abdominal gastrointestinal lymphoma. All patients underwent 18F-FDG-PET/CT and WB-DW-MRI. Histopathology findings or at least 6 months of clinical and radiological follow-up was the gold standard. The Musshoff-modified Ann Arbor system was used for staging, and diagnostic accuracy was evaluated on a per-node basis. Results. WB-DW-MRI exhibited 100% sensitivity, 96.3% specificity, and 96.1% and 100% positive and negative predictive values (PPV and NPV), respectively. The sensitivity, specificity, and PPV and NPV of PET/CT were 95.9%, 100%, and 100% and 96.4%, respectively. There were no statistically significant differences between the two techniques (p = 0.05). The weighted kappa agreement statistics with a 95% confidence interval were 0.97 (0.95–0.99) between the two MRI readers and 0.87 (0.82–0.92) between the two methods. Conclusions. WB-DW-MRI appears to have a comparable diagnostic value to 18F-FDG-PET/CT in staging patients with gastrointestinal lymphoma. PMID:26798331

  2. The relevance of image quality indices for dose optimization in abdominal multi-detector row CT in children: experimental assessment with pediatric phantoms

    NASA Astrophysics Data System (ADS)

    Brisse, H. J.; Brenot, J.; Pierrat, N.; Gaboriaud, G.; Savignoni, A.; DeRycke, Y.; Neuenschwander, S.; Aubert, B.; Rosenwald, J.-C.

    2009-04-01

    This study assessed and compared various image quality indices in order to manage the dose of pediatric abdominal MDCT protocols and to provide guidance on dose reduction. PMMA phantoms representing average body diameters at birth, 1 year, 5 years, 10 years and 15 years of age were scanned in a four-channel MDCT with a standard pediatric abdominal CT protocol. Image noise (SD, standard deviation of CT number), noise derivative (ND, derivative of the function of noise with respect to dose) and contrast-to-noise ratio (CNR) were measured. The 'relative' low-contrast detectability (rLCD) was introduced as a new quantity to adjust LCD to the various phantom diameters on the basis of the LCD1% assessed in a Catphan® phantom and a constant central absorbed dose. The required variations of CTDIvol16 with respect to phantom size were analyzed in order to maintain each image quality index constant. The use of a fixed SD or CNR level leads to major dose ratios between extreme patient sizes (factor 22.7 to 44 for SD, 31.7 to 51.5 for CNR2.8%), whereas fixed ND and rLCD result in acceptable dose ratios ranging between factors of 2.9 and 3.9 between extreme phantom diameters. For a 5-9 mm rLCD1%, adjusted ND values range between -0.84 and -0.11 HU mGy-1. Our data provide guidance on dose reduction on the basis of patient dimensions and the required rLCD (e.g., to get a constant 7 mm rLCD1% for abdominal diameters of 10, 13, 16, 20 and 25 cm, tube current-time product should be adjusted in order to obtain CTDIvol16 values of 6.2, 7.2, 8.8, 11.6 and 17.7 mGy, respectively).

  3. Poster — Thur Eve — 06: Dose assessment of cone beam CT imaging protocols as part of SPECT/CT examinations

    SciTech Connect

    Tonkopi, E; Ross, AA

    2014-08-15

    Purpose: To assess radiation dose from the cone beam CT (CBCT) component of SPECT/CT studies and to compare with other CT examinations performed in our institution. Methods: We used an anthropomorphic chest phantom and the 6 cc ion chamber to measure entrance breast dose for several CBCT and diagnostic CT acquisition protocols. The CBCT effective dose was calculated with ImPACT software; the CT effective dose was evaluated from the DLP value and conversion factor, dependent on the anatomic region. The RADAR medical procedure radiation dose calculator was used to assess the nuclear medicine component of exam dose. Results: The entrance dose to the breast measured with the anthropomorphic phantom was 0.48 mGy and 9.41 mGy for cardiac and chest CBCT scans; and 4.59 mGy for diagnostic thoracic CT. The effective doses were 0.2 mSv, 3.2 mSv and 2.8 mSv respectively. For a small patient represented by the anthropomorphic phantom, the dose from the diagnostic CT was lower than from the CBCT scan, as a result of the exposure reduction options available on modern CT scanners. The CBCT protocols used the same fixed scanning techniques. The diagnostic CT dose based on the patient data was 35% higher than the phantom dose. For most SPECT/CT studies the dose from the CBCT component was comparable with the dose from the radiopharmaceutical. Conclusions: The patient radiation dose from the cone beam CT scan can be higher than that from a diagnostic CT and should be taken into consideration in evaluating total SPECT/CT patient dose.

  4. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  5. Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999–2004

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12–18 y of age (n = 5811). ...

  6. Computation of thyroid doses and carcinogenic radiation risks to patients undergoing neck CT examinations.

    PubMed

    Huda, Walter; Spampinato, Maria V; Tipnis, Sameer V; Magill, Dennise

    2013-10-01

    The aim of the study was to investigate how differences in patient anatomy and CT technical factors in neck CT impact on thyroid doses and the corresponding carcinogenic risks. The CTDIvol and dose-length product used in 11 consecutive neck CT studies, as well as data on automatic exposure control (AEC) tube current variation(s) from the image DICOM header, were recorded. For each CT image that included the thyroid, the mass equivalent water cylinder was estimated based on the patient cross-sectional area and average relative attenuation coefficient (Hounsfield unit, HU). Patient thyroid doses were estimated by accounting for radiation intensity at the location of the patient's thyroid, patient size and the scan length. Thyroid doses were used to estimate thyroid cancer risks as a function of patient demographics using risk factors in BEIR VII. The length of the thyroid glands ranged from 21 to 54 mm with an average length of 42 ± 12 mm. Water cylinder diameters corresponding to the central slice through the patient thyroid ranged from 18 to 32 cm with a mean of 25 ± 5 cm. The average CTDIvol (32-cm phantom) used to perform these scans was 26 ± 6 mGy, but the use of an AEC increased the tube current by an average of 44 % at the thyroid mid-point. Thyroid doses ranged from 29 to 80 mGy, with an average of 55 ± 19 mGy. A 20-y-old female receiving the highest thyroid dose of 80 mGy would have a thyroid cancer risk of nearly 0.1 %, but radiation risks decreased very rapidly with increasing patient age. The key factors that affect thyroid doses in neck CT examinations are the radiation intensity at the thyroid location and the size of the patient. The corresponding patient thyroid cancer risk is markedly influenced by patient sex and age. PMID:23579263

  7. Bedside ultrasonography in the pediatric emergency department: the focused assessment with sonography in trauma examination uncovers an occult intra-abdominal tumor.

    PubMed

    Gallagher, Rachel; Vieira, Rebecca; Levy, Jason

    2012-10-01

    We present a case of a 3-year-old male with history of minor trauma, who was brought in by ambulance from the playground where he had an acute mental status change and was noted to be hypotensive on initial evaluation. History and examination did not indicate a clear etiology of his symptoms. Point-of-care emergency ultrasonography revealed free fluid in the abdomen and expedited the care of the child's unexpected intra-abdominal hemorrhage from an occult abdominal tumor. This case demonstrates the ability of practitioners to expedite and focus care with the use of rapid assessment with ultrasonography in the pediatric emergency department. PMID:23034502

  8. Detection of abdominal aortic graft infection: comparison of CT and In-labeled white blood cell scans

    SciTech Connect

    Mark, A.S.; McCarthy, S.M.; Moss, A.A.; Price, D.

    1985-02-01

    Aortic graft infections are a rare but potentially lethal complication of aortic graft surgery. The diagnosis and assessment of the extent of a graft infection is difficult on clinical grounds. A prospective study compared CT and indium-labeled white blood cell (In-WBC) scans in the diagnosis of aortic graft infection. Five patients with aortic graft infection and three patients without aortic graft infection were studied by both methods. CT correctly detected the retroperitoneal extension of the infection in three patients with groin infection; In-WBC scans diagnosed the extension only in one patient. Both CT and In-WBC were positive in two patients with aortic graft infection but no groin infection. Both studies were negative in the three patients without evidence of aortic graft infection. The study suggests that CT is more sensitive than In-WBC in evaluating the extent of aortic graft infection and should be the imaging method of choice.

  9. Development of age-specific Japanese head phantoms for dose evaluation in paediatric head CT examinations.

    PubMed

    Yamauchi-Kawaura, C; Fujii, K; Akahane, K; Yamauchi, M; Narai, K; Aoyama, T; Katsu, T; Obara, S; Imai, K; Ikeda, M

    2015-02-01

    In this study, the authors developed age-specific physical head phantoms simulating the physique of Japanese children for dose evaluation in paediatric head computed tomography (CT) examinations. Anatomical structures at 99 places in 0-, 0.5-, 1- and 3-y-old Japanese patients were measured using DICOM viewer software from CT images, and the head phantom of each age was designed. For trial manufacture, a 3-y-old head phantom consisting of acrylic resin and gypsum was produced by machine processing. Radiation doses for the head phantom were measured with radiophotoluminescence glass dosemeters and Si-pin photodiode dosemeters. To investigate whether the phantom shape was suitable for dose evaluation, organ doses in the same scan protocol were compared between the 3-y-old head and commercially available anthropomorphic phantoms having approximately the same head size. The doses of organs in both phantoms were equivalent. The authors' designed paediatric head phantom will be useful for dose evaluation in paediatric head CT examinations. PMID:24821932

  10. Estimation of the weighted CTDI{sub {infinity}} for multislice CT examinations

    SciTech Connect

    Li Xinhua; Zhang Da; Liu, Bob

    2012-02-15

    Purpose: The aim of this study was to examine the variations of CT dose index (CTDI) efficiencies, {epsilon}(CTDI{sub 100})=CTDI{sub 100}/CTDI{sub {infinity}}, with bowtie filters and CT scanner types. Methods: This was an extension of our previous study [Li, Zhang, and Liu, Phys. Med. Biol. 56, 5789-5803 (2011)]. A validated Monte Carlo program was used to calculate {epsilon}(CTDI{sub 100}) on a Siemens Somatom Definition scanner. The {epsilon}(CTDI{sub 100}) dependencies on tube voltages and beam widths were tested in previous studies. The influences of different bowtie filters and CT scanner types were examined in this work. The authors tested the variations of {epsilon}(CTDI{sub 100}) with bowtie filters on the Siemens Definition scanner. The authors also analyzed the published CTDI measurements of four independent studies on five scanners of four models from three manufacturers. Results: On the Siemens Definition scanner, the difference in {epsilon}(CTDI{sub W}) between using the head and body bowtie filters was 2.5% (maximum) in the CT scans of the 32-cm phantom, and 1.7% (maximum) in the CT scans of the 16-cm phantom. Compared with CTDI{sub W}, the weighted CTDI{sub {infinity}} increased by 30.5% (on average) in the 32-cm phantom, and by 20.0% (on average) in the 16-cm phantom. These results were approximately the same for 80-140 kV and 1-40 mm beam widths (4.2% maximum deviation). The differences in {epsilon}(CTDI{sub 100}) between the simulations and the direct measurements of four previous studies were 1.3%-5.0% at the center/periphery of the 16-cm/32-cm phantom (on average). Conclusions: Compared with CTDI{sub vol}, the equilibrium dose for large scan lengths is 30.5% higher in the 32-cm phantom, and is 20.0% higher in the 16-cm phantom. The relative increases are practically independent of tube voltages (80-140 kV), beam widths (up to 4 cm), and the CT scanners covered in this study.

  11. Reference dosimetry during diagnostic CT examination using XR-QA radiochromic film model

    SciTech Connect

    Boivin, Jonathan; Tomic, Nada; Fadlallah, Bassam; DeBlois, Francois; Devic, Slobodan

    2011-09-15

    Purpose: The authors applied 2D reference dosimetry protocol for dose measurements using XR-QA radiochromic film model during diagnostic computed tomography (CT) examinations carried out on patients and humanoid Rando phantom. Methods: Response of XR-QA model GAFCHROMIC film reference dosimetry system was calibrated in terms of Air-Kerma in air. Four most commonly used CT protocols were selected on their CT scanner (GE Lightspeed VCT 64), covering three anatomical sites (head, chest, and abdomen). For each protocol, 25 patients ongoing planned diagnostic CT examination were recruited. Surface dose was measured using four or eight film strips taped on patients' skin and on Rando phantom. Film pieces were scanned prior to and after irradiation using Epson Expression 10000XL document scanner. Optical reflectance of the unexposed film piece was subtracted from exposed one to obtain final net reflectance change, which is subsequently converted to dose using previously established calibration curves. Results: The authors' measurements show that body skin dose variation has a sinusoidal pattern along the scanning axis due to the helical movement of the x-ray tube, and a comb pattern for head dose measurements due to its axial movement. Results show that the mean skin dose at anterior position for patients is (51 {+-} 6) mGy, (29 {+-} 11) mGy, (45 {+-} 13) mGy and (38 {+-} 20) mGy for head, abdomen, angio Abdomen, and chest and abdomen protocol (UP position), respectively. The obtained experimental dose length products (DLP) show higher values than CT based DLP taken from the scanner console for body protocols, but lower values for the head protocol. Internal dose measurements inside the phantom's head indicate nonuniformity of dose distribution within scanned volume. Conclusions: In this work, the authors applied an Air-Kerma in air based radiochromic film reference dosimetry protocol for in vivo skin dose measurements. In this work, they employed green channel extracted

  12. Automatic abdominal lymph node detection method based on local intensity structure analysis from 3D x-ray CT images

    NASA Astrophysics Data System (ADS)

    Nakamura, Yoshihiko; Nimura, Yukitaka; Kitasaka, Takayuki; Mizuno, Shinji; Furukawa, Kazuhiro; Goto, Hidemi; Fujiwara, Michitaka; Misawa, Kazunari; Ito, Masaaki; Nawano, Shigeru; Mori, Kensaku

    2013-03-01

    This paper presents an automated method of abdominal lymph node detection to aid the preoperative diagnosis of abdominal cancer surgery. In abdominal cancer surgery, surgeons must resect not only tumors and metastases but also lymph nodes that might have a metastasis. This procedure is called lymphadenectomy or lymph node dissection. Insufficient lymphadenectomy carries a high risk for relapse. However, excessive resection decreases a patient's quality of life. Therefore, it is important to identify the location and the structure of lymph nodes to make a suitable surgical plan. The proposed method consists of candidate lymph node detection and false positive reduction. Candidate lymph nodes are detected using a multi-scale blob-like enhancement filter based on local intensity structure analysis. To reduce false positives, the proposed method uses a classifier based on support vector machine with the texture and shape information. The experimental results reveal that it detects 70.5% of the lymph nodes with 13.0 false positives per case.

  13. Estimation of CT-Derived Abdominal Visceral and Subcutaneous Adipose Tissue Depots from Anthropometry in Europeans, South Asians and African Caribbeans

    PubMed Central

    Eastwood, Sophie V.; Tillin, Therese; Wright, Andrew; Heasman, John; Willis, Joseph; Godsland, Ian F.; Forouhi, Nita; Whincup, Peter; Hughes, Alun D.; Chaturvedi, Nishi

    2013-01-01

    Background South Asians and African Caribbeans experience more cardiometabolic disease than Europeans. Risk factors include visceral (VAT) and subcutaneous abdominal (SAT) adipose tissue, which vary with ethnicity and are difficult to quantify using anthropometry. Objective We developed and cross-validated ethnicity and gender-specific equations using anthropometrics to predict VAT and SAT. Design 669 Europeans, 514 South Asians and 227 African Caribbeans (70±7 years) underwent anthropometric measurement and abdominal CT scanning. South Asian and African Caribbean participants were first-generation migrants living in London. Prediction equations were derived for CT-measured VAT and SAT using stepwise regression, then cross-validated by comparing actual and predicted means. Results South Asians had more and African Caribbeans less VAT than Europeans. For basic VAT prediction equations (age and waist circumference), model fit was better in men (R2 range 0.59-0.71) than women (range 0.35-0.59). Expanded equations (+ weight, height, hip and thigh circumference) improved fit for South Asian and African Caribbean women (R2 0.35 to 0.55, and 0.43 to 0.56 respectively). For basic SAT equations, R2 was 0.69-0.77, and for expanded equations it was 0.72-0.86. Cross-validation showed differences between actual and estimated VAT of <7%, and SAT of <8% in all groups, apart from VAT in South Asian women which disagreed by 16%. Conclusion We provide ethnicity- and gender-specific VAT and SAT prediction equations, derived from a large tri-ethnic sample. Model fit was reasonable for SAT and VAT in men, while basic VAT models should be used cautiously in South Asian and African Caribbean women. These equations will aid studies of mechanisms of cardiometabolic disease in later life, where imaging data are not available. PMID:24069381

  14. Multislice CT Angiography of Fenestrated Endovascular Stent Grafting for Treating Abdominal Aortic Aneurysms: a Pictorial Review of the 2D/3D Visualizations

    PubMed Central

    Mwipatayi, Bibombe P; Allen, Yvonne B; Hartley, David E; Lawrence-Brown, Michael M

    2009-01-01

    Fenestrated endovascular repair of an abdominal aortic aneurysm has been developed to treat patients with a short or complicated aneurysm neck. Fenestration involves creating an opening in the graft fabric to accommodate the orifice of the vessel that is targeted for preservation. Fixation of the fenestration to the renal arteries and the other visceral arteries can be done by implanting bare or covered stents across the graft-artery ostia interfaces so that a portion of the stent protrudes into the aortic lumen. Accurate alignment of the targeted vessels in a longitudinal aspect is hard to achieve during stent deployment because rotation of the stent graft may take place during delivery from the sheath. Understanding the 3D relationship of the aortic branches and the fenestrated vessel stents following fenestration will aid endovascular specialists to evaluate how the stent graft is situated within the aorta after placement of fenestrations. The aim of this article is to provide the 2D and 3D imaging appearances of the fenestrated endovascular grafts that were implanted in a group of patients with abdominal aortic aneurysms, based on the multislice CT angiography. The potential applications of each visualization technique were explored and compared with the 2D axial images. PMID:19412517

  15. Radiation dose to radiosensitive organs in PET/CT myocardial perfusion examination using versatile optical fibre

    NASA Astrophysics Data System (ADS)

    Salasiah, M.; Nordin, A. J.; Fathinul Fikri, A. S.; Hishar, H.; Tamchek, N.; Taiman, K.; Ahmad Bazli, A. K.; Abdul-Rashid, H. A.; Mahdiraji, G. A.; Mizanur, R.; Noor, Noramaliza M.

    2013-05-01

    Cardiac positron emission tomography (PET) provides a precise method in order to diagnose obstructive coronary artery disease (CAD), compared to single photon emission tomography (SPECT). PET is suitable for obese and patients who underwent pharmacologic stress procedures. It has the ability to evaluate multivessel coronary artery disease by recording changes in left ventricular function from rest to peak stress and quantifying myocardial perfusion (in mL/min/g of tissue). However, the radiation dose to the radiosensitive organs has become crucial issues in the Positron Emission Tomography/Computed Tomography(PET/CT) scanning procedure. The objective of this study was to estimate radiation dose to radiosensitive organs of patients who underwent PET/CT myocardial perfusion examination at Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia in one month period using versatile optical fibres (Ge-B-doped Flat Fibre) and LiF (TLD-100 chips). All stress and rest paired myocardial perfusion PET/CT scans will be performed with the use of Rubidium-82 (82Rb). The optic fibres were loaded into plastic capsules and attached to patient's eyes, thyroid and breasts prior to the infusion of 82Rb, to accommodate the ten cases for the rest and stress PET scans. The results were compared with established thermoluminescence material, TLD-100 chips. The result shows that radiation dose given by TLD-100 and Germanium-Boron-doped Flat Fiber (Ge-B-doped Flat Fiber) for these five organs were comparable to each other where the p>0.05. For CT scans,thyroid received the highest dose compared to other organs. Meanwhile, for PET scans, breasts received the highest dose.

  16. Pulmonary airways tree segmentation from CT examinations using adaptive volume of interest

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Kim, Won Pil; Zheng, Bin; Leader, Joseph K.; Pu, Jiantao; Tan, Jun; Gur, David

    2009-02-01

    Airways tree segmentation is an important step in quantitatively assessing the severity of and changes in several lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis. It can also be used in guiding bronchoscopy. The purpose of this study is to develop an automated scheme for segmenting the airways tree structure depicted on chest CT examinations. After lung volume segmentation, the scheme defines the first cylinder-like volume of interest (VOI) using a series of images depicting the trachea. The scheme then iteratively defines and adds subsequent VOIs using a region growing algorithm combined with adaptively determined thresholds in order to trace possible sections of airways located inside the combined VOI in question. The airway tree segmentation process is automatically terminated after the scheme assesses all defined VOIs in the iteratively assembled VOI list. In this preliminary study, ten CT examinations with 1.25mm section thickness and two different CT image reconstruction kernels ("bone" and "standard") were selected and used to test the proposed airways tree segmentation scheme. The experiment results showed that (1) adopting this approach affectively prevented the scheme from infiltrating into the parenchyma, (2) the proposed method reasonably accurately segmented the airways trees with lower false positive identification rate as compared with other previously reported schemes that are based on 2-D image segmentation and data analyses, and (3) the proposed adaptive, iterative threshold selection method for the region growing step in each identified VOI enables the scheme to segment the airways trees reliably to the 4th generation in this limited dataset with successful segmentation up to the 5th generation in a fraction of the airways tree branches.

  17. A Computational Geometry Approach to Automated Pulmonary Fissure Segmentation in CT Examinations

    PubMed Central

    Pu, Jiantao; Leader, Joseph K; Zheng, Bin; Knollmann, Friedrich; Fuhrman, Carl; Sciurba, Frank C; Gur, David

    2010-01-01

    Identification of pulmonary fissures, which form the boundaries between the lobes in the lungs, may be useful during clinical interpretation of CT examinations to assess the early presence and characterization of manifestation of several lung diseases. Motivated by the unique nature of the surface shape of pulmonary fissures in three-dimensional space, we developed a new automated scheme using computational geometry methods to detect and segment fissures depicted on CT images. After a geometric modeling of the lung volume using the Marching Cube Algorithm, Laplacian smoothing is applied iteratively to enhance pulmonary fissures by depressing non-fissure structures while smoothing the surfaces of lung fissures. Next, an Extended Gaussian Image based procedure is used to locate the fissures in a statistical manner that approximates the fissures using a set of plane “patches.” This approach has several advantages such as independence of anatomic knowledge of the lung structure except the surface shape of fissures, limited sensitivity to other lung structures, and ease of implementation. The scheme performance was evaluated by two experienced thoracic radiologists using a set of 100 images (slices) randomly selected from 10 screening CT examinations. In this preliminary evaluation 98.7% and 94.9% of scheme segmented fissure voxels are within 2 mm of the fissures marked independently by two radiologists in the testing image dataset. Using the scheme detected fissures as reference, 89.4% and 90.1% of manually marked fissure points have distance ≤ 2 mm to the reference suggesting a possible under-segmentation of the scheme. The case-based RMS (root-mean-square) distances (“errors”) between our scheme and the radiologist ranged from 1.48±0.92 to 2.04±3.88 mm. The discrepancy of fissure detection results between the automated scheme and either radiologist is smaller in this dataset than the inter-reader variability. PMID:19272987

  18. Automatic segmentation of the liver using multi-planar anatomy and deformable surface model in abdominal contrast-enhanced CT images

    NASA Astrophysics Data System (ADS)

    Jang, Yujin; Hong, Helen; Chung, Jin Wook; Yoon, Young Ho

    2012-02-01

    We propose an effective technique for the extraction of liver boundary based on multi-planar anatomy and deformable surface model in abdominal contrast-enhanced CT images. Our method is composed of four main steps. First, for extracting an optimal volume circumscribing a liver, lower and side boundaries are defined by positional information of pelvis and rib. An upper boundary is defined by separating the lungs and heart from CT images. Second, for extracting an initial liver volume, optimal liver volume is smoothed by anisotropic diffusion filtering and is segmented using adaptively selected threshold value. Third, for removing neighbor organs from initial liver volume, morphological opening and connected component labeling are applied to multiple planes. Finally, for refining the liver boundaries, deformable surface model is applied to a posterior liver surface and missing left robe in previous step. Then, probability summation map is generated by calculating regional information of the segmented liver in coronal plane, which is used for restoring the inaccurate liver boundaries. Experimental results show that our segmentation method can accurately extract liver boundaries without leakage to neighbor organs in spite of various liver shape and ambiguous boundary.

  19. IV Leiomyomatosis on FDG PET/CT.

    PubMed

    Jin, Xiaona; Li, Fang; Lu, Zhaohui; Cheng, Wuying

    2016-07-01

    A 48-year-old woman presented with a 2-month history of right lower extremity edema. Clinical examination only showed right lower limb swelling. Routine laboratory examination revealed no abnormal results. Abdominal ultrasonography identified uterine leiomyoma and soft tissue masses. An abdominal CT demonstrated a continuous mass extending from the right internal and external iliac vein into the common iliac vein and inferior vena cava. To distinguish the mass from malignancy, the patient underwent PET/CT scan which showed increased FDG activity in the mass. However, histopathological examination proved the mass to be IV leiomyomatosis. PMID:26914578

  20. Spectrum and detection of musculoskeletal findings on trauma-related CT torso examinations.

    PubMed

    Kung, Justin W; Wu, Jim S; Shetty, Sanjay K; Khasgiwala, Vhaibhav C; Appleton, Paul; Hochman, Mary G

    2014-08-01

    This study aims (1) to evaluate the spectrum of musculoskeletal (MSK) findings detected on trauma-related torso CT exams performed in the emergency department and (2) to identify the findings of high clinical importance that are underreported. Following IRB approval, two fellowship-trained MSK radiologists independently reviewed 200 consecutive trauma CT torso examinations performed at a level 1 trauma center, focusing on MSK findings. Discrepancies were resolved by consensus. Findings were categorized as of high, moderate, or low clinical importance based on criteria established with an orthopedic trauma surgeon. Findings evident on only one series (scout, axial, or sagittal/coronal reformations) were documented. The consensus reading was compared to the final report. Unreported findings of high clinical importance were entered into our departmental QA system. Eighty-two percent (164/200) of the studies had at least one MSK finding. There were 433 total findings of varying importance and the overall detection rate was 61 % (266/433). The detection rate for high importance findings was 80 % (177/221) with the majority representing acute fractures (99 %). For findings of high clinical importance, the lowest detection rates were for fractures of the sternum, proximal humerus, and forearm. Of the high severity findings, 6.3 % (14/221) were detected only on sagittal or coronal reformatted or scout images. Twenty percent of musculoskeletal findings of high clinical importance on trauma-related CT torso exams were not reported. Fractures of the sternum, proximal humerus, and forearm were the most commonly missed fractures and review of scout and multiplanar reformations can increase detection. PMID:24557456

  1. Analysis of Heart Rate and Heart Rate Variation During Cardiac CT Examinations

    PubMed Central

    Zhang, Jie; Fletcher, Joel G.; Harmsen, W. Scott; Araoz, Philip A.; Williamson, Eric E.; Primak, Andrew N.; McCollough, Cynthia H.

    2009-01-01

    Rationale and Objectives We sought to examine heart rate and heart rate variability during cardiac computed tomography (CT). Materials and Methods Ninety patients (59.0 ± 13.5 years) underwent coronary CT angiography (CTA), with 52 patients also undergoing coronary artery calcium scanning (CAC). Forty-two patients with heart rate greater than 70 bpm were pretreated with oral β-blockers (in five patients, use of β-blocker was not known). Sixty-four patients were given sublingual nitroglycerin. Mean heart rate and percentage of beats outside a ±5 bpm region about the mean were compared between baseline (free breathing), prescan hyperventilation, and scan acquisition (breath-hold). Results Mean scan acquisition time was 13.1 ± 1.5 seconds for CAC scanning and 14.2 ± 2.9 seconds for coronary CTA. Mean heart rate during scan acquisition was significantly lower than at baseline (CAC 58.2 ± 8.5 bpm; CTA 59.2 ± 8.8 bpm; baseline 62.8 ± 8.9 bpm; P < .001). The percentage of beats outside a ±5 bpm about the mean were not different between baseline and CTA scanning (3.5% versus 3.3%, P = .87). The injection of contrast had no significant effect on heart rate (58.2 bpm versus 59.2 bpm, P = .24) or percentage of beats outside a ±5 bpm about the mean (3.0% versus 3.3%, P = .64). No significant difference was found between gender and age groups (P > .05). Conclusions Breath-holding during cardiac CT scan acquisition significantly lowers the mean heart rate by approximately 4 bpm, but heart rate variability is the same or less compared with normal breathing. PMID:18078905

  2. How Much Is the Dose Varying between Follow-Up CT-Examinations Performed on the Same Scanner with the Same Imaging Protocol?

    PubMed Central

    Stecker, Franz Ferdinand; Guberina, Nika; Ringelstein, Adrian; Schlosser, Thomas; Theysohn, Jens Matthias; Forsting, Michael

    2016-01-01

    Purpose To investigate the dose variation between follow-up CT examinations, when a patient is examined several times on the same scanner with the identical scan protocol which comprised automated exposure control. Material and Methods This retrospective study was approved by the local ethics committee. The volume computed tomography dose index (CTDIvol) and the dose-length-product (DLP) were recorded for 60 cancer patients (29 male, 31 female, mean age 60.1 years), who received 3 follow-up CT examinations each composed of a non-enhanced scan of the liver (LI-CT) and a contrast-enhanced scan of chest (CH-CT) and abdomen (AB-CT). Each examination was performed on the same scanner (Siemens Definition FLASH) equipped with automated exposure control (CARE Dose 4D and CARE KV) using the identical scan protocol. Results The median percentage difference in DLP between follow-up examinations was 9.6% for CH-CT, 10.3% for LI-CT, and 10.1% for AB-CT; the median percentage difference in CTDIvol 8.3% for CH-CT, 7.4% for LI-CT and 7.7% for AB-CT (p<0.0001 for all values). The maximum difference in DLP between follow-up examinations was 67.5% for CH-CT, 50.8% for LI-CT and 74.3% for AB-CT; the maximum difference in CTDIvol 62.9% for CH-CT, 47.2% for LI-CT, and 49% for AB-CT. Conclusion A significant variance in the radiation dose occurs between follow-up CT examinations when the same CT scanner and the identical imaging protocol are used in combination with automated exposure control. PMID:27050659

  3. Multichannel fiber optic broadband video communication system for monitoring CT/MR examinations

    NASA Astrophysics Data System (ADS)

    Huang, H. K.; Kangarloo, Hooshang; Tecotzky, Raymond H.; Cheng, Xin; Vanderweit, Don

    1991-05-01

    The Department of Radiological Sciences, UCLA operates five MR and four CT scanners located in three different buildings and two mobile sites. We have designed and implemented a multi-channel fiber optic broadband video communication system connecting these scanners together. This system consists of baseband fiber optic transmitters and receivers, a multiplexing headend, and broadband fiber optic transmitters and receivers. It can serve up to 5 km. The video signal from each scanner is sent through a baseband fiber optic link to the headend, where it is frequency modulated and distributed over broadband fiber optic links. A receiver, consisting of a demodulator, a TV monitor, and a channel selector, is placed at fourteen strategic locations including the fiber optic hub rooms, chest, neuroradiology, abdomen, bone, gastrointestinal, genitourinary, and pediatric reading rooms as well as scheduling rooms. A radiologist can use any of these fourteen receivers to view a patient''s CT/MR image in real time by selecting the proper channel assigned to the scanner, and use the telephone to communicate with the technologist to monitor the examination. This fiber optic broadband video communication system has been integrated into daily clinical use.

  4. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  5. Evaluation of organ doses in adult and paediatric CT examinations based on Monte Carlo simulations and in-phantom dosimetry.

    PubMed

    Fujii, K; Nomura, K; Muramatsu, Y; Takahashi, K; Obara, S; Akahane, K; Satake, M

    2015-07-01

    The aim of this study was to validate the computed tomography dose index (CTDI) and organ doses evaluated by Monte Carlo simulations through comparisons with doses evaluated by in-phantom dosimetry. Organ doses were measured with radio-photoluminescence glass dosemeter (RGD) set at various organ positions within adult and 1-y-old anthropomorphic phantoms. For the dose simulations, the X-ray spectrum and bow-tie filter shape of a CT scanner were estimated and 3D voxelised data of the CTDI and anthropomorphic phantoms from the acquired CT images were derived. Organ dose simulations and measurements were performed with chest and abdomen-pelvis CT examination scan parameters. Relative differences between the simulated and measured doses were within 5 % for the volume CTDI and 13 % for organ doses for organs within the scan range in adult and paediatric CT examinations. The simulation results were considered to be in good agreement with the measured doses. PMID:25848103

  6. Abdominal Aortic Intimal Flap Motion Characterization in Acute Aortic Dissection: Assessed with Retrospective ECG-Gated Thoracoabdominal Aorta Dual-Source CT Angiography

    PubMed Central

    Yang, Shifeng; Li, Xia; Chao, Baoting; Wu, Lebin; Cheng, Zhaoping; Duan, Yanhua; Wu, Dawei; Zhan, Yiqiang; Chen, Jiuhong; Liu, Bo; Ji, Xiaopeng; Nie, Pei; Wang, Ximing

    2014-01-01

    Objectives To evaluate the feasibility of dose-modulated retrospective ECG-gated thoracoabdominal aorta CT angiography (CTA) assessing abdominal aortic intimal flap motion and investigate the motion characteristics of intimal flap in acute aortic dissection (AAD). Materials and Methods 49 patients who had thoracoabdominal aorta retrospective ECG-gated CTA scan were enrolled. 20 datasets were reconstructed in 5% steps between 0 and 95% of the R-R interval in each case. The aortic intimal flap motion was assessed by measuring the short axis diameters of the true lumen and false lumen 2 cm above of celiac trunk ostium in different R-R intervals. Intimal flap motion and configuration was assessed by two independent observers. Results In these 49 patients, 37 had AAD, 7 had intramural hematoma, and 5 had negative result for acute aortic disorder. 620 datasets of 31 patients who showed double lumens in abdominal aorta were enrolled in evaluating intimal flap motion. The maximum and minimum true lumen diameter were 12.2±4.1 mm (range 2.6∼17.4) and 6.7±4.1 mm (range 0∼15.3) respectively. The range of intimal flap motion in all patients was 5.5±2.6 mm (range 1.8∼10.2). The extent of maximum true lumen diameter decreased during a cardiac cycle was 49.5%±23.5% (range 12%∼100%). The maximum motion phase of true lumen diameter was in systolic phase (5%∼40% of R-R interval). Maximum and minimum intimal flap motion was at 15% and 75% of the R-R interval respectively. Intimal flap configuration had correlation with the phase of cardiac cycle. Conclusions Abdominal intimal flap position and configuration varied greatly during a cardiac cycle. Retrospective ECG-gated thoracoabdominal aorta CTA can reflect the actual status of the true lumen and provide more information about true lumen collapse. This information may be helpful to diagnosis and differential diagnosis of dynamic abstraction. PMID:24503676

  7. Prospective Evaluation of Prior Image Constrained Compressed Sensing (PICCS) Algorithm in Abdominal CT: A comparison of reduced dose with standard dose imaging

    PubMed Central

    Lubner, Meghan G.; Pickhardt, Perry J.; Kim, David H.; Tang, Jie; Munoz del Rio, Alejandro; Chen, Guang-Hong

    2014-01-01

    Purpose To prospectively study CT dose reduction using the “prior image constrained compressed sensing” (PICCS) reconstruction technique. Methods Immediately following routine standard dose (SD) abdominal MDCT, 50 patients (mean age, 57.7 years; mean BMI, 28.8) underwent a second reduced-dose (RD) scan (targeted dose reduction, 70-90%). DLP, CTDIvol and SSDE were compared. Several reconstruction algorithms (FBP, ASIR, and PICCS) were applied to the RD series. SD images with FBP served as reference standard. Two blinded readers evaluated each series for subjective image quality and focal lesion detection. Results Mean DLP, CTDIvol, and SSDE for RD series was 140.3 mGy*cm (median 79.4), 3.7 mGy (median 1.8), and 4.2 mGy (median 2.3) compared with 493.7 mGy*cm (median 345.8), 12.9 mGy (median 7.9 mGy) and 14.6 mGy (median 10.1) for SD series, respectively. Mean effective patient diameter was 30.1 cm (median 30), which translates to a mean SSDE reduction of 72% (p<0.001). RD-PICCS image quality score was 2.8±0.5, improved over the RD-FBP (1.7±0.7) and RD-ASIR(1.9±0.8)(p<0.001), but lower than SD (3.5±0.5)(p<0.001). Readers detected 81% (184/228) of focal lesions on RD-PICCS series, versus 67% (153/228) and 65% (149/228) for RD-FBP and RD-ASIR, respectively. Mean image noise was significantly reduced on RD-PICCS series (13.9 HU) compared with RD-FBP (57.2) and RD-ASIR (44.1) (p<0.001). Conclusion PICCS allows for marked dose reduction at abdominal CT with improved image quality and diagnostic performance over reduced-dose FBP and ASIR. Further study is needed to determine indication-specific dose reduction levels that preserve acceptable diagnostic accuracy relative to higher-dose protocols. PMID:24943136

  8. Detection and visualization of endoleaks in CT data for monitoring of thoracic and abdominal aortic aneurysm stents

    NASA Astrophysics Data System (ADS)

    Lu, J.; Egger, J.; Wimmer, A.; Großkopf, S.; Freisleben, B.

    2008-03-01

    In this paper we present an efficient algorithm for the segmentation of the inner and outer boundary of thoratic and abdominal aortic aneurysms (TAA & AAA) in computed tomography angiography (CTA) acquisitions. The aneurysm segmentation includes two steps: first, the inner boundary is segmented based on a grey level model with two thresholds; then, an adapted active contour model approach is applied to the more complicated outer boundary segmentation, with its initialization based on the available inner boundary segmentation. An opacity image, which aims at enhancing important features while reducing spurious structures, is calculated from the CTA images and employed to guide the deformation of the model. In addition, the active contour model is extended by a constraint force that prevents intersections of the inner and outer boundary and keeps the outer boundary at a distance, given by the thrombus thickness, to the inner boundary. Based upon the segmentation results, we can measure the aneurysm size at each centerline point on the centerline orthogonal multiplanar reformatting (MPR) plane. Furthermore, a 3D TAA or AAA model is reconstructed from the set of segmented contours, and the presence of endoleaks is detected and highlighted. The implemented method has been evaluated on nine clinical CTA data sets with variations in anatomy and location of the pathology and has shown promising results.

  9. Abdominal Adhesions

    MedlinePlus

    ... Abdominal Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91– ... are abdominal adhesions and intestinal obstructions ... generally do not require treatment. Surgery is the only way to treat abdominal ...

  10. Prevalence and sonographic changes compatible with fatty liver disease in patients referred for abdominal ultrasound examination in Aracaju, SE*

    PubMed Central

    Cruz, Josilda Ferreira; Cruz, Mário Augusto Ferreira; Machado Neto, José; de Santana, Demetrius Silva; Oliveira, Cristiane Costa da Cunha; Lima, Sônia Oliveira

    2016-01-01

    Objective To estimate the prevalence and evaluate sonographic findings compatible with changes consistent with hepatic steatosis in patients referred for abdominal ultrasonography at four reference centers in Aracaju, SE, Brazil. Materials and Methods Prospective, descriptive survey, with analytical and quantitative approach, comprising abdominal ultrasonography scans performed with a convex, dynamic 3.75 MHz transducer. Liver dimensions and parenchymal echotexture were evaluated, classifying hepatic steatosis into grades (1, 2 or 3). The SPSS® 22.0 software was used for statistical analysis, adopting p < 0.05 as significance level. Results A total of 800 individuals (561 women and 239 men) were evaluated. The prevalence of steatosis was 29.1%, and the male patients were most affected, presenting with more advanced grades of disease (p = 0.021), as follows: 119 grade 1 (51.0%); 94 grade 2 (40.4%); and 20 grade 3 (8.6%). The median age patients' was 46 years. Conclusion In the present study sample, the prevalence of hepatic steatosis was high, particularly in the male patients. Ultrasonography is suggested as a first choice for the diagnosis of this condition, considering its wide availability, low cost and absence of side effects or risks to the patient. PMID:26929453

  11. A method of estimating conceptus doses resulting from multidetector CT examinations during all stages of gestation

    SciTech Connect

    Damilakis, John; Tzedakis, Antonis; Perisinakis, Kostas; Papadakis, Antonios E.

    2010-12-15

    Purpose: Current methods for the estimation of conceptus dose from multidetector CT (MDCT) examinations performed on the mother provide dose data for typical protocols with a fixed scan length. However, modified low-dose imaging protocols are frequently used during pregnancy. The purpose of the current study was to develop a method for the estimation of conceptus dose from any MDCT examination of the trunk performed during all stages of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study to model the Siemens Sensation 16 and Sensation 64 MDCT scanners. Four mathematical phantoms were used, simulating women at 0, 3, 6, and 9 months of gestation. The contribution to the conceptus dose from single simulated scans was obtained at various positions across the phantoms. To investigate the effect of maternal body size and conceptus depth on conceptus dose, phantoms of different sizes were produced by adding layers of adipose tissue around the trunk of the mathematical phantoms. To verify MCNP results, conceptus dose measurements were carried out by means of three physical anthropomorphic phantoms, simulating pregnancy at 0, 3, and 6 months of gestation and thermoluminescence dosimetry (TLD) crystals. Results: The results consist of Monte Carlo-generated normalized conceptus dose coefficients for single scans across the four mathematical phantoms. These coefficients were defined as the conceptus dose contribution from a single scan divided by the CTDI free-in-air measured with identical scanning parameters. Data have been produced to take into account the effect of maternal body size and conceptus position variations on conceptus dose. Conceptus doses measured with TLD crystals showed a difference of up to 19% compared to those estimated by mathematical simulations. Conclusions: Estimation of conceptus doses from MDCT examinations of the trunk performed on pregnant patients during all stages of gestation can be made

  12. Empirical Examination of the Adoption of WebCT Using TAM

    ERIC Educational Resources Information Center

    Ngai, E. W. T.; Poon, J. K. L.; Chan, Y. H. C.

    2007-01-01

    Web Course Tools (WebCT) have enhanced the ability and motivation of institutes of higher education to support e-learning. In this study, we extended the Technology Acceptance Model to include technical support as a precursor and then investigated the role of the extended model in user acceptance of WebCT. Responses from 836 university students…

  13. Airway morphometry in the lungs as depicted in chest CT examinations variability of measurements

    NASA Astrophysics Data System (ADS)

    Leader, J. K.; Zheng, Bin; Scuirba, Frank C.; Coxson, Harvey O.; Weissfeld, Joel L.; Fuhrman, Carl R.; Maitz, Glenn S.; Gur, David

    2006-03-01

    The purpose of the study was to decrease the variability of computed tomographic airway measurements. We to developed and evaluated a novel computer scheme to automatically segment airways depicted on chest CT examinations at the level of the lobar and segmental bronchi and to decrease. The computer scheme begins with manual selection of a seed point within the airway from which the airway wall and lumen are automatically segmented and airway pixels were assigned full or partial membership to the lumen or wall. Airway pixels not assigned full membership to the lumen (< -900 HU) or wall (> 0 HU) were assigned partial membership to the lumen and wall. In fifteen subjects with no visible signs of emphysema and a range of pulmonary obstruction from none to severe, airway measures were compared to pulmonary function parameters in a rank order analysis to evaluate measuring a single airway versus multiple airways. The quality of the automated airway segmentation was visually acceptable. The Pearson Correlation coefficients for the ranking of FEV I versus wall area percent (percent of total airway size) and FVC versus wall area percent were 0.164 and 0.175 for a single measurement, respectively, and were 0.243 and 0.239 for multiple measurements, respectively. Our preliminary results suggest that averaging the measurements from multiple airways may improve the relation between airway measures and lung function compared to measurement from a single airway, which improve quantification of airway remodeling in COPD patients.

  14. Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003-2012.

    PubMed

    Murakami, Kentaro; Livingstone, M Barbara E

    2016-05-28

    The association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) with adiposity measures in US children aged 6-11 years (n 4346) and adolescents aged 12-19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003-2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours or others). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here. PMID:27001436

  15. Nondestructive Analysis of Astromaterials by Micro-CT and Micro-XRF Analysis for PET Examination

    NASA Technical Reports Server (NTRS)

    Zeigler, R. A.; Righter, K.; Allen, C. C.

    2013-01-01

    An integral part of any sample return mission is the initial description and classification of returned samples by the preliminary examination team (PET). The goal of the PET is to characterize and classify returned samples and make this information available to the larger research community who then conduct more in-depth studies on the samples. The PET tries to minimize the impact their work has on the sample suite, which has in the past limited the PET work to largely visual, nonquantitative measurements (e.g., optical microscopy). More modern techniques can also be utilized by a PET to nondestructively characterize astromaterials in much more rigorous way. Here we discuss our recent investigations into the applications of micro-CT and micro-XRF analyses with Apollo samples and ANSMET meteorites and assess the usefulness of these techniques in future PET. Results: The application of micro computerized tomography (micro-CT) to astromaterials is not a new concept. The technique involves scanning samples with high-energy x-rays and constructing 3-dimensional images of the density of materials within the sample. The technique can routinely measure large samples (up to approx. 2700 cu cm) with a small individual voxel size (approx. 30 cu m), and has the sensitivity to distinguish the major rock forming minerals and identify clast populations within brecciated samples. We have recently run a test sample of a terrestrial breccia with a carbonate matrix and multiple igneous clast lithologies. The test results are promising and we will soon analyze a approx. 600 g piece of Apollo sample 14321 to map out the clast population within the sample. Benchtop micro x-ray fluorescence (micro-XRF) instruments can rapidly scan large areas (approx. 100 sq cm) with a small pixel size (approx. 25 microns) and measure the (semi) quantitative composition of largely unprepared surfaces for all elements between Be and U, often with sensitivity on the order of a approx. 100 ppm. Our recent

  16. Variation in costs of cone beam CT examinations among healthcare systems

    PubMed Central

    Christell, H; Birch, S; Hedesiu, M; Horner, K; Ivanauskaité, D; Nackaerts, O; Rohlin, M; Lindh, C

    2012-01-01

    Objectives To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Methods Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients' and accompanying persons' time, “out of pocket” costs for examination fee and visits). Results The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range €148 000–227 000). Variation in indirect costs were mainly owing to examination fees (range €0–102.02). Conclusions Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances. PMID:22499131

  17. Abdominal mass

    MedlinePlus

    Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  18. Abdominal mass

    MedlinePlus

    ... Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  19. Peripheral embolisation after an abdominal massage.

    PubMed

    Tak, Sandeep; Tak, Shubhanjali; Gupta, Alok

    2014-01-01

    A 65-year-old man presented with a history of acute onset pain in toes of the right foot immediately after an abdominal massage by a 'local healer'. General physical examination and systemic examination were normal except for discolouration of the fourth and fifth toes and cold toes. Investigations including complete blood count, erythrocyte sedimentation rate, renal function tests, liver profile, lipid profile, antinuclear antibody, antineutrophil cytoplasmic antibody, ECG, chest X-ray, ultrasound abdomen, cardiac echocardiography, lower limb Doppler and CT scan of the abdomen were normal. The patient was treated with regular heparin infusion, aspirin and tramadol. Recovery was complete in 5 days. PMID:24928926

  20. Computerized segmentation of pulmonary nodules depicted in CT examinations using freehand sketches

    PubMed Central

    Qiang, Yongqian; Wang, Qiuping; Xu, Guiping; Ma, Hongxia; Deng, Lei; Zhang, Lei; Pu, Jiantao; Guo, Youmin

    2014-01-01

    Purpose: To aid a consistent segmentation of pulmonary nodules, the authors describe a novel computerized scheme that utilizes a freehand sketching technique and an improved break-and-repair strategy. Methods: This developed scheme consists of two primary parts. The first part is freehand sketch analysis, where the freehand sketching not only serves a natural way of specifying the location of a nodule, but also provides a mechanism for inferring adaptive information (e.g., the mass center, the density, and the size) in regard to the nodule. The second part is an improved break-and-repair strategy. The improvement avoids the time-consuming ray-triangle intersections using spherical bins and replaces the original global implicit surface reconstruction with a local implicit surface fitting and blending scheme. The performance of this scheme, including accuracy and consistence, was assessed using 50 CT examinations in the Lung Image Database Consortium (LIDC). For each of these examinations, a single nodule was selected under the aid of a publically available tool to assure these nodules were diverse in size, location, and density. Two radiologists were asked to use the developed tool to segment these nodules twice at different times (at least three months apart). A Hausdorff distance based method was used to assess the discrepancies (agreements) between the computerized results and the results by the four radiologists in the LIDC as well as the inter- and intrareader agreements in freehand sketching. Results: The maximum and mean discrepancies in boundary outlines between the computerized scheme and the radiologists were 2.73 ± 1.32 mm and 1.01 ± 0.47 mm, respectively. When the nodules were classified (binned) into different size ranges, the maximum errors ranged from 1.91 to 4.13 mm; but smaller nodules had larger percentage discrepancies in term of size. Under the aid of the developed scheme, the inter- and intrareader variability in averaged maximum discrepancy

  1. Porosity structures in synthetic quartz veins examined by micro X-ray CT

    NASA Astrophysics Data System (ADS)

    Yamada, R.; Okamoto, A.; Saishu, H.; Nakamura, M.; Okumura, S.; Sasaki, O.; Tsuchiya, N.

    2013-12-01

    Ubiquitous occurrences of quartz veins suggest that dissolution/precipitation of silica provides significant effects on the hydrological and mechanical properties within the crust. For example, a model has been proposed that fracture sealing processes control the change of pore fluid pressure and thus earthquake cycle. Previous studies on natural quartz veins have focused on estimates of P-T conditions, stress and strain fields and fluid compositions; however, details of dynamics of fluid flow and how fractures are sealed during vein formation are still unclear. In this study, we synthesized quartz veins by the hydrothermal experiments, and observed the aperture structures by using X-ray CT. The purpose of this study is to clarify how aperture structures evolve during vein formation especially focusing on effect of the state of water (vapor and supercritical region). We conducted the hydrothermal flow-through experiments for quartz precipitation from Si-supersaturated solutions under supercritical (430C, 30MPa) and vapor condition (370C, 20MPa). The experimental apparatus consists of two vessels for preparation of the Si-supersaturated solution and for precipitation, respectively. The precipitation vessel has double-structure: the main flow path was the inner alumina tube (diameter=4mm), and the outer SUS tube was filled with static solutions. Two situations were examined as the inner tubes; one is porous media composed of closed packed alumina balls(1mm in size), and the other one is fracture. The advantage of this system is that we can take out the non-destructive sample for the analyses by X-ray CT. Significant porosity reduction by silica precipitation at porous media. Under supercritical condition, amorphous silica was predominantly formed with covering the surfaces of the alumina balls and alumina tube, and discrete quartz crystal (50μm) within the amorphous silica layers. The porosity (Φ) gradually decreases with minimal porosity (Φ = 0.4) at ˜ 38mm from

  2. Average radiation doses in a standard head examination for 250 CT systems

    SciTech Connect

    McCrohan, J.L.; Patterson, J.F.; Gagne, R.M.; Goldstein, H.A.

    1987-04-01

    Approximately 250 computed tomography (CT) systems were surveyed in a nationwide study to determine the average radiation dose resulting from a typical adult head procedure. The multiple scan average dose (MSAD) was selected as the dose descriptor. For the typical adult CT head procedure, the MSAD was generally within 2.2-6.8 rads (22-68 mGy). Variations in dose by a factor of two or more were often seen for a given manufacturer and model. These dose ranges indicate a potential to reduce dose by carefully selecting imaging techniques. Overall, variations in dose can result from differences in the user's choice of technique (desired image quality) or from actual differences in scanner performance (caused by differences in collimation, filtration, or geometry). To use CT appropriately, a facility should consider dose as well as image quality in selecting optimal techniques for typical modes of operation.

  3. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  4. Establishment of a comprehensive set of regional DRLs for CT by means of electronic X-ray examination records.

    PubMed

    Charnock, P; Dunn, A F; Moores, B M; Murphy, J; Wilde, R

    2015-03-01

    The International Commission on Radiological Protection (ICRP) has indicated that the diagnostic reference level (DRL) has the optimisation of protection as its objective for diagnostic and interventional procedures [International Commission on Radiological Protection. Protection against ionising radiation from external sources: ICRP Report 105 (2007)]. An important aim of this paper was to demonstrate a straightforward and cost-effective mechanism for undertaking patient dose audits that can be employed in the production of local and regional DRLs for use by medical physics experts in the provision of scientific support services to diagnostic radiology. The process developed employs electronic X-ray examination records obtained from multiple hospital sites transferred to a central processing and reporting facility. Results of a large-scale audit of patient doses resulting from CT examinations are presented. Doses are expressed in terms of dose length product (DLP) and were collected by remotely accessing electronic examination records held in hospital radiology information systems. Data were collected from 18 hospital sites involving up to 123 different types of examinations covering an ∼18-month period from July 2011 to December 2012. In total, 177 000 CT examination records were collected. Values have been validated against equivalent records obtained from digital imaging and communications in medicine (DICOM) header data and found to be in excellent statistical agreement. Extremely large variations in DLP values were noted for many examinations when data for all scanners were pooled. Results are discussed in relation to other surveys and differences highlighted in terms of the variations in methodologies employed and the numbers of examination records investigated. A mechanism for establishing DRLs is proposed, which could help to unify mechanisms for establishing DRLs for CT examinations. PMID:25717069

  5. Validation of a Monte Carlo simulation for dose assessment in dental cone beam CT examinations.

    PubMed

    Morant, J J; Salvadó, M; Casanovas, R; Hernández-Girón, I; Velasco, E; Calzado, A

    2012-07-01

    A Monte Carlo (MC) simulation for calculating absorbed dose has been developed and applied for dental applications with an i-CAT cone beam CT (CBCT) system. To validate the method a comparison was made between calculated and measured dose values for two different clinical protocols. Measurements with a pencil CT chamber were performed free-in-air and in a CT dose head phantom; measurements were also performed with a transmission ionization chamber. In addition for each protocol a total number of 58 thermoluminescence dosemeters (TLD) were packed in groups and placed at 16 representative anatomical locations of an anthropomorphic phantom (Remab system) to assess absorbed doses. To simulate X-ray exposure, a software application based on the EGS4 package was applied. Dose quantities were calculated for different voxelized models representing the CT ionization and transmission chambers, the TLDs, and the phantoms as well. The dose quantities evaluated in the comparison were the accumulated dose averaged along the rotation axis (D(i)), the volume average dose,D(vol) for the dosimetric phantom, the dose area product (DAP) and the absorbed dose for the TLDs. Absolute differences between measured and simulated outcomes were ≤ 2.1% for free-in-air doses; ≤ 6.2% in the 5 cavities of the CT dose head phantom; ≤ 13% for TLDs inside the primary beam. Such differences were considered acceptable in all cases and confirmed the validity of the MC program for different geometries. In conclusion, the devised MC simulation program can be a robust tool to optimize protocols and estimate patient doses for CBCT units in dental, oral and maxillofacial radiology. PMID:21807542

  6. A fully automated calculation of size-specific dose estimates (SSDE) in thoracic and head CT examinations

    NASA Astrophysics Data System (ADS)

    Anam, C.; Haryanto, F.; Widita, R.; Arif, I.; Dougherty, G.

    2016-03-01

    The purpose of this study is to automatically calculate and then investigate the size- specific dose estimate (SSDE) in thoracic and head CT examinations undertaken using standard imaging protocols. The effective diameter (Deff ), the water equivalent diameter (Dw ), and the SSDE were calculated automatically from patient images. We investigated sixteen adult patients who underwent a CT head examination and thirty adult patients who underwent a CT thorax examination. Our results showed that the Dw value in the thoracic region was 4.5% lower than the value of Deff , while the Dw value in the head region was 8.6% higher than the value of Deff . The relationships between diameter (Deff and Dw ) and CTDIvol were distinctive. In the head region, decreasing the patient diameter resulted in a constant CTDIvol due to the tube current modulation (TCM) being off, while in the thoracic region decreasing the patient diameter resulted in a decrease in value of CTDIvol due to TCM being on. In the head region, decreasing the patient diameter resulted in an increase in the value of SSDE, while in the thoracic region decreasing the patient diameter resulted in a decrease in the value of SSDE.

  7. Micro-CT imaging: Developing criteria for examining fetal skeletons in regulatory developmental toxicology studies - A workshop report.

    PubMed

    Solomon, Howard M; Makris, Susan L; Alsaid, Hasan; Bermudez, Oscar; Beyer, Bruce K; Chen, Antong; Chen, Connie L; Chen, Zhou; Chmielewski, Gary; DeLise, Anthony M; de Schaepdrijver, Luc; Dogdas, Belma; French, Julian; Harrouk, Wafa; Helfgott, Jonathan; Henkelman, R Mark; Hesterman, Jacob; Hew, Kok-Wah; Hoberman, Alan; Lo, Cecilia W; McDougal, Andrew; Minck, Daniel R; Scott, Lelia; Stewart, Jane; Sutherland, Vicki; Tatiparthi, Arun K; Winkelmann, Christopher T; Wise, L David; Wood, Sandra L; Ying, Xiaoyou

    2016-06-01

    During the past two decades the use and refinements of imaging modalities have markedly increased making it possible to image embryos and fetuses used in pivotal nonclinical studies submitted to regulatory agencies. Implementing these technologies into the Good Laboratory Practice environment requires rigorous testing, validation, and documentation to ensure the reproducibility of data. A workshop on current practices and regulatory requirements was held with the goal of defining minimal criteria for the proper implementation of these technologies and subsequent submission to regulatory agencies. Micro-computed tomography (micro-CT) is especially well suited for high-throughput evaluations, and is gaining popularity to evaluate fetal skeletons to assess the potential developmental toxicity of test agents. This workshop was convened to help scientists in the developmental toxicology field understand and apply micro-CT technology to nonclinical toxicology studies and facilitate the regulatory acceptance of imaging data. Presentations and workshop discussions covered: (1) principles of micro-CT fetal imaging; (2) concordance of findings with conventional skeletal evaluations; and (3) regulatory requirements for validating the system. Establishing these requirements for micro-CT examination can provide a path forward for laboratories considering implementing this technology and provide regulatory agencies with a basis to consider the acceptability of data generated via this technology. PMID:26930635

  8. Splenic trauma during abdominal wall liposuction: a case report

    PubMed Central

    Harnett, Paul; Koak, Yashwant; Baker, Daryl

    2008-01-01

    Summary A 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery. PMID:18387911

  9. Feasibility Study of Using Gemstone Spectral Imaging (GSI) and Adaptive Statistical Iterative Reconstruction (ASIR) for Reducing Radiation and Iodine Contrast Dose in Abdominal CT Patients with High BMI Values

    PubMed Central

    Zhu, Zheng; Zhao, Xin-ming; Zhao, Yan-feng; Wang, Xiao-yi; Zhou, Chun-wu

    2015-01-01

    Purpose To prospectively investigate the effect of using Gemstone Spectral Imaging (GSI) and adaptive statistical iterative reconstruction (ASIR) for reducing radiation and iodine contrast dose in abdominal CT patients with high BMI values. Materials and Methods 26 patients (weight > 65kg and BMI ≥ 22) underwent abdominal CT using GSI mode with 300mgI/kg contrast material as study group (group A). Another 21 patients (weight ≤ 65kg and BMI ≥ 22) were scanned with a conventional 120 kVp tube voltage for noise index (NI) of 11 with 450mgI/kg contrast material as control group (group B). GSI images were reconstructed at 60keV with 50%ASIR and the conventional 120kVp images were reconstructed with FBP reconstruction. The CT values, standard deviation (SD), signal-noise-ratio (SNR), contrast-noise-ratio (CNR) of 26 landmarks were quantitatively measured and image quality qualitatively assessed using statistical analysis. Results As for the quantitative analysis, the difference of CNR between groups A and B was all significant except for the mesenteric vein. The SNR in group A was higher than B except the mesenteric artery and splenic artery. As for the qualitative analysis, all images had diagnostic quality and the agreement for image quality assessment between the reviewers was substantial (kappa = 0.684). CT dose index (CTDI) values for non-enhanced, arterial phase and portal phase in group A were decreased by 49.04%, 40.51% and 40.54% compared with group B (P = 0.000), respectively. The total dose and the injection rate for the contrast material were reduced by 14.40% and 14.95% in A compared with B. Conclusion The use of GSI and ASIR provides similar enhancement in vessels and image quality with reduced radiation dose and contrast dose, compared with the use of conventional scan protocol. PMID:26079259

  10. SU-E-I-32: Benchmarking Head CT Doses: A Pooled Vs. Protocol Specific Analysis of Radiation Doses in Adult Head CT Examinations

    SciTech Connect

    Fujii, K; Bostani, M; Cagnon, C; McNitt-Gray, M

    2015-06-15

    Purpose: The aim of this study was to collect CT dose index data from adult head exams to establish benchmarks based on either: (a) values pooled from all head exams or (b) values for specific protocols. One part of this was to investigate differences in scan frequency and CT dose index data for inpatients versus outpatients. Methods: We collected CT dose index data (CTDIvol) from adult head CT examinations performed at our medical facilities from Jan 1st to Dec 31th, 2014. Four of these scanners were used for inpatients, the other five were used for outpatients. All scanners used Tube Current Modulation. We used X-ray dose management software to mine dose index data and evaluate CTDIvol for 15807 inpatients and 4263 outpatients undergoing Routine Brain, Sinus, Facial/Mandible, Temporal Bone, CTA Brain and CTA Brain-Neck protocols, and combined across all protocols. Results: For inpatients, Routine Brain series represented 84% of total scans performed. For outpatients, Sinus scans represented the largest fraction (36%). The CTDIvol (mean ± SD) across all head protocols was 39 ± 30 mGy (min-max: 3.3–540 mGy). The CTDIvol for Routine Brain was 51 ± 6.2 mGy (min-max: 36–84 mGy). The values for Sinus were 24 ± 3.2 mGy (min-max: 13–44 mGy) and for Facial/Mandible were 22 ± 4.3 mGy (min-max: 14–46 mGy). The mean CTDIvol for inpatients and outpatients was similar across protocols with one exception (CTA Brain-Neck). Conclusion: There is substantial dose variation when results from all protocols are pooled together; this is primarily a function of the differences in technical factors of the protocols themselves. When protocols are analyzed separately, there is much less variability. While analyzing pooled data affords some utility, reviewing protocols segregated by clinical indication provides greater opportunity for optimization and establishing useful benchmarks.

  11. Reducing absorbed dose to eye lenses in head CT examinations: the effect of bismuth shielding.

    PubMed

    Ciarmatori, Alberto; Nocetti, L; Mistretta, G; Zambelli, G; Costi, T

    2016-06-01

    The eye lens is considered to be among the most radiosensitive human tissues. Brain CT scans may unnecessarily expose it to radiation even if the area of clinical interest is far from the eyes. The aim of this study is to implement a bismuth eye lens shielding system for Head-CT acquisitions in these cases. The study is focused on the assessment of the dosimetric characteristics of the shielding system as well as on its effect on image quality. The shielding system was tested in two set-ups which differ for distance ("contact" and "4 cm" Set up respectively). Scans were performed on a CTDI phantom and an anthropomorphic phantom. A reference set up without shielding system was acquired to establish a baseline. Image quality was assessed by signal (not HU converted), noise and contrast-to-noise ratio (CNR) evaluation. The overall dose reduction was evaluated by measuring the CTDIvol while the eye lens dose reduction was assessed by placing thermoluminescent dosimeters (TLDs) on an anthropomorphic phantom. The image quality analysis exhibits the presence of an artefact that mildly increases the CT number up to 3 cm below the shielding system. Below the artefact, the difference of the Signal and the CNR are negligible between the three different set-ups. Regarding the CTDI, the analysis demonstrates a decrease by almost 12 % (in the "contact" set-up) and 9 % (in the "4 cm" set-up). TLD measurements exhibit an eye lens dose reduction by 28.5 ± 5 and 21.1 ± 5 % respectively at the "contact" and the "4 cm" distance. No relevant artefact was found and image quality was not affected by the shielding system. Significant dose reductions were measured. These features make the shielding set-up useful for clinical implementation in both studied positions. PMID:27098155

  12. Assessment of a CT image of the oral cavity with use of an aid focusing on a neck examination

    NASA Astrophysics Data System (ADS)

    Lee, Hyo-Jong; Goo, Eun-Hoe; Kim, Sung-Soo; Dong, Kyung-Rae; Chung, Woon-Kwan

    2013-11-01

    The aim of this study was to provide clinical information on an oral cavity disease assessment that was conducted using a self-manufactured aid in a computed tomography (CT) oral examination. The study subjects included 30 patients, who were examined using a multi-detector CT (MDCT) 128-slice CT Scanner. Rapidia software was used for quantitative analysis, while a questionnaire and qualitative analysis were used to assess the convenience. The significance was evaluated using a Student's t-test and a Wilcoxon signed rank test. A p value < 0.05 was considered significant. The convenience was evaluated by using a multiple response frequency analysis. The means and the standard deviations, which depended on use of the aid, were 2440.41 ± 4226.26 and 57443.86 ± 12445.91 respectively, the higher values being seen in the image assessment when the aid was used (p = 0.000). In a qualitative evaluation, the means and standard deviations were 2.52 ± 0.44 and 1.62 ± 0.22, respectively, the higher values being shown in the image assessment when the aid was used (p = 0.012). According to the convenience assessment that was conducted using a questionnaire, 80% of the respondents answered that they did not have any inconvenience when using the aid because the scores were 4 points or higher on the scale. In conclusion, the contrast increased when the aid, which enabled a clear identification of the anatomical structure, was inserted to examine the oral cavity. In particular, the patients considered the use of the aid to be convenient. Overall, the aid is recommended for use in a head/neck examination.

  13. Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom

    NASA Astrophysics Data System (ADS)

    Hashim, S.; Karim, M. K. A.; Bakar, K. A.; Sabarudin, A.; Chin, A. W.; Saripan, M. I.; Bradley, D. A.

    2016-09-01

    The magnitude of radiation dose in computed tomography (CT) depends on the scan acquisition parameters, investigated herein using an anthropomorphic phantom (RANDO®) and thermoluminescence dosimeters (TLD). Specific interest was in the organ doses resulting from CT thorax examination, the specific k coefficient for effective dose estimation for particular protocols also being determined. For measurement of doses representing five main organs (thyroid, lung, liver, esophagus and skin), TLD-100 (LiF:Mg, Ti) were inserted into selected holes in a phantom slab. Five CT thorax protocols were investigated, one routine (R1) and four that were modified protocols (R2 to R5). Organ doses were ranked from greatest to least, found to lie in the order: thyroid>skin>lung>liver>breast. The greatest dose, for thyroid at 25 mGy, was that in use of R1 while the lowest, at 8.8 mGy, was in breast tissue using R3. Effective dose (E) was estimated using three standard methods: the International Commission on Radiological Protection (ICRP)-103 recommendation (E103), the computational phantom CT-EXPO (E(CTEXPO)) method, and the dose-length product (DLP) based approach. E103 k factors were constant for all protocols, ~8% less than that of the universal k factor. Due to inconsistency in tube potential and pitch factor the k factors from CTEXPO were found to vary between 0.015 and 0.010 for protocols R3 and R5. With considerable variation between scan acquisition parameters and organ doses, optimization of practice is necessary in order to reduce patient organ dose.

  14. Abdominal sounds

    MedlinePlus

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  15. Abdominal MRI

    MedlinePlus

    ... provider if you have: Artificial heart valves Brain aneurysm clips Heart defibrillator or pacemaker Inner ear (cochlear) ... which the test may be performed: Abdominal aortic aneurysm Atheroembolic renal disease Carcinoma of the renal pelvis ...

  16. Abdominal pain

    MedlinePlus

    ... threatening conditions, such as colon cancer or early appendicitis , may only cause mild pain or no pain. ... Food poisoning Stomach flu Other possible causes include: Appendicitis Abdominal aortic aneurysm (bulging and weakening of the ...

  17. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  18. A Novel Approach to CT, MR, and PET Examination of Patients with Infections Requiring Stringent Airborne Precautions.

    PubMed

    Molton, James S; Leek, Francesca A A; Ng, Lay Hong Stevia; Totman, John J; Paton, Nicholas I

    2016-03-01

    Purpose To investigate the feasibility of using a modified portable isolation chamber, which conforms to Centers for Disease Control and Prevention (CDC) isolation requirements, in the imaging of infectious patients. Materials and Methods This study was approved by the ethics committee, and all participants gave written informed consent. In this prospective study, the isolation chamber was assessed for computed tomographic (CT), magnetic resonance (MR), and positron emission tomographic (PET) image uniformity and noise by using uniform phantoms. For each modality, equivalent phantom examinations were performed without the isolation chamber. Paired analyses of the differences from these baseline values were conducted by finding the mean difference in the matched sections for each image quality parameter. A potential increase in CT patient dose was assessed, and MR radiofrequency (RF) interference was monitored. Eight participants with active pulmonary tuberculosis (mean age, 48.1 years; age range, 26-88 years; five men, three women) were then examined within a hybrid PET/MR imager. The 95% confidence intervals for the difference in the two matched population means were determined by using the two-sided t distribution for each of the phantom study imaging modalities. Results Phantom images were evaluated for image uniformity and noise. Increased image noise can affect low contrast resolution, which has the potential to mimic or mask abnormalities when the differences between healthy and diseased tissues are small; clinically, CT image noise is maintained at a constant level with dose modulation. Increased attenuation of annihilation photons, when not corrected for, could lead to photopenic areas on the PET image; PET image nonuniformity complied with guidelines. Artifacts on the MR image due to RF noise spikes could mask abnormalities; paired analysis of variations in MR imaging mean signal-to-noise ratio and uniformity from baseline were within 5% for both gradient

  19. [Myelography, CT scan, electromyography and neurologic examination in the diagnosis of herniated lumbar disk].

    PubMed

    Kristek, B; Dicić, M; Vranković, D; Kurbel, S

    1995-01-01

    The research was carried out at the Clinical Hospital Osijek during a three-year period. Sixty-nine patients (34 men and 35 women) with the diagnosis of lumbar slipped disc who underwent surgery were followed up. The main inclusion criterion was the surgical finding of hernia. The aim of the study was to obtain a clearer insight into the values of the myelography and CT scan by observing a sufficiently large number of patients with surgically verified hernia of lumbar disc. The characteristics of neurological and EMG findings were surveyed, as well. Thirty-one patients were at the age of 40-49 years and 21 were at 30-39 years of age. Only 5 hernias were at the level L3L4, 28 at the level L4L5, and 46 at the level L5S1. Sensitivity, specificity and overall accuracy of the observed parameters were estimated for 41 leftwards and 30 rightwards located hernias. Myelographic finding, regardless of the observed level of slipped disc, showed excellent sensitivity, specificity and accuracy of diagnosis. CT finding was slightly less sensitive at the level L4L5, it was 0.93, and specific at the level L5S1, amounting to 0.90. Its accuracy was not substantially lower than that of myelography. The pathological EMG was 0.88 sensitive, 0.83 specific and 0.84 accurate. The accuracy was excellent at the level L3L4, it was 0.96, but only very good at the level L5S1, amounting to 0.76. A t-test of linked pairs was used to compare surgical reports and diagnostic findings. There was a great similarity between a CT finding and surgical one in all three levels (t-values 1.00, 0.21 and 0.36). Myeolography was more congruent with the surgical finding in the middle level (t-values 1.65, 0.93 and 1.52). An EMG finding was significantly different from that found by surgery (t-values 1.71, 1.76 and 2.71). The existence of Lasègue's sign for the diagnosis of hernia was 0.93 sensitive, 0.07 specific (remarkably low) and 0.36 accurate. It was particularly inaccurate at the level L3L4, moderately

  20. [Differential diagnosis of abdominal pain].

    PubMed

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  1. Image quality and age-specific dose estimation in head and chest CT examinations with organ-based tube-current modulation.

    PubMed

    Yamauchi-Kawaura, C; Yamauchi, M; Imai, K; Ikeda, M; Aoyama, T

    2013-12-01

    The purpose of this study was to investigate the effects of an organ-based tube-current modulation (OBTCM) system on image quality and age-specific dose in head and chest CT examinations. Image noise, contrast-to-noise ratio (CNR) and image entropy were assessed using statistical and entropy analyses. Radiation doses for newborn, 6-y-old child and adult phantoms were measured with in-phantom dosimetry systems. The quality of CT images obtained with OBTCM was not different from that obtained without OBTCM. In head CT scans, the eye lens dose decreased by 20-33 % using OBTCM. In chest CT scans, breast dose decreased by 5-32 % using OBTCM. Posterior skin dose, however, increased by 11-20 % using OBTCM in head and chest CT scans. The reduction of effective dose using OBTCM was negligibly small. Detailed image quality and dose information provided in this study can be effectively used for OBTCM application. PMID:23734058

  2. Association Between Obesity, Abdominal Obesity, and Adiposity and the Prevalence of Atopic Dermatitis in Young Korean Adults: the Korea National Health and Nutrition Examination Survey 2008-2010

    PubMed Central

    Lee, Ji Hyun; Han, Kyung Do; Jung, Han mi; Youn, Young Hoon; Lee, Jun Young; Park, Yong Gyu

    2016-01-01

    Purpose Whether obesity is a risk factor for atopic dermatitis (AD) remains unclear. The aim of the present study was to investigate the association between obesity and AD in Korean young adults. Methods We included nationally representative data of 5,202 Korean adults aged 19-40 years, obtained from the cross-sectional Korea National Health and Nutrition Examination Survey 2008-2010. Results Single (unmarried) status was more frequently observed in AD patients (male, [P=0.0002] and female, [P<0.0001]). AD prevalence exhibited a U-shape trend in relation to body mass index (BMI), waist circumference (WC), and total body fat (BF) percentage, especially in young adult women. Women with BMI ≥25 kg/m2, WC ≥80 cm, and highest quartile (Q4) of total BF percentage had the highest prevalence of AD. The odds ratio (OR) for participants with both BMI ≥25 kg/m2 and WC ≥80 cm was 3.29 (95% confidence interval [CI] 1.71-3.55); therefore, having both general and abdominal obesity was considered a prominent risk factor for AD in young women. After adjustment for confounding factors, including age, smoking, alcohol drinking, exercise, vitamin D, income level, and single status, high BMI (≥30 kg/m2) (OR=4.08, 95% CI: 1.53-10.93), high WC (≥80 cm) (OR=2.05, 95% CI: 1.07-3.94), and high BF percentage (Q4) (OR=2.10, 95% CI: 1.24-3.57) were shown to be significantly associated with AD in young adult women. Conclusions In this large-scale nation-wide study of Korean adults, obesity was positively related to the presence of AD in women. Our findings suggest that weight management may help prevent AD. PMID:26739403

  3. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  4. Jujitsu kick to the abdomen: a case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis.

    PubMed

    Rosenberg, Hans; Beck, Jeremy

    2011-08-01

    Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blood per rectum shortly after being kicked in the stomach at his jujitsu class. He had no significant medical history, and results of his systems review were otherwise unremarkable. On examination, he appeared well, with normal vital signs. He had mild lower abdominal tenderness, but there were no peritoneal signs present. There was blood on the digital rectal examination. His hemoglobin, platelet, and international normalized ratio levels were normal and his abdominal radiograph was unremarkable. The gastroenterology service was contacted because of the hematochezia and a flexible sigmoidoscopy was performed. The sigmoidoscopy showed erythema, ulceration, and edema of a segment in the left colon, consistent with ischemic colitis. This was later confirmed on biopsy. A computed tomography (CT) scan of the abdomen was conducted, which revealed left colonic inflammation consistent with colonic ischemia. There was no mesenteric vascular thrombosis or mesenteric hematoma found on CT. His hematochezia and abdominal pain subsided spontaneously, and he was discharged home. This case illustrates transient ischemic colitis as a potential presentation of blunt abdominal trauma, and emergency physicians should consider this uncommon diagnosis in the differential diagnosis of patients presenting after abdominal trauma. PMID:21392850

  5. Imaging diagnosis-ultrasonographic and CT findings in a gray seal (Halichoerus grypus) with hepatic cirrhosis, pyelonephritis, and nephrolithiasis.

    PubMed

    de Swarte, Marie; Bryan, Jill; Zarelli, Micaela; Huuskonen, Vihelmiina; Schneeweiss, Wilfried; McAllister, Hester

    2013-01-01

    An immature gray seal was presented with lethargy, weight loss, vomiting and hematuria. Hepatic disease and urinary tract infection were suspected. Abdominal ultrasound showed hyperechoic structures with marked acoustic shadowing spread throughout both kidneys, but incomplete visualization of the liver. Abdominal CT showed mineral densities scattered throughout both kidneys and poor delineation of the liver. Due to the poor quality of life, the seal was euthanized. Postmortem examination showed ammonium urate nephroliths, pyelonephritis, and hepatic cirrhosis. This case report emphasizes the difficulty of characterizing liver disease with conventional 2D-ultrasound and CT in a deep-chested animal with minimal intra-abdominal fat. PMID:23578275

  6. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  7. THE EFFECT OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION ON THE ASSESSMENT OF DIAGNOSTIC IMAGE QUALITY AND VISUALISATION OF ANATOMICAL STRUCTURES IN PAEDIATRIC CEREBRAL CT EXAMINATIONS.

    PubMed

    Larsson, Joel; Båth, Magnus; Ledenius, Kerstin; Thilander-Klang, Anne

    2016-06-01

    The purpose of this study was to investigate the effect of adaptive statistical iterative reconstruction (ASiR) on the visualisation of anatomical structures and diagnostic image quality in paediatric cerebral computed tomography (CT) examinations. Forty paediatric patients undergoing routine cerebral CT were included in the study. The raw data from CT scans were reconstructed into stacks of 5 mm thick axial images at various levels of ASiR. Three paediatric radiologists rated six questions related to the visualisation of anatomical structures and one question on diagnostic image quality, in a blinded randomised visual grading study. The evaluated anatomical structures demonstrated enhanced visibility with increasing level of ASiR, apart from the cerebrospinal fluid space around the brain. In this study, 60 % ASiR was found to be the optimal level of ASiR for paediatric cerebral CT examinations. This shows that the commonly used 30 % ASiR may not always be the optimal level. PMID:26873712

  8. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

    PubMed Central

    Behboodi, Firooz; Mohtasham-Amiri, Zahra; Masjedi, Navid; Shojaie, Reza; Sadri, Peyman

    2016-01-01

    Introduction: Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy. PMID:27299142

  9. Added value of lung window in detecting drug mules on non-contrast abdominal computed tomography.

    PubMed

    Bahrami-Motlagh, Hooman; Vakilian, Fatemeh; Hassanian-Moghaddam, Hossein; Pourghorban, Ramin

    2016-06-01

    We evaluated the added value of lung window in non-contrast computed tomography (CT) of suspected body packers or stuffers. Forty suspected drug mules who were referred to our tertiary toxicology center were included. The final diagnosis of drug mule was based on the detection of packs in stool examination or surgery. Non-contrast CT scans were retrospectively interpreted by two blinded radiologists in consensus before and after reviewing the lung window images. The diagnostic performance of abdominal window scans alone and scans in both abdominal and lung windows were subsequently compared. Seven body packers and 21 body stuffers were identified. The sensitivity, negative predictive value (NPV), and diagnostic accuracy of scans in detection of drug mules (either drug packers or stuffers) raised from 60.7, 52.1, and 72.5 to 64.2, 54.5, and 75.0 %, respectively, with a more number of packs being detected (114 vs. 105 packs). In the body packers group, the diagnostic performance of both abdominal windows scans and combined abdominal and lung windows scans were 100 %. In the body stuffers group, the sensitivity, NPV, and diagnostic accuracy of scans increased from 47.6, 52.1, and 55.0 to 52.3, 54.5, and 57.5 %, respectively, after the addition of lung windows. Reviewing the lung window on non-contrast abdominal CT can be helpful in detection of drug mules. PMID:26830789

  10. [Role of urographic 64 CT examination for the evaluation of kidney inflammation diseases].

    PubMed

    Reginelli, Alfonso; Coppolino, Francesco; Russo, Anna; D'Andrea, Alfredo; La Porta, Michele; Genovese, Eugenio Annibale; Macarini, Luca; Giganti, Melchiore

    2013-01-01

    In the study of inflammatory kidney diseases, the use of integrated imaging is considered the best diagnostic approach. However, given the high cost of radiological examinations, the radiologist is responsible for the choice of the best method to solve the question asked by the clinician. In this paper are presented the main imaging methods for the study of pyelonephritis and, based on our experience, it is emphasized the role of multidetector Computed Tomography urographic technique in the identification, characterization and subsequent follow-up of inflammatory kidney diseases. PMID:24042418

  11. Nondestructive Analysis of Apollo Samples by Micro-CT and Micro-XRF Analysis: A PET Style Examination

    NASA Technical Reports Server (NTRS)

    Zeigler, Ryan A.

    2014-01-01

    An integral part of any sample return mission is the initial description and classification of returned samples by the preliminary examination team (PET). The goal of a PET is to characterize and classify the returned samples, making this information available to the general research community who can then conduct more in-depth studies on the samples. A PET strives to minimize the impact their work has on the sample suite, which often limits the PET work to largely visual measurements and observations like optical microscopy. More modern techniques can also be utilized by future PET to nondestructively characterize astromaterials in a more rigorous way. Here we present our recent analyses of Apollo samples 14321 and 14305 by micro-CT and micro-XRF (respectively), assess the potential for discovery of "new" Apollo samples for scientific study, and evaluate the usefulness of these techniques in future PET efforts.

  12. Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography: A collateral screening?

    PubMed Central

    Sconfienza, Luca Maria; Mauri, Giovanni; Muzzupappa, Claudia; Poloni, Alessandro; Bandirali, Michele; Esseridou, Anastassia; Tritella, Stefania; Secchi, Francesco; Di Leo, Giovanni; Sardanelli, Francesco

    2015-01-01

    AIM: To investigate the prevalence of relevant incidental findings (RIFs) detected during routine abdominal contrast-enhanced computed tomography (CeCT). METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal CeCT studies performed between January and May 2013. For each report, patients’ age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs (if needing additional workup) was noted. RESULTS: One thousand forty abdominal CeCT were performed in 949 patients (528 males, mean age 66 ± 14 years). No significant difference was found between inpatients and outpatients age and sex distribution (P > 0.472). RIFs were found in 195/1040 (18.8%) CeCT [inpatients = 108/470 (23.0%); outpatients = 87/570 (15.2%); P = 0.002]. RIFs were found in 30/440 (6.8%) CeCT with a previous exam and in 165/600 (27.5%) without a previous exam (P < 0.001). Radiologists’ distribution between inpatients or outpatients was significantly different (P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and lungs. CONCLUSION: A RIF is detected in 1/5 patients undergoing abdominal CeCT. Risk of overdiagnosis should be taken into account. PMID:26516432

  13. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  14. Abdominal Adhesions

    MedlinePlus

    ... Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91–111. Seek Help for ... and how to participate, visit the NIH Clinical Research Trials and You website ... Foundation for Functional Gastrointestinal Disorders 700 West Virginia ...

  15. Sterile abdominal abscess resulting from remnant laparoscopic clips after sigmoidectomy: a case report and literature review.

    PubMed

    Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Kawai, Ryosuke; Osawa, Takaaki; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Shimizu, Yasuhiro

    2014-08-01

    The occurrence of intra-abdominal sterile abscesses due to remnant clips after laparoscopic sigmoidectomy is rare. Here, we report one such case in a 74-year-old woman. Two years after laparoscopic sigmoidectomy, abdominal CT indicated an area of fluid accumulation approximately 5 cm in diameter and located in the middle of the abdominal cavity that contained a cluster of clips. Fine-needle aspiration of the fluid was performed through the wall of the sigmoid colon. The luminal fluid was found not to contain cancer cells on histological examination. After 1 year, abdominal surgery was performed. The abscess was located in the mesorectum at the anastomosis site; it was incised and a significant quantity of ivory-white viscous solution containing a cluster of clips was extracted. This case emphasizes the importance of reducing the number of clips used in laparoscopic surgery. PMID:25131325

  16. Undiagnosed Borrmann type IV gastric cancer despite repeated endoscopic biopsies and PET-CT examination: A case report

    PubMed Central

    Zhu, Fang-Qing; Chu, Hong-Jin; Gong, Zhao-Hua; Du, Feng-Cai; Chen, Jian; Jiang, Li-Xin

    2016-01-01

    Borrmann type IV gastric cancer is a particular histological type of carcinoma, which has the characteristic of diffused infiltration that invades the entire stomach, resulting in the thickening and stiffness of the stomach wall. Borrmann type IV gastric cancer is known for the difficulty of detecting tumor cells in endoscopic biopsy specimens. This is crucial in obtaining the pathological results to make a therapeutic decision. The case reported in the present study was highly suspected to be Borrmann type IV gastric cancer according to the clinical manifestations and gastrointestinal barium meal examinations, but demonstrated negative results in multiple endoscopic biopsies and positron emission tomography-computed tomography (PET-CT) examination. The patient was discharged as no affirmative diagnosis was specified. Two weeks after discharge, the patient was administered to another hospital under emergency treatment due to frequent urination. Cystoscopy examination revealed marked thickening of the right bladder wall over a large area. Biopsy specimens were sampled. Pathological consultation suggested a gastrointestinal original of the lesion, which was most likely poorly differentiated gastric adenocarcinoma with neuroendocrine metastasis to the bladder. PMID:27446457

  17. Abdominal Vascular Catastrophes.

    PubMed

    Singh, Manpreet; Koyfman, Alex; Martinez, Joseph P

    2016-05-01

    Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage. PMID:27133247

  18. Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients?

    PubMed Central

    Kim, Younglim; Kang, Gu

    2014-01-01

    Purpose The use of abdominal computed tomography (ACT) utilization is increasing to a remarkable extent in the pediatric Emergency Department (ED), but the clinical benefit of increased use of ACT for pediatric surgical patients remains uncertain. Methods A retrospective review was conducted to investigate if, for patients who had visited pediatric ED during the last 5 years, increasing utilization of ACT would increase the detection rate of acute appendicitis, increase the detection rate of surgical conditions other than appendicitis, and decrease the hospital admission rate for surgical conditions. Results During the study period, there were 37,918 ED visits; of these, 3,274 (8.6%) were for abdominal pain, 844 (2.2%) had ACT performed. The annual proportional increase of the ACT was statistically significant (1.56% to 2.46%, P = 0.00), but the detection rate of acute appendicitis (3.3% to 5.1%) or other surgical conditions (1.7% to 2.8%) showed no statistically significant changes. Hospital admission rates (5.6% to 6.8%) also showed no significant changes during the study period. Conclusion Increasing utilization of ACT does not lead to the improved outcomes in caring for pediatric surgical patients visiting the pediatric ED. Careful evaluation for the indication for ACT is needed in the pediatric ED. PMID:25368849

  19. Abdominal exploration

    MedlinePlus

    ... these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), clopidogrel (Plavix), or ticlopidine (Ticlid). Ask your ... Biopsy Cancer Chronic pancreatitis CT scan Diverticulitis Ectopic pregnancy Endometriosis Hodgkin lymphoma Pelvic inflammatory disease (PID) Peritonitis - ...

  20. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  1. Entrapped ovarian cyst. An unusual case of persistent abdominal pain.

    PubMed

    Hederström, E; Forsberg, L

    1990-05-01

    Recurrent abdominal pain in the left fossa often mimicking attacks of subileus is described in a woman aged 48 with extensive adhesions caused by multiple surgical procedures. Repeated examinations with conventional abdominal radiography and barium meals were negative with regard to mechanical intestinal obstruction. A cystic lesion varying in size from 2 to 8 cm in diameter was seen adjacent to the left ovary on repeat US examinations and also on CT. Pain episodes were sometimes correlated to increasing size of the lesion which was finally thought to be either a peritoneal inclusion cyst (fluid trapped between pelvic adhesions) or, as was finally confirmed at surgery, a true ovarian cyst (corpus luteum cyst) similarly trapped. PMID:2201330

  2. Traumatic rupture of a Meckel’s diverticulum due to blunt abdominal trauma in a soccer game: A case report

    PubMed Central

    Tummers, W.S.; van der Vorst, J.R.; Swank, D.J.

    2015-01-01

    Introduction a Meckel’s diverticulum is one of the most common congenital anomalies of the digestive tract. The reported lifetime complication rate is 4%, mostly due to hemorrhage, obstruction, perforation or inflammation. A symptomatic Meckel’s diverticulum due to rupture after blunt abdominal trauma is very rare. We believe this case report is the first reporting a rupture of a Meckel’s diverticulum after a low velocity blunt abdominal trauma and outlining the importance of a thorough and complete examination of the patient after blunt abdominal trauma. Presentation of case a 17-year-old male presented with abdominal pain after blunt abdominal trauma during a soccer game. Physical examination showed signs of peritonitis in all quadrants of the abdomen. During admission the patient deteriorated with decreasing blood pressure and raising pulse rate. A CT-scan showed free abdominal fluid. Our patient was scheduled for an emergent laparotomy where a perforated Meckel’s diverticulum with fecal spill was found. A segmental ileal resection was performed. Post-operative, patient developed a pneumonia and also intra-abdominal abscesses treated with percutaneous drainage. After an admission period of 17-days the patient was discharged. Conclusion perforation of a Meckel’s diverticulum is rarely suspected as a cause of acute deterioration following blunt abdominal trauma. This case shows the importance of awareness of this kind of injury especially in male patients. PMID:26701844

  3. Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy

    PubMed Central

    Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

    2011-01-01

    Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

  4. Teaching Cost-Conscious Medicine: Impact of a Simple Educational Intervention on Appropriate Abdominal Imaging at a Community-Based Teaching Hospital

    PubMed Central

    Covington, Matthew F.; Agan, Donna L.; Liu, Yang; Johnson, John O.; Shaw, David J.

    2013-01-01

    Background Rising costs pose a major threat to US health care. Residency programs are being asked to teach residents how to provide cost-conscious medical care. Methods An educational intervention incorporating the American College of Radiology appropriateness criteria with lectures on cost-consciousness and on the actual hospital charges for abdominal imaging was implemented for residents at Scripps Mercy Hospital in San Diego, CA. We hypothesized that residents would order fewer abdominal imaging examinations for patients with complaints of abdominal pain after the intervention. We analyzed the type and number of abdominal imaging studies completed for patients admitted to the inpatient teaching service with primary abdominal complaints for 18 months before (738 patients) and 12 months following the intervention (632 patients). Results There was a significant reduction in mean abdominal computed tomography (CT) scans per patient (1.7–1.4 studies per patient, P < .001) and total abdominal radiology studies per patient (3.1–2.7 studies per patient, P  =  .02) following the intervention. The avoidance of charges solely due to the reduction in abdominal CT scans following the intervention was $129 per patient or $81,528 in total. Conclusions A simple educational intervention appeared to change the radiologic test-ordering behavior of internal medicine residents. Widespread adoption of similar interventions by residency programs could result in significant savings for the health care system. PMID:24404274

  5. [The different genotypes of MTHFR 1298A>C and PON1 -108C>T polymorphisms confer the increased risk of the abdominal aortic aneurysm in the smoking and nonsmoking persons].

    PubMed

    Strauss, Ewa; Waliszewski, Krzysztof; Pawlak, Andrzej L

    2005-01-01

    In abdominal aortic aneurysm (AAA) both the etiology and the pathogenesis are of the multifactorial character. The genetic component in the determination of this disease is proven by its familial occurrence. Smoking represents the best recognized risk factor of the AAA development. Increased concentrations of homocysteine (Hcy) in plasma are the common finding in these patients. It is assumed that the Hcy thiolactone, the most reactive metabolite of Hcy, may participate in the aortic wall destruction in AAA. The polymorphic variants of the methylenetetrahydrofolate reductase (MTHFR 677C>T and 1298A>C) influence tissue concentrations of the Hcy. Paraoxonase (PON1), the enzyme associated in plasma with the HDL fraction, as lactonase detoxicates the Hcy thiolactone. The promotor polymorphism of PON1 - 108C>T gene may determine the lower activity of this enzyme. In the case-control study of 106 patients with AAA and 97 healthy persons, the effects of selected genetic and nongenetic risk factors on development of AAA were assessed, considering the possibilities of interaction between them. It was found, that the arterial hypertension, cigarette smoking and the lower HDL fraction are independent risk factors of AAA. The arterial hypertension was a risk factor both in the smoking and the nonsmoking males, whereas the lower HDL fraction has been the risk factor only for the smoking men. By the multivariate analysis in the nonsmoking males the MTHFR 1298 AC and CC genotypes increased the risk of AAA development 4,8-fold in relation to the MTHFR 1298 AA nonsmoking males. In reference to the genotypes of the expected high impact on the metabolism of Hcy and of Hcy thiolactone, the genotypes of MTHFR 677TT and PON1 -108CT and TT were more frequent in smoking ones, but the difference was not significant. This observation fits with the assumption that the influence of smoking on the occurrence of AAA prevails over that of genetic variability. When the patients age was considered

  6. Imaging of abdominal aortic aneurysms.

    PubMed

    Sparks, Amy R; Johnson, Philip L; Meyer, Mark C

    2002-04-15

    Given the high rate of morbidity and mortality associated with abdominal aortic aneurysms (AAAs), accurate diagnosis and preoperative evaluation are essential for improved patient outcomes. Ultrasonography is the standard method of screening and monitoring AAAs that have not ruptured. In the past, aortography was commonly used for preoperative planning in the repair of AAAs. More recently, computed tomography (CT) has largely replaced older, more invasive methods. Recent advances in CT imaging technology, such as helical CT and CT angiography, offer significant advantages over traditional CT. These methods allow for more rapid scans and can produce three-dimensional images of the AAA and important adjacent vascular structures. Use of endovascular stent grafts has increased recently and is less invasive for the repair of AAAs in selected cases. Aortography and CT angiography can precisely determine the size and surrounding anatomy of the AAA to identify appropriate candidates for the use of endovascular stent grafts. Helical CT and CT angiography represent an exciting future in the preoperative evaluation of AAAs. However, this technology is not the standard of care because of the lack of widespread availability, the cost associated with obtaining new equipment, and the lack of universal protocols necessary for acquisition and reconstruction of these images. PMID:11989632

  7. Cross-sectional imaging of thoracic and abdominal complications of cerebrospinal fluid shunt catheters.

    PubMed

    Bolster, Ferdia; Fardanesh, Reza; Morgan, Tara; Katz, Douglas S; Daly, Barry

    2016-04-01

    This study aims to review the imaging findings of distal (thoracic and abdominal) complications related to ventriculo-peritoneal (VP), ventriculo-pleural (VPL), and ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt catheter placement. Institution review board-approved single-center study of patients with thoracic and abdominal CSF catheter-related complications on cross-sectional imaging examinations over a 14-year period was performed. Clinical presentation, patient demographics, prior medical history, and subsequent surgical treatment were recorded. The presence or absence of CSF catheter-related infection and/or acute hydrocephalus on cross-sectional imaging was also recorded. There were 81 distal CSF catheter-related complications identified on 47 thoracic or abdominal imaging examinations in 30 patients (age 5-80 years, mean 39.3 years), most often on CT (CT = 42, MRI = 1, US = 4). Complications included 38 intraperitoneal and 11 extraperitoneal fluid collections. Extraperitoneal collections included nine abdominal wall subcutaneous (SC) pseudocysts associated with shunt migration and obesity, an intrapleural pseudocyst, and a breast pseudocyst. There were also two large VPL-related pleural effusions, a fractured catheter in the SC tissues, and a large VA shunt thrombus within the right atrium. Ten patients (33.3 %) had culture-positive infection from CSF or shunt catheter samples. Ten patients (33.3 %) had features of temporally related acute or worsening hydrocephalus on neuroimaging. In four of these patients, the detection of thoracic and abdominal complications on CT preceded and predicted the findings of acute hydrocephalus on cranial imaging. Thoracic and abdominal complications of CSF shunts, as can be identified on CT,  include shunt infection and/or obstruction, may be both multiple and recurrent, and may be predictive of concurrent acute intracranial problems. PMID:26610766

  8. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    PubMed

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established. PMID:25616589

  9. The role of computed tomography in evaluating body composition and the influence of reduced muscle mass on clinical outcome in abdominal malignancy: a systematic review.

    PubMed

    Gibson, D J; Burden, S T; Strauss, B J; Todd, C; Lal, S

    2015-10-01

    It is estimated that there were 3.45 million new cases and 1.75 million deaths from cancer in Europe in 2012. Colorectal cancer was one of the most common cancers, accounting for 13% of new cases and 12.2% of all deaths. Conditions causing reduced muscle mass, such as sarcopenia, can increase the morbidity and mortality of people with cancer. Computed tomography (CT) scans can provide accurate, high-quality information on body composition, including muscle mass. To date, there has been no systematic review on the role of CT scans in identifying sarcopenia in abdominal cancer. This review aimed to examine the role of CT scans in determining the influence of reduced muscle mass on clinical outcome in abdominal cancer. A systematic review of English-language articles published in 2000 or later was conducted. Articles included cohort, randomised controlled trials and validation studies. Participants were people diagnosed with abdominal cancer who had undergone a CT scan. Data extraction and critical appraisal were undertaken. Ten cohort studies met the inclusion criteria. Seven studies demonstrated that low muscle mass was significantly associated with poor clinical outcome, with six specifically demonstrating reduced survival rates. Eight studies demonstrated that a greater number of patients (27.3-66.7%) were identified as sarcopenic using CT scans compared with numbers identified as malnourished using body mass index. CT scans can identify reduced muscle mass and predict negative cancer outcomes in people with abdominal malignancies, where traditional methods of assessment are less effective. PMID:25782424

  10. Impact of single photon emission tomography combined with computed tomography (SPECT/CT) in pulmonary examinations--short review with two case reports.

    PubMed

    Garcheva, Marina

    2014-01-01

    The hybrid ventilation/perfusion (V/P) examination SPECT/CT improves the diagnostic accuracy of lung scintigraphy for pulmonary embolism (PE). It reduces the false-positive results and increases the specificity of examinations. The co-registered V/P and CT scans provide more precise functional information, as well as additional data about pulmonary parenchyma, pleural and mediastinal structures. The CT acquisition is typically low-dose and can be implemented with little additional acquisition time and radiation exposure. It is convenient as a primary examination for patients with contrast-related contraindications, young patients and premenopausal women, because of the low whole body and breast exposure. It can be also used for the follow-up of the patients’ recovery, for functional quantification, radiotherapy planning and for the prediction of radiation-associated complications. Two clinical cases from our practice present the impact of SPECT/CT application in the primary diagnosis and in the follow-up of patients with pulmonary embolism. PMID:25088111

  11. Bubble gum simulating abdominal calcifications.

    PubMed

    Geller, E; Smergel, E M

    1992-01-01

    CT examination of the abdomens of two children demonstrated sites of high attenuation in the stomach, which were revealed to be bubble gum. Investigation of the CT appearance of samples of chewing gum showed that it consistently has high attenuation (178-345 HU). The attenuation of gum base, which contains calcium carbonate, was 476 HU. In addition, examination of a volunteer who had swallowed bubble gum confirmed the CT appearance. PMID:1523059

  12. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  13. Prospective evaluation of hand-held focused abdominal sonography for trauma (FAST) in blunt abdominal trauma

    PubMed Central

    Kirkpatrick, Andrew W.; Sirois, Marco; Laupland, Kevin B.; Goldstein, Leanelle; Brown, David Ross; Simons, Richard K.; Dulchavsky, Scott; Boulanger, Bernard R.

    2005-01-01

    Background Ultrasonography (US) has become indispensable in assessing the status of the injured patient. Although hand-held US equipment is now commercially available and may expand the availability and speed of US in assessing the trauma patient, it has not been subjected to controlled evaluation in early trauma care. Methods A 2.4-kg hand-held (HH) US device was used to perform focused abdominal sonography for trauma (FAST) on blunt trauma victims at 2 centres. Results were compared with the “truth” as determined through formal FAST examinations (FFAST), CT, operative findings and serial examination. The ability of HHFAST to detect free fluid, intra-abdominal injuries and injuries requiring therapeutic interventions was assessed. Results HHFAST was positive in 80% of 313 patients who needed surgery or angiography. HHFAST test performances (sensitivity, specificity, positive and negative predictive values, likelihood ratios of positive and negative test results) were 77%, 99%, 96%, 94%, 95%, 95 and 0.2, respectively, for free fluid, and 64%, 99%, 96%, 89%, 90%, 74 and 0.4, respectively, for documented injuries. HHFAST missed or gave an indeterminate result in 8 (3%) of 270 patients with injuries who required therapeutic intervention and 25 (9%) of 270 patients who did not require intervention. FFAST performance was comparable. Conclusions HHFAST performed by clinicians detects intraperitoneal fluid with a high degree of accuracy. All FAST examinations are valuable tests when positive. They will miss some injuries, but the majority of the injuries missed do not require therapy. HHFAST provides an early extension of the physical examination but should be complemented by the selective use of CT, rather than formal repeat US. PMID:16417051

  14. Diagnosis of abdominal abscesses in patients with major trauma: the use of computed tomography

    SciTech Connect

    Whitley, N.O.; Shatney, C.H.

    1983-04-01

    The usefulness of computed tomography (CT) in diagnosing abdominal abscesses was evaluated prospectively in 69 septic patients who had suffered massive trauma. For the 82 abdominal CT scans obtained, the accuracy rate was 84%, the sensitivity was 92%, and the specificity was 79%. With the use of abdominal CT, 32 patients were spared a ''blind'' laparotomy in the search for the focus of infection. It is concluded that CT is of significant value in the diagnosis of abdominal abscess in the septic trauma patient.

  15. SU-E-I-29: Care KV: Dose It Influence Radiation Dose in Non-Contrast Examination of CT Abdomen/pelvis?

    SciTech Connect

    Zhang, J; Ganesh, H; Weir, V

    2015-06-15

    Purpose: CARE kV is a tool that automatically recommends optimal kV setting for individual patient for specific CT examination. The use of CARE kV depends on topogram and the user-selected contrast behavior. CARE kV is expected to reduce radiation dose while improving image quality. However, this may work only for certain groups of patients and/or certain CT examinations. This study is to investigate the effects of CARE kV on radiation dose of non-contrast examination of CT abdomen/pelvis. Methods: Radiation dose (CTDIvol and DLP) from patients who underwent abdomen/pelvis non-contrast examination with and without CARE kV were retrospectively reviewed. All patients were scanned in the same scanner (Siemens Somatom AS64). To mitigate any possible influences due to technologists’ unfamiliarity with the CARE kV, the data with CARE kV were retrieved 1.5 years after the start of CARE kV usage. T-test was used for significant difference in radiation dose. Results: Volume CTDIs and DLPs from 18 patients before and 24 patients after the use of CARE kV were obtained in a duration of one month. There is a slight increase in both average CTDIvol and average DLP with CARE kV compared to those without CARE kV (25.52 mGy vs. 22.65 mGy for CTDIvol; 1265.81 mGy-cm vs. 1199.19 mGy-cm). Statistically there was no significant difference. Without CARE kV, 140 kV was used in 9 of 18 patients, while with CARE KV, 140 kV was used in 15 of 24 patients. 80kV was not used in either group. Conclusion: The use of CARE kV may save time for protocol optimization and minimize variability among technologists. Radiation dose reduction was not observed in non-contrast examinations of CT abdomen/pelvis. This was partially because our CT protocols were tailored according to patient size before CARE kV and partially because of large size patients.

  16. Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations

    SciTech Connect

    Moore, Bria M.; Brady, Samuel L. Kaufman, Robert A.; Mirro, Amy E.

    2014-07-15

    Purpose: To investigate the correlation of size-specific dose estimate (SSDE) with absorbed organ dose, and to develop a simple methodology for estimating patient organ dose in a pediatric population (5–55 kg). Methods: Four physical anthropomorphic phantoms representing a range of pediatric body habitus were scanned with metal oxide semiconductor field effect transistor (MOSFET) dosimeters placed at 23 organ locations to determine absolute organ dose. Phantom absolute organ dose was divided by phantom SSDE to determine correlation between organ dose and SSDE. Organ dose correlation factors (CF{sub SSDE}{sup organ}) were then multiplied by patient-specific SSDE to estimate patient organ dose. The CF{sub SSDE}{sup organ} were used to retrospectively estimate individual organ doses from 352 chest and 241 abdominopelvic pediatric CT examinations, where mean patient weight was 22 kg ± 15 (range 5–55 kg), and mean patient age was 6 yrs ± 5 (range 4 months to 23 yrs). Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm; thus, showing appropriate scalability of the phantoms across the entire pediatric population in this study. IndividualCF{sub SSDE}{sup organ} were determined for a total of 23 organs in the chest and abdominopelvic region across nine weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7–1.4) and abdominopelvic region (average 0.9; range 0.7–1.3) was near unity. For organ/tissue that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1–0.4) for both the chest and abdominopelvic regions, respectively. A means to estimate patient organ dose was demonstrated. Calculated patient organ dose, using patient SSDE and CF{sub SSDE}{sup organ}, was compared to

  17. Emergency abdominal MRI: current uses and trends.

    PubMed

    Yu, Hei S; Gupta, Avneesh; Soto, Jorge A; LeBedis, Christina

    2016-05-01

    When evaluating the abdomen in the emergency setting, CT and ultrasound are the imaging modalities of choice, mainly because of accessibility, speed and lower relative cost. CT has the added benefit of assessing the whole abdomen for a wide spectrum of gastrointestinal disease, whereas ultrasound has the benefit of avoiding ionizing radiation. MRI is another tool that has demonstrated increasing utility in the emergency setting and also avoids the use of ionizing radiation. MRI also has the additional advantage of excellent soft-tissue contrast. However, widespread use of MRI in the emergency setting is limited by availability and relative cost. Despite such limitations, advances in MRI technology, including improved pulse sequences and coil technology and increasing clinician awareness of MRI, have led to an increased demand in abdominal MRI in the emergency setting. This is particularly true in the evaluation of acute pancreatitis; choledocholithiasis with or without cholecystitis; acute appendicitis, particularly in pregnant patients; and, in some cases, Crohn's disease. In cases of pancreatitis and Crohn's disease, MRI also plays a role in subsequent follow-up examinations. PMID:26514590

  18. Experimental validation of a single shaped filter approach for CT using variable source-to-filter distance for examination of arbitrary object diameters

    NASA Astrophysics Data System (ADS)

    Lück, Ferdinand; Kolditz, Daniel; Hupfer, Martin; Steiding, Christian; Kalender, Willi A.

    2014-10-01

    The purpose of this study was to validate the use of a single shaped filter (SF) for computed tomography (CT) using variable source-to-filter distance (SFD) for the examination of different object diameters. A SF was designed by performing simulations with the purpose of achieving noise homogeneity in the reconstructed volume and dose reduction for arbitrary phantom diameters. This was accomplished by using a filter design method thats target is to achieve a homogeneous detector noise, but also uses a correction factor for the filtered back projection process. According to simulation results, a single SF designed for one of the largest phantom diameters meets the requirements for all diameters when SFD can be adjusted. To validate these results, a SF made of aluminium alloy was manufactured. Measurements were performed on a CT scanner with polymethyl methacrylate (PMMA) phantoms of diameters from 40-100 mm. The filter was positioned at SFDs ranging from 97-168 mm depending on the phantom diameter. Image quality was evaluated for the reconstructed volume by assessing CT value accuracy, noise homogeneity, contrast-to-noise ratio weighted by dose (CNRD) and spatial resolution. Furthermore, scatter distribution was determined with the use of a beam-stop phantom. Dose was measured for a PMMA phantom with a diameter of 100 mm using a calibrated ionization chamber. The application of a single SF at variable SFD led to improved noise uniformity and dose reduction: noise homogeneity was improved from 15% down to about 0%, and dose was reduced by about 37%. Furthermore, scatter dropped by about 32%, which led to reduced cupping artifacts and improved CT value accuracy. Spatial resolution and CNRD was not affected by the SF. By means of a single SF with variable SFD designed for CT, significant dose reduction can be achieved and image quality can be improved by reducing noise inhomogeneity as well as scatter-induced artifacts.

  19. Lower Abdominal Pain.

    PubMed

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation. PMID:27133242

  20. Applications of dual energy computed tomography in abdominal imaging.

    PubMed

    Lestra, T; Mulé, S; Millet, I; Carsin-Vu, A; Taourel, P; Hoeffel, C

    2016-06-01

    Dual energy computed tomography (CT) is an imaging technique based on data acquisition at two different energy settings. Recent advances in CT have allowed data acquisition and almost simultaneously analysis of two spectra of X-rays at different energy levels resulting in novel developments in the field of abdominal imaging. This technique is widely used in cardiovascular imaging, especially for pulmonary embolism work-up but is now also increasingly developed in the field of abdominal imaging. With dual-energy CT it is possible to obtain virtual unenhanced images from monochromatic reconstructions as well as attenuation maps of different elements, thereby improving detection and characterization of a variety of renal, adrenal, hepatic and pancreatic abnormalities. Also, dual-energy CT can provide information regarding urinary calculi composition. This article reviews and illustrates the different applications of dual-energy CT in routine abdominal imaging. PMID:26993967

  1. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  2. ABDOMINAL OBESITY, MUSCLE COMPOSITION, AND INSULIN RESISTANCE IN PREMENOPAUSAL WOMEN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The independent relationships between visceral and abdominal subcutaneous adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed to...

  3. Renal Cyst Pseudoenhancement: Intraindividual Comparison Between Virtual Monochromatic Spectral Images and Conventional Polychromatic 120-kVp Images Obtained During the Same CT Examination and Comparisons Among Images Reconstructed Using Filtered Back Projection, Adaptive Statistical Iterative Reconstruction, and Model-Based Iterative Reconstruction

    PubMed Central

    Yamada, Yoshitake; Yamada, Minoru; Sugisawa, Koichi; Akita, Hirotaka; Shiomi, Eisuke; Abe, Takayuki; Okuda, Shigeo; Jinzaki, Masahiro

    2015-01-01

    Abstract The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59–85 years; mean age, 73.2 ± 5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140 kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0 ± 14.7 mm [range, 4–61 mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70 keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0 Hounsfield units [HU]; 95% confidence interval, 2.6–7.4/3.6–8.4 HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8 HU; 95% confidence interval, 9.8–14.5/10.4–15.1/9.4–14.2 HU) (all P < .001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed

  4. Organ doses, effective doses, and risk indices in adult CT: Comparison of four types of reference phantoms across different examination protocols

    SciTech Connect

    Zhang Yakun; Li Xiang; Paul Segars, W.; Samei, Ehsan

    2012-06-15

    Purpose: Radiation exposure from computed tomography (CT) to the public has increased the concern among radiation protection professionals. Being able to accurately assess the radiation dose patients receive during CT procedures is a crucial step in the management of CT dose. Currently, various computational anthropomorphic phantoms are used to assess radiation dose by different research groups. It is desirable to better understand how the dose results are affected by different choices of phantoms. In this study, the authors assessed the uncertainties in CT dose and risk estimation associated with different types of computational phantoms for a selected group of representative CT protocols. Methods: Routinely used CT examinations were categorized into ten body and three neurological examination categories. Organ doses, effective doses, risk indices, and conversion coefficients to effective dose and risk index (k and q factors, respectively) were estimated for these examinations for a clinical CT system (LightSpeed VCT, GE Healthcare). Four methods were used, each employing a different type of reference phantoms. The first and second methods employed a Monte Carlo program previously developed and validated in our laboratory. In the first method, the reference male and female extended cardiac-torso (XCAT) phantoms were used, which were initially created from the Visible Human data and later adjusted to match organ masses defined in ICRP publication 89. In the second method, the reference male and female phantoms described in ICRP publication 110 were used, which were initially developed from tomographic data of two patients and later modified to match ICRP 89 organ masses. The third method employed a commercial dosimetry spreadsheet (ImPACT group, London, England) with its own hermaphrodite stylized phantom. In the fourth method, another widely used dosimetry spreadsheet (CT-Expo, Medizinische Hochschule, Hannover, Germany) was employed together with its associated

  5. Peritoneal Breach as an Indication for Exploratory Laparotomy in Penetrating Abdominal Stab Injury: Operative Findings in Haemodynamically Stable Patients

    PubMed Central

    Aguirre, Victor; Martin, Kate; Varma, Dinesh; Fitzgerald, Mark; Pilgrim, Charles

    2015-01-01

    Introduction. Management of haemodynamically stable patients with penetrating abdominal injuries varies from nonoperative to operative management. The aim was to investigate whether peritoneal breach when used as an indication for exploratory laparotomy appropriately identified patients with intra-abdominal visceral injury. Methods. We conducted retrospective cohort study of all patients presenting with PAI at a major trauma centre from January 2007 to December 2011. We measured the incidence of peritoneal breach and correlated this with intra-abdominal visceral injury diagnosed at surgery. Results. 252 patients were identified with PAI. Of the included patients, 71 were managed nonoperatively and 118 operatively. The operative diagnoses included nonperitoneal-breaching injuries, intraperitoneal penetration without organ damage, or intraperitoneal injury with organ damage. The presenting trauma CT scan was reported as normal in 63%, 34%, and 2% of these groups, respectively. The total negative laparotomy/laparoscopy rate for all patients presented with PAI was 21%, almost half of whom had a normal CT scan. Conclusion. We found that peritoneal breach on its own does not necessarily always equate to intra-abdominal visceral injury. Observation with sequential examination for PAI patients with a normal CT scan may be more important than exclusion of peritoneal breach via laparoscopy. PMID:26064688

  6. Diagnostic imaging of intra-abdominal cyst in heifer using the computed tomography

    PubMed Central

    OTOMARU, Konosuke; FUJIKAWA, Takuro; SAITO, Yasuo; ANDO, Takaaki; OBI, Takeshi; MIURA, Naoki; KUBOTA, Chikara

    2015-01-01

    A 10-month-old Japanese black heifer was diagnosed as having an intra-abdominal cyst using computed tomography (CT). Through a posterior ventral midline incision, the cyst was removed, and the heifer completely recovered after the surgery. CT scans enabled detection of the intra-abdominal cyst and measurements of the diameter of the cyst before the surgery. PMID:25924971

  7. Clinical application of Patlak plot CT-GFR in animals with upper urinary tract disease.

    PubMed

    Alexander, Kate; Dunn, Marilyn; Carmel, Eric Norman; Lavoie, Jean-Pierre; Del Castillo, Jérôme R E

    2010-01-01

    Glomerular filtration rate (GFR), an important parameter of renal function, is difficult to assess clinically. Serum creatinine and blood urea nitrogen measurements lack sensitivity, whereas radionuclide determination of GFR is not always available and requires postinjection patient isolation. GFR can be determined using computed tomography (CT), most commonly via Patlak plot analysis. Four adult cats, two adult dogs, and a foal underwent abdominal CT under general anesthesia for various diseases of the upper urinary tract. CT-GFR was measured with a single-slice dynamic acquisition and Patlak plot analysis. In five animals, the total CT-GFR appeared to be below normal, corresponding with mild (two animals) and moderate (two animals) increases of serum creatinine in four. In the two animals with normal or increased CT-GFR, serum creatinine was within the reference values. A significant negative logarithmic relationship was found between CT-GFR and serum creatinine values (P = 0.008; r2 = 0.75). No complications occurred during or following CT-GFR. CT examination provided clinically relevant information in 3/5 patients with possible ureteral obstruction and in 3/3 patients with suspected ureteral calculi. Single-slice dynamic CT-GFR was practical and provided clinically useful information in this small series of patients undergoing CT of the upper urinary tract. There was a significant relationship between CT-GFR and serum creatinine values, which supports the clinical potential of CT-GFR and justifies further investigation of this technique. PMID:20806874

  8. Abdominal aortic aneurysm

    MedlinePlus

    ... to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ... blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ...

  9. Abdominal x-ray

    MedlinePlus

    ... More Abdominal aortic aneurysm Abdominal pain Acute cholecystitis Acute kidney failure Addison disease Adenomyosis Annular pancreas Aplastic anemia Appendicitis Ascariasis Atheroembolic renal disease Biliary atresia Blind loop syndrome Cholangitis Chronic ...

  10. Diagnostic accuracy of self-reported symptomatic assessment versus per speculum/per vaginal examination for the diagnosis of vaginal/cervical discharge and lower abdominal pain syndromes among female sex workers

    PubMed Central

    Kosambiya, Jayendrakumar K.; Baria, H. G.; Parmar, Rohit; Mhaskar, Rahul; Emmanuel, Patricia; Kumar, Ambuj

    2016-01-01

    Background: National AIDS Control Organization guidelines on enhanced syndromic case management of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) require per speculum (P/S) and per vaginal (P/V) examinations for diagnosis of STIs. However, it is not known if the addition of P/S and P/V examinations to self-reported symptomatic assessment adds any value for the diagnosis of STI/RTI. Objective: To assess the diagnostic accuracy of P/S and P/V examinations compared with self-reported symptomatic assessment in a cohort of female sex workers (FSWs). Methods: We performed a cross-sectional study from August 2009 to June 2010, among 519 FSWs in Surat city, Gujarat, India. Symptomatic assessment for the presence or absence of vaginal/cervical discharge (VCD) or lower abdominal pain (LAP) was done using a self-administered questionnaire. After completion of the questionnaire, all participants underwent P/S and P/V examinations. Summary diagnostic accuracy measures were calculated. Results: Five hundred and nineteen FSWs between the ages of 18–49 years participated in the study. The median age of participants was 31 years. The prevalence of VCD and LAP syndromes based on vaginal discharge, LAP, or both was 56%, 5,–10%, respectively. The sensitivity of P/S and P/V examinations depending on symptomatic assessment ranged from 47% to 76%. The specificity ranged from 73% to 93%. The positive predictive value ranged from 25% to 83%, and the negative predictive value ranged from 56% to 98%. Conclusion: Symptomatic assessment alone is not adequate for the diagnosis of VCD and LAP syndromes and can lead to a significant number of missed cases (36%). A P/S and P/V examinations is critical for assessment of VCD and LAP syndromes and subsequent treatment. PMID:27190406

  11. Size-specific dose estimates: Localizer or transverse abdominal computed tomography images?

    PubMed Central

    Pourjabbar, Sarvenaz; Singh, Sarabjeet; Padole, Atul; Saini, Akshay; Blake, Michael A; Kalra, Mannudeep K

    2014-01-01

    AIM: To investigate effect of body dimensions obtained from localizer radiograph and transverse abdominal computed tomography (CT) images on Size Specific Dose Estimate. METHODS: This study was approved by Institutional Review Board and was compliant with Health Insurance Portability and Accountability Act. Fifty patients with abdominal CT examinations (58 ± 13 years, Male:Female 28:22) were included in this study. Anterior-posterior (AP) and lateral (Lat) diameters were measured at 5 cm intervals from the CT exam localizer radiograph (simple X-ray image acquired for planning the CT exam before starting the scan) and transverse CT images. Average of measured AP and Lat diameters, as well as maximum, minimum and mid location AP and Lat were measured on both image sets. In addition, off centering of patients from the gantry iso-center was calculated from the localizers. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for AP, Lat, AP + Lat, and effective diameter (√ AP * Lat) to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. Data were analyzed using SPSS v19. RESULTS: Total number of 5376 measurements was done. In some patients entire body circumference was not covered on either projection radiograph or transverse CT images; hence accurate measurement of AP and Lat diameters was not possible in 11% (278/2488) of locations. Forty one patients were off-centered with mean of 1.9 ± 1.8 cm (range: 0.4-7 cm). Conversion factors for attained diameters were not listed on AAPM look-up tables in 3% (80/2488) of measurements. SSDE values were significantly different compared to CTDIvol, ranging from 32% lower to 74% greater than CTDIvol. CONCLUSION: There is underestimation and overestimation of dose comparing SSDE values to CTDIvol. Localizer radiographs are associated with overestimation of patient size and therefore underestimation of SSDE. PMID

  12. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  13. Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

    PubMed

    Wrzesień, Małgorzata; Napolska, Katarzyna

    2015-03-01

    Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger. PMID:25647828

  14. Abdominal Compartment Hypertension and Abdominal Compartment Syndrome.

    PubMed

    Maluso, Patrick; Olson, Jody; Sarani, Babak

    2016-04-01

    Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare but potentially morbid diagnoses. Clinical index of suspicion for these disorders should be raised following massive resuscitation, abdominal wall reconstruction/injury, and in those with space-occupying disorders in the abdomen. Gold standard for diagnosis involves measurement of bladder pressure, with a pressure greater than 12 mm Hg being consistent with IAH and greater than 25 mm Hg being consistent with ACS. Decompressive laparotomy is definitive therapy but paracentesis can be equally therapeutic in properly selected patients. Left untreated, ACS can lead to multisystem organ failure and death. PMID:27016163

  15. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  16. Gallbladder Tuberculosis: CT Findings with Histopathologic Correlation

    PubMed Central

    Xu, Xiu-Fang; Qiu, Ling-Ling; Shen, Jian; Dong, Fei; Chen, Ying

    2011-01-01

    Objective We wanted to describe the computed tomography (CT) findings of gallbladder tuberculosis (TB) and to correlate them with pathologic findings. Materials and Methods There were seven patients (M:F = 3:4; mean age, 46.3 years; age range, 32 to 78 years) in whom gallbladder TB was eventually diagnosed. All of them underwent cross-sectional imaging with CT, a pathologic examination and a retrospective review. CT imaging evaluation was done in each case, including the findings of a mass versus nodule, wall thickening (uniform or irregular) and the enhancement patterns (homogeneous or heterogeneous). Results All the cases of gallbladder TB revealed the following three different CT findings: micronodular lesion of the gallbladder wall (n = 1), a thickened wall (n = 4) and a gallbladder mass (n = 2). There were three cases of homogeneous enhancement of the lesions, including homogeneous enhancement with nodular lesion, homogeneous uniform thickness enhancement and homogeneous thickness enhancement in one case each, and these cases pathology showed tuberculous granuloma with a little caseating necrosis in one case and tuberculous granuloma with rich fibrous tissue, but little or no evident caseating necrosis in two cases. Four cases of heterogeneous enhancement of the lesions, including heterogeneous uniform-thickness enhancement in two cases, heterogeneous enhancement with a local mass lesion in one case and heterogeneous enhancement with a mass that replaced the gallbladder in one case; in these cases, pathology showed tuberculous granuloma with marked caseation or liquefaction necrosis in three cases and tuberculous granuloma by fibrous and calcifications accompanied by caseating necrosis in one case. Among the seven cases of gallbladder TB, six cases were accompanied by abdominal extra-gallbladder TB, including abdominal lymph node TB in five cases and hepatic TB in four cases. Conclusion Gallbladder TB has various CT manifestations, and the enhanced CT findings

  17. Hypoxia inhibits abdominal expiratory nerve activity.

    PubMed

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  18. Fifty Years of Technological Innovation: Potential and Limitations of Current Technologies in Abdominal Magnetic Resonance Imaging and Computed Tomography.

    PubMed

    Attenberger, Ulrike I; Morelli, John; Budjan, Johannes; Henzler, Thomas; Sourbron, Steven; Bock, Michael; Riffel, Philipp; Hernando, Diego; Ong, Melissa M; Schoenberg, Stefan O

    2015-09-01

    Magnetic resonance imaging (MRI) has become an important modality for the diagnosis of intra-abdominal pathology. Hardware and pulse sequence developments have made it possible to derive not only morphologic but also functional information related to organ perfusion (dynamic contrast-enhanced MRI), oxygen saturation (blood oxygen level dependent), tissue cellularity (diffusion-weighted imaging), and tissue composition (spectroscopy). These techniques enable a more specific assessment of pathologic lesions and organ functionality. Magnetic resonance imaging has thus transitioned from a purely morphologic examination to a modality from which image-based disease biomarkers can be derived. This fits well with several emerging trends in radiology, such as the need to accurately assess response to costly treatment strategies and the need to improve lesion characterization to potentially avoid biopsy. Meanwhile, the cost-effectiveness, availability, and robustness of computed tomography (CT) ensure its place as the current workhorse for clinical imaging. Although the lower soft tissue contrast of CT relative to MRI is a long-standing limitation, other disadvantages such as ionizing radiation exposure have become a matter of public concern. Nevertheless, recent technical developments such as dual-energy CT or dynamic volume perfusion CT also provide more functional imaging beyond morphology.The aim of this article was to review and discuss the most important recent technical developments in abdominal MRI and state-of-the-art CT, with an eye toward the future, providing examples of their clinical utility for the evaluation of hepatic and renal pathologies. PMID:26039773

  19. [Differential diagnosis of abdominal cysts in children].

    PubMed

    Józsa, Gergő; Mohay, Gabriella; Pintér, András; Vástyán, Attila

    2015-09-13

    19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients. PMID:26552027

  20. [Abdominal aortic aneurysm and renovascular disease].

    PubMed

    Riambau, Vicente; Guerrero, Francisco; Montañá, Xavier; Gilabert, Rosa

    2007-06-01

    Recent technological advances in the diagnosis and therapy of abdominal aortic aneurysm and renovascular disease are continuing to bring about changes in the way patients suffering from these conditions are treated. The prevalence of both these conditions is increasing. This is due to greater life-expectancy in patients with arteriosclerosis, a pathogenetic factor underlying both conditions. The application of diagnostic imaging techniques to non-vascular conditions has led to the early diagnosis of abdominal aortic aneurysm. Clinical suspicion of reno-vascular disease can be confirmed easily using high-resolution diagnostic imaging modalities such as CT angiography and magnetic resonance angiography. Endovascular intervention is successfully replacing conventional surgical repair techniques, with the result that it may be possible to improve outcome in both conditions using effective and minimally invasive approaches. Future technological developments will enable these endovascular techniques to be applied in the large majority of patients with abdominal aortic aneurysm or renovascular disease. PMID:17580053

  1. Abdominal trauma. Emphasis on computed tomography.

    PubMed

    Raptopoulos, V

    1994-09-01

    CT scans have been the champion in the diagnosis and management of abdominal injuries, and their use has decreased the number of negative exploratory laparotomies. Traditional areas for the use of CT scans include the assessment of injuries to the spleen and the liver and to signs of organ rupture into the peritoneal cavity. New technologic advances and increased experience have expanded the value of this modality to less than hemodynamically stable patients as well as to less common and more difficult to diagnose injuries of the pancreas, bowel, and the mesentery. PMID:8085007

  2. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies

    PubMed Central

    Panzer, Stephanie; Mc Coy, Mark R.; Hitzl, Wolfgang; Piombino-Mascali, Dario; Jankauskas, Rimantas; Zink, Albert R.; Augat, Peter

    2015-01-01

    The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, “A. Soft Tissues of Head and Musculoskeletal System” and “B. Organs and Organ Systems”, each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections. PMID:26244862

  3. Hereditary angio-edema involving the gastrointestinal tract: CT findings.

    PubMed

    Sadeghi, N; Van Daele, D; Hainaux, B; Engelholm, L; Michel, O

    2001-01-01

    We report a case of hereditary angio-edema in a young man presenting with recurrent abdominal pain for many years. The diagnosis was suspected on the basis of abdominal CT performed during an abdominal attack and was then confirmed by the measurement of serum concentration of C1 esterase inhibitor (C1-INH). To our knowledge, this is the first case reported of the hereditary form of angio-edema with isolated abdominal pain and in which the diagnosis was suggested by abdominal CT findings. PMID:11194925

  4. [Management of adult abdominal pain in the Emergency Room].

    PubMed

    Chiche, L; Roupie, E; Delassus, P

    2006-01-01

    Abdominal pain is a commonplace reason for surgical consultation in the emergency department and is the the most common symptom which the digestive surgeon on-call must evaluate. He must understand the pathophysiologic basis of visceral pain and referred pain in order to appreciate its diverse manifestations. Abdominal pain can stem from many causes intestinal and non-intestinal, medical and surgical. Evaluation and management in the emergency department must be rapid and pragmatic; clinical history and physical examination should define the gravity of the case, direct the first diagnostic procedures and complementary examinations, and guide the therapeutic direction. Ultrasonography is a quick and effective diagnostic procedure in the diagnosis of biliary, urologic, and gynecologic pathologies; it can be useful for other digestive problems as well. The new generation spiral CT scanner gives excellent definition of digestive and vascular pathologies. The initial evaluation and management of the acute abdomen may determine the prognosis of the patient; it should lead to prompt symptomatic relief and to a well-directed treatment appropriate to the diagnosis. PMID:16609646

  5. Paediatric case of a large gastric rupture after a blunt abdominal trauma: Report of a case in a District General Hospital

    PubMed Central

    Pafitanis, Georgios; Koulas, Spiros; Bikos, Stavros; Tsimoyiannis, Evangelos

    2012-01-01

    INTRODUCTION Isolated gastric rupture after blunt abdominal trauma is rare. In current literature gastric rupture from blunt abdominal trauma ranges between 0.02% and 1.7%. This document reports the first non-motor-vehicle case of an isolated gastric rapture after blunt abdominal injury, which repaired after early diagnosis and aggressive surgical treatment. PRESENTATION OF CASE A 14-year-old boy attended our emergency surgical department after sustained a blunt abdominal trauma following a fall from his bicycle. He presented with pain and left para-umbilical abdominal ecchymoses. Examination revealed subcutaneous emphysema and a palpable abdominal wall dimple. DISCUSSION Radiological examination with CT scan determined the need for exploratory laparotomy. Operation revealed, extensive rupture of the left lateral border of the rectus abdominus muscle, free intra-peritoneal position of the nasogastric tube with gross spillage of gastric contents and pneumo-peritoneum observed with 7-8cm full thickness rupture of anterior stomach wall, from the lesser towards the greater curvature. Primary, two-layer closure was performed. On the 5th post-operative day he developed gastrorrhagia. He was discharged on the 15th postoperative day. CONCLUSION We present this case report focusing on the paediatric patient to illustrate isolated gastric injury in terms of mechanism of injury, clinical presentation, and immediate surgical management. PMID:23295382

  6. [A Case of Intra-Abdominal Desmoid Tumor with Abacterial Peritonitis].

    PubMed

    Sumiyama, Fusao; Inada, Ryo; Nakamura, Fumiko; Ryota, Hironori; Miki, Hirokazu; Oishi, Masaharu; Matsumoto, Tomoko; Iwamoto, Shigeyoshi; Mukaide, Yumi; Ozaki, Takeshi; Michiura, Taku; Inoue, Kentaro; Kon, Masanori; Miyasaka, Chika; Uemura, Yoshiko; Hamada, Madoka

    2016-03-01

    A woman in her 50s visited our hospital in February 2015 with a complaint of dull abdominal pain in the right lower quadrant. She had a medical history of appendectomy for appendicitis in her 20s. Computed tomography(CT)revealed a tumor 90 mm in diameter near the ileocecum. Elective surgery was planned under the suspicion of gastrointestinal tumor, malignant lymphoma, or ileal cancer. She was emergently hospitalized 1 day earlier than scheduled because of high fever and severe abdominal pain. CT revealed that the tumor had increased to 120 mm in diameter without free air. Her white blood cell count was not elevated, and her symptoms improved readily with medical treatment. Thus, we performed the operation as scheduled. A tumor with a dark red recess on the surface had invaded the transverse colon intraoperatively, and a small amount of purulent ascites was present at the pouch of Douglas. We performed ileocecal resection with partial transverse colectomy. Histopathological examination led to the diagnosis of desmoid tumor in the mesentery of the terminal ileum. The surgical margins were negative for tumor cells. The tumor surface around the recess showed peritonitis, and the ascites showed no bacteria or tumor cells. The patient had been doing well without recurrence after discharge. Some cases of desmoid tumor with peritonitis have been reported, but most were caused by tumor penetration into the intestinal tract. We report herein a rare case of intra-abdominal desmoid tumor with abacterial peritonitis. PMID:27067862

  7. Combined subcutaneous, intrathoracic and abdominal splenosis.

    PubMed

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  8. [Abdominal pregnancy, institutional experience].

    PubMed

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  9. Recurrent Abdominal Pain

    ERIC Educational Resources Information Center

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  10. Role of Computed Tomography in Pediatric Abdominal Conditions.

    PubMed

    Eapen, Anu; Gibikote, Sridhar

    2016-07-01

    In the pediatric patient, computed tomography (CT) scan as an imaging modality for evaluation of the abdomen is to be used judiciously. The use of correct scanning protocols, single phase scanning, scanning only when required are key factors to minimize radiation doses to the child, while providing diagnostic quality. CT is the preferred modality in the evaluation of trauma, to assess extent of solid organ or bowel injury. It is also useful in several inflammatory conditions such as inflammatory bowel diseases and acute pancreatitis. CT also has an important role in evaluating intra-abdominal tumors, although magnetic resonance imaging (MRI) can be used as an alternative to CT. PMID:26964550

  11. Radiation exposure in body computed tomography examinations of trauma patients

    NASA Astrophysics Data System (ADS)

    Kortesniemi, M.; Kiljunen, T.; Kangasmäki, A.

    2006-06-01

    Multi-slice CT provides an efficient imaging modality for trauma imaging. The purpose of this study was to provide absorbed and effective dose data from CT taking into account the patient size and compare such doses with the standard CT dose quantities based on standard geometry. The CT examination data from abdominal and thoracic scan series were collected from 36 trauma patients. The CTDIvol, DLPw and effective dose were determined, and the influence of patient size was applied as a correction factor to calculated doses. The patient size was estimated from the patient weight as the effective radius based on the analysis from the axial images of abdominal and thoracic regions. The calculated mean CTDIvol, DLPw and effective dose were 15.2 mGy, 431 mGy cm and 6.5 mSv for the thorax scan, and 18.5 mGy, 893 mGy cm and 14.8 mSv for the abdomen scan, respectively. The doses in the thorax and abdomen scans taking the patient size into account were 34% and 9% larger than the standard dose quantities, respectively. The use of patient size in dose estimation is recommended in order to provide realistic data for evaluation of the radiation exposure in CT, especially for paediatric patients and smaller adults.

  12. Renal applications of dual-energy CT.

    PubMed

    Kaza, Ravi K; Platt, Joel F

    2016-06-01

    Dual-energy CT is being increasingly used for abdominal imaging due to its incremental benefit of material characterization without significant increase in radiation dose. Knowledge of the different dual-energy CT acquisition techniques and image processing algorithms is essential to optimize imaging protocols and understand potential limitations while using dual-energy CT renal imaging such as urinary calculi characterization, assessment of renal masses and in CT urography. This review article provides an overview of the current dual-energy CT techniques and use of dual-energy CT in renal imaging. PMID:27010938

  13. CT of Gastric Emergencies.

    PubMed

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls. PMID:26562229

  14. Computed tomography appearance of inflammatory myofibroblastic tumor in the abdomen: CT features and pathologic correlation

    PubMed Central

    Liu, Bo; Xu, Junlong; Wang, Jiaxin; Fan, Hongguang; Ang, Xuan; Liu, Wenming

    2015-01-01

    Objective: To evaluate CT findings of abdominal inflammatory myofibroblastic tumor (IMT) and the relationship with morphological character. Materials and Methods: CT examinations and pathological findings of ten intra-abdominal IMTs were retrospectively analyzed. The histopathological characteristics of the IMTs were confirmed by two pathologists and two radiologists evaluated CT findings of the lesion, with emphasis on the imaging features compared with the corresponding histopathology. Results: The most common imaging characteristics were presence of heterogeneity, all tumors showed varying degrees of contrast enhancement. Two major different CT patterns were individualized. In type one, the tumor had a distinct boundary without a lobular appearance and displayed hypo-enhanced enhancement after administration of contrast in correlated with the mainly histopathologic findings of spindle cells myxoid and hypocellular fibrous (6/10; 60%). In type two, the lesions exhibited indistinct boundaries or complete capsule, ill-defined growth patterns or low intralesional attenuation with marked heterogeneous or circumferential enhancement, which correlated well with the presence of abundance of micromodule and inflammatory cell infiltration (4/10; 40%). Conclusions: Two major different contrast enhancement CT patterns were individualized can help to determine the relationships with histopathologic findings, while cannot be reliably differentiated from other solid lesions based solely on the CT appearance, combined with diagnostic biopsy may facilitate to achieve a correct diagnosis and treatment. PMID:26629216

  15. Evaluation of Clinical Alvarado Scoring System and CT Criteria in the Diagnosis of Acute Appendicitis

    PubMed Central

    Gunes Tatar, Idil; Yilmaz, Kerim Bora; Sahin, Alpaslan; Aydin, Hasan; Akinci, Melih; Hekimoglu, Baki

    2016-01-01

    Aim. The aim was to evaluate the clinical Alvarado scoring system and computed tomography (CT) criteria for the diagnosis of acute appendicitis. Material and Methods. 117 patients with acute abdominal pain who underwent abdominal CT were enrolled in this retrospective study. Patient demographics, clinical Alvarado scoring, CT images, and pathologic results of the patients were evaluated. Results. 39 of the 53 patients who were operated on had pathologically proven acute appendicitis. CT criteria of appendiceal diameter, presence of periappendiceal inflammation, fluid, appendicolith, and white blood cell (WBC) count were significantly correlated with the inflammation of the appendix. The best cut-off value for appendiceal diameter was 6.5 mm. The correlation between appendiceal diameter and WBC count was 80% (P = 0.01 < 0.05). The correlation between appendiceal diameter and Alvarado score was 78.7% (P = 0.01 < 0.05). Conclusion. Presence of CT criteria of appendiceal diameter above 6.5 mm, periappendiceal inflammation, fluid, and appendicolith should prompt the diagnosis of acute appendicitis. Since patients with acute appendicitis may not always show the typical signs and symptoms, CT is a helpful imaging modality for patients with relatively low Alvarado score and leukocytosis and when physical examination is confusing. PMID:27242926

  16. Micromanaging abdominal aortic aneurysms.

    PubMed

    Maegdefessel, Lars; Spin, Joshua M; Adam, Matti; Raaz, Uwe; Toh, Ryuji; Nakagami, Futoshi; Tsao, Philip S

    2013-01-01

    The contribution of abdominal aortic aneurysm (AAA) disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs) by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility. PMID:23852016

  17. Evaluation of different small bowel contrast agents by multi - detector row CT

    PubMed Central

    Wang, Yong-Ren; Yu, Xiao-Li; Peng, Zhi-Yi

    2015-01-01

    Objective: This study aims to evaluate the effects of different oral small bowel contrast agents towards the intestinal dilatation and intestinal wall structure exhibition by the abdominal multi - detector row CT (MDCT) examination. Methods: 80 patients were performed the whole abdominal CT examination, then randomly divided into four groups, with 20 patients in each group. 45 minutes before the CT examination, the patients were served with a total of 1800 ml pure water, pure milk, dilute lactulose solution and isotonic mannitol solution, respectively. Results: The images were blinded read by two experienced abdominal radiologists in the workstation, the cross-sectional diameters of duodenum, jejunum, proximal and terminal ends of ileum of each patient were measured, then the analysis of variance was performed to analyze the differences in the intestinal dilatation among the experimental groups. The scoring method was used to score the intestinal dilatation and intestinal structure exhibition. The diluted lactulose solution and 2.5% mannitol exhibited the best intestinal dilation degrees. Similarly, the diluted lactulose solution and 2.5% mannitol exhibited the highest scores in the entire small bowel dilatation degree and intestinal structure exhibition. Conclusions: 2.5% osmotic mannitol and the diluted lactulose solution enabled the full dilatation of small bowel, and could clearly exhibit the wall structure. PMID:26629131

  18. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  19. Treatment options for traumatic pseudoaneurysms of the paravisceral abdominal aorta.

    PubMed

    Tucker, Sonny; Rowe, Vincent L; Rao, Rajeev; Hood, Douglas B; Harrell, Donald; Weaver, Fred A

    2005-09-01

    Penetrating gunshot wounds (GSWs) to the abdominal aorta are frequently lethal. Alternative management options for treatment of traumatic pseudoaneurysms of the abdominal aorta are illustrated by three patient case histories. Patient A sustained two GSWs to the abdomen (midepigastrium, right subcostal region). He was hypotensive in the field. Emergent laparotomy was undertaken with suture ligature of a celiac injury and distal pancreatectomy/splenectomy for a pancreatic injury. Postoperative abdominal CT for an intraabdominal infection with leukocytosis revealed a 4 cm traumatic pseudoaneurysm of the abdominal aorta that extended from the suprarenal aorta to the level of the renal arteries. Six weeks later, he underwent an open repair. Patient B sustained multiple GSWs to his right arm and right upper quadrant. He was hemodynamically stable. He underwent abdominal exploration for a grade 3 liver laceration. Postoperative abdominal CT revealed a supraceliac abdominal aortic pseudoaneurysm. An aortogram demonstrated a 1.5 cm defect in the aortic wall above the celiac trunk communicating with the inferior vena cava (IVC). He underwent endovascular repair with covered aortic stent graft. Patient C sustained multiple thoracoabdominal GSWs. He was hemodynamically stable. Emergent laparotomy revealed multiple left colonic perforations, two duodenal lacerations, and an unsalvageable left kidney laceration. Postoperatively, he developed a duodenal-cutaneous fistula with multiple intraabdominal abscesses. Serial CT scans revealed an enlarging infrarenal aortic pseudoaneurysm. He underwent angiographic coil embolization and intraarterial injection of thrombin into the pseudoaneurysm sac. The average time from injury to surgical treatment was 46 days (range 29-67). Postoperatively, none of the patients developed paraplegia. Advances in endovascular techniques have provided options to deal with traumatic pseudoaneurysms of the abdominal aorta. In a hemodynamically stable

  20. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...

  1. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  2. Abdominal exploration - series (image)

    MedlinePlus

    ... surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal ... blunt trauma"). Diseases that may be discovered by exploratory laparotomy include: inflammation of the appendix (acute appendicitis) ...

  3. Abdominal aortic aneurysm

    MedlinePlus

    ... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

  4. Abdominal x-ray

    MedlinePlus

    An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the test is done to look at the bladder and kidney structures, ...

  5. CT of schistosomal calcification of the intestine

    SciTech Connect

    Fataar, S.; Bassiony, H.; Satyanath, S.; Rudwan, M.; Hebbar, G.; Khalifa, A.; Cherian, M.J.

    1985-01-01

    The spectrum of schistosomal colonic calcification on abdominal radiographs has been described. The appearance on computed tomography (CT) is equally distinctive and occurs with varying degrees of genitourinary calcification. The authors have experience in three cases with the appearance on CT of intestinal calcification due to schistosomiasis.

  6. Abdominal aortic aneurysm.

    PubMed

    Setacci, Francesco; Galzerano, Giuseppe; De Donato, Gianmarco; Benevento, Domenico; Guerrieri, Massimiliano W; Ruzzi, Umberto; Borrelli, Maria P; Setacci, Carlo

    2016-02-01

    Endovascular repair of abdominal aortic aneurysms has become a milestone in the treatment of patients with abdominal aortic aneurysm. Technological improvement allows treatment in more and more complex cases. This review summarizes all grafts available on the market. A complete review of most important trial on this topic is provided to the best of our knowledge, and technical tips and tricks for standard cases are also included. PMID:26771730

  7. Estimation of patient radiation dose from whole body 18F- FDG PET/CT examination in cancer imaging: a preliminary study

    NASA Astrophysics Data System (ADS)

    Mahmud, M. H.; Nordin, A. J.; Saad, F. F. Ahmad; Fattah Azman, A. Z.

    2014-11-01

    This study aims to estimate the radiation effective dose resulting from whole body fluorine-18 flourodeoxyglucose Positron Emission Tomography (18F-FDG PET) scanning as compared to conservative Computed Tomography (CT) techniques in evaluating oncology patients. We reviewed 19 oncology patients who underwent 18F-FDG PET/CT at our centre for cancer staging. Internal and external doses were estimated using radioactivity of injected FDG and volume CT Dose Index (CTDIvol), respectively with employment of the published and modified dose coefficients. The median differences of dose among the conservative CT and PET protocols were determined using Kruskal Wallis test with p < 0.05 considered as significant. The median (interquartile range, IQR) effective doses of non-contrasted CT, contrasted CT and PET scanning protocols were 7.50 (9.35) mSv, 9.76 (3.67) mSv and 6.30 (1.20) mSv, respectively, resulting in the total dose of 21.46 (8.58) mSv. Statistically significant difference was observed in the median effective dose between the three protocols (p < 0.01). The effective doses of whole body 18F-FDG PET technique may be effective the lowest amongst the conventional CT imaging techniques.

  8. Angular on-line tube current modulation in multidetector CT examinations of children and adults: The influence of different scanning parameters on dose reduction

    SciTech Connect

    Papadakis, Antonios E.; Perisinakis, Kostas; Damilakis, John

    2007-07-15

    The purpose of this study was to assess the potential of angular on-line tube current modulation on dose reduction in pediatric and adult patients undergoing multidetector computed tomography (MDCT) examinations. Five physical anthropomorphic phantoms that simulate the average individual as neonate, 1-year-old, 5-year-old, 10-year-old, and adult were employed in the current study. Phantoms were scanned with the use of on-line tube current modulation (TCM). Percent dose reduction (%DR) factors achieved by applying TCM, were determined for standard protocols used for head and neck, shoulder, thorax, thorax and abdomen, abdomen, abdomen and pelvis, pelvis, and whole body examinations. A preliminary study on the application of TCM in MDCT examinations of adult patients was performed to validate the results obtained in anthropomorphic phantoms. Dose reduction was estimated as the percentage difference of the modulated milliamperes for each scan and the preset milliamperes prescribed by the scan protocol. The dose reduction in children was found to be much lower than the corresponding reduction achieved for adults. For helical scans the %DR factors, ranged between 1.6% and 7.4% for the neonate, 2.9% and 8.7% for the 1-year old, 2% and 6% for the 5-year-old, 5% and 10.9% for the 10-year-old, and 10.4% and 20.7% for the adult individual. For sequential scans the corresponding %DR factors ranged between 1.3% and 6.7%, 4.5% and 11%, 4.2% and 6.6%, 6.4% and 12.3%, and 8.9% and 23.3%, respectively. Broader beam collimations are associated with decreased %DR factors, when other scanning parameters are held constant. TCM did not impair image noise. In adult patients, the %DR values were found to be in good agreement with the corresponding results obtained in the anthropomorphic adult phantom. In conclusion, on-line TCM may be considered as a valuable tool for reducing dose in routine CT examinations of pediatric and adult patients. However, the dose reduction achieved with TCM

  9. Imaging the pregnant patient with abdominal pain.

    PubMed

    Wallace, Graham W; Davis, Melissa A; Semelka, Richard C; Fielding, Julia R

    2012-10-01

    Imaging of pregnant patients with non-obstetric abdominal pain is reviewed, with an accompanying pictorial essay of cases with concentration on magnetic resonance imaging. Non-obstetric causes of abdominal pain during pregnancy are similar to those of non-pregnant patients. The most common causes are appendicitis and cholecystitis. Other causes are myriad and include biliary, gastrointestinal, infectious, inflammatory, and malignant etiologies, among others. The approach to imaging in pregnant patient is unique, as it is imperative to minimize potentially harmful radiation exposures to the fetus. Ultrasound and MRI are the primary modalities for evaluation of the pregnant patient with abdominal pain. The use of intravenous contrast is discouraged, except in highly-selected patients where there is no other way to obtain vital diagnostic information. CT is still used as the mainstay of evaluation of blunt abdominal trauma and is commonly used for diagnosis of small bowel obstruction, stone disease, and work-up of malignancy during pregnancy. A discussion of test selection and underlying rationale is presented. PMID:22160283

  10. MRI, enhanced CT, and FDG PET/CT in primary retroperitoneal mucinous cystadenocarcinoma.

    PubMed

    Dong, Aisheng; Zhai, Zhijun; Wang, Yang; Zuo, Changjing

    2015-01-01

    Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare neoplasm. We present a case of PRMC with MRI, enhanced CT, and FDG PET/CT findings. Abdominal MRI showed a cystic lesion in the retroperitoneum with a mural nodule. The mural nodule showed progressive enhancement on enhanced CT and intense FDG uptake on early PET/CT with increased SUVmax on delayed PET/CT. Laparoscopy was performed. Retroperitoneal mucinous cystadenocarcinoma was confirmed histopathologically. Metastasis from gastrointestinal tract or ovary was excluded. This case indicates, although rare, PRMC should be considered when a hypermetabolic retroperitoneal cystic lesion with bilateral normal ovaries is found on FDG PET/CT. PMID:24445275

  11. Marketing cardiac CT programs.

    PubMed

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing. PMID:22276376

  12. Abdominal Compartment Syndrome: Risk Factors, Diagnosis, and Current Therapy

    PubMed Central

    Luckianow, Gina M.; Ellis, Matthew; Governale, Deborah; Kaplan, Lewis J.

    2012-01-01

    Abdominal compartment syndrome's manifestations are difficult to definitively detect on physical examination alone. Therefore, objective criteria have been articulated that aid the bedside clinician in detecting intra-abdominal hypertension as well as the abdominal compartment syndrome to initiate prompt and potentially life-saving intervention. At-risk patient populations should be routinely monitored and tiered interventions should be undertaken as a team approach to management. PMID:22720147

  13. Immunoglobulin G4-related large thoraco-abdominal aortic aneurysm.

    PubMed

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Sasaguri, Shiro

    2016-07-01

    We report a case of immunoglobulin G4-related large thoraco-abdominal aortic aneurysm in a 38-year old man. Preoperative contrast-enhanced computed tomography revealed that the mid-descending thoracic aorta was extremely enlarged and the maximum diameter of the aneurysm was 92 mm. The patient underwent thoraco-abdominal aortic replacement through a thoraco-abdominal incision under left heart bypass. The postoperative pathological examination diagnosed immunoglobulin G4-related aortic aneurysm. PMID:27059069

  14. Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts

    PubMed Central

    Lee, Chang Hyun; Goo, Jin Mo; Lee, Hyun Ju; Hong, Sung-Tae; Shen, Cheng Hua; Chung, Doo Hyun; Son, Kyu Ri; Chang, Jung Min; Eo, Hong

    2007-01-01

    Objective To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. Materials and Methods This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. Results The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. Conclusion The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus. PMID:17923779

  15. Abdominal Kaposiform Hemangioendothelioma Associated With Lymphangiomatosis Involving Mesentery and Ileum

    PubMed Central

    Dong, Aisheng; Zhang, Ling; Wang, Yang; He, Tianlin; Zuo, Changjing

    2016-01-01

    Abstract Kaposiform hemangioendothelioma (KH) is a rare vascular tumor of intermediate malignancy that occurs mainly in the childhood. Adult patients with KH are rare. Imaging findings of KH have rarely been reported before. We present magnetic resonance imaging (MRI), computed tomography (CT), and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in an adult patient with KH associated with lymphangiomatosis involving mesentery and ileum. A 22-year-old female complained of a 9-month history of intermittent melena, weakness, and palpitation. Laboratory tests revealed anemia and hypoproteinemia. Fecal occult blood test was positive. Abdominal enhanced MRI and CT showed a large abdominal mass involving mesentery and ileum. On enhanced MRI, there were many hypervascular nodules in the mass. On FDG PET/CT, the mass and the nodules showed slight FDG uptake. Small bowel capsule endoscopy showed numerous grape-shaped red nodules in the luminal wall of the involved ileum. The patient underwent resection of the abdominal mass and a segment of the ileum invaded by the abdominal mass. KH arising within lymphangiomatosis involving mesentery and ileum was confirmed by pathology. After surgery, the patient's symptoms improved. This is the first case of KH associated with lymphangiomatosis involving mesentery and ileum. In this case, the lymphangiomatosis overshadowed the small tumor nodules resulting in unusual imaging findings. Familiarity with these imaging findings is helpful for diagnosis and differential diagnosis of KH. PMID:26871848

  16. MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

    SciTech Connect

    Moore, B; Brady, S; Kaufman, R; Mirro, A

    2014-06-15

    Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

  17. Torso Computed Tomography Can Be Bypassed after Thorough Trauma Bay Examination of Patients Who Fall from Standing.

    PubMed

    Lavingia, Kedar S; Collins, Jay N; Soult, Michael C; Terzian, W Helman; Weireter, Leonard J; Britt, L D

    2015-08-01

    Reliance on CT imaging in the evaluation of low-impact blunt trauma is a major source of radiation exposure, cost, and resource utilization. This study sought to determine if torso (chest and abdomen) CT could be avoided in patients with ground level falls. This was a retrospective chart review of patients admitted to the trauma service between January 2013 and April 2014. The mechanism of injury was ground level fall or fall from sitting. Patient demographics, physical examination (PE) findings, imaging results, length of stay, and complications were reviewed. History and physical data were based on chief resident or attending documentation. A significant thoracic injury was defined as a hemothorax, a pneumothorax, greater than three rib fractures, or aortic injury. A significant abdominal injury was defined as a solid organ injury, an intra-abdominal hematoma, a hollow viscus injury, aortic injury, or a urologic injury. The trauma service evaluated 156 patients. Nine patients were excluded for intubation or Glasgow Coma Scale (GCS) < 13. Of the 147 remaining, mean age was 69 years, mean GCS was 14.8. A chest CT was obtained in 111 (76%). Eight (7%) had a significant thoracic injury. All patients with significant thoracic injury had positive examination findings. No patient with a normal PE was found to have a significant thoracic injury (negative predictive value of 100%). An abdominal CT was obtained in 86 (59%). Five (6%) were found to have a significant abdominal injury. All patients who had a significant radiographic injury had an abnormal PE (negative predictive value of 100%). In conclusion, thorough history and physical in the trauma bay allow the clinician to obtain selective torso CT imaging. Routine torso CT warrants re-evaluation in low-impact injury mechanisms as there appears to be little benefit compared with the resource utilization and expense. PMID:26215242

  18. Haustral fold detection method for CT colonography based on difference filter along colon centerline

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Kitasaka, Takayuki; Mori, Kensaku; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru

    2009-02-01

    This paper presents a haustral fold detection method from 3D abdominal CT images. CT colonography (CTC) or virtual colonoscopy is a new colon diagnostic method to examine the inside of the colon. CTC system can visualize the interior of the colon from any viewpoint and viewing direction based on CT images of a patient. Both the supine and the prone positions of CT images are used for colon diagnosis to improve sensitivity of lesion detection. Registration of the supine and the prone positions of a patient is needed to improve efficiency of diagnosis using CT images in the two positions. Positions of haustral folds are utilizable as landmarks to establish correspondence between these two positions. We present a haustral fold detection method for registration of the supine and the prone positions. Haustral folds protrude almost perpendicular to a centerline of the colon. We designed new difference filter of CT values that can detect haustral folds. The difference filter calculates difference values of CT values along the colon centerline. It outputs high values in the haustral folds. False positive elimination is performed using two feature values including output value of the difference filter and volume of connected component. As the results of experiments using 12 cases of CT images, we confirmed that the proposed method can detect haustral folds satisfactorily. From evaluation using haustral folds >~ 3 [mm] in height and thickness, sensitivity of our method was 90.8% with 6.1 FPs/case.

  19. The Effects of Combined Exercise on Health-Related Fitness, Endotoxin, and Immune Function of Postmenopausal Women with Abdominal Obesity

    PubMed Central

    Park, Sung-Mo; Kwak, Yi-Sub; Ji, Jin-Goo

    2015-01-01

    This study was conducted to examine the effects of combined exercise on health-related fitness, endotoxin concentrations, and immune functions of postmenopausal women with abdominal obesity. 20 voluntary participants were recruited and they were randomly allocated to the combined exercise group (n = 10) or the control group (n = 10). Visceral obesity was defined as a visceral-to-subcutaneous fat ratio ≥0.4 based on computed tomography (CT) results. Body composition, exercise stress testing, fitness measurement, CT scan, and blood variables were analyzed to elucidate the effects of combined exercise. The SPSS Statistics 18.0 program was used to calculate means and standard deviations for all variables. Significant differences between the exercise group and control group were determined with 2-way ANOVA and paired t-tests. The exercise group's abdominal obesity was mitigated due to visceral fat reduction; grip strength, push-ups, and oxygen uptake per weight improved; and HDL-C and IgA level also increased, while TNF-α, CD14, and endotoxin levels decreased. Lowered TNF-α after exercise might have an important role in the obesity reduction. Therefore, we can conclude that combined exercise is effective in mitigating abdominal obesity, preventing metabolic diseases, and enhancing immune function. PMID:26075288

  20. Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

    PubMed Central

    Rehim, S. A.; Dagash, H.; Godbole, P. P.; Raghavan, A.; Murthi, G. V.

    2010-01-01

    Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT) scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children. PMID:21209813

  1. Spontaneous rupture of a hepatic hydatid cyst into the peritoneum causing only mild abdominal pain: a case report.

    PubMed

    Karakaya, Kemal

    2007-02-01

    Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery. PMID:17278209

  2. Abdominal Dual Energy Imaging

    NASA Astrophysics Data System (ADS)

    Sommer, F. Graham; Brody, William R.; Cassel, Douglas M.; Macovski, Albert

    1981-11-01

    Dual energy scanned projection radiography of the abdomen has been performed using an experimental line-scanned radiographic system. Digital images simultaneously obtained at 85 and 135 kVp are combined, using photoelectric/Compton decomposition algorithms to create images from which selected materials are cancelled. Soft tissue cancellation images have proved most useful in various abdominal imaging applications, largely due to the elimination of obscuring high-contrast bowel gas shadows. These techniques have been successfully applied to intravenous pyelography, oral cholecystography, intravenous abdominal arteriog-raphy and the imaging of renal calculi.

  3. Abdominal Aortic Aneurysms

    PubMed Central

    Fortner, George; Johansen, Kaj

    1984-01-01

    Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness. Images PMID:6702193

  4. A case of abdominal aortic injury caused by a traffic accident.

    PubMed

    Kutsukata, Noriyoshi; Mashiko, Kunihiro; Matsumoto, Hisashi; Hara, Yoshiaki; Sakamoto, Yuichiro; Takei, Kenkichi; Saito, Nobuyuki

    2008-12-01

    A 30-year-old man was injured when the large motorcycle he was riding crashed into a power pole. Upon arrival at our institution, the patient complained of abdominal pain; blood pressure at admission was 160/70 mmHg, and the heart rate was 112 bpm. Abdominal ultrasonography showed a small collection of fluid in Morrison's pouch. A chest X-ray film showed a right rib fracture. Multidetector computed tomography (MD-CT) revealed pleural effusion, a hepatic lesion, and a dissection of the abdominal aorta distal to the renal artery. Because of the complicated intraluminal injuries, the insertion of a stent graft was difficult. On the 34th day after injury, elective surgery was performed. Because dissection of the lumen was observed, the vessel was replaced with an artificial graft. Medial degeneration of the aorta wall was not observed upon pathological examination, and no degenerative disorders have occurred. The postoperative progress was favorable, and the patient was discharged from hospital. PMID:19155570

  5. Intra-Abdominal Hematoma Following Enoxaparin Injection

    PubMed Central

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  6. Intra-Abdominal Hematoma Following Enoxaparin Injection.

    PubMed

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  7. Practical CT dosimetry

    SciTech Connect

    Yoshizumi, T.T.; Suneja, S.K.; Teal, J.S. )

    1989-07-01

    The dose from computed tomography (CT) examinations is not negligible from a radiation safety standpoint. Occasionally, one encounters a case in which an unsuspected pregnant woman undergoes a CT pelvic scan, and the radiologist is required to estimate the dose to the fetus. This article addresses practical methods of CT dosimetry with a specific discussion on fetal dose estimate. Three methods are described: (1) the use of a dose chart, (2) the pencil ionization chamber method, and (3) the thermoluminescence dosimetry (TLD) method.

  8. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting.

    PubMed

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  9. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting

    PubMed Central

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  10. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents.

    PubMed

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław

    2015-02-01

    Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and <50% of the thickness differences in all muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents. PMID:25088309

  11. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  12. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  13. An unusual cause of abdominal pain.

    PubMed

    Terneu, S; Verhelst, D; Thys, F; Ketelslegers, E; Hantson, P; Wittebole, X

    2003-01-01

    A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K. PMID:14635532

  14. Use of CT imaging to examine the coarse roots, rhizomes, and peat associated with creek bank Spartina alterniflora in fertilized and control creeks in Plum Island (MA)

    EPA Science Inventory

    We used computer-aided tomography (CT) to quantify the wet mass, abundance, and diameter of coarse roots and rhizomes as well as the wet mass and particle density of marsh peat in 7-year fertilized and control creeks in Plum Island (MA). In shallow soils (0 – 10 cm) and at dep...

  15. Negative predictive value of preoperative computed tomography in determining pathologic local invasion, nodal disease, and abdominal metastases in gastric cancer

    PubMed Central

    Kagedan, D.J.; Frankul, F.; El-Sedfy, A.; McGregor, C.; Elmi, M.; Zagorski, B.; Dixon, M.E.; Mahar, A.L.; Vasilevska-Ristovska, J.; Helyer, L.; Rowsell, C.; Swallow, C.J.; Law, C.H.; Coburn, N.G.

    2016-01-01

    Background Before undergoing curative-intent resection of gastric adenocarcinoma (ga), most patients undergo abdominal computed tomography (ct) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited to single-institution studies. We sought to assess, on a population level, the clinical relevance of preoperative ct in evaluating the resectability of ga tumours in patients undergoing surgery. Methods In a provincial cancer registry, 2414 patients with ga diagnosed during 2005–2008 at 116 institutions were identified, and a primary chart review of radiology, operative, and pathology reports was performed for all patients. Preoperative abdominal ct reports were compared with intraoperative findings and final pathology reports (reference standard) to determine the negative predictive value (npv) of ct in assessing local invasion, nodal involvement, and intra-abdominal metastases. Results Among patients undergoing gastrectomy, the npv of ct imaging in detecting local invasion was 86.9% (n = 536). For nodal metastasis, the npv of ct was 43.3% (n = 450). Among patients undergoing surgical exploration, the npv of ct for intra-abdominal metastases was 52.3% (n = 407). Conclusions Preoperative abdominal ct imaging reported as negative is most accurate in determining local invasion and least accurate in nodal assessment. The poor npv of ct should be taken into account when selecting patients for staging laparoscopy. PMID:27536178

  16. Quantitative anatomical labeling of the anterior abdominal wall

    NASA Astrophysics Data System (ADS)

    Allen, Wade M.; Xu, Zhoubing; Asman, Andrew J.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-03-01

    Ventral hernias (VHs) are abnormal openings in the anterior abdominal wall that are common side effects of surgical intervention. Repair of VHs is the most commonly performed procedure by general surgeons worldwide, but VH repair outcomes are not particularly encouraging (with recurrence rates up to 43%). A variety of open and laparoscopic techniques are available for hernia repair, and the specific technique used is ultimately driven by surgeon preference and experience. Despite routine acquisition of computed tomography (CT) for VH patients, little quantitative information is available on which to guide selection of a particular approach and/or optimize patient-specific treatment. From anecdotal interviews, the success of VH repair procedures correlates with hernia size, location, and involvement of secondary structures. Herein, we propose an image labeling protocol to segment the anterior abdominal area to provide a geometric basis with which to derive biomarkers and evaluate treatment efficacy. Based on routine clinical CT data, we are able to identify inner and outer surfaces of the abdominal walls and the herniated volume. This is the first formal presentation of a protocol to quantify these structures on abdominal CT. The intra- and inter rater reproducibilities of this protocol are evaluated on 4 patients with suspected VH (3 patients were ultimately diagnosed with VH while 1 was not). Mean surfaces distances of less than 2mm were achieved for all structures.

  17. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  18. [Pediatric Abdominal Pain – Harmless or Harmful?].

    PubMed

    Furlano, Raoul Ivano

    2016-04-27

    Abdominal pain is a very common pediatric complaint. In the majority of cases there is no life-threatening pathology behind this symptom, but a functional disease. However, all-day activities of children and adolescents are often limited, frequent absences from school, and general physician/ pediatrician office visits with often unnecessary diagnostic and therapies are registered. Once an organic etiology of the abdominal pain is excluded by a thoroughly medical history taking and physical examination, the first steps for a successful alleviation of the pain is the reassurance of the patients and their family that there is no life-threatening pathology. There is evidence that cognitive-behavioral therapy may be useful in improving pain and disability outcome in the short term. There is no evidence for pharmacological, dietetic, or complementary intervention in the treatment of chronic functional abdominal pain. PMID:27120211

  19. Clinical observation of the adverse drug reactions caused by non-ionic iodinated contrast media: results from 109,255 cases who underwent enhanced CT examination in Chongqing, China

    PubMed Central

    Li, X; Chen, J; Zhang, L; Liu, H; Wang, S; Chen, X; Fang, J; Wang, S

    2015-01-01

    Objective: To analyse the pattern and factors that influence the incidence of adverse drug reactions (ADRs) induced by non-ionic iodinated contrast media and to evaluate their safety profiles. Methods: Data from 109,255 cases who underwent enhanced CT examination from 1 January 2008 to 31 August 2013 were analysed. ADRs were classified according to the criteria issued by the American College of Radiology and the Chinese Society of Radiology. Results: A total of 375 (0.34%) patients had ADRs, including 281 mild (0.26%); 80 moderate (0.07%); and 14 severe (0.01%) ADRs; no death was found. 302 (80.53%) of the ADRs occurred within 15 min after examination. Patients aged 40–49 years (204 cases, 0.43%; p < 0.01) or who underwent coronary CT angiography (93 cases, 0.61%; p < 0.01) were at a higher risk of ADRs. Female patients (180 cases, 0.40%; p < 0.01) or outpatients had significantly higher incidence rates of ADRs. The symptoms and signs of most of the ADRs were resolved spontaneously within 24 h after appropriate treatment without sequelae. Conclusion: The occurrence of ADRs is caused by the combined effects of multiple factors. The ADRs induced by non-ionic iodinated contrast media are mainly mild ones, while moderate or severe ADRs are relatively rare, suggesting that enhanced CT examination with non-ionic iodinated contrast media is highly safe, and severe adverse events will seldom occur under appropriate care. Advances in knowledge: The study included 109,255 patients enrolled in various types of enhanced CT examinations, which could reflect ADR conditions and regulations in Chinese population accurately and reliably. PMID:25582519

  20. Abdominal computed tomographic scan-merits and demerits over ultrasonography: evaluation of 70 cases.

    PubMed

    Obajimi, M O; Ogunseyinde, A O; Agunloye, A M

    2002-06-01

    Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of abdominal symptoms. In a retrospective study of 70 Nigerian patients who had abdominal ultrasonography prior to abdominal CT scans, the most frequent clinical feature was abdominal pain, which was reported in 20.8% of the patients. The prevalent ultrasonographic finding was hepatomegaly (12.2%) while bowel displacement was the most frequently reported CT finding (18.3%). There was no correlation between USS and CT findings in 11 patients (15.7%). There was some agreement in the findings of both tests in 75.7% of cases. Additional findings were noted in 38 (54.3%) of the latter group of patients on CT scans. Hundred percent agreement was reported in both imaging techniques in 5 radiological findings namely: dilated gall bladder, renal cysts, ascites, adrenal mass and utero-cervical mass. These findings suggest a high yield of diagnostic accuracy from abdominal sonography and increased diagnostic details provided by CT imaging. Our overall impression is that the diagnostic information provided by the two techniques are complimentary. PMID:12518911

  1. Predominance of Abdominal Visceral Adipose Tissue Reflects the Presence of Aortic Valve Calcification

    PubMed Central

    Oikawa, Masayoshi; Owada, Takashi; Yamauchi, Hiroyuki; Misaka, Tomofumi; Machii, Hirofumi; Yamaki, Takayoshi; Sugimoto, Koichi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-ichi; Takeishi, Yasuchika

    2016-01-01

    Background. Aortic valve calcification (AVC) is a common feature of aging and is related to coronary artery disease. Although abdominal visceral adipose tissue (VAT) plays fundamental roles in coronary artery disease, the relationship between abdominal VAT and AVC is not fully understood. Methods. We investigated 259 patients who underwent cardiac and abdominal computed tomography (CT). AVC was defined as calcified lesion on the aortic valve by CT. %abdominal VAT was calculated as abdominal VAT area/total adipose tissue area. Results. AVC was detected in 75 patients, and these patients showed higher %abdominal VAT (44% versus 38%, p < 0.05) compared to those without AVC. When the cutoff value of %abdominal VAT was set at 40.9%, the area under the curve to diagnose AVC was 0.626. Multivariable logistic regression analysis showed that age (OR 1.120, 95% CI 1.078–1.168, p < 0.01), diabetes (OR 2.587, 95% CI 1.323–5.130, p < 0.01), and %abdominal VAT (OR 1.032, 95% CI 1.003–1.065, p < 0.05) were independent risk factors for AVC. The net reclassification improvement value for detecting AVC was increased when %abdominal VAT was added to the model: 0.5093 (95% CI 0.2489–0.7697, p < 0.01). Conclusion. We determined that predominance of VAT is associated with AVC. PMID:26904670

  2. A multimodality vascular imaging phantom of an abdominal aortic aneurysm with a visible thrombus

    SciTech Connect

    Allard, Louise; Chayer, Boris; Qin Zhao; Soulez, Gilles; Roy, David; Cloutier, Guy

    2013-06-15

    concordance with the literature for vascular and abdominal tissues. Conclusions: The mimicked abdominal tissues, AAA wall, and surrounding thrombus were developed to match imaging features of in vivo MR, CT, and ultrasound examinations. This phantom should be of value for image calibration, segmentation, and testing of endovascular devices for AAA endovascular repair.

  3. Component separation in abdominal trauma.

    PubMed

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  4. Endovascular Repair of Abdominal Aortic Aneurysm: Follow-up with Noninvasive Vascular Elastography in a Canine Model.

    PubMed

    Salloum, Eli; Bertrand-Grenier, Antony; Lerouge, Sophie; Kauffman, Claude; Héon, Hélène; Therasse, Eric; Salazkin, Igor; Roy Cardinal, Marie-Hélène; Cloutier, Guy; Soulez, Gilles

    2016-05-01

    Purpose To assess the ability of noninvasive vascular elastography (NIVE) to help characterize endoleaks and thrombus organization in a canine model of abdominal aortic aneurysm after endovascular aneurysm repair with stent-grafts, in comparison with computed tomography (CT) and pathologic examination findings. Materials and Methods All protocols were approved by the Animal Care Committee in accordance with the guidelines of the Canadian Council of Animal Care. Stent-grafts were implanted in a group of 18 dogs with aneurysms created in the abdominal aorta. Type I endoleak was created in four aneurysms; type II endoleak, in 13 aneurysms; and no endoleak, in one aneurysm. Doppler ultrasonography and NIVE examinations were performed at baseline and at 1-week, 1-month, 3-month, and 6-month follow-up. Angiography, CT, and macroscopic tissue examination were performed at sacrifice. Strain values were computed by using the Lagrangian speckle model estimator. Areas of endoleak, solid organized thrombus, and fresh thrombus were identified and segmented by comparing the results of CT and macroscopic tissue examination. Strain values were compared by using the Wilcoxon rank-sum and Kruskal-Wallis tests. Results All stent-grafts were successfully deployed, and endoleaks were clearly depicted in the last follow-up elastography examinations. Maximal axial strains over consecutive heart cycles in endoleak, organized thrombus, and fresh thrombus areas were 0.78% ± 0.22, 0.23% ± 0.02, 0.10% ± 0.04, respectively. Strain values were significantly different between endoleak and organized or fresh thrombus areas (P < .000) and between organized and fresh thrombus areas (P < .0002). No correlation was found between strain values and type of endoleak, sac pressure, endoleak size, and aneurysm size. Conclusion NIVE may be able to help characterize endoleak and thrombus organization, regardless of the size, pressure, and type of endoleak. (©) RSNA, 2015. PMID:26690905

  5. CT -- Body

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Body Computed tomography (CT) of the body uses special x-ray ... Body? What is CT Scanning of the Body? Computed tomography, more commonly known as a CT or CAT ...

  6. CT findings and clinical features of pancreatic hemolymphangioma: a case report and review of the literature.

    PubMed

    Pan, Liang; Jian-bo, Gao; Javier, Pullas Tapia Gonzalo

    2015-01-01

    Pancreatic hemolymphangioma is a very rare benign tumor. There were only 10 reports of this disease until June 2014.The aim of the present study was to describe a hemolymphangioma in the neck and body of the pancreas in a 57-year-old woman.The method used in the present study consists of description of the clinical history, image lab features, and pathological result.The patient complained of a 10-day history of epigastric discomfort. Abdominal computed tomography (CT) showed a cystic-solid tumor with an irregular shape, in the neck and body of the pancreas. The tumoral cystic wall and its internal division could be seen intensified on contrast-enhanced CT images compared with those on precontrast images. The pathological examination confirmed the diagnosis.The clinical feature of pancreatic hemolymphangioma includes a lack of specificity. The CT appearance combined with age and sex may be useful in making an early diagnosis. PMID:25621699

  7. Reduced alpha(2)-adrenergic sensitivity of subcutaneous abdominal adipocytes as a modulator of fasting and postprandial triglyceride levels in men.

    PubMed

    Imbeault, P; Couillard, C; Tremblay, A; Després, J P; Mauriège, P

    2000-09-01

    This study examined the postprandial lipemia of two groups of men displaying similar age, body weight, and regional fat distribution, but characterized by either low (n = 11) or high (n = 15) alpha(2)-adrenergic sensitivity of subcutaneous abdominal adipocytes. In addition to fat cell lipolysis, adipose tissue lipoprotein lipase (AT-LPL) as well as postheparin plasma LPL activities were measured in the fasting state. Fasting AT-LPL and PH-LPL activities were similar in both groups. Maximal adipose cell lipolysis induced by isoproterenol (beta-adrenergic agonist) as well as the beta-adrenergic sensitivity did not differ between both groups of men. The selective alpha(2)-adrenergic agonist UK-14304 promoted a similar antilipolytic response in subcutaneous abdominal adipocytes from both groups. However, the alpha(2)-adrenergic sensitivity, defined as the dose of UK-14304 that produced half-maximal inhibition of lipolysis (IC(50)), was significantly different between groups (P < 0.0001). Men with low versus high subcutaneous abdominal fat cell alpha(2)-adrenergic sensitivity showed higher fasting TG levels. In the whole group, a positive relationship was observed between log-transformed IC(50) UK-14304 values of subcutaneous adipocytes and fasting TG levels (r = 0.39, P < 0.05), suggesting that a low abdominal adipose cell alpha(2)-adrenergic sensitivity is associated with high TG levels. After the consumption of a high-fat meal, subjects with low subcutaneous abdominal adipose cell alpha(2)-adrenergic sensitivity showed higher TG levels in total, medium, and small triglyceride-rich lipoprotein (TRL) fractions at 0- to 6-h time points than men with high adipocyte alpha(2)-adrenergic sensitivity (P values ranging from 0.01 to 0.05). Stepwise regression analysis showed that the fasting TG concentration was the only variable retained as a significant predictor of the area under the curve of TG levels in total TRL fractions (73% of variance) among independent variables

  8. Multi-Atlas Segmentation for Abdominal Organs with Gaussian Mixture Models

    PubMed Central

    Burke, Ryan P.; Xu, Zhoubing; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-01-01

    Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid/gray matter/white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation. PMID:25914508

  9. Multi-atlas segmentation for abdominal organs with Gaussian mixture models

    NASA Astrophysics Data System (ADS)

    Burke, Ryan P.; Xu, Zhoubing; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid / gray matter / white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation.

  10. Antibiotic penetration of experimental intra-abdominal abscesses.

    PubMed

    Galandiuk, S; Lamos, J; Montgomery, W; Young, S; Polk, H C

    1995-06-01

    Intra-abdominal abscess is seldom adequately treated by systemic antibiotics alone and often requires surgical or computed tomography-guided drainage for resolution. Abscess penetration of six currently used antibiotics was examined in a murine intra-abdominal abscess model. Ampicillin/sulbactam, cefmetazole, clindamycin, and trospectomycin penetrated intra-abdominal abscesses to a greater degree than cefoxitin and ceftriaxone. Abscess pus antibiotic levels were not significantly higher after multiple doses than after a single dose. Pus antibiotic levels below the MIC90 for Bacteroides and E. coli within intra-abdominal abscess were observed for most antibiotics with the doses used in this study. Selection of antibiotics with a greater ability to penetrate abscess may be important in optimally treating patients with abdominal infection. PMID:7762902

  11. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot.

    PubMed

    Stefanou, Christos; Zikos, Nicolaos; Pappas-Gogos, George; Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  12. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    PubMed Central

    Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  13. Quantitative Features of Liver Lesions, Lung Nodules, and Renal Stones at Multi-Detector Row CT Examinations: Dependency on Radiation Dose and Reconstruction Algorithm.

    PubMed

    Solomon, Justin; Mileto, Achille; Nelson, Rendon C; Roy Choudhury, Kingshuk; Samei, Ehsan

    2016-04-01

    Purpose To determine if radiation dose and reconstruction algorithm affect the computer-based extraction and analysis of quantitative imaging features in lung nodules, liver lesions, and renal stones at multi-detector row computed tomography (CT). Materials and Methods Retrospective analysis of data from a prospective, multicenter, HIPAA-compliant, institutional review board-approved clinical trial was performed by extracting 23 quantitative imaging features (size, shape, attenuation, edge sharpness, pixel value distribution, and texture) of lesions on multi-detector row CT images of 20 adult patients (14 men, six women; mean age, 63 years; range, 38-72 years) referred for known or suspected focal liver lesions, lung nodules, or kidney stones. Data were acquired between September 2011 and April 2012. All multi-detector row CT scans were performed at two different radiation dose levels; images were reconstructed with filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction (MBIR) algorithms. A linear mixed-effects model was used to assess the effect of radiation dose and reconstruction algorithm on extracted features. Results Among the 23 imaging features assessed, radiation dose had a significant effect on five, three, and four of the features for liver lesions, lung nodules, and renal stones, respectively (P < .002 for all comparisons). Adaptive statistical iterative reconstruction had a significant effect on three, one, and one of the features for liver lesions, lung nodules, and renal stones, respectively (P < .002 for all comparisons). MBIR reconstruction had a significant effect on nine, 11, and 15 of the features for liver lesions, lung nodules, and renal stones, respectively (P < .002 for all comparisons). Of note, the measured size of lung nodules and renal stones with MBIR was significantly different than those for the other two algorithms (P < .002 for all comparisons). Although lesion texture was

  14. Surgical removal of multiple mesenteric fibroids (Kg 4,500) by abdominal spread of previous laparoscopic uterine myomectomy

    PubMed Central

    LEANZA, V.; GULINO, F.A.; LEANZA, G.; ZARBO, G.

    2015-01-01

    Introduction Huge and multiple mesenteric fibroids (4,500 Kg weight) are very unusual. In many cases they are mistaken for subserosal fibroids of the womb due to the proximity with uterine walls. When they have a rapid growth, the risk of becoming malignant (sarcoma) has not to be underestimated. Surgery is challenging to remove abdominal nodes. Case report A case of a 40-year old woman, admitted to the hospital with abdominal masses occupying the entire cavity was reported. Both computerized tomography (CT) and ultrasounds (US) were not diriment for belonging of tumours. Clinical history of patient reports a laparoscopic removal of uterine fibroids, using the morcellator. Laparoscopy was performed four years before. Open surgery by means of a large transversal suprapubic laparotomy according to Pfannestiel was carried out. Multiple and huge mesenteric, peritoneal and intestinal tumours spread in the whole abdominal cavity were found, removed and examined by frozen section histology; in addition a series of small conglomerated myomas in the site of previous laparoscopic transumbilical route was taken away as well (the largest fibroid weighed Kg 3.500 and the all tumors removed 4,500 Kg); the result was benign (fibroids) and genital apparatus was preserved. Operation was challenging. Postoperative course was uneventful; after five days patient was discharged. Conclusions This case is very interesting for many factors: A) many extra-uterine fibroids spread throughout abdominal cavity; B) considerable weight of the masses C) intraoperative and postoperative danger. Finally, due to involvement of previous laparoscopic transumbilical incision together with other findings, the hypothesis of post laparoscopic dissemination has to be considered. A case of so large extragenital abdominal fibroids following laparoscopic uterine myomectomy has never been published so far. PMID:25827668

  15. Abdominal imaging: An introduction

    SciTech Connect

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures.

  16. Pediatric Abdominal Organ Transplantation: Current Indications, Techniques, and Imaging Findings.

    PubMed

    Stanescu, A Luana; Hryhorczuk, Anastasia L; Chang, Patricia T; Lee, Edward Y; Phillips, Grace S

    2016-03-01

    The anatomy, normal postoperative radiological appearance, and imaging features of common postoperative complications of pediatric abdominal transplants are reviewed, including renal, liver, and intestinal transplants. Doppler ultrasound is the mainstay of imaging after transplantation. Computed tomography (CT) and CT angiography, MR imaging and magnetic resonance (MR) angiography, MR cholangiopancreatography, conventional angiography, and nuclear medicine imaging may be used for problem-solving in pediatric transplant patients. Accurate and timely radiological diagnosis of transplant complications facilitates appropriate treatment and minimizes morbidity and mortality. PMID:26896225

  17. Imaging of Chest and Abdominal Trauma in Children.

    PubMed

    Goodwin, Susie J; Flanagan, Sean G; McDonald, Kirsteen

    2015-01-01

    Trauma is the commonest cause of death in children over a year old. The injuries sustained and management of these children differs to adults, due to differences in anatomy and physiology. Careful thought must also be given to exposing children to radiation, and CT scans should be performed only in select patients. This article reviews these important points and explains the imaging findings in chest and abdominal trauma. PMID:26219741

  18. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  19. Conservative management of an abdominal gunshot injury with a peritoneal breach: wisdom or absurdity?

    PubMed Central

    Khan, Salma; Pardhan, Amyn; Bawa, Tufail; Haroon, Naveed

    2013-01-01

    Surgical exploration has been the standard of care for abdominal gunshot injuries. The authors report a case of a 28-year-old man who sustained a transabdominal gunshot injury, which entered the anterior abdominal wall and exited adjacent to the T12 vertebra posteriorly with a tangential trajectory. On presentation, the patient was haemodynamically stable with no peritoneal signs. Based on trajectory of the bullet, intra-abdominal injury was suspected. Therefore a CT scan abdomen with intravenous and rectal contrast was performed. The CT scan revealed no extravasation of the rectal contrast but showed free air specks behind the descending colon. Delayed renal images of the left ureter were also normal. Based on the clinical findings, the patient was managed non-operatively with nothing per oral, intravenous antibiotics and frequent abdominal assessments. He made an uneventful recovery without necessitating laparotomy. PMID:24272989

  20. CT Scans

    MedlinePlus

    ... cross-sectional pictures of your body. Doctors use CT scans to look for Broken bones Cancers Blood clots Signs of heart disease Internal bleeding During a CT scan, you lie still on a table. The table ...

  1. Comparison of Tumor Volumes as Determined by Pathologic Examination and FDG-PET/CT Images of Non-Small-Cell Lung Cancer: A Pilot Study

    SciTech Connect

    Yu Jinming; Li Xinke; Xing Ligang; Mu Dianbin; Fu Zheng; Sun Xiaorong; Sun Xiangyu; Yang Guoren; Zhang Baijiang; Sun Xindong; Ling, C. Clifton

    2009-12-01

    Purpose: To determine the cut-off standardized uptake value (SUV) on {sup 18}F fluoro-2-deoxy-glucose (FDG) positron emission tomography/computed tomography (FDG-PET/CT) images that generates the best volumetric match to pathologic gross tumor volume (GTV{sub path}) for non-small-cell lung cancer (NSCLC). Methods and Materials: Fifteen patients with NSCLC who underwent FDG-PET/CT scans followed by lobectomy were enrolled. The surgical specimen was dissected into 5-7-mum sections at approximately 4-mm intervals and stained with hematoxylin and eosin. The tumor-containing area was outlined slice by slice and the GTV{sub path} determined by summing over all the slices, taking into account the interslice thickness and fixation-induced volume reduction. The gross tumor volume from the PET images, GTV{sub PET}, was determined as a function of cut-off SUV. The optimal threshold or optimal absolute SUV was defined as the value at which the GTV{sub PET} was the same as the GTV{sub path}. Results: The fixation process induced a volumetric reduction to 82% +- 10% (range, 62-100%) of the original. The maximal SUV was 10.1 +- 3.6 (range, 4.2-18.7). The optimal threshold and absolute SUV were 31% +- 11% and 3.0 +- 1.6, respectively. The optimal threshold was inversely correlated with GTV{sub path} and tumor diameter (p < 0.05), but the optimal absolute SUV had no significant correlation with GTV{sub path} or tumor diameter (p > 0.05). Conclusion: This study evaluated the use of GTV{sub path} as a criterion for determining the optimal cut-off SUV for NSCLC target volume delineation. Confirmatory studies including more cases are being performed.

  2. Discriminative dictionary learning for abdominal multi-organ segmentation.

    PubMed

    Tong, Tong; Wolz, Robin; Wang, Zehan; Gao, Qinquan; Misawa, Kazunari; Fujiwara, Michitaka; Mori, Kensaku; Hajnal, Joseph V; Rueckert, Daniel

    2015-07-01

    An automated segmentation method is presented for multi-organ segmentation in abdominal CT images. Dictionary learning and sparse coding techniques are used in the proposed method to generate target specific priors for segmentation. The method simultaneously learns dictionaries which have reconstructive power and classifiers which have discriminative ability from a set of selected atlases. Based on the learnt dictionaries and classifiers, probabilistic atlases are then generated to provide priors for the segmentation of unseen target images. The final segmentation is obtained by applying a post-processing step based on a graph-cuts method. In addition, this paper proposes a voxel-wise local atlas selection strategy to deal with high inter-subject variation in abdominal CT images. The segmentation performance of the proposed method with different atlas selection strategies are also compared. Our proposed method has been evaluated on a database of 150 abdominal CT images and achieves a promising segmentation performance with Dice overlap values of 94.9%, 93.6%, 71.1%, and 92.5% for liver, kidneys, pancreas, and spleen, respectively. PMID:25988490

  3. Dose management in CT facility

    PubMed Central

    Tsapaki, V; Rehani, M

    2007-01-01

    Computed Tomography (CT) examinations have rapidly increased in number over the last few years due to recent advances such as the spiral, multidetector-row, CT fluoroscopy and Positron Emission Tomography (PET)-CT technology. This has resulted in a large increase in collective radiation dose as reported by many international organisations. It is also stated that frequently, image quality in CT exceeds the level required for confident diagnosis. This inevitably results in patient radiation doses that are higher than actually required, as also stressed by the US Food and Drug Administration (FDA) regarding the CT exposure of paediatric and small adult patients. However, the wide range in exposure parameters reported, as well as the different CT applications reveal the difficulty in standardising CT procedures. The purpose of this paper is to review the basic CT principles, outline the recent technological advances and their impact in patient radiation dose and finally suggest methods of radiation dose optimisation. PMID:21614279

  4. Spontaneous rupture of a hepatic hydatıd cyst into the peritoneum causing only mild abdominal pain: A case report

    PubMed Central

    Karakaya, Kemal

    2007-01-01

    Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery. PMID:17278209

  5. [Surgical criteria for reoperation in abdominal surgery].

    PubMed

    Bricot, R

    1975-07-01

    Analysis of the surgical criteria for reintervention in Abdominal Surgery led to the accentuation of a certain number of pictures of occlusion, general infectious syndromes, postoperative peritonitis, gastro-intestinal fistula and hemorrhagic syndrome. In all cases, the clinical examination can be misleading in particular in the case of peritonitis, and the history and non-surgical criteria must be strongly borne in mind. PMID:2036

  6. A man from South Asia presenting with abdominal pain

    PubMed Central

    Shiratori, Beata; Usami, Osamu; Hattori, Toshio; Ashino, Yugo

    2014-01-01

    The diagnosis of abdominal tuberculosis (TB) is challenging due to the non-specific clinical presentation and frequent failure to detect the pathogen. A young Bangladeshi man presented to the Emergency Outpatient department with constipation and burning abdominal pain that was localised primarily in the epigastrium. Although the infectious agent was not detected, findings of histological examination were helpful in guiding the treatment strategy. As a good clinical practice, it is important to consider abdominal TB as a possible diagnosis in such cases, particularly when a patient has previously been residing in a high TB burden country. Thus, appropriate diagnosis and early antituberculous therapy are essential for achieving a positive outcome. PMID:24554676

  7. A mycotic abdominal aortic aneurysm caused by Listeria monocytogenes in a patient with HIV infection

    PubMed Central

    Gunst, Jesper Damsgaard; Jensen-Fangel, Søren

    2014-01-01

    A 65-year-old man with HIV infection presented with acute severe abdominal pain radiating to the back. A CT scan revealed an infrarenal abdominal aortic aneurysm, and an aortobifemoral bypass was undertaken. Subsequently, tissue specimens from the aortic wall grew Listeria monocytogenes. The patient received 8 weeks of intravenous antibiotic treatment followed by oral sulfotrim as secondary prophylaxis and made an uneventful recovery. PMID:24443338

  8. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice

    PubMed Central

    Al Moudi, Mansour; Cao, Yan

    2014-01-01

    Computed tomography (CT) angiography represents the most important technical development in CT imaging and it has challenged invasive angiography in the diagnostic evaluation of cardiovascular abnormalities. Over the last decades, technological evolution in CT imaging has enabled CT angiography to become a first-line imaging modality in the diagnosis of cardiovascular disease. This review provides an overview of the diagnostic applications of CT angiography (CTA) in cardiovascular disease, with a focus on selected clinical challenges in some common cardiovascular abnormalities, which include abdominal aortic aneurysm (AAA), aortic dissection, pulmonary embolism (PE) and coronary artery disease. An evidence-based review is conducted to demonstrate how CT angiography has changed our approach in the diagnosis and management of cardiovascular disease. Radiation dose reduction strategies are also discussed to show how CT angiography can be performed in a low-dose protocol in the current clinical practice. PMID:25392823

  9. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice.

    PubMed

    Sun, Zhonghua; Al Moudi, Mansour; Cao, Yan

    2014-10-01

    Computed tomography (CT) angiography represents the most important technical development in CT imaging and it has challenged invasive angiography in the diagnostic evaluation of cardiovascular abnormalities. Over the last decades, technological evolution in CT imaging has enabled CT angiography to become a first-line imaging modality in the diagnosis of cardiovascular disease. This review provides an overview of the diagnostic applications of CT angiography (CTA) in cardiovascular disease, with a focus on selected clinical challenges in some common cardiovascular abnormalities, which include abdominal aortic aneurysm (AAA), aortic dissection, pulmonary embolism (PE) and coronary artery disease. An evidence-based review is conducted to demonstrate how CT angiography has changed our approach in the diagnosis and management of cardiovascular disease. Radiation dose reduction strategies are also discussed to show how CT angiography can be performed in a low-dose protocol in the current clinical practice. PMID:25392823

  10. A numerical investigation of the healthy abdominal wall structures.

    PubMed

    Pachera, P; Pavan, P G; Todros, S; Cavinato, C; Fontanella, C G; Natali, A N

    2016-06-14

    The present work aims to assess, via numerical modeling, the global passive mechanical behavior of the healthy abdominal wall under the action of pressures that characterize different daily tasks and physiological functions. The evaluation of a normal range of intra-abdominal pressure (IAP) during activities of daily living is fundamental because pressure alterations can cause several adverse effects. At this purpose, a finite element model is developed from literature histomorphometric data and from diagnostic images of Computed Tomography (CT), detailing the different anatomical regions. Numerical simulations cover an IAP up to the physiological limit of 171 (0.0223MPa) mmHg reached while jumping. Numerical results are in agreement with evidences on physiological abdomens when evaluating the local deformations along the craniocaudal direction, the transversal load forces in different regions and the increase of the abdominal area at a IAP of 12mmHg. The developed model can be upgraded for the investigation of the abdominal hernia repair and the assessment of prostheses mechanical compatibility, correlating stiffness and tensile strength of the abdominal tissues with those of surgical meshes. PMID:27133659

  11. Clinical evaluation of semi-automatic landmark-based lesion tracking software for CT-scans

    PubMed Central

    2014-01-01

    Background To evaluate a semi-automatic landmark-based lesion tracking software enabling navigation between RECIST lesions in baseline and follow-up CT-scans. Methods The software automatically detects 44 stable anatomical landmarks in each thoraco/abdominal/pelvic CT-scan, sets up a patient specific coordinate-system and cross-links the coordinate-systems of consecutive CT-scans. Accuracy of the software was evaluated on 96 RECIST lesions (target- and non-target lesions) in baseline and follow-up CT-scans of 32 oncologic patients (64 CT-scans). Patients had to present at least one thoracic, one abdominal and one pelvic RECIST lesion. Three radiologists determined the deviation between lesions’ centre and the software’s navigation result in consensus. Results The initial mean runtime of the system to synchronize baseline and follow-up examinations was 19.4 ± 1.2 seconds, with subsequent navigation to corresponding RECIST lesions facilitating in real-time. Mean vector length of the deviations between lesions’ centre and the semi-automatic navigation result was 10.2 ± 5.1 mm without a substantial systematic error in any direction. Mean deviation in the cranio-caudal dimension was 5.4 ± 4.0 mm, in the lateral dimension 5.2 ± 3.9 mm and in the ventro-dorsal dimension 5.3 ± 4.0 mm. Conclusion The investigated software accurately and reliably navigates between lesions in consecutive CT-scans in real-time, potentially accelerating and facilitating cancer staging. PMID:25609496

  12. Functional Abdominal Pain in Children

    MedlinePlus

    ... dominalPa in inCh ildre n What is functional abdominal pain, and why does it happen? Most otherwise-healthy ... stomachaches for two months or more have functional abdominal pain. The term “functional” refers to the fact that ...

  13. CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation.

    PubMed

    Hiller, Nurith; Fux, Tal; Finkelstein, Anna; Mezeh, Haggi; Simanovsky, Natalia

    2016-04-01

    To investigate which clinical, laboratory, and CT findings potentially facilitate the differential diagnosis between tubo-ovarian abscess (TOA) and periappendicular abscess (PAA), we retrospectively reviewed abdominal CT examinations and medical records for all women who presented to our medical center with unilateral right pelvic abscess formation who underwent CT evaluation from 2004-2014. A wide spectrum of clinical data and imaging findings were recorded. CT diagnoses were made in consensus by two experienced body radiologists blinded to the final diagnosis. Findings associated with the infections were compared using the chi-square (χ(2)) or the Fisher exact test. Ninety-one patients were included; 58 with PAA (mean age 46 years) and 33 with TOA (mean age 37 years). Pain on cervical motion (67 %) and vaginal discharge (21 %) were significantly more common in TOA; other clinical signs were similar. The presence of right ovarian vein entering the mass on CT had 100 % specificity and 94 % sensitivity to TOA. Distended right fallopian tube (79 %), mass posterior to mesovarium (76 %), contralateral pelvic fat stranding (55 %), and thickening of sacrouterine ligaments (55 %) were significantly more common in TOA. Positive "arrowhead sign" (91 %), mesenteric lymphadenopathy (85 %), small bowel wall thickening (55 %), fluid in the right paracolic gutter (50 %), and cecal wall thickening (48 %) were significantly more common in PAA;internal gas was revealed only in PAA (33 %). Distinct CT features can increase diagnostic certainty regarding the origin of right lower quadrant abscess in women. PMID:26719159

  14. Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis.

    PubMed

    Vukšić, Tihomir; Rastović, Pejana; Dragišić, Vedran

    2016-01-01

    Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination. PMID:27340586

  15. Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis

    PubMed Central

    Vukšić, Tihomir; Rastović, Pejana; Dragišić, Vedran

    2016-01-01

    Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination. PMID:27340586

  16. Technical prerequisites and imaging protocols for CT perfusion imaging in oncology.

    PubMed

    Klotz, Ernst; Haberland, Ulrike; Glatting, Gerhard; Schoenberg, Stefan O; Fink, Christian; Attenberger, Ulrike; Henzler, Thomas

    2015-12-01

    The aim of this review article is to define the technical prerequisites of modern state-of-the-art CT perfusion imaging in oncology at reasonable dose levels. The focus is mainly on abdominal and thoracic tumor imaging, as they pose the largest challenges with respect to attenuation and patient motion. We will show that low kV dynamic scanning in conjunction with detection technology optimized for low photon fluxes has the highest impact on reducing dose independently of other choices made in the protocol selection. We discuss, derived from relatively simple first principles, on what appropriate temporal sampling and total scan duration depend on and why optimized contrast medium injection protocols are also essential in limiting dose. Finally we will examine the possibility of simultaneously extracting standard morphological and functional information from one single 4D examination as a potential enabler for a more widespread use of dynamic contrast enhanced CT in oncology. PMID:26137905

  17. Abdominal Organ Location, Morphology, and Rib Coverage for the 5th, 50th, and 95th Percentile Males and Females in the Supine and Seated Posture using Multi-Modality Imaging

    PubMed Central

    Hayes, Ashley R.; Gayzik, F. Scott; Moreno, Daniel P.; Martin, R. Shayn; Stitzel, Joel D.

    2013-01-01

    The purpose of this study was to use data from a multi-modality image set of males and females representing the 5th, 50th, and 95th percentile (n=6) to examine abdominal organ location, morphology, and rib coverage variations between supine and seated postures. Medical images were acquired from volunteers in three image modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and upright MRI (uMRI). A manual and semi-automated segmentation method was used to acquire data and a registration technique was employed to conduct a comparative analysis between abdominal organs (liver, spleen, and kidneys) in both postures. Location of abdominal organs, defined by center of gravity movement, varied between postures and was found to be significant (p=0.002 to p=0.04) in multiple directions for each organ. In addition, morphology changes, including compression and expansion, were seen in each organ as a result of postural changes. Rib coverage, defined as the projected area of the ribs onto the abdominal organs, was measured in frontal, lateral, and posterior projections, and also varied between postures. A significant change in rib coverage between postures was measured for the spleen and right kidney (p=0.03 and p=0.02). The results indicate that posture affects the location, morphology and rib coverage area of abdominal organs and these implications should be noted in computational modeling efforts focused on a seated posture. PMID:24406951

  18. A Re-Interpretation of the Eocene Anuran Thaumastosaurus Based on MicroCT Examination of a ‘Mummified’ Specimen

    PubMed Central

    Laloy, Fabien; Rage, Jean-Claude; Evans, Susan E.; Boistel, Renaud; Lenoir, Nicolas; Laurin, Michel

    2013-01-01

    What originally appeared to be only an external cast of an anuran ‘mummy’ from the Quercy Phosphorites (southwestern France) was described as Rana plicata during the 19th century. Its geographical provenance is only vaguely known; therefore its precise age within the Paleogene was uncertain. The taxon was erected on the basis of the external morphology of the specimen, which includes few diagnostic characters. As a further complication, the name Rana plicata was recently shown to be unavailable at the time of the description, and the name Rana cadurcorum was proposed as a replacement. In order to see whether internal features were fossilized, the fossil was CT scanned. This showed that a large part of the skeleton is preserved. Unexpectedly, the scans revealed that the skull of the mummy is almost identical to that of Thaumastosaurus gezei, another anuran from the late middle or late Eocene of the Quercy Phosphorites. The few observed differences are attributable to intraspecific and ontogenetic variation, and R. cadurcorum is a junior subjective synonym of T. gezei. The mummy is therefore probably from the same time interval as T. gezei. The latter was previously known only by its skull, but the mummy provides important information on the postcranial skeleton. Earlier assessments, based only on the skull, placed Thaumastosaurus close to South American hyloid anurans, but a new phylogenetic analysis including postcranial characters reveals ranoid affinities. This study exemplifies the usefulness of modern imaging technologies that allow non-destructive study of previously inaccessible internal anatomical features. PMID:24086389

  19. Standardized anatomic space for abdominal fat quantification

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-03-01

    The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.

  20. Abdominal Mondor disease mimicking acute appendicitis

    PubMed Central

    Schuppisser, Myriam; Khallouf, Joe; Abbassi, Ziad; Erne, Michel; Vettorel, Denise; Paroz, Alexandre; Naiken, Surennaidoo P.

    2016-01-01

    Introduction Mondor disease (MD), a superficial thrombophlebitis of the thoraco-epigastric veins and their confluents is rarely reported in the literature. The superior epigastric vein is the most affected vessel but involvement of the inferior epigastric vessels or their branches have also been described. There is no universal consensus on treatment in the literature but most authors suggest symptomatic treatment with non-steroid anti-inflammatory drugs (NSAIDs). Case report We report the case of a marathon runner who presented with right iliac fossa pain mimicking the clinical symptomatology of an acute appendicitis. The history and the calculated Alvarado score were not in favor of an acute appendicitis. This situation motivated multiple investigations and we finally arrived at the diagnosis of MD. Discussion Acute appendicitis (AA) is the most common cause of surgical emergencies and one of the most frequent indications for an urgent abdominal surgical procedure around the world. In some cases, right lower quadrant pain remains unclear in spite of US, CT scan, and exclusion of urological and gynecological causes, thus we need to think of some rare pathologies like MD. Conclusion MD is often mentioned in the differential diagnosis of breast pathologies but rarely in abdominal pain assessment. It should be mentioned in the differential diagnosis of the right lower quadrant pain when the clinical presentation is unclear and when acute appendicitis has been excluded. Awareness of MD can avoid misdiagnosis and decrease extra costs by sparing unnecessary imaging. PMID:26803533

  1. Endovascular Repair of an Anastomotic Leak Following Open Repair of Abdominal Aortic Aneurysm

    SciTech Connect

    Mofidi, R. Flett, M.; Milne, A.; Chakraverty, S.

    2007-09-15

    This report describes the case of an early postoperative anastomotic leak following elective open repair of an infrarenal abdominal aortic aneurysm which was successfully treated by endovascular stent-grafting. A 71-year-old man underwent open tube graft repair of abdominal aortic aneurysm. Twelve days later he presented with a contained leak from the distal anastomosis, which was confirmed on CT scan. This was successfully treated with a bifurcated aortic stent-graft. This case illustrates the usefulness of the endovascular approach for resolving this rare surgical complication of open repair of abdominal aortic aneurysm and the challenges associated with the deployment of such a device within an aortic tube graft.

  2. Solid organ abdominal ischemia, part I: clinical features, etiology, imaging findings, and management.

    PubMed

    Ricci, Zina J; Oh, Sarah K; Stein, Marjorie W; Kaul, Bindu; Flusberg, Milana; Chernyak, Victoria; Rozenblit, Alla M; Mazzariol, Fernanda A

    2016-01-01

    Solid organ abdominal ischemia commonly presents with acute pain prompting radiologic evaluation and often requires urgent treatment. Despite different risk factors and anatomic differences, most solid organ ischemia is due to arterial or venous occlusion and, less frequently, a low-flow state. Radiologic diagnosis is critical, as clinical presentations are often nonspecific. Contrast-enhanced computed tomography (CT) is the modality of choice (except in adnexal torsion) with magnetic resonance imaging (MRI) useful in equivocal cases or follow-up of ischemic disease. This article will provide a pictorial review of the CT and MRI features of solid abdominal organ ischemia while highlighting key clinical features, etiology, and management. PMID:27317217

  3. Hepatoblastoma evaluated by 18F-fluoromethyl choline PET/CT.

    PubMed

    Bieze, Matthanja; van Gulik, Thomas M; Bennink, Roelof J

    2013-02-01

    Hepatoblastoma is a rare carcinoma mostly seen in children. Neoadjuvant chemotherapy followed by resection and adjuvant chemotherapy is the optimal treatment. We present the case of an 18-year-old woman who presented with abdominal pain, nausea, bloating, and fatigue. MRI showed 3 hepatic lesions with high signal intensity on arterial phase T1-weighted images and slight washout on the late phase, suggestive for hepatocellular carcinoma. Laboratory examinations revealed plasma α-feto-protein of 114,245 μg/L. Subsequent baseline and posttreatment F-fluoromethyl choline PET/CT were performed to possibly evaluate extent of the disease and assess disease response after neoadjuvant chemotherapy. PMID:23334143

  4. Imaging of Hepatic Ectopic Pregnancy by 18F-FDG PET/CT.

    PubMed

    Hao, Jingwen; Cheng, Zhen; Hu, Na; Xiao, Lizhi; Wang, Yunhua

    2016-09-01

    Hepatic ectopic pregnancy is an uncommon form of extrauterine pregnancy. A 31-year-old woman had acute abdominal pain and distention. Laboratory examination showed significantly increased serum β-human chorionic gonadotropin level. Both ultrasound and MRI identified a lesion located at the right lobe of the liver. FDG PET/CT was performed to determine whether the other causes of elevated β-human chorionic gonadotropin level, which showed an oval mass with mid peripherally increased FDG activity. After surgery, pathological results confirmed a diagnosis of hepatic ectopic pregnancy. PMID:27454601

  5. [A Case of Abdominal Wall Desmoid Tumor after Radical Nephrectomy for Renal Cancer].

    PubMed

    Ohtake, Shinji; Namura, Kazuhiro; Fujikawa, Atsushi; Sawada, Takuto; Ohta, Junichi; Moriyama, Masatoshi; Hayashi, Hiroyuki

    2015-09-01

    A 71-year-old man with a right renal tumor underwent nephrectomy. The procedure was converted from laparoscopy to open surgery due to profound bleeding from the renal vein. Pathological diagnosis was clear cell carcinoma G2pT3b v1 ly1 INFα. Three years after surgery, a 5 cm tumor in the abdominal wall was found on computed tomography (CT). A mild uptake was shown on positron emission tomography/CT and as the tumor was located near the surgical wound, recurrence of the renal cell carcinoma was suspected. However, desmoid tumor was suggested by the pathological examination of the tumor biopsy. En-bloc resection of the mass was carried out and the pathological examination showed an array of proliferating and tangling atypical spindle-shaped tumor cells. Immunohistochemical staining of the tumor cells was positive for vimentin, but negative for CD34, c-kit, and s100. Pathological diagnosis was desmoid tumor. There has been no recurrence so far. Desmoid tumor, despite its extremely low incidence, should be considered in a postoperative neoplasm. PMID:26497861

  6. Vertebral destruction due to abdominal aortic aneurysm

    PubMed Central

    Jiménez Viseu Pinheiro, J.F.; Blanco Blanco, J.F.; Pescador Hernández, D.; García García, F.J.

    2014-01-01

    Introduction Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic. Presentation of case We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain. Discusion Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability. Conclusion We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present. PMID:25569196

  7. SU-E-I-33: Establishment of CT Diagnostic Reference Levels in Province Nova Scotia

    SciTech Connect

    Tonkopi, E; Abdolell, M; Duffy, S

    2015-06-15

    Purpose: To evaluate patient radiation dose from the most frequently performed CT examinations and to establish provincial diagnostic reference levels (DRLs) as a tool for protocol optimization. Methods: The study investigated the following CT examinations: head, chest, abdomen/pelvis, and chest/abdomen/pelvis (CAP). Dose data, volume CT dose index (CTDIvol) and dose-length product (DLP), were collected from 15 CT scanners installed during 2004–2014 in 11 hospital sites of Nova Scotia. All scanners had dose modulation options and multislice capability (16–128 detector rows). The sample for each protocol included 15 average size patients (70±20 kg). Provincial DRLs were calculated as the 75th percentile of patient dose distributions. The differences in dose between hospitals were evaluated with a single factor ANOVA statistical test. Generalized linear modeling was used to determine the factors associated with higher radiation dose. A sample of 36 abdominal studies performed on three different scanners was blinded and randomized for an assessment by an experienced radiologist who graded the imaging quality of anatomic structures. Results: Data for 900 patients were collected. The DRLs were proposed using CTDIvol (mGy) and DLP (mGy*cm) values for CT head (67 and 1049, respectively), chest (12 and 393), abdomen/pelvis (16 and 717), and CAP (14 and 1034). These DRLs were lower than the published national data except for the head CTDIvol. The differences between the means of the dose distributions from each scanner were statistically significant (p<0.05) for all examinations. A very weak correlation was found between the dose and the scanner age or the number of slices with Pearson’s correlation coefficients of 0.011–0.315. The blinded analysis of image quality demonstrated no clinically significant difference except for the noise category. Conclusion: Provincial DRLs were established for typical CT examinations. The variations in dose between the hospitals

  8. Chronic Contained Rupture of an Abdominal Aortic Aneurysm: From Diagnosis to Endovascular Resolution

    SciTech Connect

    Gandini, Roberto Chiocchi, Marcello; Maresca, Luciano; Pipitone, Vincenzo; Messina, Massimo; Simonetti, Giovanni

    2008-07-15

    A male patient, 69 years old, presented with fever, leucocytosis, and persistent low back pain; he also had an abdominal aortic aneurysm (AAA), as previously diagnosed by Doppler UltraSound (US), and was admitted to our hospital. On multislice computed tomography (msCT), a large abdominal mass having no definite border and involving the aorta and both of the psoas muscles was seen. This mass involved the forth-lumbar vertebra with lysis, thus simulating AAA rupture into a paraspinal collection; it was initially considered a paraspinal abscess. After magnetic resonance imaging examination and culture of the fluid aspirated from the mass, no infective organisms were found; therefore, a diagnosisof chronically contained AAA rupture was made, and an aortic endoprosthesis was subsequently implanted. The patient was discharged with decreased lumbar pain. At 12-month follow-up, no evidence of leakage was observed. To our knowledge, this is the first case of endoprosthesis implantation in a patient, who was a poor candidate for surgical intervention due to renal failure, leucocytosis and high fever, having a chronically contained AAA ruptured simulatingspodilodiscitis abscess. Appropriate diagnosis and therapy resolved potentially crippling pathology and avoided surgical graft-related complications.

  9. Head CT scan

    MedlinePlus

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial ... or other growth (mass) Cerebral atrophy (loss of brain tissue) ... with the hearing nerve Stroke or transient ischemic attack (TIA)

  10. Should intensivist do routine abdominal ultrasound?

    PubMed

    Samanta, Sukhen; Samanta, Sujay; Soni, Kapil Dev; Aggarwal, Richa

    2015-09-01

    Roundworm infestation is common in tropical climate population with a low socioeconomic status. We describe a case of a young male with polytrauma accident who presented with small bowel dysfunction with a high gastric residual volume during enteral feeding. While searching the etiology, the intensivist performed bedside abdominal ultrasound (USG) as a part of whole body USG screening along with clinical examination using different frequency probes to examine bowel movement and ultimately found ascariasis to be the cause. This case report will boost up the wide use of bedside USG by critical care physicians in their patient workup. PMID:26430346

  11. Economics of abdominal wall reconstruction.

    PubMed

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. PMID:24035086

  12. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  13. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. PMID:25398912

  14. Modern CT applications in veterinary medicine.

    PubMed

    Garland, Melissa R; Lawler, Leo P; Whitaker, Brent R; Walker, Ian D F; Corl, Frank M; Fishman, Elliot K

    2002-01-01

    Although computed tomography (CT) is used primarily for diagnosis in humans, it can also be used to diagnose disease in veterinary patients. CT and associated three-dimensional reconstruction have a role in diagnosis of a range of illnesses in a variety of animals. In a sea turtle with failure to thrive, CT showed a nodal mass in the chest, granulomas in the lungs, and a ball in the stomach. CT of a sea dragon with balance and movement problems showed absence of the swim bladder. In a sloth with failure to thrive, CT allowed diagnosis of a coin in the intestine. CT of a puffin with failure to thrive showed a mass in the chest, which was found to be a hematoma. In a smooth-sided toad whose head was tilted to one side and who was circling in that direction, CT showed partial destruction of the temporal bone. CT of a domestic cat with listlessness showed a mass with focal calcification, which proved to be a leiomyosarcoma. CT of a sea otter showed pectus excavatum, which is caused by the animal smashing oysters against its chest. In a Japanese koi with abdominal swelling, CT allowed diagnosis of a hepatoma. PMID:11796898

  15. COMPARISON OF COMPUTED TOMOGRAPHY AND ABDOMINAL RADIOGRAPHY FOR DETECTION OF CANINE MECHANICAL INTESTINAL OBSTRUCTION.

    PubMed

    Drost, Wm Tod; Green, Eric M; Zekas, Lisa J; Aarnes, Turi K; Su, Lillian; Habing, Gregory G

    2016-07-01

    Vomiting, often caused by mechanical intestinal obstruction, is common in dogs. Equivocal radiographic signs often necessitate repeat radiographs or additional imaging procedures. For our prospective, case-controlled, accuracy study, we hypothesized the following: (1) using computed tomography (CT), radiologists will be more sensitive and specific for detecting mechanical intestinal obstruction and recommending surgery compared to using radiographs; and (2) using measurements, radiologists will be more sensitive and specific using radiographs or CT for detecting mechanical intestinal obstruction and recommending surgery. Twenty dogs had abdominal radiographs and abdominal CT. Seventeen dogs had abdominal surgery and three dogs were not obstructed based on clinical follow-up. Confidence levels (five-point scale) of three experienced radiologists for mechanical intestinal obstruction and recommending surgery were recorded before and after making selected measurements. Eight dogs had surgically confirmed mechanical intestinal obstruction, and 12 dogs did not have obstruction. For detecting mechanical intestinal obstruction, CT was more sensitive (95.8% vs. 79.2%) and specific (80.6% vs. 69.4%) compared to radiographs, but the difference was not statistically significant. For recommending surgery, radiography was more sensitive (91.7% vs. 83.3%) and specific (83.3% vs. 72.2%) than using CT, but differences were not statistically significant. We reported objective CT measurements for predicting small mechanical intestinal obstruction. By incorporating these objective data, the diagnosis of mechanical intestinal obstruction changed in five of 120 instances (radiographs and CT). In no instance (0/120), did the objective data change the recommendation for surgery. Using CT or abdominal radiographs for the detection of canine mechanical intestinal obstruction is sensitive and specific when evaluated by experienced veterinary radiologists. PMID:27038072

  16. Abdominal Injuries in Belt-Positioning Booster Seats

    PubMed Central

    Arbogast, Kristy B.; Ghati, Yoganand

    2009-01-01

    Previous studies have demonstrated that booster seats reduce the risk of abdominal injuries by improving the fit of the seat belt on young children and encouraging better posture and compatibility with the vehicle seat. Recently, several studies have reported cases of abdominal injuries in booster seated children questioning the protective effects of these restraints. The objective of this study was to examine cases of abdominal injuries in booster seated children through parametric modeling to gain a thorough understanding of the injury causation scenarios. The Partners for Child Passenger Safety and CIREN in-depth crash investigation databases were queried to identify children in belt-positioning booster seats with abdominal injuries. The injury causation scenarios for these injuries were delineated using the CIREN Biotab method. The cases were modeled, using MADYMO with variations in key parameters, to determine the ranges of loads and loading rates for the abdomen and thorax. A parametric study was completed examining the influence of pretensioners and load limiters on the injury metrics obtained. Query of the two databases revealed three cases involving abdominal injuries to booster seated children. Children in two of the cases sustained a thoracic injury (AIS 3/AIS 4) in addition to their abdominal injuries (AIS 2) and review of these cases pointed to the role of shoulder belt loading in the injury causation. Modeling of these cases revealed chest compressions and accelerations of 30–53 mm and 41–89 g, respectively and abdominal deflection and velocity of 7.0–13.3 mm and 1.2–2.2 m/s, respectively. Parametric study suggested that coupling shoulder belt load limiting and lap belt buckle pretensioning resulted in improved chest and abdominal metrics while reducing head excursion, indicating that these technologies may provide injury reduction potential to pediatric rear seat occupants. PMID:20184845

  17. JAMA Patient Page: Abdominal Hernia

    MedlinePlus

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  18. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  19. DIEP breast reconstruction following multiple abdominal liposuction procedures

    PubMed Central

    Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the terms “DIEP”, “deep inferior epigastric”, “TRAM”, “transverse rectus abdominis”, “perforator” and “laparotomy”, “abdominal wall”, “liposuction”, “liposculpture”, “fat graft”, “pfannenstiel”, with subsequent appraisal of relevant papers by the first and second authors. Results: Patient 1 had 3 episodes of liposuction from the abdomen for fat grafting to a reconstructed breast. Subsequent revision reconstruction of the same breast with DIEP flap was preceded by CT angiography, which demonstrated normal perforator anatomy. The reconstruction healed well with no ischaemic complications. Patient 2 had 5 liposuction procedures from the abdomen to graft fat to a wide local excision defect. Recurrence of cancer led to mastectomy and immediate reconstruction with free DIEP flap. Preoperative MR angiography demonstrated a large perforator right of the umbilicus, with which the intraoperative findings were consistent. The patient had an uneventful recovery and good healing with no fat necrosis or wound dehiscence. Conclusions: We demonstrate that DIEP flaps can safely be raised without perfusion-related complications following multiple liposuction procedures to the abdomen. The safe interval between procedures is difficult to quantify, but we demonstrate successful free flap after 16 months. PMID:25671046

  20. EGD IN CHILDREN WITH ABDOMINAL PAIN: A SYSTEMATIC REVIEW

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: We performed a systematic review to examine the diagnostic yield (endoscopic and histologic) of esophagogastroduodenoscopy (EGD) for the evaluation of abdominal pain of unclear etiology in children. We also examined the effect of EGD on change in treatment, quality of life, change in abd...

  1. Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult☆

    PubMed Central

    Moreno-Sanz, C.; Herrero Bogajo, M.L.; Picazo-Yeste, J.; Morandeira Rivas, A.; Manzanera-Diaz, M.; Sedano-Vizcaino, C.

    2013-01-01

    INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach. PMID:24091075

  2. Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula

    SciTech Connect

    Guzzardi, Giuseppe Fossaceca, Rita; Divenuto, Ignazio; Musiani, Antonello; Brustia, Piero; Carriero, Alessandro

    2010-08-15

    Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA). We report the endovascular repair of an AAA rupture into the inferior vena cava. A 78-year-old woman was admitted to our hospital for acute hypotension. She presented with a pulsatile abdominal mass and became rapidly anuric. Abdominal computed tomography (CT) showed an AAA rupture into the inferior vena cava. The features of the AAA made it suitable for endovascular repair. To prevent pulmonary embolism caused by the presence of sac thrombosis near the vena cava lumen, a temporary vena cava filter was deployed before the procedure. A bifurcated stent-graft was placed with the patient under local anaesthesia, and the AAA was successfully treated. A transient type II endoleak was detected on CT 3 days after endograft placement. At routine follow-up 6 and 12 months after the procedure, the patient was in good clinical condition, and the type II endoleak had sealed completely. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of ACF; however, only small numbers of patients have been treated, and long-term follow-up interval is lacking.

  3. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  4. Abdominal intrauterine vacuum aspiration.

    PubMed

    Tjalma, W A A

    2014-01-01

    Evaluating and "cleaning" of the uterine cavity is probably the most performed operation in women. It is done for several reasons: abortion, evaluation of irregular bleeding in premenopausal period, and postmenopausal bleeding. Abortion is undoubtedly the number one procedure with more than 44 million pregnancies terminated every year. This procedure should not be underestimated and a careful preoperative evaluation is needed. Ideally a sensitive pregnancy test should be done together with an ultrasound in order to confirm a uterine pregnancy, excluding extra-uterine pregnancy, and to detect genital and/or uterine malformations. Three out of four abortions are performed by surgical methods. Surgical methods include a sharp, blunt, and suction curettage. Suction curettage or vacuum aspiration is the preferred method. Despite the fact that it is a relative safe procedure with major complications in less than one percent of cases, it is still responsible for 13% of all maternal deaths. All the figures have not declined in the last decade. Trauma, perforation, and bleeding are a danger triage. When there is a perforation, a laparoscopy should be performed immediately, in order to detect intra-abdominal lacerations and bleeding. The bleeding should be stopped as soon as possible in order to not destabilize the patient. When there is a perforation in the uterus, this "entrance" can be used to perform the curettage. This is particularly useful if there is trauma of the isthmus and uterine wall, and it is difficult to identify the uterine canal. A curettage is a frequent performed procedure, which should not be underestimated. If there is a perforation in the uterus, then this opening can safely be used for vacuum aspiration. PMID:25134300

  5. Spontaneous superior mesenteric artery (SMA) dissection: an unusual cause of abdominal pain.

    PubMed

    Watring, Nicole J; Smith, Corbett M; Stokes, Gordon K; Counselman, Francis L

    2010-11-01

    A 44-year-old woman presented to our Emergency Department with a 4-day history of severe, sharp left upper quadrant abdominal pain associated with nausea and vomiting. She had been seen 3 days prior at another Emergency Department, and had a negative work-up including a normal non-contrast computed tomography (CT) scan of the abdomen/pelvis for possible kidney stone. Vital signs were: temperature 36.3°C (97.3°F), pulse 100 beats/min, respiratory rate 18 breaths/min, and blood pressure 141/80 mm Hg. Physical examination was remarkable for marked tenderness in the left upper and middle quadrants and voluntary guarding. Bowel sounds were normal. Although laboratory studies were normal, a CT scan of the abdomen/pelvis with intravenous contrast suggested a superior mesenteric artery dissection. This was confirmed with arteriography. The clinical presentation, diagnostic evaluation, and management of superior mesenteric artery dissection are reviewed. PMID:18180132

  6. Comparison of spirometry and abdominal height as four-dimensional computed tomography metrics in lung

    SciTech Connect

    Lu Wei; Low, Daniel A.; Parikh, Parag J.; Nystrom, Michelle M.; El Naqa, Issam M.; Wahab, Sasha H.; Handoko, Maureen; Fooshee, David; Bradley, Jeffrey D.

    2005-07-15

    An important consideration in four-dimensional CT scanning is the selection of a breathing metric for sorting the CT data and modeling internal motion. This study compared two noninvasive breathing metrics, spirometry and abdominal height, against internal air content, used as a surrogate for internal motion. Both metrics were shown to be accurate, but the spirometry showed a stronger and more reproducible relationship than the abdominal height in the lung. The abdominal height was known to be affected by sensor placement and patient positioning while the spirometer exhibited signal drift. By combining these two, a normalization of the drift-free metric to tidal volume may be generated and the overall metric precision may be improved.

  7. Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma

    PubMed Central

    2013-01-01

    In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children. PMID:23902930

  8. Evaluation of porcine dermal collagen (Permacol) used in abdominal wall reconstruction.

    PubMed

    Hsu, Patrick W; Salgado, Christopher J; Kent, Kathryn; Finnegan, Matthew; Pello, Mark; Simons, Robert; Atabek, Umur; Kann, Brian

    2009-11-01

    Various methods have been employed to reconstruct complex abdominal wall defects. Structural prosthetic materials such as polypropylene mesh and ePTFE (expanded polytetrafluoroethylene) have been widely used to close these large fascial defects, however, complications with infection and adhesions have led to the recent use of more biocompatible implants. Permacol (acellular porcine dermis) is used as a dermal scaffold, which eventually becomes vascularised and remodelled to reconstruct the abdominal wall in these complex patients. A retrospective review was performed of all patients who underwent consecutive abdominal wall reconstruction with Permacol at our institution in the year 2006. Twenty-eight patients were identified and included in our study. Factors evaluated were: body mass index, relevant co-morbidities, aetiology of hernia, hernia defect size based on CT scan and intraoperative measurement, size of Permacol implant, length of hospital stay, and postoperative complications. Surgical technique was standardised among six surgeons and involved a single layer of acellular porcine dermis as a subfascial 'underlay' graft under moderate tension upon maximal hernia reduction. Tissue expanders were not required for skin closure. Out of 28 patients, 12 were male and 16 were female. Mean intraoperative hernia size was 150 cm(2) (range of 10 cm(2) to 600 cm(2)). Mean age was 55 years with an average body mass index (BMI) of 34 (largest BMI of 61.4). Defects were attributed to either a previous laparotomy incision or open abdomen. Mean hospital stay was 9.67 days. At a mean follow-up of sixteen months, there were three recurrent hernias (10.7%) based on physical examination and postoperative CT scan evaluation. One patient developed a superficial wound dehiscence which was successfully treated with local wound care and one patient developed a cellulitis which was successfully treated with antibiotic therapy. Four patients (14.3%) developed a chronic, non

  9. Texture analysis improves level set segmentation of the anterior abdominal wall

    SciTech Connect

    Xu, Zhoubing; Allen, Wade M.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-12-15

    Purpose: The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.Methods: In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors’ approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Results: Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2–5 mm) for methods that did not use the texture.Conclusions: The authors’ approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture

  10. Giant adrenal hemangioma: Unusual cause of huge abdominal mass

    PubMed Central

    Tarchouli, Mohamed; Boudhas, Adil; Ratbi, Moulay Brahim; Essarghini, Mohamed; Njoumi, Noureddine; Sair, Khalid; Zentar, Aziz

    2015-01-01

    Adrenal hemangioma is an extremely rare benign and non-functioning neoplasm of the adrenal gland. We report a case of a 71-year-old woman admitted for intermittent abdominal pain and abdominal distension associated with vomiting and chronic constipation for 5 years. Physical examination revealed a large abdominal mass. Both computed tomography scan and magnetic resonance imaging suggested hemangioma in the right lobe of the liver. Laboratory examinations and tumour markers were within normal limits, except for hypochromic microcytic anemia. The mass was removed intact by conventional surgery and histopathology revealed a cavernous hemangioma of the adrenal gland with no signs of malignancy. Surgical resection was curative, with no recurrence at the 2-year follow-up. PMID:26600897

  11. Intra-abdominal fluid aspirate from a dog.

    PubMed

    Crippa, Valentina; Ghisleni, Gabriele; Avallone, Giancarlo; Caniatti, Mario

    2016-02-01

    A 12-year-old, neutered female, Siberian husky, was presented with a 6-months history of progressive abdominal distension, anorexia, and weight loss. The dog appeared normal on physical examination except for marked abdominal distension. A fluid wave was balloted strongly suggesting an abdominal effusion. Ultrasound examination confirmed this clinical finding. Results of the CBC included mild nonregenerative anemia, with an RBC count of 4.9 × 10(6)/µL (reference interval 5.5-8.5 × 10(6)/µL), hemoglobin concentration of 12 g/dL (reference interval 12-18 g/dL), HCT of 36% (reference interval 37-55%), and reticulocytes <60,000/µL. No abnormalities in serum chemistry were detected. PMID:26668089

  12. Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review.

    PubMed

    Cokkinos, D; Antypa, E; Stefanidis, K; Tserotas, P; Kostaras, V; Parlamenti, A; Tavernaraki, K; Piperopoulos, P N

    2012-02-01

    Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient's bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up. PMID:22274907

  13. CT scan

    MedlinePlus

    ... that slides into the center of the CT scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern spiral scanners can perform the exam without stopping. A computer ...

  14. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  15. Familial aggregation of abdominal visceral fat level: results from the Quebec family study.

    PubMed

    Pérusse, L; Després, J P; Lemieux, S; Rice, T; Rao, D C; Bouchard, C

    1996-03-01

    The purpose of this study was to investigate the importance of familial aggregation in abdominal visceral fat (AVF) level as assessed by computed tomography (CT). Four measures of abdominal adipose tissue, obtained from an abdominal scan between the fourth and fifth Lumbar vertebrae (L4-L5) taken in 366 adult subjects from 100 French-Canadian nuclear families, were considered in this study. Total abdominal fat, AVF, subcutaneous abdominal fat, obtained by computing the difference between total and AVF tissue areas, and the visceral to total abdominal fat ratio were measured. Spouses, parent-offspring, and sibling correlations were computed by maximum likelihood methods after adjustment of the four phenotypes for age and for age and total fat mass (FM) derived from underwater weighing. Significant familial aggregation was found for all phenotypes, whether adjusted or not for body FM. However, after adjustment of data for body FM, in addition to age, all spouse correlations became nonsignificant, suggesting that the familial aggregation of abdominal fat is primarily genetic. Heritability estimates reached 42% and 56% for subcutaneous fat and AVF, respectively. These results suggest that genetic factors are major determinants of the familial aggregation observed in the amount of abdominal fat, irrespective of total body fat content, and that AVF seems more influenced by genetic factors than abdominal subcutaneous adipose tissue. These findings imply that some individuals are more at risk than others to exhibit the various metabolic complications associated with upper-body obesity because of their inherited tendency to store abdominal fat in the visceral depot rather than in the subcutaneous depot. PMID:8606647

  16. Combined vesical and abdominal endometriosis following abdominal hysterotomy and tubal ligation.

    PubMed

    Dhall, K; Bhatia, K; Sharma, S K

    1980-09-01

    The article reports on the case of a 29 year old patient who developed abdominal endometriosis 4 years after having had hysterotomy and tubal ligation. About a month after the excision of the endometrial tissue she was examined for suprapubic pains, strangury, and frequency of micturition. A nodule was found in the deepest part of the abdominal wall and the patient was treated for 6 months, without success, with medroxyprogesterone acetate. A subsequent laparotomy showed bladder endometriosis, obviously still an endometrial implant at the time of hysterotomy, which was missed at the time of the first excision. Total hysterectomy was carried out and the patient recovered successfully. Bladder endometriosis is the most common site of involvement among urinary tract endometriosis. The peculiarity of the case presented here is in the total absence of hematuria, and in the fact that pains had no relation with the menstrual cycle. Hormonal therapy is often ineffective, and surgery often the only advisable form of treatment. PMID:12311304

  17. The evolution of PET-CT.

    PubMed

    Wilson, Bettye G

    2005-01-01

    Positron emission tomography-computed tomography (PET-CT) was the first fused or combined medical imaging technique. Although PET-CT has received widespread acclaim as a major imaging advancement, many questions have surfaced regarding its use. This article answers some of these questions and examines what PET-CT means to medicine and the medical imaging community. PMID:15835615

  18. A Curious Case of Right Upper Quadrant Abdominal Pain

    PubMed Central

    Grock, Andrew; Chan, Wendy; deSouza, Ian S.

    2016-01-01

    An otherwise healthy 36-year-old man presented with sudden-onset right upper quadrant abdominal pain and vomiting. A bedside ultrasound, performed to evaluate hepatobiliary pathology, revealed a normal gallbladder but free intraperitoneal fluid. After an expedited CT and emergent explorative laparotomy, the patient was diagnosed with a small bowel obstruction with ischemia secondary to midgut volvulus. Though midgut volvulus is rare in adults, delays in definitive diagnosis and management can result in bowel necrosis. Importantly, an emergency physician must be able to recognize bedside ultrasound findings associated with acutely dangerous intrabdominal pathology. PMID:27625732

  19. Abdominal bloating: pathophysiology and treatment.

    PubMed

    Seo, A Young; Kim, Nayoung; Oh, Dong Hyun

    2013-10-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  20. Abdominal pain with a twist

    PubMed Central

    2011-01-01

    Malrotation in children is due to either an incomplete or non-rotation of the foetal mid-gut during perinatal development. Presentation is usually in the first few weeks of life, often with life-threatening volvulus and ischaemia. However, it can be a rare cause of abdominal pain in older children and young adults. We present such a case, as a reminder to emergency physicians that malrotation should be considered in the differential diagnosis of recurrent or chronic abdominal pain not only in children but also in adolescents. PMID:21635723

  1. Ultrasonographic diagnosis in abdominal tuberculosis.

    PubMed

    Sheikh, M; Moosa, I; Hussein, F M; Qurttom, M A; Behbehani, A I

    1999-05-01

    Sonographic findings were retrospectively analysed in 39 patients with proven abdominal tuberculosis (TB). The patients were treated over 15 years at a major teaching hospital, Mubarak Al-Kabber Hospital, in Kuwait. The findings included clear or complex ascites with fine strands, loculations and debris. The other findings were lymphadenopathy, bowel wall thickening, omental mass, focal lesions in the liver and spleen and psoas abscess. The sonographic findings in abdominal TB are not specific but may give valuable information to prevent unnecessary laparotomy. PMID:10901897

  2. Recurrent abdominal pain in children.

    PubMed

    Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul

    2002-09-01

    Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

  3. Secondary abdominal appendicular ectopic pregnancy.

    PubMed

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy. PMID:17630175

  4. Unenhanced Computed Tomography to Visualize Hollow Viscera and/or Mesenteric Injury After Blunt Abdominal Trauma

    PubMed Central

    Yang, Xu-Yang; Wei, Ming-Tian; Jin, Cheng-Wu; Wang, Meng; Wang, Zi-Qiang

    2016-01-01

    Abstract To identify and describe the major features of unenhanced computed tomography (CT) images of blunt hollow viscera and/or mesenteric injury (BHVI/MI) and to determine the value of unenhanced CT in the diagnosis of BHVI/MI. This retrospective study included 151 patients who underwent unenhanced CT before laparotomy for blunt abdominal trauma between January 2011 and December 2013. According to surgical observations, patients were classified as having BHVI/MI (n = 73) or not (n = 78). Sensitivity, specificity, P values, and likelihood ratios were calculated by comparing CT findings between the 2 groups. Six significant CT findings (P < 0.05) for BHVI/MI were identified and their sensitivity and specificity values determined, as follows: bowel wall thickening (39.7%, 96.2%), mesentery thickening (46.6%, 88.5%), mesenteric fat infiltration (12.3%, 98.7%), peritoneal fat infiltration (31.5%, 87.1%), parietal peritoneum thickening (30.1%, 85.9%), and intra- or retro-peritoneal air (34.2%, 96.2%). Unenhanced CT scan was useful as an initial assessment tool for BHVI/MI after blunt abdominal trauma. Six key features on CT were correlated with BHVI/MI. PMID:26945375

  5. Blunt Abdominal Wall Disruption by Seatbelt Injury; A Case Report and Review of the Literature

    PubMed Central

    Cornelissen, Maarten Philip; van Buijtenen, Jesse; van den Heuvel, Baukje; Bloemers, Frank; Geeraedts Jr., Leo

    2016-01-01

    With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. A review of the literature is provided. Two patients were brought in after a high velocity Motor Vehicle Collision. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Both patients had an abdominal wall disruption along the seatbelt sign. These disruptions were primarily closed and during six months of follow-up no complications occurred. A disruption of the abdominal wall is a rare complication. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. CT-scanning is an accurate method to detect disruptions. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. If there is a disruption primary repair is a good option. PMID:27331068

  6. Clear Depiction of Inflammatory Abdominal Aortic Aneurysm with Diffusion-Weighted Magnetic Resonance Imaging

    SciTech Connect

    Orta Kilickesmez, Kadriye; Kilickesmez, Ozgur

    2010-04-15

    We report the case of an inflammatory abdominal aortic aneurysm incidentally detected clearly with diffusion-weighted magnetic resonance imaging (DW-MRI) during the examination of a patient with myelofibrosis with myeloid metaplasia that later converted to acute myeloid leukemia. DW-MRI revealed a hyperintense halo surrounding the abdominal aorta with aneurysmatic dilatation, establishing the diagnosis.

  7. CT Perfusion of the Head

    MedlinePlus

    ... scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the ... being studied can then be examined on a computer monitor, printed or transferred to a CD. CT ...

  8. Maintenance of pain in children with functional abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A significant proportion of children with functional abdominal pain develop chronic pain. Identifying clinical characteristics predicting pain persistence is important in targeting interventions. We examined whether child anxiety and/or pain-stooling relations were related to maintenance of abdomina...

  9. Investigation of optimal feature value set in false positive reduction process for automated abdominal lymph node detection method

    NASA Astrophysics Data System (ADS)

    Nakamura, Yoshihiko; Nimura, Yukitaka; Kitasaka, Takayuki; Mizuno, Shinji; Furukawa, Kazuhiro; Goto, Hidemi; Fujiwara, Michitaka; Misawa, Kazunari; Ito, Masaaki; Nawano, Shigeru; Mori, Kensaku

    2015-03-01

    This paper presents an investigation of optimal feature value set in false positive reduction process for the automated method of enlarged abdominal lymph node detection. We have developed the automated abdominal lymph node detection method to aid for surgical planning. Because it is important to understand the location and the structure of an enlarged lymph node in order to make a suitable surgical plan. However, our previous method was not able to obtain the suitable feature value set. This method was able to detect 71.6% of the lymph nodes with 12.5 FPs per case. In this paper, we investigate the optimal feature value set in the false positive reduction process to improve the method for automated abdominal lymph node detection. By applying our improved method by using the optimal feature value set to 28 cases of abdominal 3D CT images, we detected about 74.7% of the abdominal lymph nodes with 11.8 FPs/case.

  10. Abdominal body composition differences in NFL football players.

    PubMed

    Bosch, Tyler A; Burruss, T Pepper; Weir, Nate L; Fielding, Kurt A; Engel, Bryan E; Weston, Todd D; Dengel, Donald R

    2014-12-01

    The purpose of this study was to examine visceral fat mass as well as other measures abdominal body composition in National Football League (NFL) players before the start of the season. Three hundred and seventy NFL football players were measured before the start of the season using dual-energy x-ray absorptiometry. Regional fat and lean mass was measured for each player. Players were categorized into 3 groups based on positions that mirror each other: linemen; linebackers/tight ends/running backs and wide receivers/defensive backs. Significant differences were observed between the position groups for both lean and fat regional measurements. However, the magnitude of difference was much greater for fat measures than lean measures. Additionally, a threshold was observed (∼114 kg) at which there is a greater increase in fat accumulation than lean mass accumulation. The increase in fat accumulation is distributed to the abdominal region where thresholds were observed for subcutaneous abdominal fat accumulation (12.1% body fat) and visceral abdominal fat accumulation (20.1% body fat), which likely explains the regional fat differences between groups. The results of this study suggest that as players get larger, there is more total fat than total lean mass accumulation and more fat is distributed to the abdominal region. This is of importance as increased fat mass may be detrimental to performance at certain positions. The thresholds observed for increased abdominal fat accumulation should be monitored closely given recent research observed that abdominal obesity predicts lower extremity injury risk and visceral adipose tissue's established association with cardiometabolic risk. PMID:25187247

  11. A Traumatic Abdominal Wall Hernia Repair: A Laparoscopic Approach

    PubMed Central

    Wilson, Kenneth L.; Rosser, James C.

    2012-01-01

    Background: Traumatic abdominal wall hernias from blunt trauma usually occur as a consequence of motor vehicle collisions where the force is tangential, sudden, and severe. Although rare, these hernias can go undetected due to preservation of the skin overlying the hernia defect. Open repairs can be challenging and unsuccessful due to avulsion of muscle directly from the iliac crest, with or without bone loss. A laparoscopic approach to traumatic abdominal wall hernia can aid in the delineation of the hernia and allow for a safe and effective repair. Case Description: A 36-year-old female was admitted to our Level 1 trauma center with a traumatic abdominal wall hernia located in the right flank near the iliac crest after being involved in a high-impact motor vehicle collision. Computed tomography and magnetic resonance imaging of the abdomen revealed the presence of an abdominal wall defect that was unapparent on physical examination. The traumatic abdominal wall hernia in the right flank was successfully repaired laparoscopically. One-year follow-up has shown no sign of recurrence. Discussion: A traumatic abdominal wall hernia rarely presents following blunt trauma, but should be suspected following a high-impact motor vehicle collision. Frequently, repair is complicated by the need to have fixation of mesh to bony landmarks (eg, iliac crest). In spite of this challenge, the laparoscopic approach with tension-free mesh repair of a traumatic abdominal wall hernia can be accomplished successfully using an approach similar to that taken for laparoscopic inguinal hernia repair. PMID:23477181

  12. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe it to you. Here are different kinds of pain: ...

  13. PET/CT: fundamental principles.

    PubMed

    Seemann, Marcus D

    2004-05-28

    Positron emission tomography (PET) facilitates the evaluation of metabolic and molecular characteristics of a wide variety of cancers, but is limited in its ability to visualize anatomical structures. Computed tomography (CT) facilitates the evaluation of anatomical structures of cancers, but can not visualize their metabolic and molecular aspects. Therefore, the combination of PET and CT provides the ability to accurately register metabolic and molecular aspects of disease with anatomical findings, adding further information to the diagnosis and staging of tumors. The recent generation of high performance PET/CT scanners combines a state of the art full-ring 3D PET scanner and a high-end 16-slice CT scanner. In PET/CT scanners, a CT examination is used for attenuation correction of PET images rather than standard transmission scanning using superset 68 Ge sources. This reduces the examination time, but metallic objects and contrast agents that alter the CT image quality and quantitative measurements of standardized uptake values (SUV) may lead to artifacts in the PET images. Hybrid PET/CT imaging will be very important in oncological applications in the decades to come, and possibly for use in cancer screening and cardiac imaging. PMID:15257877

  14. An unusual cause of postpartum abdominal pain: case report.

    PubMed

    Zimmer, Gregory J; Fagen, Kimberly; Shepherd, Matthew; Boswell, Gilbert

    2009-08-01

    Abdominal pain is a common presenting complaint in the Emergency Department. It extends to all populations regardless of age, sex, or socioeconomic status. After gathering a history and examining the patient, most Emergency Physicians form a differential diagnosis and initiate an appropriate work-up. However, in the postpartum woman, additional causes must be considered and treated accordingly, knowing that there are consequences for both mother and child. We present a case of a postpartum woman presenting with right-sided abdominal pain, the cause of which, although atypical, has potential for significant morbidity and mortality if it goes undiscovered. PMID:18572346

  15. An unusual duplication of the inferior vena cava in a patient with endovascular repair for abdominal aortic aneurysm.

    PubMed

    Polguj, Michał; Szubert, Wojciech; Topol, Mirosław; Stefańczyk, Ludomir

    2015-01-01

    A 66-year-old Caucasian male, with sensation of abdominal pulsation was admitted to our hospital. In multidetector 64-row computed tomography (CT) angiography, an abdominal aortic aneurysm was observed. Endovascular aortic repair was performed. Control CT confirmed prosperity with stent graft fixation and absence of any vascular complications. Investigation also showed asymmetrical duplication of the inferior vena cava (IVC). Right (RIVC) and left (LIVC) inferior vena cava arose from the confluence of the right and left iliac veins. The LIVC continued as left renal vein. PMID:26429190

  16. Molecular Imaging of Experimental Abdominal Aortic Aneurysms

    PubMed Central

    Ramaswamy, Aneesh K.; Hamilton, Mark; Joshi, Rucha V.; Kline, Benjamin P.; Li, Rui; Wang, Pu; Goergen, Craig J.

    2013-01-01

    Current laboratory research in the field of abdominal aortic aneurysm (AAA) disease often utilizes small animal experimental models induced by genetic manipulation or chemical application. This has led to the use and development of multiple high-resolution molecular imaging modalities capable of tracking disease progression, quantifying the role of inflammation, and evaluating the effects of potential therapeutics. In vivo imaging reduces the number of research animals used, provides molecular and cellular information, and allows for longitudinal studies, a necessity when tracking vessel expansion in a single animal. This review outlines developments of both established and emerging molecular imaging techniques used to study AAA disease. Beyond the typical modalities used for anatomical imaging, which include ultrasound (US) and computed tomography (CT), previous molecular imaging efforts have used magnetic resonance (MR), near-infrared fluorescence (NIRF), bioluminescence, single-photon emission computed tomography (SPECT), and positron emission tomography (PET). Mouse and rat AAA models will hopefully provide insight into potential disease mechanisms, and the development of advanced molecular imaging techniques, if clinically useful, may have translational potential. These efforts could help improve the management of aneurysms and better evaluate the therapeutic potential of new treatments for human AAA disease. PMID:23737735

  17. Assessment of sub-milli-sievert abdominal computed tomography with iterative reconstruction techniques of different vendors

    PubMed Central

    Padole, Atul; Sainani, Nisha; Lira, Diego; Khawaja, Ranish Deedar Ali; Pourjabbar, Sarvenaz; Lo Gullo, Roberto; Otrakji, Alexi; Kalra, Mannudeep K

    2016-01-01

    AIM: To assess diagnostic image quality of reduced dose (RD) abdominal computed tomography (CT) with 9 iterative reconstruction techniques (IRTs) from 4 different vendors to the standard of care (SD) CT. METHODS: In an Institutional Review Board approved study, 66 patients (mean age 60 ± 13 years, 44 men, and 22 women) undergoing routine abdomen CT on multi-detector CT (MDCT) scanners from vendors A, B, and C (≥ 64 row CT scanners) (22 patients each) gave written informed consent for acquisition of an additional RD CT series. Sinogram data of RD CT was reconstructed with two vendor-specific and a vendor-neutral IRTs (A-1, A-2, A-3; B-1, B-2, B-3; and C-1, C-2, C-3) and SD CT series with filtered back projection. Subjective image evaluation was performed by two radiologists for each SD and RD CT series blinded and independently. All RD CT series (198) were assessed first followed by SD CT series (66). Objective image noise was measured for SD and RD CT series. Data were analyzed by Wilcoxon signed rank, kappa, and analysis of variance tests. RESULTS: There were 13/50, 18/57 and 9/40 missed lesions (size 2-7 mm) on RD CT for vendor A, B, and C, respectively. Missed lesions includes liver cysts, kidney cysts and stone, gall stone, fatty liver, and pancreatitis. There were also 5, 4, and 4 pseudo lesions (size 2-3 mm) on RD CT for vendor A, B, and C, respectively. Lesions conspicuity was sufficient for clinical diagnostic performance for 6/24 (RD-A-1), 10/24 (RD-A-2), and 7/24 (RD-A-3) lesions for vendor A; 5/26 (RD-B-1), 6/26 (RD-B-2), and 7/26 (RD-B-3) lesions for vendor B; and 4/20 (RD-C-1) 6/20 (RD-C-2), and 10/20 (RD-C-3) lesions for vendor C (P = 0.9). Mean objective image noise in liver was significantly lower for RD A-1 compared to both RD A-2 and RD A-3 images (P < 0.001). Similarly, mean objective image noise lower for RD B-2 (compared to RD B-1, RD B-3) and RD C-3 (compared to RD C-1 and C-2) (P = 0.016). CONCLUSION: Regardless of IRTs and MDCT vendors

  18. [Omental infarction: CT findings (case report)].

    PubMed

    Yildiz, Seçil; Atasoy, Cetin; Yağci, Cemil; Akyar, Serdar

    2004-06-01

    Omental infarction, the end result of impaired perfusion of the greater omentum, is an uncommon cause of acute abdominal pain. Because its clinical symptoms are nonspecific, it is usually confused with more common conditions such as appendicitis or cholecystitis. Consequently, the diagnosis is generally made intraoperatively. However, computed tomography shows characteristic findings and allows a reliable preoperative diagnosis, preventing unnecessary laparotomy. We report two cases of omental infarction, and describe typical CT findings of this rare entitiy. PMID:15236134

  19. Duodenal Transection without Pancreatic Injury following Blunt Abdominal Trauma

    PubMed Central

    Bankar, Sanket Subhash; Gosavi, Vikas S.; Hamid, Mohd.

    2014-01-01

    With the inventions of faster cars and even more faster motorbikes there is a worldwide increase in road traffic accidents, which has increased the incidence of blunt abdominal trauma but still duodenal injury following a blunt abdominal trauma is uncommon and can pose a formidable challenge to the surgeon and failure to manage it properly can result in devastating results. It may typically occur in isolation or with pancreatic injury. Here, we report a case of an isolated transection of the third part of the duodenum with normal pancreas following a blunt abdominal trauma. The initial clinical changes in isolated duodenal injury may be extremely subtle before life-threatening, peritonitis develops. Hence, a high index of suspicion, on the basis of mechanism of injury and physical examination is the key in early detection of duodenal injury especially in a rural hospital like ours where the facilities for computed tomography scan are not available. PMID:25598947

  20. Duodenal Transection without Pancreatic Injury following Blunt Abdominal Trauma.

    PubMed

    Bankar, Sanket Subhash; Gosavi, Vikas S; Hamid, Mohd

    2014-01-01

    With the inventions of faster cars and even more faster motorbikes there is a worldwide increase in road traffic accidents, which has increased the incidence of blunt abdominal trauma but still duodenal injury following a blunt abdominal trauma is uncommon and can pose a formidable challenge to the surgeon and failure to manage it properly can result in devastating results. It may typically occur in isolation or with pancreatic injury. Here, we report a case of an isolated transection of the third part of the duodenum with normal pancreas following a blunt abdominal trauma. The initial clinical changes in isolated duodenal injury may be extremely subtle before life-threatening, peritonitis develops. Hence, a high index of suspicion, on the basis of mechanism of injury and physical examination is the key in early detection of duodenal injury especially in a rural hospital like ours where the facilities for computed tomography scan are not available. PMID:25598947

  1. Intra-abdominal esophageal duplication cyst in an adult.

    PubMed

    Kim, Young Wan; Sohn, Tai Il; Shim, Hyo Sup; Kim, Choong Bai

    2005-12-31

    Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period. PMID:16385665

  2. 18F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor

    PubMed Central

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body 18F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by 18F-FDG PET imaging.

  3. Model-based pancreas segmentation in portal venous phase contrast-enhanced CT images.

    PubMed

    Hammon, Matthias; Cavallaro, Alexander; Erdt, Marius; Dankerl, Peter; Kirschner, Matthias; Drechsler, Klaus; Wesarg, Stefan; Uder, Michael; Janka, Rolf

    2013-12-01

    This study aims to automatically detect and segment the pancreas in portal venous phase contrast-enhanced computed tomography (CT) images. The institutional review board of the University of Erlangen-Nuremberg approved this study and waived the need for informed consent. Discriminative learning is used to build a pancreas tissue classifier incorporating spatial relationships between the pancreas and surrounding organs and vessels. Furthermore, discrete cosine and wavelet transforms are used to build texture features to describe local tissue appearance. Classification is used to guide a constrained statistical shape model to fit the data. The algorithm to detect and segment the pancreas was evaluated on 40 consecutive CT data that were acquired in the portal venous contrast agent phase. Manual segmentation of the pancreas was carried out by experienced radiologists and served as reference standard. Threefold cross validation was performed. The algorithm-based detection and segmentation yielded an average surface distance of 1.7 mm and an average overlap of 61.2 % compared with the reference standard. The overall runtime of the system was 20.4 min. The presented novel approach enables automatic pancreas segmentation in portal venous phase contrast-enhanced CT images which are included in almost every clinical routine abdominal CT examination. Reliable pancreatic segmentation is crucial for computer-aided detection systems and an organ-specific decision support. PMID:23471751

  4. (18)F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor.

    PubMed

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body (18)F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by (18)F-FDG PET imaging. PMID:27408882

  5. Abdominal muscle size and symmetry at rest and during abdominal hollowing exercises in healthy control subjects

    PubMed Central

    Mannion, A F; Pulkovski, N; Toma, V; Sprott, H

    2008-01-01

    The symmetry of, and physical characteristics influencing, the thickness of the lateral abdominal muscles at rest and during abdominal exercises were examined in 57 healthy subjects (20 men, 37 women; aged 22–62 years). M-mode ultrasound images were recorded from the abdominal muscles at rest and during abdominal hollowing exercises in hook-lying. The fascial lines bordering the transvs. abdominis, obliquus internus and obliquus externus were digitized and the absolute thickness, relative thickness (% of total lateral thickness) and contraction ratio (thickness during hollowing/thickness at rest), as well as the asymmetry (difference between sides expressed as a percent of the smallest value for the two sides) for each of these parameters were determined for each muscle. Both at rest and during hollowing, obliquus internus was the thickest and transvs. abdominis the thinnest muscle. There were no significant differences between left and right sides for group mean thicknesses of any muscle; however, individual asymmetries were evident, with mean values for the different muscles ranging from 11% to 26%; asymmetry was much less for the contraction ratios (mean % side differences, 5–14% depending on muscle). Body mass was the most significant positive predictor of absolute muscle thickness, for all muscles at rest and during hollowing, accounting for 30–44% variance. Body mass index explained 20–30% variance in transvs. abdominis contraction ratio (negative relationship). The influence of these confounders must be considered in comparative studies of healthy controls and back pain patients, unless groups are very carefully matched. Asymmetries observed in patients should be interpreted with caution, as they are also common in healthy subjects. PMID:19172732

  6. Paget sarcoma of the pelvic bone with widespread metastatic disease on radiography, CT, MRI, and 18F-FDG PET/CT with pathologic correlation.

    PubMed

    Davis, Michael A; Scalcione, Luke R; Gimber, Lana H; Thompson, Rebecca B; Avery, Ryan J; Taljanovic, Mihra S

    2014-04-01

    We report a case of Paget sarcoma of the left superior pubic ramus and disseminated metastatic disease in a 70-year-old man. Paget disease of the left hemipelvis with malignant degeneration in the region of the left superior pubic ramus was initially diagnosed on radiographs. Subsequent CT, MRI, PET/CT imaging, and CT-guided biopsy confirmed the diagnosis and showed extensive left-sided pelvic and abdominal lymphadenopathy with widespread metastatic disease to liver, spleen, and lungs. PMID:24566398

  7. How different modes of child delivery influence abdominal muscle activities in the active straight leg raise.

    PubMed

    Kwon, Yu-Jeong; Hyung, Eun-Ju; Yang, Kyung-Hye; Lee, Hyun-Ok

    2014-08-01

    [Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20 cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects. PMID:25202194

  8. The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas

    PubMed Central

    Sabzghabaei, Anita; Shojaee, Majid; Safari, Saeed; Hatamabadi, Hamid Reza; Shirvani, Reza

    2016-01-01

    Introduction: In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Methods: Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT) scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. Results: 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4), 58.5% (95% CI: 51.2-65.5), 56% (95% CI: 48.5-63.3), 79.6% (95% CI: 71.8-85.7), 1.27% (95% CI: 1.30-1.57), and 0.25% (95% CI: 0.18-0.36), respectively. Conclusion: The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging. PMID:26862543

  9. CT and MR Imaging Findings of Pancreatic Paragangliomas

    PubMed Central

    Liang, Wenjie; Xu, Shunliang

    2016-01-01

    Abstract Previous studies on pancreatic paraganglioma, a rare neoplasm, have primarily reported its ultrasound and routine and contrast-enhanced computed tomography (CT) findings. To our knowledge, we are the first to report the contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) sequence findings of pancreatic paraganglioma. A male patient, ages 41 years, was admitted to our hospital due to a pancreatic space-occupying lesion that had been present for more than 10 days. The patient had no obvious discomfort. He had a history of hypertension and hyperthyroidism. Physical examination revealed upper abdominal tenderness without a palpable mass. Routine and contrast-enhanced abdominal CT showed a soft tissue mass at the pancreatic head/uncinate process, with patchy calcification within the lesion. On a contrast-enhanced CT scan, severe enhancement of the mass in the arterial phase was noted, as was slightly reduced but still marked enhancement in the venous phase. The celiac trunk and superior mesenteric artery segment were wrapped by the tumor. Thickened, tortuous vessels were observed at the lesion edges, around which there were multiple enlarged lymph nodes. The main pancreatic duct was markedly dilated. Routine and contrast-enhanced pancreatic MRI demonstrated an abnormal nodular signal in the pancreatic head/uncinate process that was approximately 4.3 × 6.4 cm2 in size. T1-weighted imaging (T1WI) revealed hypointensity, whereas T2-weighted imaging (T2WI) revealed nonhomogeneous, slight hyperintensity. Patchy hypointensity on both T1WI and T2WI was observed within the lesion. DWI showed slight hyperintensity. Grossly heterogeneous enhancement of the mass was observed on a contrast-enhanced MRI scan, with the tumor wrapped around the adjacent vasculature, and multiple enlarged lymph nodes were observed peripherally. After preoperative preparation, the patient underwent pancreatoduodenectomy. Histopathology and

  10. How to Avoid Nontherapeutic Laparotomy in Patients With Multiple Organ Failure of Unknown Origin. The Role of CT Scan Revisited

    PubMed Central

    Fui, Stephanie Li Sun; Lupinacci, Renato Micelli; Trésallet, Christophe; Faron, Matthieu; Godiris-Petit, Gaelle; Salepcioglu, Harika; Noullet, Severine; Menegaux, Fabrice

    2015-01-01

    Diagnosis of intra-abdominal diseases in critically ill patients remains a clinical challenge. Physical examination is unreliable whereas exploratory laparotomy may aggravate patient's condition and delay further evaluation. Only a few studies have investigated the place of computed tomography (CT) on this hazardous situation. We aimed to evaluate the ability of CT to prevent unnecessary laparotomy during the management of critically ill patients. Charts of all consecutive patients who had undergone an emergency nontherapeutic laparotomy from 1996 to 2013 were retrospectively studied and patient's demographic, clinical characteristics, and surgical findings were collected. During this period 59 patients had an unnecessary laparotomy. Fifty-one patients had at least one preoperative imaging and 36 had a CT scan. CT scans were interpreted to be normal (n = 12), with minor anomalies (n = 10), or major anomalies (pneumoperitoneum, portal venous gas/pneumatosis intestinalis, thickened gallbladder wall, and small bowel obstruction signs). Surgical exploration was performed through laparotomy (n = 55) or laparoscopy. Overall mortality was 37% with a median survival after surgery of 7 days. In univariate analysis, hospitalization in ICU before surgical exploration was the only factor related to death. In our series CT scans, objectively interpreted, helped avoid unnecessary surgical exploration in 61% of our patients. PMID:25785329

  11. Planting the seeds of success: CT-guided gold seed fiducial marker placement to guide robotic radiosurgery.

    PubMed

    Patel, Aashish; Khalsa, Bhavraj; Lord, Bryce; Sandrasegaran, Kumar; Lall, Chandana

    2013-04-01

    Fiducial marker (FM)-guided stereotactic body radiation therapy (SBRT) allows for precise targeting and delivery of radiation to a tumor site. In this article, we briefly discuss SBRT, provide examples to describe CT-guided FM placement to guide SBRT, and discuss some of the associated risks and benefits. This article serves as a pictorial review for body imagers and interventional radiologists who perform CT-guided procedures and interpret diagnostic studies for oncology patients. CT-guided FMs were placed in patients who were appropriate candidates for SBRT. One week following placement, patients underwent diagnostic CT and/or MR examinations in order to include the FM data in the development of a treatment plan. From October 2007-November 2009, a total of 89 patients were implanted with FMs. Sites of implantation included lung, liver, bone, chest and abdominal wall, and peritoneum/retroperitoneum. Complications included pneumothorax and FM migration. Twenty-one patients (33%) with lung FM placement experienced at least a small pneumothorax and 6 patients (9%) required thoracostomy tubes. FM migration occurred in 5 patients (8%) with lung placement. SBRT provides a safer and more effective alternative to conventional radiotherapy, and CT-guided FM implantation of tumor sites increases the precision of SBRT. Technical improvements in FM placement can limit the complications associated with the procedure and further enable highly localized tumor therapy. PMID:23551782

  12. How to Avoid Nontherapeutic Laparotomy in Patients With Multiple Organ Failure of Unknown Origin. The Role of CT Scan Revisited.

    PubMed

    Fui, Stephanie Li Sun; Lupinacci, Renato Micelli; Trésallet, Christophe; Faron, Matthieu; Godiris-Petit, Gaelle; Salepcioglu, Harika; Noullet, Severine; Menegaux, Fabrice

    2015-03-01

    Diagnosis of intra-abdominal diseases in critically ill patients remains a clinical challenge. Physical examination is unreliable whereas exploratory laparotomy may aggravate patient's condition and delay further evaluation. Only a few studies have investigated the place of computed tomography (CT) on this hazardous situation. We aimed to evaluate the ability of CT to prevent unnecessary laparotomy during the management of critically ill patients. Charts of all consecutive patients who had undergone an emergency nontherapeutic laparotomy from 1996 to 2013 were retrospectively studied and patient's demographic, clinical characteristics, and surgical findings were collected. During this period 59 patients had an unnecessary laparotomy. Fifty-one patients had at least one preoperative imaging and 36 had a CT scan. CT scans were interpreted to be normal (n = 12), with minor anomalies (n = 10), or major anomalies (pneumoperitoneum, portal venous gas/pneumatosis intestinalis, thickened gallbladder wall, and small bowel obstruction signs). Surgical exploration was performed through laparotomy (n = 55) or laparoscopy. Overall mortality was 37% with a median survival after surgery of 7 days. In univariate analysis, hospitalization in ICU before surgical exploration was the only factor related to death. In our series CT scans, objectively interpreted, helped avoid unnecessary surgical exploration in 61% of our patients. PMID:25785329

  13. Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department.

    PubMed

    Lin, Wei-Ching; Lin, Chien-Heng

    2016-06-01

    The accurate diagnosis of pediatric acute abdominal pain is one of the most challenging tasks in the emergency department (ED) due to its unclear clinical presentation and non-specific findings in physical examinations, laboratory data, and plain radiographs. The objective of this study was to evaluate the impact of abdominal multidetector computed tomography (MDCT) performed in the ED on pediatric patients presenting with acute abdominal pain. A retrospective chart review of children aged <18 years with acute abdominal pain who visited the emergency department and underwent MDCT between September 2004 and June 2007 was conducted. Patients with a history of trauma were excluded. A total of 156 patients with acute abdominal pain (85 males and 71 females, age 1-17 years; mean age 10.9 ± 4.6 years) who underwent abdominal MDCT in the pediatric ED during this 3-year period were enrolled in the study. One hundred and eighteen patients with suspected appendicitis underwent abdominal MDCT. Sixty four (54.2%) of them had appendicitis, which was proven by histopathology. The sensitivity of abdominal MDCT for appendicitis was found to be 98.5% and the specificity was 84.9%. In this study, the other two common causes of nontraumatic abdominal emergencies were gastrointestinal tract (GI) infections and ovarian cysts. The most common etiology of abdominal pain in children that requires imaging with abdominal MDCT is appendicitis. MDCT has become a preferred and invaluable imaging modality in evaluating uncertain cases of pediatric acute abdominal pain in ED, in particular for suspected appendicitis, neoplasms, and gastrointestinal abnormalities. PMID:27154197

  14. [A Case in Which a Patient Was Operated for Intra-Abdominal Desmoid Tumors after Total Colectomy in FAP].

    PubMed

    Hoshi, Minako; Ikeda, Kimimasa; Higashiguchi, Kimiya; Kobayashi, Teruyuki; Sakai, Kenji; Koyama, Taichi; Doi, Takasi; Taniguchi, Hirokazu; Murakami, Masakazu; Kurokawa, Eiji; Nakamichi, Itsuko

    2015-11-01

    The patient was a 22-year-old woman with FAP, who had undergone laparoscopic total colectomy 3 years previously. She presented to our hospital with a high fever and abdominal pain. Large hard tumors were palpated in the right lower abdomen and pelvis. Blood examination showed an inflammatory response. CT scan revealed 17 cm diameter solid tumors. At surgery, 2 tumors arising from the mesentery of the small intestine were found, neither of which invaded any organs. We performed tumor extirpation with partial resection of the duodenum, ileum, right fallopian tube and rectum. A jejunal stoma was formed, leaving a length of remnant intestine of about 120 cm. The histopathological diagnosis was given as desmoid tumor with infection. The patient was discharged from the hospital on the 9th postoperative day. Desmoid tumor is the second most common cause of death in FAP patients. Although desmoids can also occur in the extremities, most FAP patients develop intra-abdominal tumors. Despite being histologically benign, they are locally infiltrative and can cause death through invasion and destruction of adjacent vital structures and organs. Here, we report a case of desmoid tumors with FAP with reference to the literature. PMID:26805225

  15. Diagnostic imaging of blunt abdominal trauma in pediatric patients.

    PubMed

    Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

    2016-05-01

    Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children. PMID:27075018

  16. Multiple giant intra abdominal lipomas: A rare presentation

    PubMed Central

    Kshirsagar, Ashok Y.; Nangare, Nitin R.; Gupta, Vaibhav; Vekariya, Mayank A.; Patankar, Ritvij; Mahna, Abhishek; Wader, J.V.

    2014-01-01

    INTRODUCTION Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis. PMID:24862028

  17. Pathologic aerophagia: a rare cause of chronic abdominal distension

    PubMed Central

    de Jesus, Lisieux Eyer; Cestari, Ana Beatriz C.S.S.; da Silva, Orli Carvalho; Fernandes, Marcia Antunes; Firme, Livia Honorato

    2015-01-01

    Objective: To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses. Case description: An 11-year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive-compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition. Comments: Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy. PMID:26100594

  18. Principles of CT and CT technology.

    PubMed

    Goldman, Lee W

    2007-09-01

    This article provides a review of the basic principles of CT within the context of the evolution of CT. Modern CT technology can be understood as a natural progression of improvements and innovations in response to both engineering problems and clinical requirements. Detailed discussions of multislice CT, CT image quality evaluation, and radiation doses in CT will be presented in upcoming articles in this series. PMID:17823453

  19. [CT diagnosis of coal workers' pneumoconiosis].

    PubMed

    Pan, J S

    1989-02-01

    In order to evaluate the usefulness of CT in CWP, 100 coal workers were examined with both chest radiograph and CT scan. Comparison was done, the result indicated that both modalities yielded similar sensitivity to simple CWP. The CT score of simple CWP correlated well with ILO classification and 1986 Chinese criteria for staging of pneumoconiosis, whereas in complicated CWP, the CT scan was significantly superior to chest radiograph. CT scan identified readily large opacities. It could detect large opacities in 40% of simple CWP diagnosed on the basis of chest radiograph. CT scan also identified more cavities and calcifications within large opacities. The CT attenuation values were less reliable. The authors were of the opinion that at present CT attenuation values is not recommended for routine evaluation of CWP. PMID:2758921

  20. Lumbosacral spine CT

    MedlinePlus

    Spinal CT; CT - lumbosacral spine ... In other cases, a CT of the lumbosacral spine may be done after injecting contrast dye into ... of the body. A CT of the lumbosacral spine can evaluate fractures and changes of the spine, ...

  1. Thoracic CT

    MedlinePlus

    ... table that slides into the center of the scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. ... than 300 pounds, have your doctor contact the scanner operator before the exam. CT scanners have a ...

  2. Familial clustering of abdominal visceral fat and total fat mass: the Québec Family Study.

    PubMed

    Rice, T; Pérusse, L; Bouchard, C; Rao, D C

    1996-05-01

    The evidence for common familial factors underlying total fat mass (estimated from underwater weighing) and abdominal visceral fat (assessed from CT scan) was examined in families participating in phase 2 of the Québec Family Study (QFS) using a bivariate familial correlation model. Previous QFS investigations suggest that both genetic (major and polygenic) and familial environmental factors influence each phenotype, accounting for between 55% to 71% of the phenotypic variance in fat mass, and between 55% to 72% for abdominal visceral fat. The current study suggests that the bivariate familial effect ranges from 29% to 50%. This pattern suggests that there may be common familial determinants for abdominal visceral fat and total fat mass, as well as additional familial factors which are specific to each. The relatively high spouse cross-trait correlations usually suggest that a large percent of the bivariate familial effect may be environmental in origin. However, if mating is not random, then the spouse resemblance may reflect either genetic or environmental causes, depending on the source [i.e., through similar genes or cohabitation (environmental) effects]. Finally, there are significant sex differences in the magnitude of the familial cross-trait correlations involving parents, but not offspring, suggesting complex generation (i.e., age) and sex effects. For example, genes may turn on or off as a function of age and sex, and/or there may be an accumulation over time of effects due to the environment which may vary by sex. Whether the common familial factors are genetic (major and/or polygenic), environmental, or some combination of both, and whether the familial expression depends on sex and/or age warrants further investigation using more complex models. PMID:8732959

  3. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  4. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated. PMID:15219082

  5. A Mimic of Intra-abdominal Malignancy: Physiological Urinary Excretion of FDG in the Rare Adult Vesicourachal Diverticulum.

    PubMed

    Hsieh, Te-Chun; Sun, Shung-Shung; Lin, Chen-Yuan; Wu, Yu-Chin; Kao, Chia-Hung

    2016-06-01

    Urachal remnant anomalies are rare, and vesicourachal diverticulum is the most uncommon subtype of these anomalies. We present such a rare case of vesicourachal diverticulum that is incidentally discovered during the staging surveillance of a known esophageal cancer with F-FDG PET/CT. The physiological urinary excretion of radiopharmaceutical in the vesicourachal diverticulum mimics intra-abdominal malignancy, which resolves spontaneously in the follow-up FDG PET/CT. PMID:26825197

  6. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  7. [A case of abdominal wall actinomycosis].

    PubMed

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  8. Digital bowel cleansing free detection method of colonic polyp from fecal tagging CT images

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Kitasaka, Takayuki; Mori, Kensaku; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru

    2008-03-01

    This paper presents a digital bowel cleansing (DBC) free detection method of colonic polyp from fecal tagging CT images. Virtual colonoscopy (VC) or CT colonography is a new colon diagnostic method to examine the inside of the colon. However, since the colon has many haustra and its shape is long and convoluted, there is a risk of overlooking of lesions existing in blinded areas caused by haustra. Automated polyp detection from colonic CT images will reduce the risk of overlooking. Although many methods for polyp detection have been proposed, these methods needed DBC to detect polyps surrounded by tagged fecal material (TFM). However, DBC may changes shapes of polyps or haustra while removing TFM and it adversely affect polyp detection. We propose a colonic polyp detection method that enables us to detect polyps surrounded by either the air or the TFM simultaneously without any DBC processes. CT values inside polyps surrounded by the air and polyps surrounded by the TFM regions tend to gradually increase (blob structure) and decrease (inverse-blob structure) from outward to inward, respectively. We thus employ blob and inverse-blob structure enhancement filters based on the eigenvalues of the Hessian matrix to detect polyps using intensity characteristic of polyps. False positive elimination is performed using three feature values: the volume, maximum value of the filter outputs, and the standard deviation of CT values inside polyp candidate regions. We applied the proposed method to 104 cases of abdominal CT images. Sensitivity for polyps >= 6 mm was 91.2% with 7.8 FPs/case.

  9. Observer Performance in the Detection and Classification of Malignant Hepatic Nodules and Masses with CT Image-Space Denoising and Iterative Reconstruction1

    PubMed Central

    Fletcher, Joel G.; Yu, Lifeng; Li, Zhoubo; Manduca, Armando; Blezek, Daniel J.; Hough, David M.; Venkatesh, Sudhakar K.; Brickner, Gregory C.; Cernigliaro, Joseph C.; Hara, Amy K.; Fidler, Jeff L.; Lake, David S.; Shiung, Maria; Lewis, David; Leng, Shuai; Augustine, Kurt E.; Carter, Rickey E.; Holmes, David R.; McCollough, Cynthia H.

    2015-01-01

    Purpose To determine if lower-dose computed tomographic (CT) scans obtained with adaptive image-based noise reduction (adaptive nonlocal means [ANLM]) or iterative reconstruction (sinogram-affirmed iterative reconstruction [SAFIRE]) result in reduced observer performance in the detection of malignant hepatic nodules and masses compared with routine-dose scans obtained with filtered back projection (FBP). Materials and Methods This study was approved by the institutional review board and was compliant with HIPAA. Informed consent was obtained from patients for the retrospective use of medical records for research purposes. CT projection data from 33 abdominal and 27 liver or pancreas CT examinations were collected (median volume CT dose index, 13.8 and 24.0 mGy, respectively). Hepatic malignancy was defined by progression or regression or with histopathologic findings. Lower-dose data were created by using a validated noise insertion method (10.4 mGy for abdominal CT and 14.6 mGy for liver or pancreas CT) and images reconstructed with FBP, ANLM, and SAFIRE. Four readers evaluated routine-dose FBP images and all lower-dose images, circumscribing liver lesions and selecting diagnosis. The jack-knife free-response receiver operating characteristic figure of merit (FOM) was calculated on a per-malignant nodule or per-mass basis. Noninferiority was defined by the lower limit of the 95% confidence interval (CI) of the difference between lower-dose and routine-dose FOMs being less than −0.10. Results Twenty-nine patients had 62 malignant hepatic nodules and masses. Estimated FOM differences between lower-dose FBP and lower-dose ANLM versus routine-dose FBP were noninferior (difference: −0.041 [95% CI: −0.090, 0.009] and −0.003 [95% CI: −0.052, 0.047], respectively). In patients with dedicated liver scans, lower-dose ANLM images were noninferior (difference: +0.015 [95% CI: −0.077, 0.106]), whereas lower-dose FBP images were not (difference −0.049 [95% CI:

  10. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  11. Internal abdominal hernia: Intestinal obstruction due to trans-mesenteric hernia containing transverse colon

    PubMed Central

    Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Orendo-Velásquez, Edwin; Andrade, Felipe P.

    2014-01-01

    INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain. PMID:24880799

  12. Automatic segmentation of abdominal vessels for improved pancreas localization

    NASA Astrophysics Data System (ADS)

    Farag, Amal; Liu, Jiamin; Summers, Ronald M.

    2014-03-01

    Accurate automatic detection and segmentation of abdominal organs from CT images is important for quantitative and qualitative organ tissue analysis as well as computer-aided diagnosis. The large variability of organ locations, the spatial interaction between organs that appear similar in medical scans and orientation and size variations are among the major challenges making the task very difficult. The pancreas poses these challenges in addition to its flexibility which allows for the shape of the tissue to vastly change. Due to the close proximity of the pancreas to numerous surrounding organs within the abdominal cavity the organ shifts according to the conditions of the organs within the abdomen, as such the pancreas is constantly changing. Combining these challenges with typically found patient-to-patient variations and scanning conditions the pancreas becomes harder to localize. In this paper we focus on three abdominal vessels that almost always abut the pancreas tissue and as such useful landmarks to identify the relative location of the pancreas. The splenic and portal veins extend from the hila of the spleen and liver, respectively, travel through the abdominal cavity and join at a position close to the head of the pancreas known as the portal confluence. A third vein, the superior mesenteric vein, anastomoses with the other two veins at the portal confluence. An automatic segmentation framework for obtaining the splenic vein, portal confluence and superior mesenteric vein is proposed using 17 contrast enhanced computed-tomography datasets. The proposed method uses outputs from the multi-organ multi-atlas label fusion and Frangi vesselness filter to obtain automatic seed points for vessel tracking and generation of statistical models of the desired vessels. The approach shows ability to identify the vessels and improve localization of the pancreas within the abdomen.

  13. Performance benchmarking of liver CT image segmentation and volume estimation

    NASA Astrophysics Data System (ADS)

    Xiong, Wei; Zhou, Jiayin; Tian, Qi; Liu, Jimmy J.; Qi, Yingyi; Leow, Wee Kheng; Han, Thazin; Wang, Shih-chang

    2008-03-01

    In recent years more and more computer aided diagnosis (CAD) systems are being used routinely in hospitals. Image-based knowledge discovery plays important roles in many CAD applications, which have great potential to be integrated into the next-generation picture archiving and communication systems (PACS). Robust medical image segmentation tools are essentials for such discovery in many CAD applications. In this paper we present a platform with necessary tools for performance benchmarking for algorithms of liver segmentation and volume estimation used for liver transplantation planning. It includes an abdominal computer tomography (CT) image database (DB), annotation tools, a ground truth DB, and performance measure protocols. The proposed architecture is generic and can be used for other organs and imaging modalities. In the current study, approximately 70 sets of abdominal CT images with normal livers have been collected and a user-friendly annotation tool is developed to generate ground truth data for a variety of organs, including 2D contours of liver, two kidneys, spleen, aorta and spinal canal. Abdominal organ segmentation algorithms using 2D atlases and 3D probabilistic atlases can be evaluated on the platform. Preliminary benchmark results from the liver segmentation algorithms which make use of statistical knowledge extracted from the abdominal CT image DB are also reported. We target to increase the CT scans to about 300 sets in the near future and plan to make the DBs built available to medical imaging research community for performance benchmarking of liver segmentation algorithms.

  14. Multiple myeloma: evaluation by CT

    SciTech Connect

    Schreiman, J.S.; McLeod, R.A.; Kyle, R.A.; Beabout, J.W.

    1985-02-01

    Although patients who have multiple myeloma usually have straightforward clinical symptoms and corroborative radiographs, in some instances, these patients will present atypically, with symptoms suggesting active disease but radiographs that are normal or nonspecific. The authors reviewed the records of 32 patients who had documented multiple myeloma and had undergone CT examinations, assessing the value of those examinations. Although CT is not indicated in all patients who have multiple myeloma, it is especially useful in patients who have bone pain and normal or nonspecific radiographs. CT provided confirmatory information in all cases in which lesions were seen on radiographs. CT also frequently demonstrated a greater extent of disease than could be appreciated on the radiographs.

  15. Overbeaming and overlapping of volume-scan CT with tube current modulation in a 320-detector row CT scanner

    NASA Astrophysics Data System (ADS)

    Liao, Ying-Lan; Chen, Yan-Shi; Lai, Nan-Ku; Chuang, Keh-Shih; Tsai, Hui-Yu

    2014-11-01

    The purpose of this study was to evaluate the performance of volume scan tube current modulation (VS-ATCM) with adaptive iterative dose reduction 3D (AIDR3D) technique in abdomen CT examinations. We scanned an elliptical cone-shaped phantom utilizing AIDR3D technique combined with VS-ATCM mode in a 320-detector row CT scanner. The image noise distributions with conventional filtered back-projction (FBP) technique and those with AIDR3D technique were compared. The radiation dose profile and tube current time product (mAs) in three noise levels of VS-ATCM modes were compared. The radiation beam profiles of five preset scan lengths were measured using Gafchromic film strips to assess the effects of overbeaming and everlapping. The results indicated that the image noises with AIDR3D technique was 13-74% lower than those in FBP technique. The mAs distributions can be a prediction for various abdominal sizes when undergoing a VS-ATCM mode scan. Patients can receive the radiation dose of overbeaming and overlapping during the VS-ATCM mode scans.

  16. [Ultrasound of the large abdominal vessels].

    PubMed

    Oviedo-García, A A; Algaba-Montes, M; Segura-Grau, A; Rodríguez-Lorenzo, Á

    2016-01-01

    Ultrasound has recently become an indispensable tool for the family physician, whether exercised in primary care and emergency department; and likewise it has spread to many other specialties: internal medicine, critical care, neurology, pneumology, digestive, etc. and that ultrasound has proven to be a safe diagnostic tool and have great capacity. We firmly believe that ultrasound done to «bedside» the patient by the family doctor, can greatly complement the physical examination and greatly improve clinical effectiveness, allowing the browser an immediate view of the anatomy and physiology of certain structures. It is within this context is particularly relevant ultrasonography of the Aorta and large abdominal vessels, made by the family doctor or the emergency itself, which will develop along this chapter. PMID:25475534

  17. [CT fluoroscopy].

    PubMed

    Rogalla, P; Juran, R

    2004-07-01

    Percutaneous biopsy of pulmonary nodules requires precise needle placement, with the goal of attaining a secure position of the needle for therapeutic or diagnostic purposes as quickly as possible and with minimal tissue damage along the access route. The requirements from the image guidance system during the intervention are, in addition to universal applicability, a quick reaction time and a user-friendly interface. CT fluoroscopy fulfils these requirements, although radiation protection for the patient and radiologist becomes an important issue. PMID:15232690

  18. Pulmonary langerhans cell histiocytosis: PET/CT for initial workup and treatment response evaluation.

    PubMed

    Hansen, Neil J; Hankins, Jordan H

    2015-02-01

    A 40-year-old man underwent pan-endoscopy owing to abdominal pain. Biopsies of the gastrointestinal tract demonstrated diffuse Langerhans cell histiocytosis. PET/CT was done, with CT demonstrating classic pulmonary manifestations of Langerhans cell histiocytosis that had association with intense FDG uptake on PET. Bowel appeared normal. Treatment was initiated with smoking cessation and 6 cycles of cytarabine. Follow-up PET/CT after initial treatment demonstrated improvement of parenchymal abnormalities seen on CT, with resolution of hypermetabolic activity. Maintenance chemotherapy was initiated. PET/CT is increasingly being used for initial staging and treatment response assessment in this rare disorder. PMID:24999688

  19. Invisible fat on CT: making it visible by MRI

    PubMed Central

    Ünal, Emre; Karaosmanoğlu, Ali Devrim; Akata, Deniz; Özmen, Mustafa Nasuh; Karçaaltıncaba, Muşturay

    2016-01-01

    Presence of fat in a lesion significantly narrows the differential diagnosis. Small quantities of macroscopic fat and intracellular fat are invisible on computed tomography (CT) and ultrasonography. Magnetic resonance imaging (MRI) can reveal any fatty change in a lesion and can also differentiate macroscopic fat from intracellular and intravoxel fat. Hypodensity on CT may be a sign of invisible fat and MRI can help to diagnose even minute amounts of fat in liver, pancreas, adrenal, musculoskeletal, and omental pseudolesions and lesions. This article will review the superiority of MRI over CT in demonstrating fat in abdominal lesions. PMID:26782156

  20. MR Evaluation of the Nontraumatic Acute Abdomen with CT Correlation.

    PubMed

    Bannas, Peter; Pickhardt, Perry J

    2015-11-01

    Cross-sectional imaging plays a crucial role in the triage of patients with acute abdominal pain. Ionizing radiation exposure is a recognized drawback of computed tomography (CT), the primary imaging technique. MR imaging is a promising alternative to CT; it provides excellent image quality with high-contrast resolution without the disadvantages of ionizing radiation and iodinated contrast. This article provides a basic overview of the typical MR findings of the most frequent disease entities encountered in the setting of the nontraumatic acute abdomen, including direct comparison with CT findings to familiarize the readers with these same findings on MR. PMID:26526441

  1. A simple method for labeling CT images with respiratory states

    SciTech Connect

    Berlinger, Kajetan; Sauer, Otto; Vences, Lucia; Roth, Michael

    2006-09-15

    A method is described for labeling CT images with their respiratory state by a needle, connected to the patient's chest/abdomen. By means of a leverage the needle follows the abdominal respiratory motion. The needle is visible as a blurred spot in every CT slice. The method was tested with nine patients. A series of volume scans during free breathing was performed. The detected positions of the moving needle in every single slice were compared to each other thus enabling respiratory state assignment. The tool is an inexpensive alternative to complex respiratory measuring tools for four dimensional (4D) CT and was greatly accepted in the clinic due to its simplicity.

  2. Management and outcome of abdominal shotgun wounds. Trauma score and the role of exploratory laparotomy.

    PubMed Central

    Cairns, B A; Oller, D W; Meyer, A A; Napolitano, L M; Rutledge, R; Baker, C C

    1995-01-01

    OBJECTIVE: The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA: It has been proposed that exploratory laparotomy may be unnecessary and even overused in a subset of patients with abdominal shotgun wounds. METHODS: Data on shotgun wound patients from October 1987 through March 1992 from a statewide trauma registry were examined. Patients with abdominal shotgun wounds were identified and compared with patients with nonabdominal shotgun wounds. RESULTS: Of 516 shotgun wound patients, 138 (26.7%) had abdominal wounds and 88 (63.8%) had exploratory laparotomies. Abdominal shotgun wounds resulted in significantly longer number of intensive care unit days (4.3 vs. 2.5, p < 0.05), a greater number of blood units transfused (7.8 vs. 2.4, p < 0.05), and a higher mortality (15.9% vs. 4.8%, p < 0.05) when compared with nonabdominal shotgun wounds. When stratified for trauma score, the mortality for abdominal shotgun wounds always was significantly greater than for nonabdominal shotgun wounds. All abdominal shotgun wound patients with trauma scores less than ten died. The negative laparotomy rate for abdominal shotgun wound patients with normal trauma scores was 9.4%. No patient with a negative laparotomy died. CONCLUSION: Abdominal shotgun wounds are a particularly lethal subset of shotgun wounds. Although some abdominal shotgun wound patients can be managed without laparotomy, the morbidity and mortality for these injuries are substantial, even in patients with normal trauma score. Clinical judgment is an excellent predictor of the need for laparotomy. PMID:7717780

  3. ABDOMINAL SUBCUTANEOUS ADIPOSE TISSUE (SAT) AND VICERAL ADIPOSE TISSUE (VAT) MEASUREMENTS IN HIV+ ADULTS: INFLUENCES OF MEASUREMENT SITE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Loss of SAT and an increase in VAT are common with HIV lipodystrophy. Excess abdominal VAT is a known risk factor for cardiovascular disease. Computerized axial tomography (CT) can be used to measure SAT and VAT areas in cross-sectional images of the abdomen. The ideal site(s) and number of abdomina...

  4. Large abdominal photopenic area on 99mTc-sestamibi myocardial perfusion imaging.

    PubMed

    Lyon, Jennifer; Spaulding, John; Zack, Paul M

    2012-12-01

    (99m)Tc-sestamibi myocardial perfusion imaging is frequently performed in conjunction with exercise or pharmacologic stress testing for evaluation of coronary heart disease. Interpretation of these studies includes systematic review of unprocessed rotating projectional images for evaluation of cardiac size as well as the presence of motion or attenuation artifacts. Occasionally, incidental noncardiac findings are detected on review of the projectional images. We report a case of a patient with a history of autosomal dominant polycystic kidney disease who was found to have a large abdominal photopenic area on the projectional images. The photopenic area corresponded to the location of large intraabdominal cysts on abdominal CT and was consistent with hepatic cysts associated with the patient's known polycystic kidney disease. We review the differential diagnosis of large abdominal photopenic regions identified on myocardial projectional images and the importance of routinely analyzing these images for incidental noncardiac findings. PMID:22997275

  5. Abdominal Wall Metastasis of Uterine Papillary Serous Carcinoma in a Post-Menopausal Woman: A Case Report

    PubMed Central

    Park, Jung-Woo

    2014-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  6. Abdominal wall metastasis of uterine papillary serous carcinoma in a post-menopausal woman: a case report.

    PubMed

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-04-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  7. [Abdominal CSF pseudocyst recurrence in a 14-year-old patient with ventricular-peritoneal shunt].

    PubMed

    Laurent, P; Hennecker, J-L; Schillaci, A; Scordidis, V

    2014-08-01

    Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication of ventricular-peritoneal shunt (VPS) but needs to be considered in every patient with abdominal complaints or signs of intracranial hypertension (IH). The pathogenesis of pseudocysts remains unclear. Diverse predisposing factors have been proposed such as previous abdominal surgeries, multiple VPS revisions, infections, history of necrotizing enterocolitis, and nonspecific inflammatory processes. We report the case of a 14-year-old patient, known to have a VPS as intraventricular hemorrhage treatment, presenting cephalalgia, vomiting, apathy, and an indurate abdominal mass without fever. The first abdominal CSF pseudocyst diagnosis had been established 3 months earlier. Abdominal ultrasounds confirmed a large homogeneous cyst with the shunt tip within the pseudocyst. Cerebral CT revealed an increased ventricular size. An exploratory laparotomy with cyst aspiration, lysis of adhesions, excision of cystic walls, and repositioning of the peritoneal catheter was performed. No antibiotics were initiated given that the cultures were negative. Ultrasonography proved to be the method of choice in the diagnosis of VPS abdominal complications, especially CSF pseudocyst. CT can also reliably confirm the pseudocyst. In case of IH signs, a cerebral CT scan can be performed to evaluate the ventricular distension and to check the shunt position. Various methods to process the cyst have been described in the medical literature, but the recurrence rate remains elevated (25-100%). Then the probability of an infection without any clinical sign has to be considered. In case of suspected infection, the VPS is removed and replaced by an external ventricular drain. Antibiotics are started and adjusted to the results of the CSF culture. If there is no direct sign of infection, only the distal catheter is externalized and antibiotics are introduced until infection is treated. Depending on the peritoneal absorption state

  8. Blunt abdominal trauma in children.

    PubMed

    Tepas, J J

    1993-06-01

    The growing popularity of nonoperative treatment of children with splenic injuries has seduced some physicians into a false sense of security regarding care of the injured child. Although it has been established that hemodynamically stable children with splenic, hepatic, and even renal injuries can safely be treated "expectantly," this concept cannot be applied indiscriminately. Accurate diagnosis and effective care of the child with blunt abdominal trauma is an exercise of clinical precision that demands attention to detail and thorough evaluation. This review addresses this process in light of recent advances in diagnostic imaging and in consideration of recent reports analyzing different protocols for therapeutic decision making. PMID:8374651

  9. BIOMECHANICS OF ABDOMINAL AORTIC ANEURYSM

    PubMed Central

    Vorp, David A.

    2009-01-01

    Abdominal aortic aneurysm (AAA) is a condition whereby the terminal aorta permanently dilates to dangerous proportions, risking rupture. The biomechanics of AAA has been studied with great interest since aneurysm rupture is a mechanical failure of the degenerated aortic wall and is a significant cause of death in developed countries. In this review article, the importance of considering the biomechanics of AAA is discussed, and then the history and the state-of-the-art of this field is reviewed - including investigations into the biomechanical behavior of AAA tissues, modeling AAA wall stress and factors which influence it, and the potential clinical utility of these estimates in predicting AAA rupture. PMID:17254589

  10. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  11. Hollow organ abdominal ischemia, part II: clinical features, etiology, imaging findings and management.

    PubMed

    Ricci, Zina J; Mazzariol, Fernanda S; Kaul, Bindu; Oh, Sarah K; Chernyak, Victoria; Flusberg, Milana; Stein, Marjorie W; Rozenblit, Alla M

    2016-01-01

    Acute hollow organ ischemia commonly presents with acute pain prompting radiologic evaluation and almost always requires urgent treatment. Despite different risk factors and anatomic differences, ischemia is commonly due to low flow states but can also be due to arterial and venous occlusion. Radiologic diagnosis is critical as many present with nonspecific symptoms. Contrast-enhanced computed tomography (CT) is the modality of choice. Magnetic resonance imaging (MRI) is preferred in suspected appendicitis in pregnant patients and is superior in biliary necrosis. This article provides a pictorial review of the CT/MRI features of hollow abdominal organ ischemia while highlighting key clinical features, pathogenesis, and management. PMID:27317221

  12. Eccrine Porocarcinoma presenting as an abdominal wall mass in a patient with ulcerative colitis—A rare case report

    PubMed Central

    Parmar, Narendrasinh; Mohamed, Mohamed; Elmoghrabi, Adel; McCann, Michael

    2016-01-01

    Introduction Eccrine porocarcinoma (EPC) is a rare malignancy of eccrine sweat glands. It is often seen during the sixth to eighth decades of life. We report the first case of eccrine porocarcinoma arising on the abdomen of a 21-year-old patient with ulcerative colitis. Case presentation A 21-Year-old female presented to emergency department with a one month history of an enlarging mass over left lower abdomen. Abdominal examination revealed a slightly erythematous, nodular and non-mobile firm mass in left lower quadrant. There was superficial ulceration with slight serous discharge. CT scan of the abdomen and pelvis with contrast revealed a superficial cystic lesion over the anterior abdominal wall, provisionally diagnosed as sebaceous cyst. Incision and drainage were performed and on follow-up, no signs of healing were observed and the patient subsequently underwent surgical excision. Histopathological examination revealed an eccrine porocarcinoma. Discussion EPC is a rare and aggressive tumor. It may occur de novo or as a result of malignant transformation of an eccrine poroma. A long period of clinical history is often encountered. It usually occurs on the lower extremities followed by the, trunk, head and neck, and upper extremities. The clinical picture usually consists of a painless nodule or papule. Treatment is wide local excision. No strong evidence exists for adjuvant therapy. The risk of local recurrence is about 20%. Conclusion High index of suspicion is required for diagnosis of EPC. Early diagnosis is achieved by histopathological examination and early definitive surgical excision leads to excellent results. PMID:27085107

  13. Endovascular repair of a pseudoaneurysm of the abdominal aorta secondary to translumbar aortography.

    PubMed

    Mir, Naheed; De Nunzio, Mario; Pollock, John G

    2006-01-01

    This report describes an incidental finding of a pseudoaneurysm of the abdominal aorta on a computed tomography (CT) renal angiogram during investigation of chronic renal failure in a 73-year-old man. The patient had undergone a translumbar aortogram 20 years previously. An increase in the size of the aneurysm by 7 mm over 6 months prompted treatment and the aneurysm underwent successful endovascular repair with a custom-made stent-graft. PMID:16184323

  14. Long-term prognosis in children with recurrent abdominal pain.

    PubMed

    Christensen, M F; Mortensen, O

    1975-02-01

    The present study is a follow-up of 34 cases admitted to a paediatric department with recurrent abdominal pain (RAP) in 1942 and 1943. 45 persons without a history of RAP were selected at random and included as controls. Using a questionnaire, there was a higher incidence of gastrointestinal symptoms among persons with a history of RAP during childhood than among controls (P less than 0.05). 18 of the original 34 cases who still had symptoms were re-examined; 11 had a clinical picture consistent with a diagnosis of irritable colon, 5 had a picture compatible with both irritable colon and peptic ulcer/gastritis, and 2 had duodenal ulcer. Abdominal pains occurred no more frequently among children of parents who had had RAP during childhood than among children of parents without such a history. However, there was a higher incidence of abdominal pain among children of parents who were complaining of abdominal discomfort at the time of the investigation than among children whose parents were without such symptoms (P less than 0.005). PMID:1130815

  15. Diagnosis of acute abdominal pain in older patients.

    PubMed

    Lyon, Corey; Clark, Dwayne C

    2006-11-01

    Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly benign, even with catastrophic conditions such as abdominal aortic aneurysm rupture and mesenteric ischemia. Changes that occur in the biliary system because of aging make older patients vulnerable to acute cholecystitis, the most common indication for surgery in this population. In older patients with appendicitis, the initial diagnosis is correct only one half of the time, and there are increased rates of perforation and mortality when compared with younger patients. Medication use, gallstones, and alcohol use increase the risk of pancreatitis, and advanced age is an indicator of poor prognosis for this disease. Diverticulitis is a common cause of abdominal pain in the older patient; in appropriately selected patients, it may be treated on an outpatient basis with oral antibiotics. Small and large bowel obstructions, usually caused by adhesive disease or malignancy, are more common in the aged and often require surgery. Morbidity and mortality among older patients presenting with acute abdominal pain are high, and these patients often require hospitalization with prompt surgical consultation. PMID:17111893

  16. Abdominal wall reconstruction with implantable meshes.

    PubMed

    Masden, Derek; Felder, John M; Iorio, Matthew L; Bhanot, Parag; Attinger, Christopher E

    2011-01-01

    Abdominal wall defects present a difficult problem for the reconstructive surgeon. Over the years, numerous implantable materials have becomes available to aid the surgeon in recreating the abdominal wall. This spectrum of implants includes permanent synthetic meshes, absorbable meshes, composite meshes and biomaterials. This review includes the pros and cons for the commercially available abdominal wall implants as well as a review of the literature regarding outcomes for each material. This review will provide the surgeon with current evidence-based information on implantable abdominal materials to be able to make a more informed decision about which implant to use. PMID:21663579

  17. Acute Abdominal Pain after Intercourse: Adrenal Hemorrhage as the First Sign of Metastatic Lung Cancer

    PubMed Central

    Packer, Clifford D.

    2014-01-01

    Although the adrenal glands are a common site of cancer metastases, they are often asymptomatic and discovered incidentally on CT scan or autopsy. Spontaneous adrenal hemorrhage associated with metastatic lung cancer is an exceedingly rare phenomenon, and diagnosis can be difficult due to its nonspecific symptoms and ability to mimic other intra-abdominal pathologies. We report a case of a 65-year-old man with a history of right upper lobectomy seven months earlier for stage IB non-small cell lung cancer who presented with acute abdominal pain after intercourse. CT scan revealed a new right adrenal mass with surrounding hemorrhage, and subsequent FDG-PET scan confirmed new metabolic adrenal metastases. The patient's presentation of abdominal pain and adrenal hemorrhage immediately after sexual intercourse suggests that exertion, straining, or increased intra-abdominal pressure might be risk factors for precipitation of hemorrhage in patients with adrenal metastases. Management includes pain control and supportive treatment in mild cases, with arterial embolization or adrenalectomy being reserved for cases of severe hemorrhage. PMID:25126096

  18. [Ultrasound diagnosis of an abdominal aortic aneurysm in a 52 year old woman].

    PubMed

    Romero-Hernández, Juan José; Lozano-Corona, Marco Antonio; Díaz-Méndez, Macrina; Aspeitia-León, Jorge Alejandro; Hernández-Díaz, Víctor; Magaña-Cabrera, Daniel

    2012-01-01

    The abdominal aortic aneurysm (AAA) is defined as increasing the diameter of the aorta in more than 50 % of its original size and the infra-renal location is the most common (90 %). AAA disease mainly affects older men and white smokers, and has a male: female ratio of 4:1, as well the diagnosis is rare in women under age 55. Aneurysm rupture is the most common complication and cause of death in the general population, its etiology is unclear, but is commonly associated with atherosclerosis. The AAA do not exhibit rupture and it is usually asymptomatic diagnosed incidentally, however, as the aneurysm grows, appears symptoms such as back pain, abdominal or groin pain, well as palpation of a pulse mass on umbilical and supra-umbilical region. Imaging study such as ultrasound and CT scan are the mainstay of diagnosis. We present a case of 52 years old patient with no history related to the diagnosis, who presented sudden and severe abdominal pain. She was admitted to the emergency room with a diagnosis of acute cholecystitis vs. acute pancreatitis. After ultrasound and CT studies, the diagnosis was a complicated abdominal aortic aneurysm. PMID:22882988

  19. Interfraction variation in lung tumor position with abdominal compression during stereotactic body radiotherapy

    SciTech Connect

    Mampuya, Wambaka Ange; Nakamura, Mitsuhiro; Matsuo, Yukinori; Ueki, Nami; Iizuka, Yusuke; Monzen, Hajime; Mizowaki, Takashi; Hiraoka, Masahiro; Fujimoto, Takahiro; Yano, Shinsuke

    2013-09-15

    of tumor motion. However, in most of the authors’ patients, the use of abdominal compression seemed to increase the interfraction variation in tumor position, despite reducing lung tumor motion. The daily tumor position deviated more systematically from the tumor position in the planning CT scan in the lateral and longitudinal directions in patients treated with abdominal compression compared to those treated without compression. Therefore, target matching is required to correct or minimize the interfraction variation.

  20. Abdominal injuries in a low trauma volume hospital - a descriptive study from northern Sweden

    PubMed Central

    2014-01-01

    Background Abdominal injuries occur relatively infrequently during trauma, and they rarely require surgical intervention. In this era of non-operative management of abdominal injuries, surgeons are seldom exposed to these patients. Consequently, surgeons may misinterpret the mechanism of injury, underestimate symptoms and radiologic findings, and delay definite treatment. Here, we determined the incidence, diagnosis, and treatment of traumatic abdominal injuries at our hospital to provide a basis for identifying potential hazards in non-operative management of patients with these injuries in a low trauma volume hospital. Methods This retrospective study included prehospital and in-hospital assessments of 110 patients that received 147 abdominal injuries from an isolated abdominal trauma (n = 70 patients) or during multiple trauma (n = 40 patients). Patients were primarily treated at the University Hospital of Umeå from January 2000 to December 2009. Results The median New Injury Severity Score was 9 (range: 1–57) for 147 abdominal injuries. Most patients (94%) received computed tomography (CT), but only 38% of patients with multiple trauma were diagnosed with CT < 60 min after emergency room arrival. Penetrating trauma caused injuries in seven patients. Solid organ injuries constituted 78% of abdominal injuries. Non-operative management succeeded in 82 patients. Surgery was performed for 28 patients, either immediately (n = 17) as result of operative management or later (n = 11), due to non-operative management failure; the latter mainly occurred with hollow viscus injuries. Patients with multiple abdominal injuries, whether associated with multiple trauma or an isolated abdominal trauma, had significantly more non-operative failures than patients with a single abdominal injury. One death occurred within 30 days. Conclusions Non-operative management of patients with abdominal injuries, except for hollow viscus injuries, was highly

  1. Co-incidence of acute appendicitis and appendiceal transection after blunt abdominal trauma: a case report.

    PubMed

    Moslemi, Sam; Forootan, Hamid Reza; Tahamtan, Maryam

    2013-12-01

    A 13-year-old boy with a history of bicycle handlebar injury to the left side of his abdomen was brought to the Emergency Department of our center. On admission, his vital signs were stable and abdominal examination revealed ecchymosis and tenderness of the injured areas. Mild to moderate free fluid and two small foci of free air in the anterior aspect of the abdomen, in favor of pneumoperitoneum, were detected in abdominopelvic sonography and CT-scan, respectively. In less than 6 hours, the patient developed generalized peritonitis. Therefore, exploratory laparotomy was promptly performed, which revealed appendiceal transection and rupture of the small bowel mesentery. Appendectomy and small bowel mesoplasty were done, with pathological diagnosis of acute appendicitis and periappendicitis. After surgery, the patient had a non-complicated hospital course. This rare case highlights the significance of the early management of appendiceal traumatic injuries in order to prevent further complicated events, especially in patients who are much more exposed to this risk due to their traumatic background. PMID:24293790

  2. Use of ICT and its Relationship with Performance in Examinations: A Comparison of the ImpaCT2 Project's Research Findings Using Pupil-Level, School-Level and Multilevel Modelling Data

    ERIC Educational Resources Information Center

    Harrison, Colin; Lunzer, Eric A.; Tymms, Peter; Fitz-Gibbon, Carol Taylor; Restorick, Jane

    2004-01-01

    This paper reports a previously unpublished comparative analysis of data from the ImpaCT2 study investigating the relationship between students' performance in England on national tests and their reported use of information technology (particularly networked technology) for school work, at three age levels (11, 14 and 16), in English, Maths and…

  3. Slipping Rib Syndrome as Persistent Abdominal and Chest Pain.

    PubMed

    Bolaños-Vergaray, Juan Javier; de la Gala García, Francisco; Obaya Rebollar, Juan Carlos; Bové Alvarez, Maria

    2015-11-01

    Slipping rib syndrome is an overlooked cause of persistent abdominal or chest pain. The etiology of this syndrome is not well understood, but the characteristic pain is from hypermobility of the false ribs. Although it is a diagnosis of exclusion, misdiagnosis may lead to an excessive workup. A simple clinical examination via the hooking maneuver is the most significant feature of its diagnosis. We describe the case of a 41-year-old woman with slipping rib syndrome. PMID:26528703

  4. A Kinect™ camera based navigation system for percutaneous abdominal puncture

    NASA Astrophysics Data System (ADS)

    Xiao, Deqiang; Luo, Huoling; Jia, Fucang; Zhang, Yanfang; Li, Yong; Guo, Xuejun; Cai, Wei; Fang, Chihua; Fan, Yingfang; Zheng, Huimin; Hu, Qingmao

    2016-08-01

    Percutaneous abdominal puncture is a popular interventional method for the management of abdominal tumors. Image-guided puncture can help interventional radiologists improve targeting accuracy. The second generation of Kinect™ was released recently, we developed an optical navigation system to investigate its feasibility for guiding percutaneous abdominal puncture, and compare its performance on needle insertion guidance with that of the first-generation Kinect™. For physical-to-image registration in this system, two surfaces extracted from preoperative CT and intraoperative Kinect™ depth images were matched using an iterative closest point (ICP) algorithm. A 2D shape image-based correspondence searching algorithm was proposed for generating a close initial position before ICP matching. Evaluation experiments were conducted on an abdominal phantom and six beagles in vivo. For phantom study, a two-factor experiment was designed to evaluate the effect of the operator’s skill and trajectory on target positioning error (TPE). A total of 36 needle punctures were tested on a Kinect™ for Windows version 2 (Kinect™ V2). The target registration error (TRE), user error, and TPE are 4.26  ±  1.94 mm, 2.92  ±  1.67 mm, and 5.23  ±  2.29 mm, respectively. No statistically significant differences in TPE regarding operator’s skill and trajectory are observed. Additionally, a Kinect™ for Windows version 1 (Kinect™ V1) was tested with 12 insertions, and the TRE evaluated with the Kinect™ V1 is statistically significantly larger than that with the Kinect™ V2. For the animal experiment, fifteen artificial liver tumors were inserted guided by the navigation system. The TPE was evaluated as 6.40  ±  2.72 mm, and its lateral and longitudinal component were 4.30  ±  2.51 mm and 3.80  ±  3.11 mm, respectively. This study demonstrates that the navigation accuracy of the proposed system is acceptable

  5. Sudden death in advanced abdominal pregnancy: a case report and discussion of the related medicolegal issues.

    PubMed

    Pradhan, M; Sreenivas, M; Singh, Bajrang; Behera, C; Dikshit, P C

    2013-04-01

    We report sudden unexpected death in a 35-year-old woman with pregnancy of seven months duration. There was an allegation by the parents of the woman that she was subjected to an assault prior to death. Autopsy examination showed an abdominal pregnancy with a dead fetus, ruptured gestational sac, massive haemorrhage and secondary placental attachment. During her antenatal check-ups, she had persistently complained of abdominal pain and loose stools, but the diagnosis of abdominal pregnancy was missed clinically and on ultrasound scan. In this paper we discuss the diagnostic difficulties and medicolegal issues in such cases. PMID:23362236

  6. Evaluation and management of acute abdominal pain in the emergency department

    PubMed Central

    Macaluso, Christopher R; McNamara, Robert M

    2012-01-01

    Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain. PMID:23055768

  7. Inhibition of cyclooxygenase-2 prevents intra-abdominal adhesions by decreasing activity of peritoneal fibroblasts

    PubMed Central

    Wei, Guangbing; Chen, Xin; Wang, Guanghui; Jia, Pengbo; Xu, Qinhong; Ping, Gaofeng; Wang, Kang; Li, Xuqi

    2015-01-01

    Background Postoperative intra-abdominal adhesions are common complications after abdominal surgery. The exact molecular mechanisms that are responsible for these complications remain unclear, and there are no effective methods for preventing adhesion formation or reformation. The aim of the study reported here was to investigate the preventive effects and underlying potential molecular mechanisms of selective cyclooxygenase-2 (COX-2) inhibitors in a rodent model of postoperative intra-abdominal adhesions. Materials and methods The expression of COX-2 in postoperative intra-abdominal adhe-sions and normal peritoneal tissue was examined by immunohistochemistry and Western blot analysis. Assays were performed to elucidate the effect of COX-2 inhibition on hypoxia-induced fibroblast activity in vitro and on intra-abdominal adhesion formation in vivo. Results Hypoxia-induced COX-2 expression in peritoneal fibroblasts was increased in postoperative intra-abdominal adhesions. Inhibition of COX-2 attenuated the activating effect of hypoxia on normal peritoneal fibroblasts in vitro. Data indicate that selective COX-2 inhibitor prevents in vivo intra-abdominal adhesion by inhibition of basic fibroblast growth factor and transforming growth factor-beta expression, but not through an antiangiogenic mechanism. Furthermore, using selective COX-2 inhibitors to prevent intra-abdominal adhesions did not adversely affect the weight, bowel motility, or healing of intestinal anastomoses in a rat model. Conclusion These results show that hypoxia-induced COX-2 expression in peritoneal fibroblasts is involved in the formation of intra-abdominal adhesions. Inhibition of COX-2 prevents postoperative intra-abdominal adhesions through suppression of inflammatory cytokines. PMID:26109851

  8. 42 CFR 410.19 - Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Ultrasound screening for abdominal aortic aneurysms... aneurysms: Condition for and limitation on coverage. (a) Definitions: As used in this section, the following... screening for an abdominal aortic aneurysm as a result of an initial preventive physical examination...

  9. 42 CFR 410.19 - Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Ultrasound screening for abdominal aortic aneurysms... aneurysms: Condition for and limitation on coverage. (a) Definitions: As used in this section, the following... screening for an abdominal aortic aneurysm as a result of an initial preventive physical examination...

  10. 42 CFR 410.19 - Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Ultrasound screening for abdominal aortic aneurysms... aneurysms: Condition for and limitation on coverage. (a) Definitions: As used in this section, the following... screening for an abdominal aortic aneurysm as a result of an initial preventive physical examination...

  11. 42 CFR 410.19 - Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Ultrasound screening for abdominal aortic aneurysms... aneurysms: Condition for and limitation on coverage. (a) Definitions: As used in this section, the following... screening for an abdominal aortic aneurysm as a result of an initial preventive physical examination...

  12. Computed tomography diagnosis of a primary aortoduodenal fistula in a patient with a partially thrombosed abdominal aortic aneurysm.

    PubMed

    Shree, Divya; Jeppu, Sandeep; Puneet, Pulak; Rani, Kanchan

    2010-08-01

    Primary aortoenteric fistula is a rare but fatal cause of gastrointestinal bleeding and requires urgent intervention. A high index of clinical suspicion in conjunction with imaging is required because a favorable outcome relies on prompt diagnosis. The primary forms of aortoduodenal fistulas are nearly always associated with abdominal aortic aneurysm, mostly atherosclerotic. Technological advances in imaging, particularly computed tomography (CT), play a pivotal role in the preoperative detection of these fistulas. We report the case of a 76-year-old man who was diagnosed with a large abdominal aortic aneurysm with associated contained rupture and suggestion of an aortoduodenal fistula on CT. This case demonstrated the effectiveness, ease, and low cost of the preoperative evaluation and documentation of a primary aortoduodenal fistula using CT scans. PMID:20799019

  13. Mechanical small bowel obstruction following a blunt abdominal trauma: A case report

    PubMed Central

    Zirak-Schmidt, Samira; El-Hussuna, Alaa

    2015-01-01

    Introduction Intestinal obstruction following abdominal trauma has previously been described. However, in most reported cases pathological finding was intestinal stenosis. Presentation of the case A 51-year-old male was admitted after a motor vehicle accident. Initial focused abdominal sonogram for trauma and enhanced computerized tomography were normal, however there was a fracture of the tibia. Three days later, he complained of abdominal pain, constipation, and vomiting. An exploratory laparotomy showed bleeding from the omentum and mechanical small bowel obstruction due to a fibrous band. Discussion The patient had prior abdominal surgery, but clinical and radiological findings indicate that the impact of the motor vehicle accident initiated his condition either by causing rotation of a bowel segment around the fibrous band, or by formation of a fibrous band secondary to minimal bleeding from the omentum. Conclusion High index of suspicion of intestinal obstruction is mandatory in trauma patients presenting with complaints of abdominal pain, vomiting, and constipation despite uneventful CT scan. PMID:26566436

  14. [Radiological examinations that have disappeared].

    PubMed

    Puylaert, Carl B A J; Puylaert, Julien B C M

    2011-01-01

    If a radiologist from 1950 could travel in time to 2011, he or she would be baffled to see how few of the radiological examinations he was familiar with, remain. We review the radiological examinations that have disappeared since X-rays were discovered, and include the causes of their disappearance. Barium studies have mainly been replaced by endoscopy, oral cholecystography by ultrasound, and intravenous urography by CT-scan. Angiography by means of a direct puncture of carotid artery and aorta has been replaced by Seldinger angiography. Pneumencephalography and myelography have been replaced by CT and MRI. Bronchography has been replaced by bronchoscopy and CT-scan, arthrography by MRI and arthroscopy. Many other radiological examinations have been replaced by ultrasound, CT or MRI. PMID:21447222

  15. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    PubMed

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  16. Autotransfusion utilization in abdominal trauma.

    PubMed

    Smith, L A; Barker, D E; Burns, R P

    1997-01-01

    The purpose of this review is to investigate the utility of autotransfusion in trauma patients in the past 3 years. A retrospective review was conducted of the charts for whom the Haemonetics Cell Saver autotransfusion device (Haemonetics Corp., Natick, MA) was utilized between January 1, 1993, and December 31, 1995. The estimated blood loss and quantity of blood transfused were noted for abdominal trauma patients. Costs of autotransfusion were then compared to estimated blood bank costs for this group. The Haemonetics Cell Saver autotransfusion device was requested for 592 cases from January 1, 1993, to December 31, 1995. Nonorthopedic trauma cases comprised 25 per cent of all autotransfusion cases. One hundred twenty-six patients had isolated abdominal trauma and had a mean estimated blood loss of 4864 +/- 6070 cc. The average volume of intraoperatively salvaged autologous blood transfused (autotransfusion) per patient was 1547 +/- 2359 cc, or a bank blood equivalent of 6.9 units of packed red blood cells. The total cost of autotransfusion in these patients was $63,252.00. Had bank blood been used instead of salvaged autologous blood, the cost would have been $114,523.00; thus, autotransfusion resulted in a savings of $51,271.00. The use of salvaged autologous blood comprised 45 per cent of total blood transfused. On a case-by-case basis, 75 per cent of cases were cost-effective compared to blood bank costs for an equivalent transfusion. Transfusion of intraoperatively salvaged autologous blood (autotransfusion) is a cost-effective, efficient way to provide blood products to operative trauma patients. PMID:8985070

  17. Comparison of 64-Detector CT Colonography and Conventional Colonoscopy in the Detection of Colorectal Lesions

    PubMed Central

    Devir, Cigdem; Kebapci, Mahmut; Temel, Tuncer; Ozakyol, Aysegul

    2016-01-01

    Background: Colon cancer is a leading cause of morbidity and mortality in developed countries. The early detection of colorectal cancer using screening programs is important for managing early-stage colorectal cancers and polyps. Modalities that allow examination of the entire colon are conventional colonoscopy, double contrast barium enema examination and multi-detector computed tomography (MDCT) colonography. Objectives: To compare CT colonography and conventional colonoscopy results and to evaluate the accuracy of CT colonography for detecting colorectal lesions. Patients and Methods: In a prospective study performed at Gastroenterology and Radiology Departments of Medical Faculty of Eskisehir Osmangazi University, CT colonography and colonoscopy results of 31 patients with family history of colorectal carcinoma, personal or family history of colorectal polyps, lower gastrointestinal tract bleeding, change in bowel habits, iron deficiency anemia and abdominal pain were compared. Regardless of the size, CT colonography and conventional colonoscopy findings for all the lesions were cross - tabulated and the sensitivity, specificity, and positive and negative predictive values were calculated. To assess the agreement between CT colonography and conventional colonoscopy examinations, the Kappa coefficient of agreementt was used. Statistical analysis was performed by SPSS ver 15.0. Results: Regardless of the size, MDCT colonography showed 83% sensitivity and 95% specificity, with a positive predictive value of 95% and a negative predictive value of 83% for the detection of colorectal polyps and masses. MDCT colonography displayed 92% sensitivity and 95% specificity, with a positive predictive value of 92% and a negative predictive value of 95% for polyps ≥ 10 mm. For polyps between 6mm and 9 mm, MDCT colonography displayed 75% sensitivity and 100% specificity, with a positive predictive value of 100% and a negative predictive value of 90%. For polyps ≤ 5 mm MDCT

  18. Intra-abdominal hypertension in the ICU – a prospective epidemiological study

    PubMed Central

    ARABADZHIEV, GEORGI M.; TZANEVA, VALENTINA G.; PEEVA, KATYA G.

    2015-01-01

    The aim of this prospective study is to examine the frequency and the severity of intra-abdominal hypertension in a mixed ICU of the University hospital. Methods A closed system for intravesical intermittent measurement of IAP was constructed. Results The frequency and the severity of IAH were examined in the period from June 2009 to December 2012 in 240 ICU patients divided into 3 groups (patients submitted to elective surgery, emergency surgery, and medical patients) in the University Hospital. In the elective surgery group there was 12.5% IAH, while in the emergency group IAH was 43.75%, and in the medical patients it was 42.5%. There was no statistical significant difference in the frequency of IAH among the mixed population of patients we examined and those studied by other authors with the same type of population. Conclusions The standardized measurement of intra-abdominal pressure is fundamental for defining intra-abdominal hypertension and abdominal compartment syndrome. The measurement of intra-abdominal pressure should be a part of the basic monitoring of patients at risk of intra-abdominal hypertension. Our point of view is that before there are indications for a surgical decompression, less invasive treatment options should be optimized. PMID:26528070

  19. Locating the kidneys on CT to guide nephrotomography.

    PubMed

    Chen, M Y; Gelfand, D W; Spangler, K; Dyer, R B; Zagoria, R J; Ott, D J

    1997-01-01

    Tomography of the kidneys is a routine procedure performed during intravenous urography. Precisely locating the kidneys, however, can be difficult. This article describes a study performed to determine a simple and accurate measurement for kidney location as a guide to obtaining initial nephrotomographic sections. The authors measured the distance from the midplane of the kidney to the posterior skin line on abdominal CT images in 26 patients. This distance averaged one-third the thickness of the abdominal region. The best depth for the nephrotomographic cut was found to be one-third the thickness of the abdomen plus the thickness of any table pad. PMID:9085416

  20. Effect of Gender on the Total Abdominal Fat, Intra-Abdominal Adipose Tissue and Abdominal Sub-Cutaneous Adipose Tissue among Indian Hypertensive Patients

    PubMed Central

    Kumari, Savita; Jain, Sanjay

    2016-01-01

    Introduction Abdominal obesity is a better marker of adverse metabolic profile than generalized obesity in hypertensive subjects. Further, gender has effect on adiposity and its distribution. Aim Effect of gender on obesity and the distribution of fat in different sub-compartments of abdomen among Indian hypertensive subjects. Materials and Methods This observational study included 278 adult subjects (Males-149 & Females-129) with essential hypertension from a tertiary care centre in north India over one year. A detailed history taking and physical examination including anthropometry were performed in all patients. Total Abdominal Fat (TAF) and abdominal adipose tissue sub-compartments like Intra-Abdominal Adipose Tissue (IAAT) and Sub-Cutaneous Adipose Tissue (SCAT) were measured using the predictive equations developed for Asian Indians. Results Female hypertensive subjects had higher Body Mass Index (BMI) with more overweight (BMI ≥ 23kg/m2), and obesity (BMI≥ 25 kg/m2). Additionally, they had higher prevalence of central obesity based on both Waist Circumference (WC) criteria (WC≥ 90 cm in males and WC≥ 80 cm in females) and TAF criteria {≥245.6 cm2 (males) and ≥203.46 cm2 (females)} than male patients. But there was no difference in the prevalence of central obesity based on Waist Hip Ratio (WHR) criteria (WHR ≥0.90 in males and WHR ≥ 0.85 in females) between two genders. High TAF & IAAT were present in more females although there was no difference in the distribution of high SCAT between two genders. Conclusion Female hypertensive subjects were more obese with higher abnormal TAF & IAAT compared to male patients. However, there was no difference in the distribution of high SCAT among them. PMID:27190876

  1. X-Ray Dose Reduction in Abdominal Computed Tomography Using Advanced Iterative Reconstruction Algorithms

    PubMed Central

    Ning, Peigang; Zhu, Shaocheng; Shi, Dapeng; Guo, Ying; Sun, Minghua

    2014-01-01

    Objective This work aims to explore the effects of adaptive statistical iterative reconstruction (ASiR) and model-based iterative reconstruction (MBIR) algorithms in reducing computed tomography (CT) radiation dosages in abdominal imaging. Methods CT scans on a standard male phantom were performed at different tube currents. Images at the different tube currents were reconstructed with the filtered back-projection (FBP), 50% ASiR and MBIR algorithms and compared. The CT value, image noise and contrast-to-noise ratios (CNRs) of the reconstructed abdominal images were measured. Volumetric CT dose indexes (CTDIvol) were recorded. Results At different tube currents, 50% ASiR and MBIR significantly reduced image noise and increased the CNR when compared with FBP. The minimal tube current values required by FBP, 50% ASiR, and MBIR to achieve acceptable image quality using this phantom were 200, 140, and 80 mA, respectively. At the identical image quality, 50% ASiR and MBIR reduced the radiation dose by 35.9% and 59.9% respectively when compared with FBP. Conclusions Advanced iterative reconstruction techniques are able to reduce image noise and increase image CNRs. Compared with FBP, 50% ASiR and MBIR reduced radiation doses by 35.9% and 59.9%, respectively. PMID:24664174

  2. Delay in diagnosis and lessons learnt from a case of abdominal wall abscess caused by fishbone perforation

    PubMed Central

    Shanmugam, V; Badrinath, K; Dube, M; Panto, P

    2015-01-01

    Complications following foreign body (FB) ingestion are an uncommon clinical problem. A 59-year-old man presented with a 4-week history of left iliac fossa pain and 1 episode of dark red blood mixed with stools. Inflammatory markers were elevated, and computed tomography (CT) of the abdomen and pelvis showed an ill defined abdominal wall inflammatory collection in close contact with the small bowel loops. He was treated with antibiotics, and follow-up CT, colonoscopy and small bowel enema were mostly unremarkable. The patient presented again ten months later with left iliac fossa cellulitis and fever. Multiplanar CT (the patient’s fourth scan) demonstrated a 10cm abdominal wall collection with a linear hyperdense structure in the collection. The radiologists suspected a FB and on close scrutiny of the previous scans, they noted it to have been present on all of them. A targeted incision led to the removal of a 3cm fishbone from the collection. This case highlights the need to consider the possibility of a FB being the underlying cause in any unexplained intra-abdominal or abdominal wall inflammatory process so that the diagnosis is made in a timely manner. PMID:26263825

  3. Whole Abdominal Wall Segmentation using Augmented Active Shape Models (AASM) with Multi-Atlas Label Fusion and Level Set

    PubMed Central

    Xu, Zhoubing; Baucom, Rebeccah B.; Abramson, Richard G.; Poulose, Benjamin K.; Landman, Bennett A.

    2016-01-01

    The abdominal wall is an important structure differentiating subcutaneous and visceral compartments and intimately involved with maintaining abdominal structure. Segmentation of the whole abdominal wall on routinely acquired computed tomography (CT) scans remains challenging due to variations and complexities of the wall and surrounding tissues. In this study, we propose a slice-wise augmented active shape model (AASM) approach to robustly segment both the outer and inner surfaces of the abdominal wall. Multi-atlas label fusion (MALF) and level set (LS) techniques are integrated into the traditional ASM framework. The AASM approach globally optimizes the landmark updates in the presence of complicated underlying local anatomical contexts. The proposed approach was validated on 184 axial slices of 20 CT scans. The Hausdorff distance against the manual segmentation was significantly reduced using proposed approach compared to that using ASM, MALF, and LS individually. Our segmentation of the whole abdominal wall enables the subcutaneous and visceral fat measurement, with high correlation to the measurement derived from manual segmentation. This study presents the first generic algorithm that combines ASM, MALF, and LS, and demonstrates practical application for automatically capturing visceral and subcutaneous fat volumes. PMID:27127333

  4. Do Patients with Penetrating Abdominal Stab Wounds Require Laparotomy?

    PubMed Central

    Sanei, Behnam; Mahmoudieh, Mohsen; Talebzadeh, Hamid; Shahabi Shahmiri, Shahab; Aghaei, Zahra

    2013-01-01

    Background The optimal management of hemodynamically stable asymptomatic patients with anterior abdominal stab wounds (AASWs) remains controversial. The goal is to identify and treat injuries in a safe cost-effective manner. Common evaluation strategies are local wound exploration (LWE), diagnostic peritoneal lavage (DPL), serial clinical assessment (SCAs) and computed tomography (CT) imaging. Making a decision about the right time to operate on a patient with a penetrating abdominal stab wound, especially those who have visceral evisceration, is a continuing challenge. Objectives Until the year 2010, our strategy was emergency laparotomy in patients with penetrating anterior fascia and those with visceral evisceration. This survey was conducted towards evaluating the results of emergency laparotomy. So, better management can be done in patients with penetrating abdominal stab wounds. Patients and Methods This retrospective cross-sectional study was performed on patients with abdominal penetrating trauma who referred to Al- Zahra hospital in Isfahan, Iran from October 2000 to October 2010. It should be noted that patients with abdominal blunt trauma, patients under 14 years old, those with lateral abdomen penetrating trauma and patients who had unstable hemodynamic status were excluded from the study. Medical records of patients were reviewed and demographic and clinical data were collected for all patients including: age, sex, mechanism of trauma and the results of LWE and laparotomy. Data were analyzed with PASW v.20 software. All data were expressed as mean ± SD. The distribution of nominal variables was compared using the Chi-squared test. Also, diagnostic index for LWE were calculated. A two-sided P value less than 0.05 was considered to be statistically significant. Results During the 10 year period of the study, 1100 consecutive patients with stab wounds were admitted to Al-Zahra hospital Isfahan, Iran. In total, about 150 cases had penetrating traumas in

  5. Colorectal infarction following resection of abdominal aortic aneurysms.

    PubMed

    Launer, D P; Miscall, B G; Beil, A R

    1978-01-01

    Infarctions of the colon and rectum (incidences approximately 1 and 0.5 per cent, respectively) are caused by compromised collateral circulation to the colon and rectum, usually as a result of arteriosclerotic disease of the superior and inferior mesenteric arterial systems, as well as the hypogastric arteries. Patients who have colorectal ischemia after operations for abdominal aortic aneurysms have diarrhea (sometimes bloody), abdominal pain, and distention. The diagnosis may be established by sigmoidoscopic examination. Treatment includes surgical removal of the compromised bowel and creation of a temporary or permanent end colostomy. Prevention of this complication is aided by preservation of primary and collateral circulation, avoidance of hypotension, and preoperative bowel preparation. PMID:738176

  6. A Large Pleural Effusion following Abdominal Aortic Surgery

    PubMed Central

    Ramsaran, Vinoo K.; Seeram, Vandana K.; Cury, James; Shujaat, Adil

    2015-01-01

    Chylous ascites and coexistent chylothorax is a rare but important complication following retroperitoneal abdominal surgery. We report a 70-year-old male who developed gradual abdominal distension, chest tightness, and dyspnea five months after having an uncomplicated aortobifemoral bypass performed. Physical examination was consistent with a large right sided effusion and ascites which were confirmed by computed tomography. Thoracentesis yielded an opaque milky fluid with analysis consistent with a chylothorax with a paracentesis revealing fluid that was similar in both appearance and biochemistry. The patient failed initial conservative management so a chest tube was placed followed by chemical pleurodesis. We review the literature of the pathophysiology and treatment approach to such a pleural effusion. PMID:26635989

  7. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    SciTech Connect

    Nattenmüller, Johanna Filsinger, Matthias Bryant, Mark Stiller, Wolfram Radeleff, Boris Grenacher, Lars Kauczor, Hans-Ullrich Hosch, Waldemar

    2013-06-19

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.

  8. [Performance evaluation for CT-AEC(CT automatic exposure control)systems].

    PubMed

    Muramatsu, Yoshihisa; Ikeda, Shu; Osawa, Kazuaki; Sekine, Ryo; Niwa, Nobuyuki; Terada, Masami; Keat, Nicholas; Miyazaki, Shigeru

    2007-05-20

    Although many current CT scanners incorporate CT-AEC, performance evaluation is not standardized. This study evaluates the performance of the latest CT-AEC of each manufacturer with the aim of establishing a standard CT-AEC performance evaluation method. The design of the phantoms was based upon the operation characteristics of different CT-AECs. A cone, an ellipse, a variable-shaped ellipse, stepped phantoms, and their analysis software were devised and carried out the field test. The targets were LightSpeed VCT 64 with 2D and 3D Auto mA(GE), Aquilion 64M with Real-EC and Volume-EC(Toshiba), Sensation 64 with CARE Dose and CARE Dose 4D(Siemens), and Bulliance 16P with Dose Right(Philips). Data was acquired while varying the typical abdominal CT(with CT-AEC)scanning conditions (120 kV, 5 mm slice, standard function for abdomen, scanning range 200 mm). The acquired images were converted to the DICOM format and image noise(SD) was calculated using dedicated software. All 4 CT-AECs reduced exposure dose. For GE and Toshiba, image noise was constant and met the target. For Siemens, noise was independent of phantom shape but varied uniformly with phantom size. For Philips, noise varied with phantom size and shape, and variation degree depended on phantom thickness in scanogram direction. The results reflect the basic concept and performance characteristics of the methods. Standardization of CT-AEC performance evaluation is possible using these phantoms. PMID:17538218

  9. Surgical outcome of abdominal sacrocolpopexy with synthetic mesh versus abdominal sacrocolpopexy with cadaveric fascia lata.

    PubMed

    Gregory, W Thomas; Otto, Lesley N; Bergstrom, John O; Clark, Amanda L

    2005-01-01

    Nineteen women who had an abdominal sacrocolpopexy (ASC) with synthetic mesh and 18 women who had an ASC with freeze-dried, irradiated cadaveric fascia lata returned for blinded pelvic organ prolapse quantification (POPQ) examinations. The mean relative vaginal descent (delta) from perfect total vaginal length in the mesh group was 1.1 (0.3) cm, and the delta in the fascia group was 2.8 (0.8) cm (p=0.02, Mann-Whitney U). The proportion of women with "optimal" surgical outcome in the mesh group was 89% and 61% in the fascia group (p=0.06, Fischer's exact test). This study suggests that cadaveric fascia lata may not be a good choice for ASC. PMID:15645147

  10. Gastric interposition following transhiatal esophagectomy: CT evaluation

    SciTech Connect

    Gross, B.H.; Agha, F.P.; Glazer, G.M.; Orringer, M.B.

    1985-04-01

    Transhiatal esophagectomy without thoracotomy (THE) but with gastric interposition results in less morbidity and mortality than standard transpleural esophagectomy with thoracotomy. Barium examination has been the primary radiographic study following THE for detecting postoperative complications. The authors reviewed computed tomography (CT) scans of 21 patients who had undergone THE and correlated CT appearance with clinical status and with findings of the barium studies. Local mediastinal recurrent neoplasm was detected by CT in seven patients; barium study within 2 weeks of the CT scan failed to detect tumor recurrence in three of these patients. CT is the modality of choice for detecting locally recurrent neoplasm and distant metastases following THE and may also be helpful in patients with postoperative mediastinal abscess. Normal mediastinal CT anatomy after esophagectomy is reviewed in order to warn against pitfalls in scan interpretation.

  11. [The patient with intra-abdominal hypertension].

    PubMed

    Sakka, Samir G

    2016-01-01

    An intra-abdominal hypertension (IAH) defined as a pathological increase in intra-abdominal pressure (IAP) is commonly found on ICU admission or during the ICU stay. Several studies confirmed that an IAH is an independent predictor for mortality of critically ill patients. The abdominal compartment syndrome (ACS) which is defined as a sustained IAP>20 mmHg (with or without an abdominal perfusion pressure [APP]<60mmHg) that is associated with new organ dysfunction or failure has a mortality of up to 60%. In general, an IAH may be induced by several intra-abdominal as well as extra-abdominal conditions. Reduced abdominal wall compliance, intra-abdominal pathologies (either of the peritoneal space or parenchymateous organs) may lead to an IAH. Most commonly, intra-abdominal infections and/or sepsis and severe trauma or burns are predisposing for an IAH. An early sign may be a decrease in urinary output. The effects of an increased IAP on cardiovascular function are well recognized and include negative effects on preload, afterload and contractility. However, all other compartments of the body may be affected by an IAH. Thus, by an increase of the respective compartment pressure, e.g. intracranial pressure, a poly-compartment syndrome may result. Adequate prevention, a forward-looking strategy, and objective techniques for measurement of IAP are required to avoid or early detect an IAH or ACS. Finally, an immediate and consequent interdisciplinary management using conservative, interventional and operative options are necessary to solve an IAH or ACS. PMID:26863642

  12. Computed Tomography (CT) - Spine

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Spine Computed tomography (CT) of the spine is a diagnostic imaging ... Spine? What is CT Scanning of the Spine? Computed tomography, more commonly known as a CT or CAT ...

  13. Abdominal Pain in the Geriatric Patient.

    PubMed

    Leuthauser, Amy; McVane, Benjamin

    2016-05-01

    Abdominal pain in the elderly can be a challenging and difficult condition to diagnose and treat. The geriatric population has significant comorbidities and often takes polypharmacy that can mask symptoms. The presentation of common conditions can be different than that in the younger population, often lacking the traditional indicators of disease, making it of pivotal importance for the clinician to consider a wide differential during their workup. It is also important to consider extra-abdominal abnormality that may manifest as abdominal pain. PMID:27133249

  14. Chylous Ascites after Abdominal Aortic Aneurysm Repair

    PubMed Central

    Ohki, Shinichi; Kurumisawa, Soki

    2015-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  15. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    PubMed

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  16. [Diagnostic laparocentesis in closed abdominal injury].

    PubMed

    Berkutov, A N; Deriabin, I I; Zakurdaev, V E

    1976-09-01

    To improve the diagnosis of closed abdominal trauma since 1966 the authors have been widely employing laparocentesis. The results of using abdominal punctures an 260 patients are reported. The method proved to be reliable in 97.7%. The use of laparocentesis enabled the authors to reduce the number of errors by 7.3 times, to shorten the terms of establishing the diagnosis by 4 times as compared with the control group of patients (190 subjects in whom the recognition of abdominal injuries is based on common clinical symptoms). PMID:136785

  17. Diagnostic exercise: ascites, abdominal masses, and diffuse peritoneal nodules in a rat.

    PubMed

    Cooper, T K; Dumpala, P R; Whitcomb, T L

    2014-05-01

    A 1.4-year-old virgin female brown-hooded fancy rat presented for abdominal distention, jaundice, and dyspnea. At physical examination, a firm mass was palpable in the caudoventral abdomen as well as multiple small nodular masses associated with the abdominal viscera. At necropsy, in addition to a large mass replacing the left ovary and myriad nodules studding the peritoneal surface, there was 31 ml of abdominal effusion. By cytology, the abdominal fluid contained numerous pleomorphic vacuolated tumor cells surrounding globular pale eosinophilic to amphophilic acellular material that was strongly periodic acid-Schiff positive. Histologically, the tumor was biphasic with abundant acellular hyaline matrix that was also periodic acid-Schiff positive. PMID:23912713

  18. Ultrasound findings in critical care patients: the "liver sign" and other abnormal abdominal air patterns.

    PubMed

    Dahine, Joseph; Giard, Annie; Chagnon, David-Olivier; Denault, André

    2016-12-01

    In critical care patients, point of care abdominal ultrasound examination, although it has been practiced for over 30 years, is not as widespread as its cardiac or pulmonary counterparts. We report two cases in which detection of air during abdominal ultrasound allowed the early detection of life-threatening pathologies. In the first case, a patient with severe Clostridium difficile was found to have portal venous gas but its significance was confounded by a recent surgery. Serial ultrasonographic exams triggered a surgical intervention. In the second case, we report what we call the "liver sign" a finding in patients with pneumoperitoneum. These findings, all obtained prior to conventional abdominal imaging, had immediate clinical impact and avoided unnecessary delays and radiation. Detection of abdominal air should be part of the routine-focused ultrasonographic exam and for critically ill patients an algorithm is proposed. PMID:26968407

  19. Effects of lumbopelvic sling and abdominal drawing-in exercises on lung capacity in healthy adults

    PubMed Central

    Kim, Myoung-Kwon; Cha, Hyun-Gyu; Shin, Young-Jun

    2016-01-01

    [Purpose] To examine the effects of lumbopelvic sling and abdominal drawing-in exercises on the lung capacities of healthy subjects. [Subjects and Methods] Twenty-nine healthy subjects with no orthopedic history of the back were recruited. Subjects were randomly assigned to a experimental group and control group. Subjects were allocated to one of two groups; an experimental group that underwent lumbopelvic sling and abdominal drawing-in exercises and a control group that underwent treadmill and abdominal drawing-in exercises. Lung capacities were evaluated 4 weeks after exercises. [Results] The experimental group showed significant increments in EV, ERV, IRV, VT vs. pre-intervention results, and the control group showed significant increments in the EVC and IRV. Significant intergroup differences were observed in terms of post-training gains in EVC, IRV, and VT. [Conclusion] Combined application of lumbopelvic sling and abdominal drawing-in exercises were found to have a positive effect on lung capacity.

  20. Delayed presentation of a sigmoid colon injury following blunt abdominal trauma: a case report

    PubMed Central

    2012-01-01

    Introduction The low incidence of colon injury due to blunt abdominal trauma and the lack of a definitive diagnostic method for the same can lead to delays in diagnosis and treatment, subsequently resulting in high morbidity and mortality. Case presentation A 66-year-old woman with sigmoid colon injury was admitted to our emergency department after sustaining blunt abdominal trauma. Her physical examination findings and laboratory results led to a decision to perform a laparotomy; exploration revealed a sigmoid colon injury that was treated by sigmoid loop colostomy. Conclusions Surgical abdominal exploration revealed gross fecal contamination and a perforation site. Intra-abdominal irrigation and a sigmoid loop colostomy were performed. Our patient was discharged on post-operative day six without any problems. Closure of the sigmoid loop colostomy was performed three months after the initial surgery. PMID:22905731