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Sample records for abdominal ct findings

  1. Abdominal CT findings in small bowel perforation.

    PubMed

    Zissin, R; Osadchy, A; Gayer, G

    2009-02-01

    Small bowel perforation is an emergent medical condition for which the diagnosis is usually not made clinically but by CT, a common imaging modality used for the diagnosis of acute abdomen. Direct CT features that suggest perforation include extraluminal air and oral contrast, which are often associated with secondary CT signs of bowel pathology. This pictorial review illustrates the CT findings of small bowel perforation caused by various clinical entities.

  2. Multidetector CT Findings of Bowel Transection in Blunt Abdominal Trauma

    PubMed Central

    Cho, Hyun Suk; Hong, Hye-Suk; Park, Mee Hyun; Ha, Hong Il; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji-Young

    2013-01-01

    Objective Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. Materials and Methods We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. Results The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Conclusion Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity. PMID:23901318

  3. Inflammatory aneurysms of the abdominal aorta: CT findings.

    PubMed

    Arrivé, L; Corréas, J M; Lesèche, G; Ghebontni, L; Tubiana, J M

    1995-12-01

    Inflammatory aneurysm of the abdominal aorta (IAAA) is a variant of atherosclerotic aneurysm that is characterized by inflammatory and/or fibrotic changes in the periaortic regions of the retroperitoneum [1, 2]. These inflammatory and/or fibrotic changes are probably the result of a local autoallergic reaction to certain components of atherosclerotic plaques [2]. This distinct entity has important implications, as the periaortic fibrotic tissue adherent to ureters, the duodenum, and the inferior vena cava may complicate surgical repair [1, 2]. The purpose of this essay is to illustrate the CT appearance of IAAA, with emphasis on the identification of IAAA and differentiation from conventional aortic aneurysms, evaluation of the involvement of adjacent structures by the periaortic fibrosis, and evaluation of the retroperitoneum after aneurysmal repair to analyze the resolution or the persistence of the periaortic fibrosis.

  4. CT of abdominal tuberculosis

    SciTech Connect

    Epstein, B.M.; Mann, J.H.

    1982-11-01

    Intraabdominal tuberculosis (TB) presents with a wide variety of clinical and radiologic features. Besides the reported computed tomographic (CT) finding of high-density ascites in tuberculous peritonitis, this report describes additional CT features highly suggestive of abdominal tuberculosis in eight cases: (1) irregular soft-tissue densities in the omental area; (2) low-density masses surrounded by thick solid rims; (3) a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a poorly defined mass; (4) low-density lymph nodes with a multilocular appearance after intravenous contrast administration; and (5) possibly high-density ascites. The differential diagnosis of these features include lymphoma, various forms of peritonitis, peritoneal carcinomatosis, and peritoneal mesothelioma. It is important that the CT features of intraabdominal tuberculosis be recognized in order that laparotomy be avoided and less invasive procedures (e.g., laparoscopy, biopsy, or a trial of antituberculous therapy) be instituted.

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

    PubMed

    Chen, Jingjing; Wu, Zengjie; Sun, Binbin; Li, Dacheng; Wang, Zhenguang; Liu, Fangjun; Hua, Hui

    2016-05-01

    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.

  6. Abdominal CT scan

    MedlinePlus

    Computed tomography scan - abdomen; CT scan - abdomen; CT abdomen and pelvis ... 2016:chap 133. Radiologyinfo.org. Computed tomography (CT) - abdomen and pelvis. Updated June 16, 2016. www.radiologyinfo. ...

  7. Abdominal and Pelvic CT

    MedlinePlus Videos and Cool Tools

    ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  8. [Gallstone ileus. Abdominal CT usefulness].

    PubMed

    Sukkarieh, F; Brasseur, P; Bissen, L

    2004-06-01

    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  9. 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

  10. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. PMID:25410842

  11. Hypovolemic shock in children: abdominal CT manifestations.

    PubMed

    Taylor, G A; Fallat, M E; Eichelberger, M R

    1987-08-01

    The authors describe a "hypoperfusion complex," seen on abdominal computed tomography, which consists of marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidneys, and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava; and moderate to large peritoneal fluid collections. This complex was present in three patients less than 2 years of age and was associated with severe injury and a poor outcome. Recognition of this constellation of findings may help direct attention to the patient's serious hemodynamic abnormality as much as to individual organ defects.

  12. PET/CT detects abdominal wall and port site metastases of colorectal carcinoma.

    PubMed

    Goshen, E; Davidson, T; Aderka, D; Zwas, S T

    2006-07-01

    Abdominal wall metastases from colorectal cancer (CRC) may be resected with curative results. Such lesions, often indicators of additional intra-abdominal lesions, may appear in surgical scars, stomas and port site metastases after laparoscope-assisted surgery (LAS). Post-operative changes, primarily surgical scars, alter local physical findings making early detection of small lesions challenging. The purpose of this study was to retrospectively evaluate the contribution of PET/CT to the diagnosis of recurrent colorectal cancer in the post-operative abdominal wall. 120 patients were referred for PET/CT with suspected recurrent CRC based on clinical, radiological or laboratory findings. All underwent whole body PET/CT imaging. 12 of these 120 (10%), were found to have abdominal wall lesions. A total of 16 abdominal wall lesions were detected, located to surgical scars, stomas, drain and laparoscope ports. Additional findings on PET/CT in this group included liver metastases, intra-abdominal lesions and retroperitoneal lymph node involvement. In general, the patients in this small group were young with high grade tumours presenting in advanced stages. In conclusion, PET/CT appears to be a sensitive tool for the diagnosis of abdominal wall recurrence of CRC. The accuracy of localization afforded by the fused functional and anatomic images makes PET/CT a likely tool for diagnosing abdominal wall lesions, including port site metastases of other aetiologies.

  13. CT evaluation of complications of abdominal aortic surgery

    SciTech Connect

    Mark, A.; Moss, A.A.; Lusby, R.; Kaiser, J.A.

    1982-11-01

    The authors conducted a retrospective analysis of the CT findings in 29 consecutive patients being studied to detect complications of aortofemoral bypass surgery. Presenting symptoms included fever in 22 (76%), gastrointestinal bleeding in 2 (7%), a pulsating mass in 3 (10%), jaundice in 1 (3%), and back pain in 1 (3%). The complications observed most frequently were groin infection in 7 (24%), abdominal perigraft abscess in 11 (38%), pseudoaneurysm in 6 (21%), aorto-enteric fistula in 3 (10%), and lymphocystic hematoma in 3 (10%). There were no false negatives, and overall accuracy and sensitivity of CT in detecting complications was 100%. The authors recommend that CT be performed prior to angiography or surgery whenever an abscess, pseudoaneurysm, or aorto-enteric fistula is suspected.

  14. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  15. Acute small bowel ischemia: CT imaging findings.

    PubMed

    Segatto, Enrica; Mortelé, Koenraad J; Ji, Hoon; Wiesner, Walter; Ros, Pablo R

    2003-10-01

    Small bowel ischemia is a disorder related to a variety of conditions resulting in interruption or reduction of the blood supply of the small intestine. It may present with various clinical and radiologic manifestations, and ranges pathologically from localized transient ischemia to catastrophic necrosis of the intestinal tract. The primary causes of insufficient blood flow to the small intestine are various and include thromboembolism (50% of cases), nonocclusive causes, bowel obstruction, neoplasms, vasculitis, abdominal inflammatory conditions, trauma, chemotherapy, radiation, and corrosive injury. Computed tomography (CT) can demonstrate changes because of ischemic bowel accurately, may be helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. However, common CT findings in acute small bowel ischemia are not specific and, therefore, it is often a combination of clinical, laboratory and radiologic signs that may lead to a correct diagnosis. Understanding the pathogenesis of various conditions leading to mesenteric ischemia and being familiar with the spectrum of diagnostic CT signs may help the radiologist recognize ischemic small bowel disease and avoid delayed diagnosis. The aim of this article is to provide a review of the pathogenesis and various causes of acute small bowel ischemia and to demonstrate the contribution of CT in the diagnosis of this complex disease.

  16. Abdominal vascular syndromes: characteristic imaging findings.

    PubMed

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe

    2016-01-01

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic.

  17. Abdominal vascular syndromes: characteristic imaging findings*

    PubMed Central

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe

    2016-01-01

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. PMID:27777480

  18. Billowing of Endologix Powerlink Stent Graft in Post Endovascular Repair of Abdominal Aortic Aneurysm: Simultaneous Findings on CT and Ultrasound Imaging.

    PubMed

    Helo, Naseem; Chang, Arthur C; Hyun, Christine; Chon, Kenneth S; Yi, Alex C

    2016-08-01

    Endoleaks remain a main concern in endovascular aneurysm repair. A potential false positive in the diagnosis of endoleak surveillance includes "billowing," a phenomenon of the polytetrafluoroethylene plastic outer fabric of the stent graft is seen separated from the struts of the metallic endoskeleton. Contrast presents beyond the endoskeleton but is still contained within the graft. This is secondary to intermittent attachment of the graft to the endoskeleton, and is only found in the Endologix Powerlink. The finding of billowing has been previously reported and is a common knowledge by those who deploy the stent graft. We report a case where there is contemporaneous imaging on computed tomography angiography as well as on ultrasound.

  19. Perforation of the mesenteric small bowel: etiologies and CT findings.

    PubMed

    Hines, John; Rosenblat, Juliana; Duncan, Dameon R; Friedman, Barak; Katz, Douglas S

    2013-04-01

    The purpose of this article is to illustrate and discuss the various etiologies of perforation of the mesenteric small bowel and associated findings on abdominal CT. Perforation of the mesenteric small bowel is an uncommon cause of an acute abdomen and can be due to various etiologies. In underdeveloped countries, infection is probably the most common cause, while in industrialized nations, perforation may be due to Crohn disease, diverticulitis, foreign body, trauma, tumor, mechanical obstruction, primary ischemic event, or iatrogenic causes. CT is usually the initial imaging examination in patients with an acute abdomen and is sensitive in diagnosing small bowel perforation. CT findings in the setting of small bowel perforation are often subtle, but when present, may help the radiologist determine a specific cause of perforation. The aims of this pictorial essay are to review the various causes of mesenteric small bowel perforation and to discuss and illustrate the CT findings that can help arrive at the diagnosis.

  20. Adrenal cortex dysfunction: CT findings

    SciTech Connect

    Huebener, K.H.; Treugut, H.

    1984-01-01

    The computed tomographic appearance of the adrenal gland was studied in 302 patients with possible endocrinologic disease and 107 patients undergoing CT for nonendocrinologic reasons. Measurements of adrenal size were also made in 100 adults with no known adrenal pathology. CT proved to be a sensitive diagnostic tool in combination with clinical studies. When blood hormone levels are increased, CT can differentiate among homogeneous organic hyperplasia, nodular hyperplasia, benign adenoma, and malignant cortical adenoma. When blood hormone levels are decreased, CT can demonstrate hypoplasia or metastatic tumorous destruction. Calcifications can be demonstrated earlier than on plain radiographs. When hormone elimination is increased, the morphologic substrate can be identified; tumorous changes can be localized and infiltration of surrounding organs recognized.

  1. 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.

  2. Abdominal CT scanning in reproductive-age women with right lower quadrant abdominal pain: does its use reduce negative appendectomy rates and healthcare costs?

    PubMed

    Morse, Bryan C; Roettger, Richard H; Kalbaugh, Corey A; Blackhurst, Dawn W; Hines, William B

    2007-06-01

    Although acute appendicitis is the most frequent cause of the acute abdomen in the United States, its accurate diagnosis in reproductive-age women remains difficult. Problems in making the diagnosis are evidenced by negative appendectomy rates in this group of 20 per cent to 45 per cent. Abdominal CT scanning has been used in diagnosing acute appendicitis, but its reliability and usefulness remains controversial. There is concern that the use of CT scanning to make this diagnosis leads to increased and unwarranted healthcare charges and costs. The purpose of our study is to determine if abdominal CT scanning is an effective test in making the diagnosis of acute appendicitis in reproductive-age women (age, 16-49 years) with right lower quadrant abdominal pain and to determine if its use is cost-effective. From January 2003 to December 2006, 439 patients were identified from our academic surgical database and confirmed by chart review as undergoing an appendectomy with a pre- or postoperative diagnosis of acute appendicitis. Data, including age, presence and results of preoperative abdominal CT scans, operative findings, and pathology reports were reviewed. Comparison of patients receiving a preoperative CT scan with those who did not was performed using chi-squared analysis. In the subgroup of reproductive-age women, there was a significant difference in negative appendectomy rates of 17 per cent in the group that received abdominal CT scans versus 42 per cent in the group that did not (P < 0.038). After accounting for the patient and insurance company costs, abdominal CT scan savings averaged $1412 per patient. Abdominal CT scanning is a reliable, useful, and cost-effective test for evaluating right lower quadrant abdominal pain and making the diagnosis of acute appendicitis in reproductive-age women.

  3. 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

  4. Distribution of abdominal and pelvic Hodgkin disease: implications for CT scanning

    SciTech Connect

    Aisen, A.M.; Gross, B.H.; Glazer, G.M.; Amendola, M.A.

    1985-05-01

    Computed tomography of the abdomen and pelvis is frequently performed for the staging of abdominal and pelvic lymphoma. Certain limited CT protocols have been nearly as accurate as more complete examinations at defining the extent of lymphadenopathy and the response to therapy, with the advantages of decreased scanning time and patient radiation dose. The authors reviewed abdominal and pelvic CT scans and reports of 58 patients with Hodgkin disease to determine whether the entire abdomen and pelvis must always be scanned in such patients. Pelvic adenopathy without concurrent abdominal adenopathy was present in only one of 58 patients, and that patient presented clinically with inguinal adenopathy. These findings are supported by larger pathologic studies showing that Hodgkin disease always spreads contiguously. Patients with Hodgkin disease presenting above the diaphragm should undergo abdominal CT for staging; if the abdomen is normal, the pelvis need not be scanned. For Hodgkin patients with clinical or CT evidence of disease below the diaphragm, both abdomen and pelvis should be scanned.

  5. Cytomegalovirus pneumonia in transplant patients: CT findings

    SciTech Connect

    Eun-Young Kang; Patz, E.F. Jr.; Mueller, N.L.

    1996-03-01

    Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). Nine of 10 patients had parenchymal abnormalities apparent at CT and I had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation. 13 refs., 4 figs., 1 tab.

  6. Incidental discovery of radiopaque pills on abdominal CT in a patient with abdominal pain.

    PubMed

    Judge, Bryan S; Hoyle, John D

    2008-07-01

    We present a case in which a young female ingested several tablets of an over-the-counter cough and cold remedy over the course of a week. Pill fragments were identifiable and incidentally discovered when a CT scan of the abdomen was performed to evaluate the cause of her abdominal pain. Discovery of radiopaque pills on diagnostic imaging studies warrants further history and appropriate testing to rule out a life-threatening ingestion.

  7. Postmortem abdominal radiographic findings in feline cadavers.

    PubMed

    Heng, Hock Gan; Teoh, Wen Tian; Sheikh-Omar, Abdul Rahman

    2008-01-01

    Postmortem radiographic examinations of animals are commonly performed in judicial investigations to rule out gunshot and fractures. However, there was no available data on radiographic postmortem changes of animals. Forty-one sets of abdominal radiographs of feline cadavers made within 12 h of death were evaluated for postmortem changes. Intravascular gas was detected in 11 of 41 (27%) cadavers. The most common site of intravascular gas was the liver. Intravascular gas was also present in the aorta, femoral artery, celiac and cranial mesenteric arteries, and caudal superficial epigastric artery. Intrasplenic gas was detected in two cadavers. Only two cadavers had distended small intestine. One cadaver had pneumatosis coli. The changes detected were most likely due to putrefaction.

  8. PET/CT imaging of abdominal aorta with intramural hematomas, penetrating ulcer, and saccular pseudoaneurysm.

    PubMed

    Nguyen, Vien X; Nguyen, Ba D

    2014-05-01

    Acute aortic syndromes, encompassing intramural hematoma, penetrating ulcer, and pseudoaneurysm, are best demonstrated by angiographic CT and magnetic resonance imaging. These imaging modalities provide an accurate evaluation and allow timely therapies of these frequently symptomatic lesions, thus reducing their morbidity and mortality. The inflammatory pathogenesis of these acute aortic syndromes may exhibit positive PET findings predictive of prognosis and outcomes of these vascular events. The authors present a case of PET/CT imaging showing asymptomatic intramural hematomas with penetrating ulcer and saccular pseudoaneurysm of the proximal abdominal aorta.

  9. Stercoral colitis: diagnostic value of CT findings

    PubMed Central

    Ünal, Emre; Onur, Mehmet Ruhi; Balcı, Sinan; Görmez, Ayşegül; Akpınar, Erhan; Böge, Medine

    2017-01-01

    PURPOSE We aimed to evaluate the CT findings of stercoral colitis (SC). METHODS Forty-one patients diagnosed with SC between February 2006 and April 2015 were retrospectively reviewed. RESULTS Rectosigmoid colon was the most frequently involved segment (100%, n=41). CT findings can be summarized as follows: dilatation >6 cm and wall thickening >3 mm of the affected colon segment (100%, n=41), pericolonic fat stranding (100%, n=41), mucosal discontinuity (14.6 %, n=6), presence of free air (14.6%, n=6), free fluid (9.7%, n=4), and pericolonic abscess (2.4%, n=1). The sign most related with mortality was the length of the affected colon segment >40 cm. CONCLUSION CT has an important role in SC, since life-threatening complications can be easily revealed by this imaging modality. Increased length of involved colon segment (>40 cm) is more likely to be associated with mortality. PMID:27910814

  10. 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.

  11. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma

    PubMed Central

    Li, Jing; Geng, Zhi-Jun; Xie, Chuan-Miao; Zhang, Xin-Ke; Chen, Rui-Ying; Cai, Pei-Qiang; Lv, Xiao-Fei

    2016-01-01

    Abstract Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with “rapid wash-in and slow wash-out” or “progressive enhancement” enhancement patterns in the solid component are seen. PMID:26735543

  12. Intracerebral pneumatoceles following facial trauma: CT findings

    SciTech Connect

    Mendelsohn, D.B.; Hertzanu, Y.

    1985-01-01

    Three patients with delayed frontal intracerebral pneumatoceles following facial injury are presented. In one patient an unusual appearance of bilateral and symmetrical frontal lobe pneumatoceles was demonstrated. While diagnosis is not difficult on routine radiographs, CT is valuable for determining effects on the brain and clearly delineating the fracture site; CT shows the location of the pneumatocele and may show an associated air-fluid level, mass effect or surrounding edema, or rim enhancement following administration of contrast material. The radiological appearances in conjunction with the clinical findings are highly characteristic and should not be mistaken for gas-forming cerebral abscesses.

  13. Mesentery neurilemmoma: CT, MRI and angiographic findings.

    PubMed

    Lao, Wilson T; Yang, Shih-Hung; Chen, Chi-Long; Chan, Wing P

    2011-01-01

    Mesenteric neurilemmoma is extremely rare. We present a case of a 45-year-old man with mesenteric neurilemmoma, with CT, MRI and angiographic findings. The patient was healthy and had had no symptoms previously. CT and MRI images revealed a 2.2-cm well-defined, soft-tissue mass adjacent to the posterior border of the left lobe of the liver. The tumor mass displayed a heterogenous low signal on T2-weighted image and peripheral enhancement after gadolinium administration. Angiography showed a hypervascular mass beneath the tail of pancreas, which was supplied by small branches of middle splenic artery. Histopathology revealed a mesentery neurilemmoma composed of spindle tumor cells.

  14. 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.

  15. CT Findings in Temporal Bone Osteoradionecrosis

    PubMed Central

    Ahmed, Salmaan; Gupta, Nakul; Hamilton, Jackson D.; Garden, Adam S.; Gidley, Paul W.; Ginsberg, Lawrence E.

    2014-01-01

    Purpose The goal of this study is to describe CT findings in patients with clinically proven temporal bone osteoradionecrosis (TB-ORN). Methods and materials CT scans of twenty patients were retrospectively evaluated for bony and soft tissue abnormalities. Clinical severity was graded based on level of therapy administered: mild (observation), moderate (antibiotics/hyperbaric oxygen), or severe (surgery). Results Radiation dose to the primary tumor ranged from 30 to 75.6 Gy. Time to onset of ORN from completion of radiation therapy was 2 to 22 years (median=7yrs). Clinical findings: Exposed bone=20/20, otorrhea=17/20, hearing loss=11/20, otalgia=10/20, facial nerve paralysis=2/20, gait imbalance=2/20. CT findings: EAC erosions=18/20, mastoid effusion=18/20, mastoid bony coalescence=5/20, enhancing soft tissue=6/20, soft tissue gas=6/20, temporomandibular joint/condylar erosion=3/20. 3 patients developed an abscess. Conclusion Mastoid effusion and EAC erosions are commonly seen with TB-ORN. Clinically moderate or severe cases of TB-ORN are more likely to demonstrate enhancing soft tissue (p=0.002), soft tissue gas (p=0.002), and temporomandibular joint involvement (p=0.07). PMID:24834883

  16. FDG PET/CT findings of common bile duct tuberculosis.

    PubMed

    Dong, Aisheng; Wang, Yang; Gong, Jing; Zuo, Changjing

    2014-01-01

    Common bile duct (CBD) tuberculosis is rare. A 39-year-old woman was referred because of a 5-month history of abdominal pain. Abdominal enhanced MRI and CT showed dilatation of the distal CBD with irregularly thickened wall. Enhanced CT revealed enlarged retroperitoneal lymph nodes. FDG PET/CT showed increased FDG uptake of the CBD lesion and several retroperitoneal lymph nodes with slight FDG uptake. CBD cholangiocarcinoma with retroperitoneal lymph node metastasis was suspected. CBD tuberculosis was confirmed by endoluminal biopsy. Tuberculosis should be considered in the differential diagnosis of abnormal biliary FDG accumulation, particularly in tuberculosis endemic areas.

  17. 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.

  18. Endovascular repair of inflammatory abdominal aortic aneurysm: serial changes of periaortic fibrosis demonstrated by CT.

    PubMed

    Sueyoshi, Eijun; Sakamoto, Ichiro; Uetani, Masataka

    2009-07-01

    Inflammatory abdominal aortic aneurysm (IAAA) is characterized by inflammatory and/or fibrotic changes in the periaortic regions of the retroperitoneum. Surgical repair is usually selected for this disease. However, the perioperative mortality associated with open surgical repair of IAAs is three times higher than that with noninflammatory aortic aneurysms due to inflammation and periaortic fibrosis (PAF). Endovascular aneurysm repair of IAAs excludes the aneurysm and seems to reduce the size of the aneurysmal sac and the extent of PAF with acceptable peri-interventional and long-term morbidity. We describe the successful endovascular repair of an IAAA and the serial CT findings after repair.

  19. CT findings of small cell lung carcinoma

    PubMed Central

    Lee, Dongjun; Rho, Ji Young; Kang, Seunghun; Yoo, Koun Joy; Choi, Hye Jeong

    2016-01-01

    Abstract The purpose of this study was to clarify the recognizable computed tomography (CT) features of small cell lung carcinoma (SCLC). Contrast enhanced CT scans were reviewed retrospectively for mass location, mediastinal extension, and other concomitant findings in 142 patients with pathologically proven SCLC. SCLC was classified into hilar mass only (type I), hilar mass with ipsilateral mediastinal extension (type II), hilar mass with bilateral mediastinal extension (type III), and peripheral mass (type IV). When mediastinal lymphadenopathy (m-LAP) was indistinguishable from a hilar mass, we defined it as a mediastinal conglomerate mass (m-CM). Type IIa or IIIa had ipsilateral or bilateral m-LAP and type IIb, IIIb or IIIc had ipsilateral or bilateral m-CM. Type I (n = 8, 5.6%), type II (n = 58, 40.8%), type III (n = 55, 38.8%), and type IV (n = 21, 14.8%) were manifested. The combination of a hilar mass and m-CM was found in 68 patients (47.9%). Type IV masses showed lobulation in 11, microlobulation in 4, both lobulated and irregular margins in 4, and spiculation in 2. A total of 120 patients (84.5%) had a bronchial stenosis/obstruction; single (n = 52) and 2 or more (n = 68). Ninety-five patients (67.0%) had vascular invasion including main/lobar pulmonary artery and superior vena cava, and 55 (38.7%) had pleural effusion and/or pleural nodules. Concomitant parenchymal findings (n = 92, 64.8%) were noted: contiguous consolidation/nodule (n = 45), hematogeneous spread (n = 32), lymphangitic spread (n = 21), obstructive pneumonia (n = 22), and obstructive atelectasis (n = 14). In conclusion, the recognizable CT features of SCLC were a hilar mass with m-CM. Most of the hilar masses showed 2 or more bronchial stenoses/obstructions. Most cases of peripheral SCLC manifested as a lobulated mass rather than a spiculated mass. Vascular invasion and concomitant parenchymal findings were observed commonly. PMID:27893684

  20. Computed Tomography (CT) Findings of a Diagnostic Dilemma: Atypically Located Acute Appendicitis

    PubMed Central

    Evrimler, Sehnaz; Okumuser, Irfan; Unal, Nermin

    2016-01-01

    Summary Background Acute appendicitis is an emergent surgically treated disease generally represented by right lower abdominal pain. The most common location of the appendix is descending intraperitoneal. However, it can also show atypical locations such as inguinal canal, femoral canal, subhepatic, retrocecal, intraperitoneal abdominal midline and left side in situs inversus or intestinal malrotation patients. Atypical location can lead to atypical clinical presentations. Ultrasonography is the first choice modality for imaging. However, it can be insufficient for demonstration of the appendix. Therefore, computed tomography (CT) is needed for further examination. We aim to review the CT findings of atypically located acute appendicitis with cases and remind the clinicians and radiologists the importance of the prompt diagnosis. Case Report We presented five atypically-located appendix cases, including four with acute appendicitis that presented to our emergency department with acute abdominal pain. Two of the acute appendicitis cases had normal, the other two had elevated white blood cell count, but all of them had elevated CRP. Ultrasonography imaging was performed as a first-line imaging modality. Because of the inconclusive results of both clinical-laboratory findings and ultrasonography, CT imaging was performed. Abdominal CT demonstrated all of the atypically localised appendices successfully, which were left-sided in a malrotated patient, retrocecal, subhepatic, retrocecal ascending, intraperitoneal abdominal midline localised. Conclusıons Atypically located acute appendicitis can show atypical presentation and result in misdiagnosis. If ultrasonograpgy is inconclusive, we suggest abdominal CT in such confusing, complicated cases, because misdiagnosis or delay in the right diagnosis can result in complications and increased morbidity and mortality rates. PMID:28058072

  1. [The chest CT findings and pathologic findings of pulmonary tuberculosis].

    PubMed

    Ogata, Hideo

    2009-08-01

    The past research of the radiologic manifestations of pulmonary tuberculosis in Japan was based on morphological pathology of the untreated patient autopsy. I would like to show the chest CT scan of tuberculosis diseases with caseous granuloma at its exudative reaction, proliferative reaction, productive reaction, cirrhotic reaction until self cure. This progress reflects the normal cell mediated immunological responses. Also I would like to show the cavitation of granuloma, which results from liquefaction of caseous materials during the course and results in the formation of the source of infection. And finally I would like to show the morphological differences of acinous lesion, acino-nodular lesion and caseous lobular pneumonia. These differences reflect the amount of bacilli disseminated in the peripheral parts under the lobules. In this study, I do not show old age cases and HIV positive cases, who do not form typical granuloma due to the decreased cell mediated immnunity and whose X ray findings are atypical.

  2. Comparing the diagnostic performance of MRI versus CT in the evaluation of acute nontraumatic abdominal pain during pregnancy.

    PubMed

    Baron, Keren Tuvia; Arleo, Elizabeth Kagan; Robinson, Christopher; Sanelli, Pina C

    2012-12-01

    The objectives of this study were to document the utilization of MRI compared with CT in pregnant patients presenting with acute nontraumatic abdominal pain at our institution and to compare the diagnostic performance of the two modalities. A retrospective review identified all pregnant patients at our institution who had MRI or CT exams of the abdomen and/or pelvis for acute nontraumatic abdominal pain over a 3-year period from January 2008 through December 2010. The imaging diagnoses were compared with pathologic data or operative findings as the primary reference standard or with clinical follow-up and laboratory data as the secondary reference standard. Patients without surgically proven diagnoses were followed clinically until delivery, when possible. Ninety-four pregnant patients were included in this study: 61 MRI exams were performed in 57 patients, 44 CT exams were performed in 43 patients (including six patients who had both), and 72 patients (77 %) had ultrasound prior to cross-sectional imaging, with the appendix specifically assessed in 25 patients but visualized in only two of them. Of 61 MRI exams, 24 were considered positive for imaging diagnoses, 33 were negative, and 4 were equivocal. Of 44 CT exams, 24 were positive and 20 were negative. The test characteristics for MRI and CT in the diagnosis of acute abdominal pain were as follows: sensitivity 91 and 88 %, specificity 85 and 90 %, positive predictive value 81 and 91 %, negative predictive value 94 and 8 5 %, and diagnostic accuracy 88 and 88 %, respectively. Differences were not statistically significant (p value = 1). The majority of MRIs (34/61 = 56 %) were read by emergency radiologists. MRI and CT performed equally well in the evaluation of acute nontraumatic abdominal pain during pregnancy. Given its lack of ionizing radiation, MRI may be preferable. Given that the majority of MRIs were read by radiologists specializing in emergency imaging, this is a technique that emergency

  3. Papillary carcinoma of the pancreas: findings of US and CT

    SciTech Connect

    Kim, S.Y.; Lim, J.H.; Lee, J.D.

    1985-02-01

    Two cases of papillary carcinoma of the pancreas were evaluated by ultrasound and CT. The sonographic and CT findings were those of a well-defined oval mass with partial cystic change. There was radiologic-pathologic correlation.

  4. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    PubMed

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period.

  5. CT of benign cystic abdominal masses in children

    SciTech Connect

    Haney, P.J.; Whitley, N.O.

    1984-06-01

    Computed tomography (CT) correctly portrayed the gross anatomic features of six mesenteric, omental, and ovarian cysts and diagnosed two pancreatic pseudocysts in children. Large, well defined, low-density masses were found, often containing septa and filling most of the abdomen and pelvis. CT displayed the size and extent of the mass and showed extrinsic compression of displacement of surrounding structures. Different pathologic entities may have similar CT appearances, particularly with very large cystic masses.

  6. Construction of Abdominal Probabilistic Atlases and Their Value in Segmentation of Normal Organs in Abdominal CT Scans

    NASA Astrophysics Data System (ADS)

    Park, Hyunjin; Hero, Alfred; Bland, Peyton; Kessler, Marc; Seo, Jongbum; Meyer, Charles

    A good abdominal probabilistic atlas can provide important information to guide segmentation and registration applications in the abdomen. Here we build and test probabilistic atlases using 24 abdominal CT scans with available expert manual segmentations. Atlases are built by picking a target and mapping other training scans onto that target and then summing the results into one probabilistic atlas. We improve our previous abdominal atlas by 1) choosing a least biased target as determined by a statistical tool, i.e. multidimensional scaling operating on bending energy, 2) using a better set of control points to model the deformation, and 3) using higher information content CT scans with visible internal liver structures. One atlas is built in the least biased target space and two atlases are built in other target spaces for performance comparisons. The value of an atlas is assessed based on the resulting segmentations; whichever atlas yields the best segmentation performance is considered the better atlas. We consider two segmentation methods of abdominal volumes after registration with the probabilistic atlas: 1) simple segmentation by atlas thresholding and 2) application of a Bayesian maximum a posteriori method. Using jackknifing we measure the atlas-augmented segmentation performance with respect to manual expert segmentation and show that the atlas built in the least biased target space yields better segmentation performance than atlases built in other target spaces.

  7. Percutaneous transhepatic drainage of inaccessible abdominal abscesses following abdominal surgery under real-time CT-fluoroscopic guidance.

    PubMed

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

    2010-02-01

    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.

  8. Pulmonary talcosis: CT findings in three cases.

    PubMed

    Padley, S P; Adler, B D; Staples, C A; Miller, R R; Müller, N L

    1993-01-01

    The authors describe the computed tomographic (CT) appearances in three patients with pulmonary talcosis resulting from chronic intravenous drug abuse. There was widespread ground-glass attenuation in one case and an appearance similar to that of progressive massive fibrosis in two cases. In the latter cases, there were confluent perihilar masses with areas of high attenuation. While the CT appearances may be suggestive of pulmonary talcosis, tissue sampling is required for definitive diagnosis.

  9. Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain.

    PubMed

    Pereira, Jose M; Sirlin, Claude B; Pinto, Pedro S; Jeffrey, R Brooke; Stella, Damien L; Casola, Giovanna

    2004-01-01

    Fat stranding adjacent to thickened bowel wall seen at computed tomography (CT) in patients with acute abdominal pain suggests an acute process of the gastrointestinal tract, but the differential diagnosis is wide. The authors observed "disproportionate" fat stranding (ie, stranding more severe than expected for the degree of bowel wall thickening present) and explored how this finding suggests a narrower differential diagnosis, one that is centered in the mesentery: diverticulitis, epiploic appendagitis, omental infarction, and appendicitis. The characteristic CT findings (in addition to fat stranding) of each of these entities often lead to a final diagnosis. Diverticulitis manifests with mild, smooth bowel wall thickening and no lymphadenopathy. Epiploic appendagitis manifests with central areas of high attenuation and a hyperattenuated rim, in addition to its characteristic location adjacent to the colon. In contrast, omental infarction is always centered in the omentum. The most specific finding of appendicitis is a dilated, fluid-filled appendix. Correct noninvasive diagnosis is important because treatment approaches for these conditions range from monitoring to surgery.

  10. Traumatic hypovolemic shock revisited: the spectrum of contrast-enhanced abdominal computed tomography findings and clinical implications for its management.

    PubMed

    Higashi, Hiroki; Kanki, Akihiko; Watanabe, Shigeru; Yamamoto, Akira; Noda, Yasufumi; Yasokawa, Kazuya; Higaki, Atsushi; Tamada, Tsutomu; Ito, Katsuyoshi

    2014-10-01

    Hypovolemic shock is often seen in patients with severe blunt trauma who have suffered from blood circulation inadequate to maintain oxygen delivery to multiple organs. The early recognition and prompt management of hypovolemic shock in patients with multiple injuries are mandatory to improving prognosis and patient conditions. The diagnostic accuracy of computed tomography (CT) as a primary diagnostic tool is well established. The abdominal organs show several common and classic appearances on contrast-enhanced CT in patients with trauma. The hypovolemic shock complex is reported in the previous literature as decreased enhancement of the viscera, increased mucosal enhancement and luminal dilation of the small bowel, mural thickening and fluid-filled loops of the small bowel, the halo sign and flattening of the inferior vena cava, reduced aortic diameter, and peripancreatic edema. However, there have been controversial CT reports with contradictory appearances. Physicians understanding these findings could prompt alternative approaches to the early assessment and management of hypovolemic shock. The aim of this article is to illustrate common and well-known abdominal CT features in patients with traumatic hypovolemic shock, to discuss controversial CT signs in the pancreas and adrenal gland, and to describe CT findings' clinical implications when managing hypovolemic shock.

  11. [Development of CT manifestations and anatomic studies on thoracic-abdominal junctional zone].

    PubMed

    Ye, Yilan; Deng, Wen; Yang, Zhigang

    2010-12-01

    Thoracic-abdominal junctional zone is an area from the inferior chest to superior belly. The inferior chest contains inferior pulmonary lobes, pulmonary ligament, inferior mediastinum and lower thoracic cavity,while the superior belly contains upper abdominal cavity, spatium retroperitonaeale, abdominal aorta, inferior vena cava, liver, stomach, adrenal glands, kidneys and spleen. This article is to review the CT manifestations and anatomy of diseases such as infection, trauma, hemorrhage, hernia and tumor involving this area. It could provides anatomic and pathological information for instituting clinical treatments.

  12. Pulmonary embolism findings on chest radiographs and multislice spiral CT.

    PubMed

    Coche, Emmanuel; Verschuren, Franck; Hainaut, Philippe; Goncette, Louis

    2004-07-01

    Multislice spiral CT is becoming an increasingly important tool for diagnosing pulmonary embolism. However, in many instances, a chest radiograph is usually performed as a first-line examination. Many parenchymal, vascular, and other ancillary findings may be observed on both imaging modalities with a highly detailed depiction of abnormalities on multislice CT. A comprehensive review of chest radiograph findings is presented with side-by-side correlations of CT images reformatted mainly in the frontal plane.

  13. Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema.

    PubMed

    Moore, Christopher; Meyers, Arthur B; Capotasto, Juliana; Bokhari, Jamal

    2009-03-01

    Many women with ovarian torsion present with nonspecific abdominal/pelvic pain and initially receive computed tomography (CT). We hypothesize that the CT scans preformed on these women will all show abnormalities of the involved ovary. Our purpose is to review cases of surgically proven ovarian torsion at our institution over the last 20 years, assessing CT findings in women with ovarian torsion. A retrospective review of all patients at our institution with surgically proven ovarian torsion from 1985-2005 was conducted. Two physicians reviewed available CT reports, and a radiologist reviewed all available images. CT was obtained in 33% of the 167 patients. Dictated reports were available for 28 studies; all described an enlarged ovary, ovarian cyst, or adnexal mass of the involved ovary. Radiologist review of the available CT images confirmed these findings. This series supports the claim that a CT scan with well-visualized normal appearing ovaries rules out ovarian torsion, while abnormal pelvic findings or failure to visualize the ovaries in women with pelvic pain necessitates further evaluation of torsion.

  14. Automatic vessel extraction and abdominal aortic stent planning in multislice CT

    NASA Astrophysics Data System (ADS)

    Subramanyan, Krishna; Smith, Dava; Varma, Jay; Chandra, Shalabh

    2002-05-01

    The abdominal aorta is the most common site for an aneurysm, which may lead to hemorrhage and death, to develop. The aim of this study was to develop a semi-automated method to de-lineate the vessels and detect the center-line of these vessels to make measurements necessary for stent design from multi-detector computed tomograms. We developed a robust method of tracking the aortic vessel tree with branches from a user selected seed point along the vessel path using scale space approaches, central transformation measures, vessel direction findings, iterative corrections and a priori information in determining the vessel branches. Fifteen patients were scanned with contrast on Mx8000 CT scanner (Philips Medical Systems), with a 3.2 mm thickness, 1.5 mm slice spacing, and a stack of 512x512x320 volume data sets were reconstructed. The algorithm required an initial user input to locate the vessel seen in axial CT slice. Next, the automated image processing took approximately two minutes to compute the centerline and borders of the aortic vessel tree. The results between the manually and automatically generated vessel diameters were compared and statistics were computed. We observed our algorithm was consistent (less than 0.01 S.D) and similar (less than 0.1 S.D) to manual results.

  15. 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.

  16. Colitis detection on abdominal CT scans by rich feature hierarchies

    NASA Astrophysics Data System (ADS)

    Liu, Jiamin; Lay, Nathan; Wei, Zhuoshi; Lu, Le; Kim, Lauren; Turkbey, Evrim; Summers, Ronald M.

    2016-03-01

    Colitis is inflammation of the colon due to neutropenia, inflammatory bowel disease (such as Crohn disease), infection and immune compromise. Colitis is often associated with thickening of the colon wall. The wall of a colon afflicted with colitis is much thicker than normal. For example, the mean wall thickness in Crohn disease is 11-13 mm compared to the wall of the normal colon that should measure less than 3 mm. Colitis can be debilitating or life threatening, and early detection is essential to initiate proper treatment. In this work, we apply high-capacity convolutional neural networks (CNNs) to bottom-up region proposals to detect potential colitis on CT scans. Our method first generates around 3000 category-independent region proposals for each slice of the input CT scan using selective search. Then, a fixed-length feature vector is extracted from each region proposal using a CNN. Finally, each region proposal is classified and assigned a confidence score with linear SVMs. We applied the detection method to 260 images from 26 CT scans of patients with colitis for evaluation. The detection system can achieve 0.85 sensitivity at 1 false positive per image.

  17. Foreign objects encountered in the abdominal cavity at CT.

    PubMed

    Gayer, Gabriela; Petrovitch, Ivan; Jeffrey, R Brooke

    2011-01-01

    Foreign objects are not infrequently seen at computed tomography (CT) of the abdomen and pelvis and may pose a diagnostic challenge to the radiologist, who must recognize the object, characterize its nature and location, and determine its clinical significance. Most foreign objects are incidentally detected at CT, but they may mimic a wide range of pathologic conditions. Some foreign objects (eg, an object that has been swallowed either intentionally or unintentionally) are the cause of the patient's signs and symptoms and require prompt medical attention. Other objects, such as a sponge or surgical instrument that has been retained postoperatively, may have medicolegal consequences. Furthermore, certain objects, such as intentionally concealed drug packets, may go undetected unless a high degree of suspicion exists and appropriate window settings are used to review the study. The radiologist should be familiar with the wide range of foreign objects that may be encountered at abdominopelvic CT, be able to recognize them promptly, and understand their implications for patient treatment.

  18. [Radiographic diagnosis of abdominal diseases in foals and ponys. II. Pathologic findings in 60 cases].

    PubMed

    Gerhards, H; Klein, H J; Offeney, F

    1990-08-01

    A diagnostic approach based on clinical and radiographic examinations for evaluation of young foals and small ponies with acute abdominal discomfort is presented. Standing right to left lateral abdominal radiographs were taken of 54 foals and 6 ponies using a previously described technique. Interpretation of the radiographs was in conjunction with all clinical and laboratory findings and patient management. Using this approach, the site and cause of acute abdominal discomfort could be diagnosed accurately in 55 of 60 (91%) patients as confirmed by clinical, surgical or necropsy findings. Typical radiographs and photographs taken at surgery or at necropsy are presented. Typical radiographic findings, their interpretation and possible underlying gastrointestinal diseases are listed. The incorporation of standing lateral abdominal radiography in the clinical evaluation of foals and ponies with acute abdominal diseases gives findings of high diagnostic significance and should contribute to clinical decision-making. Abdominal radiography can replace data from rectal palpation in foals and ponies.

  19. Unusual Finding in the Inguinal Canal: Abdominal Tuberculosis Presenting as Inguinal Hernia

    PubMed Central

    Dhandore, Priya; Hombalkar, Narendra Narayan

    2016-01-01

    Abnormal findings in the inguinal canal during Herniotomy are not very rare for a paediatric surgeon. These abnormal findings may range from opposite gender sex organ (e.g. uterus and fallopian tube during orchidopexy) to unexpected malignancy (e.g. Rhabdomyosarcoma) to the abnormal embryological development (Splenogonadal fusion). Though abdominal tuberculosis is common, abdominal tuberculosis presenting as an inguinal hernia is exceedingly uncommon. We report an unusual case of abdominal tuberculosis presenting as inguinal hernia. PMID:27190886

  20. [CT findings of the temporal bones in Waardenburg's syndrome].

    PubMed

    Irie, K; Ogata, H; Mitsudome, A

    1990-05-01

    We reported three cases of Waardenburg's syndrome and discussed CT findings of the temporal bones. Two cases of these patients were mother and daughter. Case 1, a two-year-old girl, had lateral displacement of the medial canthi, a broad nasal root, hetero-chromic iridis, left ptosis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules, short lateral semicircular canal, and absent right posterior semicircular canal. The mother had congenital deafness, heterochromia iridis, and a white forelock and showed similar abnormal CT findings of the temporal bones. Case 2, a one-year-old boy, had lateral displacement of the medial canthi, a broad nasal root, partial heterochromia iridis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules and absence of semicircular canals except the right lateral semicircular canal. These cases were diagnosed as Waardenburg's syndrome on the basis of the characteristic features.

  1. Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

    PubMed Central

    Tonolini, Massimo

    2016-01-01

    Inguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since radiologists are increasingly requested to investigate suspected iatrogenic complications, this paper aims to provide an increased familiarity with early CT studies after IHR, including complications and normal postoperative appearances such as focal pseudolesions, in order to avoid misinterpretation and inappropriate management. PMID:27460285

  2. CT findings in ulcerative, granulomatous, and indeterminate colitis.

    PubMed

    Gore, R M; Marn, C S; Kirby, D F; Vogelzang, R L; Neiman, H L

    1984-08-01

    Eight patients with ulcerative colitis, three with colitis indeterminate, and 15 patients with Crohn disease were studied by computed tomography (CT) to establish CT criteria for each disorder in hopes of providing a new diagnostic perspective useful in the radiographic evaluation of inflammatory colitis. The CT findings in ulcerative colitis included thickening of the colon wall (mean, 7.8 mm), which was characterized by inhomogeneous attenuation and a "target" appearance of the rectum, and proliferation of perirectal fat. Bowel wall thickening (mean, 13 mm) with homogeneous attenuation, fistula and abscess formation, and mesenteric abnormalities were observed in patients with Crohn colitis. Patients with colitis indeterminate showed colonic changes on CT observed in both disorders. Initial experience suggests that CT can differentiate patients with well established ulcerative and Crohn colitis.

  3. CT findings in ulcerative, granulomatous, and indeterminate colitis

    SciTech Connect

    Gore, R.M.; Marn, C.S.; Kirby, D.F.; Vogelzang, R.L.; Neiman, H.L.

    1984-08-01

    Eight patients with ulcerative colitis, three with colitis indeterminate, and 15 patients with Crohn disease were studied by computed tomography (CT) to establish CT criteria for each disorder in hopes of providing a new diagnostic perspective useful in the radiographic evaluation of inflammatory colitis. The CT findings in ulcerative colitis included thickening of the colon wall, which was characterized by inhomogeneous attenuation and a target appearance of the rectum, and proliferation of perirectal fat. Bowel wall thickening with homogeneous attenuation, fistula and abscess formation, and mesenteric abnormalities were observed in patients with Crohn colitis. Patients with colitis indeterminate showed colonic changes on CT observed in both disorders. Initial experience suggests that CT can differentiate patients with well established ulcerative and Crohn colitis.

  4. 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).

  5. 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.

  6. Askin tumor: CT and FDG-PET/CT imaging findings and follow-up.

    PubMed

    Xia, Tingting; Guan, Yubao; Chen, Yongxin; Li, Jingxu

    2014-07-01

    The aim of the study was to describe the imaging findings of Askin tumors on computed tomography (CT) and fluorine 18 fluorodeoxyglucose-positron emission tomography (FDG-PET/CT).Seventeen cases of Askin tumors confirmed by histopathology were retrospectively analyzed in terms of CT (17 cases) and FDG-PET/CT data (6 cases).Fifteen of the tumors were located in the chest wall and the other 2 were in the anterior middle mediastinum. Of the 15 chest wall cases, 13 demonstrated irregular, heterogeneous soft tissue masses with cystic degeneration and necrosis, and 2 demonstrated homogeneous soft tissue masses on unenhanced CT scans. Two mediastinal tumors demonstrated the irregular, heterogeneous soft tissue masses. Calcifications were found in 2 tumors. The tumors demonstrated heterogeneously enhancement in 16 cases and homogeneous enhancement in 1 case on contrast-enhanced scans. FDG-PET/CT images revealed increased metabolic activity in all 6 cases undergone FDG-PET/CT scan, and the lesion SUVmax ranged from 4.0 to 18.6. At initial diagnosis, CT and FDG-PET/CT scans revealed rib destruction in 9 cases, pleural effusion in 9 cases, and lung metastasis in 1 case. At follow-up, 12 cases showed recurrence and/or metastases, 4 cases showed improvement or remained stable, and 1 was lost to follow-up.In summary, CT and FDG-PET/CT images of Askin tumors showed heterogeneous soft tissue masses in the chest wall and the mediastinum, accompanied by rib destruction, pleural effusion, and increased FDG uptake. CT and FDG-PET/CT imaging play important roles in the diagnosis and follow-up of patients with Askin tumors.

  7. PET/CT imaging in lung cancer: indications and findings*

    PubMed Central

    Hochhegger, Bruno; Alves, Giordano Rafael Tronco; Irion, Klaus Loureiro; Fritscher, Carlos Cezar; Fritscher, Leandro Genehr; Concatto, Natália Henz; Marchiori, Edson

    2015-01-01

    The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer. PMID:26176525

  8. Cardiac calcified amorphous tumors: CT and MRI findings

    PubMed Central

    Yılmaz, Ravza; Demir, Ali Aslan; Önür, İmran; Yılbazbayhan, Dilek; Dursun, Memduh

    2016-01-01

    PURPOSE We aimed to evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings of cardiac calcified amorphous tumors (CATs). METHODS CT and MRI findings of cardiac CATs in 12 patients were included. We retrospectively examined patient demographics, location, size, shape configuration, imaging features, calcification distribution of tumors, and accompanying medical problems. RESULTS There was a female predominance (75%), with a mean age at presentation of 65 years. Patients were mostly asymptomatic on presentation (58.3%). The left ventricle of the heart was mostly involved (91%). CT findings of CATs were classified as partial calcification with a hypodense mass in four patients or a diffuse calcified form in eight. Calcification was predominant with large foci appearance as in partially calcified masses. On T1- and T2-weighted magnetic resonance images, CATs appeared hypointense and showed no contrast enhancement. CONCLUSION The shape and configuration of cardiac CATs are variable with a narrow spectrum of CT and MRI findings, but large foci in a partially calcified mass or diffuse calcification of a mass on CT is very important in the diagnosis of cardiac CATs. Masses show a low signal intensity on T1- and T2-weighted images with no contrast enhancement on MRI. PMID:27705878

  9. Pelvic hydatid disease: CT and MRI findings causing sciatica.

    PubMed

    Sanal, Hatice Tuba; Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun

    2007-01-01

    Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2). We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings.

  10. Metastasectomy of Abdominal Wall Lesions due to Prostate Cancer Detected Through PET/CT Gallium 68-PMSA: First Case Report.

    PubMed

    Ochoa, Claudia; Ramirez, Angie; Varela, Rodolfo; Godoy, Fabian; Vargas, Rafael; Forero, Jorge; Rojas, Andres; Roa, Carmen; Céspedes, Carlos; Ramos, Jose; Cabrera, Marino; Calderon, Andres

    2017-05-01

    Introducing the topic of abdominal wall metastasis secondary to prostate cancer with a reminder of the disease's rarity, being the first published case. This article is about a 66 year old patient diagnosed with prostate cancer [cT2aNxMx iPSA: 5,6 ng/ml Gleason 3+3, (Grade 1 Group)], treated with radical prostatectomy as well as accompanied with amplified pelvic lymphadenectomy, who subsequently presented metastatic lesions to the abdominal wall diagnosed with PET/CT Gallium 68-PMSA technique and treated with abdominal metastasectomy with adequate short term results.

  11. 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

  12. Low-dose multiphase abdominal CT reconstruction with phase-induced swap prior

    NASA Astrophysics Data System (ADS)

    Selim, Mona; Rashed, Essam A.; Kudo, Hiroyuki

    2016-10-01

    Multiphase abdominal CT is an imaging protocol in which the patient is scanned at different phases before and after the injection of a contrast agent. Reconstructed images with different concentrations of contrast material provide useful information for effective detection of abnormalities. However, several scanning during a short period of time eventually increase the patient radiation dose to a remarkable value up to a risky level. Reducing the patient dose by modulating the x-ray tube current or acquiring the projection data through a small number of views are known to degrade the image quality and reduce the possibility to be useful for diagnosis purpose. In this work, we propose a novel multiphase abdominal CT imaging protocol with patient dose reduction and high image quality. The image reconstruction cost function consists of two terms, namely the data fidelity term and penalty term to enforce the anatomical similarity in successive contrast phase reconstruction. The prior information, named phase-induced swap prior (PISP) is computed using total variation minimization of image acquired from different contrast phases. The new method is evaluated through a simulation study using digital abdominal phantom and real data and results are promising.

  13. Adapted morphing model for 3D volume reconstruction applied to abdominal CT images

    NASA Astrophysics Data System (ADS)

    Fadeev, Aleksey; Eltonsy, Nevine; Tourassi, Georgia; Martin, Robert; Elmaghraby, Adel

    2005-04-01

    The purpose of this study was to develop a 3D volume reconstruction model for volume rendering and apply this model to abdominal CT data. The model development includes two steps: (1) interpolation of given data for a complete 3D model, and (2) visualization. First, CT slices are interpolated using a special morphing algorithm. The main idea of this algorithm is to take a region from one CT slice and locate its most probable correspondence in the adjacent CT slice. The algorithm determines the transformation function of the region in between two adjacent CT slices and interpolates the data accordingly. The most probable correspondence of a region is obtained using correlation analysis between the given region and regions of the adjacent CT slice. By applying this technique recursively, taking progressively smaller subregions within a region, a high quality and accuracy interpolation is obtained. The main advantages of this morphing algorithm are 1) its applicability not only to parallel planes like CT slices but also to general configurations of planes in 3D space, and 2) its fully automated nature as it does not require control points to be specified by a user compared to most morphing techniques. Subsequently, to visualize data, a specialized volume rendering card (TeraRecon VolumePro 1000) was used. To represent data in 3D space, special software was developed to convert interpolated CT slices to 3D objects compatible with the VolumePro card. Visual comparison between the proposed model and linear interpolation clearly demonstrates the superiority of the proposed model.

  14. 3D segmentation of abdominal aorta from CT-scan and MR images.

    PubMed

    Duquette, Anthony Adam; Jodoin, Pierre-Marc; Bouchot, Olivier; Lalande, Alain

    2012-06-01

    We designed a generic method for segmenting the aneurismal sac of an abdominal aortic aneurysm (AAA) both from multi-slice MR and CT-scan examinations. It is a semi-automatic method requiring little human intervention and based on graph cut theory to segment the lumen interface and the aortic wall of AAAs. Our segmentation method works independently on MRI and CT-scan volumes and has been tested on a 44 patient dataset and 10 synthetic images. Segmentation and maximum diameter estimation were compared to manual tracing from 4 experts. An inter-observer study was performed in order to measure the variability range of a human observer. Based on three metrics (the maximum aortic diameter, the volume overlap and the Hausdorff distance) the variability of the results obtained by our method is shown to be similar to that of a human operator, both for the lumen interface and the aortic wall. As will be shown, the average distance obtained with our method is less than one standard deviation away from each expert, both for healthy subjects and for patients with AAA. Our semi-automatic method provides reliable contours of the abdominal aorta from CT-scan or MRI, allowing rapid and reproducible evaluations of AAA.

  15. Statistical 4D graphs for multi-organ abdominal segmentation from multiphase CT.

    PubMed

    Linguraru, Marius George; Pura, John A; Pamulapati, Vivek; Summers, Ronald M

    2012-05-01

    The interpretation of medical images benefits from anatomical and physiological priors to optimize computer-aided diagnosis applications. Diagnosis also relies on the comprehensive analysis of multiple organs and quantitative measures of soft tissue. An automated method optimized for medical image data is presented for the simultaneous segmentation of four abdominal organs from 4D CT data using graph cuts. Contrast-enhanced CT scans were obtained at two phases: non-contrast and portal venous. Intra-patient data were spatially normalized by non-linear registration. Then 4D convolution using population training information of contrast-enhanced liver, spleen and kidneys was applied to multiphase data to initialize the 4D graph and adapt to patient-specific data. CT enhancement information and constraints on shape, from Parzen windows, and location, from a probabilistic atlas, were input into a new formulation of a 4D graph. Comparative results demonstrate the effects of appearance, enhancement, shape and location on organ segmentation. All four abdominal organs were segmented robustly and accurately with volume overlaps over 93.6% and average surface distances below 1.1mm.

  16. X-linked stapes gusher: CT findings in one patient.

    PubMed

    Kumar, Gaurav; Castillo, Mauricio; Buchman, Craig A

    2003-01-01

    A 31-year-old male patient presented with progressive mixed hearing loss since birth. A stapedectomy was attempted and was unsuccessful because of perilymph gushing. CT of the temporal bones showed bulbous dilatation of the fundi of the internal auditory canals and absence of the bone plates separating them from the base of the cochleas. This unusual abnormality was found after the attempted stapedectomy and explains the clinical findings. The findings in male patients are fairly typical X-linked congenital deafness.

  17. Basic study for automatic recognition of osteoporosis using abdominal x-ray CT images

    NASA Astrophysics Data System (ADS)

    Nishihara, Sadamitsu; Fujita, Hiroshi; Iida, Tadayuki; Takigawa, Atsushi; Hara, Takeshi; Zhou, Xiangrong

    2004-05-01

    We have developed an algorithm that can be used to distinguish the central part of the vertebral body from an abdominal X-ray CT image and to automatically calculate three measures to diagnose the degree of osteoporosis in a patient. In addition, we examined whether it is possible to use these CT images as an aid in diagnosing osteoporosis. Three measures that were automatically extracted from the central part of a vertebral body in the CT images were compared with the bone mineral density (BMD) values that were obtained from the same vertebral body. We calculated the mean CT number, coefficient of variation, and the first moment of power spectrum in the recognized vertebral body. We judged whether a patient had osteoporosis using the diagnostic criteria for primary osteoporosis (Year 2000 revision, published by the Japanese Society for Bone and Mineral Research). We classified three measures for normal and abnormal groups using the principal component analysis, and the two groups were compared with the results obtained from the diagnostic criteria. As a result, it was found that the algorithm could be used to distinguish the central part of the vertebral body in the CT images and to calculate these measures automatically. When distinguishing whether a patient was osteoporotic or not with the three measures obtained from the CT images, the ratio (sensitivity) usable for diagnosing a patient as osteoporotic was 0.93 (14/15), and the ratio (specificity) usable for diagnosing a patient as normal was 0.64 (7/11). Based on these results, we believe that it is possible to utilize the measures obtained from these CT images to aid in diagnosing osteoporosis.

  18. CT of lumbar spine disk herniation: correlation with surgical findings

    SciTech Connect

    Firooznia, H.; Benjamin, V.; Kricheff, I.I.; Rafii, M.; Golimbu, C.

    1984-03-01

    Computed tomography (CT) of the lumbar spine was performed with selectively positioned 5-mm-thick axial cross sections to examine each disk level from the top of the neural foramen to the pedicle of the next caudad vertebra. One hundred consecutive patients with 116 surgical disk explorations were reviewed. There was agreement between the CT and surgical findings in 89 patients (104 explorations) in determination of presence or absence of a herniated nucleus pulposus (HNP). Discrepancy occurred in 12 instances (11 patients): two because of incorrect interpretations, five in previously operated patients, three in spondylolisthesis, and two in spinal stenosis. There were 97 true-positives, eight false-negatives, seven true-negatives, and four false-positives. If nine previously operated patients are excluded from the study, then CT was accurate in detection of presence or absence of an HNP in 93% of the disk explorations.

  19. Posttraumatic shock in children: CT findings associated with hemodynamic instability.

    PubMed

    Sivit, C J; Taylor, G A; Bulas, D I; Kushner, D C; Potter, B M; Eichelberger, M R

    1992-03-01

    Twenty-seven of 1,018 children evaluated with contrast material-enhanced computed tomography (CT) after blunt trauma demonstrated a characteristic hypoperfusion complex. This complex was usually seen in young children (median age, 2 years). CT findings in all 27 patients included a dilated, fluid-filled bowel and abnormally intense enhancement of the bowel wall, mesentery, kidneys, aorta, and inferior vena cava. Twenty-four percent of all children with a Trauma Score of 10 or less and 20% with a Glasgow Coma Score of 6 or less had the hypoperfusion complex. All 27 patients had a normal blood pressure immediately before CT, but five (19%) became hypotensive within 10 minutes of intravenous contrast material administration. Twenty-three children (85%) died. Of 16 children who survived 24 hours, four (25%) developed renal insufficiency. The intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability. Recognition that the constellation of CT findings is due to hypovolemic shock and not to injured viscera helps avoid unnecessary laparotomy.

  20. 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.

  1. Utility of the CT Scan in Diagnosing Midgut Volvulus in Patients with Chronic Abdominal Pain

    PubMed Central

    Morshedi, Mehdi; Baradaran Jamili, Mohammad; Shafizadeh Barmi, Fatemeh

    2017-01-01

    Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient. The preoperative CT findings were pathognomonic. PMID:28182093

  2. 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.

  3. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma: A Report of 5 Cases.

    PubMed

    Li, Jing; Geng, Zhi-Jun; Xie, Chuan-Miao; Zhang, Xin-Ke; Chen, Rui-Ying; Cai, Pei-Qiang; Lv, Xiao-Fei

    2016-01-01

    Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with "rapid wash-in and slow wash-out" or "progressive enhancement" enhancement patterns in the solid component are seen.

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

    PubMed

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

    2015-03-20

    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.

  5. Efficient multi-atlas abdominal segmentation on clinically acquired CT with SIMPLE context learning.

    PubMed

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

    2015-08-01

    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.

  6. 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.

  7. Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings

    PubMed Central

    Yang, B T; Chong, V F H; Wang, Z C; Xian, J F; Chen, Q H

    2010-01-01

    Ectopic pituitary adenomas (EPAs) are rare lesions. The purpose of this study was to describe the CT and MRI features of sphenoid sinus EPAs. Eight patients with histology-proven EPAs in the sphenoid sinus, all of whom underwent CT and MRI, were reviewed retrospectively. The following imaging features were analysed: (i) size, (ii) margin, (iii) CT attenuation characteristics and (iv) MRI signal intensity. In addition, the involvement of adjacent structures and the time–intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI were analysed. All EPAs had well-defined margins and showed no relationship to the intrasellar pituitary gland. The mean size was 28 mm (range, 20–46 mm). On non-enhanced CT, the lesions appeared isodense to grey matter in 7 (88%) patients and hypodense in 1 (12%) patient. Only two patients underwent post-contrast CT, and they showed moderate enhancement. On T1 weighted images, EPAs appeared isointense in 6 (75%) patients and hypointense in 2 (25%). On T2 weighted images, the lesions appeared hyperintense in 2 (25%) patients and isointense in 6 (75%). EPAs showed mild to moderate heterogeneous contrast enhancement and exhibited a cribriform-like appearance. Two patients underwent DCE MRI; the TIC showed a rapidly enhancing and slow washout pattern. The following features were also seen: an empty sella, bone changes and involvement of the cavernous sinus (5 patients; 62.5%). In conclusion, a high index of suspicion for EPA and a familiarity with the imaging findings may help to diagnose this rare entity accurately. PMID:19651706

  8. Renal infarction: CT diagnosis and correlation between CT findings and etiologies

    SciTech Connect

    Wong, W.S.; Moss, A.A.; Federle, M.P.; Cochran, S.T.; London, S.S.

    1984-01-01

    The CT scans and the clinical records of 12 patients who had renal infarction were reviewed. The renal infarcts were classified as either focal or global. The CT findings were correlated with the etiologies of renal infarction. Embolism was the most common cause of renal infarcts that were multifocal with involvement of both kidneys. Trauma caused a unilateral global type of infract. A case of sickle cell anemia presented with multiple ''slit-like'' focal infarcts and enlarged kidneys. Forty-seven per cent of infarcts demonstrated the cortical rim sign, 11% were acapsular fluid collection, and 6% had an abnormally thickened renal fascia.

  9. Texture-learning-based system for three-dimensional segmentation of renal parenchyma in abdominal CT images

    NASA Astrophysics Data System (ADS)

    Peng, Cong-Qi; Chang, Yuan-Hsiang; Wang, Li-Jen; Wong, Yon-Choeng; Chiang, Yang-Jen; Jiang, Yan-Yau

    2009-02-01

    Abdominal CT images are commonly used for the diagnosis of kidney diseases. With the advances of CT technology, processing of CT images has become a challenging task mainly because of the large number of CT images being studied. This paper presents a texture-learning based system for the three-dimensional (3D) segmentation of renal parenchyma in abdominal CT images. The system is designed to automatically delineate renal parenchyma and is based on the texturelearning and the region-homogeneity-based approaches. The first approach is achieved with the texture analysis using the gray-level co-occurrence matrix (GLCM) features and an artificial neural network (ANN) to determine if a pixel in the CT image is likely to fall within the renal parenchyma. The second approach incorporates a two-dimensional (2D) region growing to segment renal parenchyma in single CT image slice and a 3D region growing to propagate the segmentation results to neighboring CT image slices. The criterion for the region growing is a test of region-homogeneity which is defined by examining the ANN outputs. In system evaluation, 10 abdominal CT image sets were used. Automatic segmentation results were compared with manually segmentation results using the Dice similarity coefficient. Among the 10 CT image sets, our system has achieved an average Dice similarity coefficient of 0.87 that clearly shows a high correlation between the two segmentation results. Ultimately, our system could be incorporated in applications for the delineation of renal parenchyma or as a preprocessing in a CAD system of kidney diseases.

  10. Liver Segmentation Based on Snakes Model and Improved GrowCut Algorithm in Abdominal CT Image

    PubMed Central

    He, Baochun; Ma, Zhiyuan; Zong, Mao; Zhou, Xiangrong; Fujita, Hiroshi

    2013-01-01

    A novel method based on Snakes Model and GrowCut algorithm is proposed to segment liver region in abdominal CT images. First, according to the traditional GrowCut method, a pretreatment process using K-means algorithm is conducted to reduce the running time. Then, the segmentation result of our improved GrowCut approach is used as an initial contour for the future precise segmentation based on Snakes model. At last, several experiments are carried out to demonstrate the performance of our proposed approach and some comparisons are conducted between the traditional GrowCut algorithm. Experimental results show that the improved approach not only has a better robustness and precision but also is more efficient than the traditional GrowCut method. PMID:24066017

  11. Comparison of CT and dual-energy DEXA using a modified trunk compartment in the measurement of abdominal fat.

    PubMed

    Lane, James T; Mack-Shipman, Lynn R; Anderson, Joseph C; Moore, Timothy E; Erickson, Judi M; Ford, Timothy C; Stoner, Julie A; Larsen, Jennifer L

    2005-08-01

    The quantification of abdominal fat is a marker of health risk. While dual-energy x-ray absorptiometry (DEXA) is easily applied, it measures overall fat, although abdominal fat may be a better indicator of health risk from obesity. We have evaluated whether a subcomponent of DEXA measurements correlates better with computed tomography (CT) for body fat than those traditionally used. Forty-seven healthy adults (22 M/25 F), aged 54.5+/-15.8 yr (mean+/-SD), with BMI of 27.1+/-4.6 kg/m2 participated in a cross-sectional study. Body fat was measured using abdominal CT and DEXA for total fat, trunk fat, and a modified trunk measurement that excludes the chest, termed "lower trunk," and compared. The coefficient of variation for DEXA measurements for trunk, lower trunk, and total body were 1.98, 3.12, and 0.85%, respectively. Mean DEXA for percentage fat ranged from 31.7% to 34.1% for trunk, lower trunk, and total body, compared to 54.2% for abdominal CT (p<0.003 for each pairwise comparison). Lower trunk, whole trunk, and total body DEXA measurements were not different. Measurement of subcomponents of fat content by DEXA is not superior to whole body measurements and remains consistently lower than measurements by CT.

  12. Efficacy of Computed Tomography (CT) Attenuation Values and CT Findings in the Differentiation of Pleural Effusion

    PubMed Central

    Yalçin-Şafak, Kadihan; Umarusman-Tanju, Neslihan; Ayyıldız, Muhammet; Yücel, Nihal; Baysal, Tamer

    2017-01-01

    Summary Background The aim of this study was to investigate the efficacy of computed tomography (CT) findings for characterizing pleural effusions with the use of attenuation values. Material/Methods One hundred and twenty eight patients with pleural effusions on thoracic CT who underwent thoracentesisis within two weeks were studied. Pleural effusions were classified as exudates or transudates according to the Light’s criteria. A region of interest was placed for the measurement of Hounsfield Unit (HU) values in the area of the greatest amount of effusion on each slice of the three slices used. CT features that were evaluated for distinguishing pleural exudates from transudates included pleural nodules, pleural thickening and loculation. Results Thirty three (26%) of the 128 pleural effusions were transudates and 95 (74%) were exudates. The mean HU values of the exudates (8.82±7.04) were significantly higher than those of the transudates (2.91±8.53), (p<0.001). No statistically significant difference was found between transudate and exudate patients in terms of pleural thickness, pleural nodules and loculation (p>0.05). Conclusions HU values can help in differentiating exudative pleural effusions from transudative pleural effusions. Because of overlapping HU values, correlation with clinical findings is essential. PMID:28289482

  13. MR imaging of the pelvis: a guide to incidental musculoskeletal findings for abdominal radiologists.

    PubMed

    Gaetke-Udager, Kara; Girish, Gandikota; Kaza, Ravi K; Jacobson, Jon; Fessell, David; Morag, Yoav; Jamadar, David

    2014-08-01

    Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy. Though not all-encompassing, this essay will help abdominal radiologists to identify and describe this variety of pelvic musculoskeletal conditions, understand key radiologic findings, and synthesize a differential diagnosis when appropriate.

  14. 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.

  15. Adynamic ileus after caesarean section mimicking intestinal obstruction: findings on abdominal radiographs.

    PubMed

    Kammen, B F; Levine, M S; Rubesin, S E; Laufer, I

    2000-09-01

    The purpose of this study was to determine the spectrum of findings and the frequency of apparent distal colonic obstruction on abdominal radiographs in women with obstructive symptoms following Caesarean section. A search of radiology files yielded 21 patients who had abdominal radiographs because of obstructive symptoms during the early post-operative period. The radiographs were reviewed retrospectively to characterize the bowel gas patterns in these patients. Medical records were also reviewed to determine the treatment and patient course. Abdominal radiographs showed findings suggestive of distal colonic obstruction in 15 patients (71%), small bowel obstruction in 2 (10%), adynamic ileus in 3 (14%) and a normal bowel gas pattern in 1 (5%). In all 15 patients with apparent distal colonic obstruction, there was minimal or no gas in the rectosigmoid, with an associated pelvic mass representing the enlarged post-partum uterus, which compressed the rectosigmoid and prevented it from filling with gas. All 21 patients had rapid clinical or radiographic improvement on conservative management, indicating a transient post-operative ileus. Radiologists should be aware of the limitations of abdominal plain radiographs following Caesarean section so that a post-operative ileus is not mistaken for a distal colonic obstruction and conservative measures can be undertaken to decompress the bowel until the ileus resolves.

  16. 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.

  17. [Evaluation of Intra-abdominal fat distribution using X-ray CT data for detection of rectal cancer].

    PubMed

    Ogura, Toshihiro; Takatsu, Kazuaki; Negishi, Ryoichi; Koizumi, Kouichi; Satou, Masanori; Yanai, Kazuya; Sasaki, Isamu; Fukuda, Kazuya; Nagashima, Hiroyuki; Kouno, Atsushi; Shimomura, Younosuke

    2005-06-20

    To develop a novel method of detecting rectal cancer, we assessed relationships between intra-abdominal fat distribution and rectal cancer in Japanese patients. Subjects comprised 38 patients with rectal cancer apparent on CT-colonography and 110 other cases. The intra-abdominal fat area was determined by calculating pixel distribution with attenuation values from -140 HU to -40 HU. The area of intra-abdominal fat was measured on axial images using an interslice gap of 10 mm. Profile curves of intra-abdominal fat were in the plane direction from diaphragm to anus. Of note is the fact that Ogura's peak, a secondary small peak around the rectal cancer, was apparent on the profile of intra-abdominal fat, with 73.7% of rectal cancers displaying Ogura's peak. In comparison, only 19.1% of other cases displayed Ogura's peak on this profile. The relationship between fat and rectal cancer is difficult to explain. However, making good use of these results showing intra-abdominal fat distribution, a computer-aided diagnosis (CAD) system for detecting rectal cancer according to the presence of Ogura's peak has potential as a method of mass screening. As only 148 cases were investigated in the present study, the accumulation of additional data is needed. More detailed studies with larger patient populations are warranted.

  18. Wassel's Type V Polydactyly with Plain Radiographic and CT Findings

    PubMed Central

    Mete, Berna Dirim; Altay, Canan; Gursoy, Merve; Oyar, Orhan

    2015-01-01

    Duplication of the thumb is the most common polydactyly of the hand. Wassel's classification is frequently used to classify the polydactyly of the hand. His classification was based on the level of duplication and the number of bones in the thumb, and has seven groups (Types I–VII) according to the level of the bifurcation, except for his Type VII. The most common type is the bifurcation at the metacarpophalangeal joint (Type IV). In this paper, we report a very rare case of Type V thumb polydactyly in a 42-year-old man, who presented with swan neck deformity of the radial thumb and discuss the plain radiography and computed tomography (CT) findings. Kumar recently reported plain radiography findings in a case of bifid first metacarpal in a 13-year-old girl, who presented with swan neck deformity of the left thumb. To our knowledge, our case is the second presented case that has a swan neck deformity with bifid metacarpal. PMID:25861550

  19. 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.

  20. Automatically Pairing Measured Findings across Narrative Abdomen CT Reports

    PubMed Central

    Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

    2013-01-01

    Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements. PMID:24551406

  1. Abdominal x-ray and pathological findings in distal unishunt obstruction.

    PubMed

    Le Roux, P; Berger, M; Benjamin, D

    1988-12-01

    A new x-ray finding suggesting distal obstruction of the Unishunt is described. Fusiform swelling of the distal slit valve ("pantaloon sign") seen on an abdominal x-ray film was associated with surgically proven distal shunt obstruction in 8 of 10 patients. No patient with a normally functioning (n = 67) or proximally malfunctioning shunt (n = 6) displayed this abnormality. This finding in association with clinical and computed tomographic evidence of shunt malfunction can direct surgical revision to the appropriate site. The pathology of distal shunt malfunction is also reviewed.

  2. A novel multiinstance learning approach for liver cancer recognition on abdominal CT images based on CPSO-SVM and IO.

    PubMed

    Jiang, Huiyan; Zheng, Ruiping; Yi, Dehui; Zhao, Di

    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.

  3. 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

  4. CT and MRI of aortic coarctation: pre- and postsurgical findings.

    PubMed

    Karaosmanoglu, Ali Devrim; Khawaja, Ranish Deedar Ali; Onur, Mehmet Ruhi; Kalra, Mannudeep K

    2015-03-01

    OBJECTIVE. The purpose of this article is to summarize the roles of CT and MRI in the diagnosis and follow-up of patients with aortic coarctation. CONCLUSION. Aortic coarctation is a common congenital heart disease accounting for approximately 6-8% of congenital heart defects. Despite its deceptively simple anatomic presentation, it is a complex medical problem with several associated anatomic and physiologic abnormalities. CT and MRI may provide very accurate information of the coarctation anatomy and other associated cardiac abnormalities.

  5. Abdominal ultrasonographic findings associated with feline infectious peritonitis: a retrospective review of 16 cases.

    PubMed

    Lewis, Kristin M; O'Brien, Robert T

    2010-01-01

    The feline infectious peritonitis virus (FIPV) is a mutated form of the feline enteric coronavirus (FeCV) that can present with a variety of clinical signs. The purpose of this retrospective study was to analyze abdominal ultrasonographic findings associated with cats with confirmed FIPV infection. Sixteen cases were included in the study from a review of medical records at two academic institutions; inclusion was based either on necropsy lesions (n=13) or a combination of histopathological, cytological, and clinicopathological findings highly suggestive of FIPV infection (n=3). The liver was judged to be normal in echogenicity in 11 (69%) cats, diffusely hypoechoic in three cats, focally hyperechoic in one cat, and focally hypoechoic in one cat. Five cats had a hypoechoic subcapsular rim in one (n=3) or both (n=2) kidneys. Free fluid was present in the peritoneal cavity in seven cats and in the retroperitoneal space in one cat. Abdominal lymphadenopathy was noted in nine cats. The spleen was normal in echogenicity in 14 cats and was hypoechoic in two. One cat had bilateral orchitis with loss of normal testicular architecture. Although none of these ultrasonographic findings are specific for FIPV infection, a combination of these findings should increase the index of suspicion for FIPV infection when considered along with appropriate clinical signs.

  6. Hepatic trauma: CT findings and considerations based on our experience in emergency diagnostic imaging.

    PubMed

    Romano, Luigia; Giovine, Sabrina; Guidi, Guido; Tortora, Giovanni; Cinque, Teresa; Romano, Stefania

    2004-04-01

    Abdominal blunt trauma represents the main cause of death in people of age less than 40 years; the liver injury occurs frequently, with an incidence varying from 3 to 10%. Isolated hepatic lesions are rare and in 77-90% of cases, lesions of other organs and viscera are involved. Right hepatic lobe is a frequent site of injury, because it is the more voluminous portion of liver parenchyma; posterior superior hepatic segments are proximal to fixed anatomical structures such as ribs and spine that may have an important role in determining of the lesion. The coronal ligaments' insertion in this parenchymal region augments the effect of acceleration-deceleration mechanism. Associated lesions usually are homolateral costal fractures, laceration or contusion of the inferior right pulmonary lobe, haemothorax, pneumothorax, renal and/or adrenal lesions. Traumatic lesions of left hepatic lobe are rare and usually associated with direct impact on the superior abdomen, such as in car-crash when the wheel causes a compressive effect on thorax and abdomen. Associated lesions to left hepatic lobe injuries correlated to this mechanism are: sternal fractures, pancreatic, myocardial, gastrointestinal tract injuries. Lesions of the caudal lobe are extremely rare, usually not isolated and noted with other large parenchymal lesions. The Institution of Specialized Trauma Centers and the technical progress in imaging methodology developed in the last years a great reduction of mortality. New diagnostic methodologies allow a reduction of negatives laparotomies and allow the possibility of conservative treatment of numerous traumatic lesions; however, therapy depends from imaging findings and clinical conditions of the patient. Computed tomography (CT) certainly presents a large impact on diagnosis and management of patients with lesions from blunt abdominal traumas. It is important to establish a prognostic criteria allowing decisions for conservative or surgical treatment; CT findings

  7. 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.

  8. 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

  9. 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

  10. Primary Cardiac Lymphoma: Helical CT Findings and Radiopathologic Correlation

    SciTech Connect

    Marco de Lucas, Enrique Pagola, Miguel Angel; Fernandez, Fidel; Lastra, Pedro; Delgado, M. Luisa Ruiz; Sadaba, Pablo; Pinto, Jesus; Ballesteros, Ma Angeles; Ortiz, Antonio

    2004-03-15

    Primary tumors of the heart are extremely rare.Clinical manifestations are nondiagnostic and the patients are often misdiagnosed. Magnetic resonance imaging and echocardiography are standard in this diagnostic workup. We report a case of a man with acromegaly, dysphagia, chest pain and weight loss. An invasive cardiac mass was diagnosed by helical-CT. Autopsy demonstrated a B-cell aggressive lymphoma.

  11. Meckel's cave epidermoid with trigeminal neuralgia: CT findings.

    PubMed

    Kapila, A; Steinbaum, S; Chakeres, D W

    1984-12-01

    An epidermoid tumor of Meckel's cave was found in a middle-aged woman with trigeminal neuralgia. On CT the lesion had negative attenuation numbers of fat and extended from an expanded Meckel's cave through the porous trigeminus into the ambient and cerebellopontine angle cisterns. Surgical excision provided relief of the patient's trigeminal neuralgia.

  12. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    PubMed

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180 s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH.

  13. Spontaneous vertebral dissection: Clinical, conventional angiographic, CT, and MR findings

    SciTech Connect

    Provenzale, J.M.; Morgenlander, J.C.; Gress, D.

    1996-03-01

    The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontratimatic precipitating event ({open_quotes}trivial trauma{close_quotes}) and presence of possible risk factors such as hypertension. All patients under-went conventional angiography, 13 either CT or MRI (II both CT and MRI), and 3 MRA. Conventional arteriograrris were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation, CT examinations for the presence of infarction or subarachnoid hemorrhage, MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one.

  14. Concurrent Diffuse Pyelonephritis and Prostatitis: Discordant Findings on Sequential FDG PET/CT and 67Ga SPECT/CT Imaging.

    PubMed

    Lucaj, Robert; Achong, Dwight M

    2017-01-01

    A 45-year-old man underwent FDG PET/CT for initial imaging evaluation of recurrent Escherichia coli urinary tract infections, which demonstrated no significant FDG uptake in either kidney and subtle FDG uptake in the right prostate lobe. Subsequent Ga SPECT/CT demonstrated abnormal intense gallium uptake throughout the right kidney and entire prostate gland, clearly discordant with PET/CT findings and consistent with unexpected concurrent pyelonephritis and prostatitis. Although FDG has effectively replaced Ga in everyday clinical practice, the current case serves as a reminder that there is still a role for Ga in the evaluation of genitourinary infections.

  15. 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.

  16. CT findings of accidental fish bone ingestion and its complications

    PubMed Central

    Venkatesh, Sandeep Halagatti; Karaddi, Nanda Kumar Venkatanarasimha

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  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. 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.

  19. Cone-Beam CT with Flat-Panel-Detector Digital Angiography System: Early Experience in Abdominal Interventional Procedures

    SciTech Connect

    Hirota, Shozo Nakao, Norio; Yamamoto, Satoshi; Kobayashi, Kaoru; Maeda, Hiroaki; Ishikura, Reiichi; Miura, Koui; Sakamoto, Kiyoshi; Ueda, Ken; Baba, Rika

    2006-12-15

    We developed a cone-beam computed tomography (CBCT) system equipped with a large flat-panel detector. Data obtained by 200{sup o} rotation imaging are reconstructed by means of CBCT to generate three-dimensional images. We report the use of CBCT angiography using CBCT in 10 patients with 8 liver malignancies and 2 hypersplenisms during abdominal interventional procedures. CBCT was very useful for interventional radiologists to confirm a perfusion area of the artery catheter wedged on CT by injection of contrast media through the catheter tip, although the image quality was slightly degraded, scoring as 2.60 on average by streak artifacts. CBCT is space-saving because it does not require a CT system with a gantry, and it is also time-saving because it does not require the transfer of patients.

  20. CT findings of colonic complications associated with colon cancer.

    PubMed

    Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young; Kim, Young Tong; Kim, Chang-Jin

    2010-01-01

    A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.

  1. Development of automated extraction method of biliary tract from abdominal CT volumes based on local intensity structure analysis

    NASA Astrophysics Data System (ADS)

    Koga, Kusuto; Hayashi, Yuichiro; Hirose, Tomoaki; Oda, Masahiro; Kitasaka, Takayuki; Igami, Tsuyoshi; Nagino, Masato; Mori, Kensaku

    2014-03-01

    In this paper, we propose an automated biliary tract extraction method from abdominal CT volumes. The biliary tract is the path by which bile is transported from liver to the duodenum. No extraction method have been reported for the automated extraction of the biliary tract from common contrast CT volumes. Our method consists of three steps including: (1) extraction of extrahepatic bile duct (EHBD) candidate regions, (2) extraction of intrahepatic bile duct (IHBD) candidate regions, and (3) combination of these candidate regions. The IHBD has linear structures and intensities of the IHBD are low in CT volumes. We use a dark linear structure enhancement (DLSE) filter based on a local intensity structure analysis method using the eigenvalues of the Hessian matrix for the IHBD candidate region extraction. The EHBD region is extracted using a thresholding process and a connected component analysis. In the combination process, we connect the IHBD candidate regions to each EHBD candidate region and select a bile duct region from the connected candidate regions. We applied the proposed method to 22 cases of CT volumes. An average Dice coefficient of extraction result was 66.7%.

  2. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings.

    PubMed

    Artigas, José M; Martí, Milagros; Soto, Jorge A; Esteban, Helena; Pinilla, Inmaculada; Guillén, Eugenia

    2013-01-01

    Acute gastrointestinal bleeding is a common reason for emergency department admissions and an important cause of morbidity and mortality. Factors that complicate its clinical management include patient debility due to comorbidities; intermittence of hemorrhage; and multiple sites of simultaneous bleeding. Its management, therefore, must be multidisciplinary and include emergency physicians, gastroenterologists, and surgeons, as well as radiologists for diagnostic imaging and interventional therapy. Upper gastrointestinal tract bleeding is usually managed endoscopically, with radiologic intervention reserved as an alternative to be used if endoscopic therapy fails. Endoscopy is often less successful in the management of acute lower gastrointestinal tract bleeding, where colonoscopy may be more effective. The merits of performing bowel cleansing before colonoscopy in such cases might be offset by the resultant increase in response time and should be weighed carefully against the deficits in visualization and diagnostic accuracy that would result from performing colonoscopy without bowel preparation. In recent years, multidetector computed tomographic (CT) angiography has gained acceptance as a first-line option for the diagnosis and management of lower gastrointestinal tract bleeding. In selected cases of upper gastrointestinal tract bleeding, CT angiography also provides accurate information about the presence or absence of active bleeding, its source, and its cause. This information helps shorten the total diagnostic time and minimizes or eliminates the need for more expensive and more invasive procedures.

  3. Thoraco-Abdominal Duplication Cyst- Role Tc-99m Pertechnetate SPECT-CT Scintigraphy in Localising Ectopic Gastric Mucosa

    PubMed Central

    Ravina, Mudalsha; Datta, Deepanksha; Rangan, Kasturi; Suraj, Ajay Singh; Gambhir, Sanjay

    2017-01-01

    Thoraco-abdominal duplication cyst, a congenital malformation of the posterior primitive foregut rarely presents with anaemia. Ectopic gastric mucosa is seen in around 20%-30% of the enteric duplication cysts. We report the scintigraphic findings of one such case which helped in final diagnosis and management of the patient. PMID:28242991

  4. 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.

  5. Crouzon syndrome associated with acanthosis nigricans: prenatal 2D and 3D ultrasound findings and postnatal 3D CT findings

    PubMed Central

    Nørgaard, Pernille; Hagen, Casper Petri; Hove, Hanne; Dunø, Morten; Nissen, Kamilla Rothe; Kreiborg, Sven; Jørgensen, Finn Stener

    2012-01-01

    Crouzon syndrome with acanthosis nigricans (CAN) is a very rare condition with an approximate prevalence of 1 per 1 million newborns. We add the first report on prenatal 2D and 3D ultrasound findings in CAN. In addition we present the postnatal 3D CT findings. The diagnosis was confirmed by molecular testing. PMID:23986840

  6. 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

  7. 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%.

  8. Automated pediatric abdominal effective diameter measurements versus age-predicted body size for normalization of CT dose.

    PubMed

    Cheng, Phillip M; Vachon, Linda A; Duddalwar, Vinay A

    2013-12-01

    There has been increasing interest in adjusting CT radiation dose data for patient body size. A method for automated computation of the abdominal effective diameter of a patient from a CT image has previously only been tested in adult patients. In this work, we tested the method on a set of 128 pediatric patients aged 0.8 to 12.9 years (average 8.0 years, SD = 3.7 years) who had CT abdomen/pelvis exams performed on a Toshiba Aquilion 64 scanner. For this set of patients, age-predicted abdominal effective diameter extrapolated based on data from the International Commission on Radiation Units and Measurements was a relatively poor predictor of measured effective diameter. The mean absolute percentage error between the CTDI normalization coefficient calculated from a manually measured effective diameter and the coefficient determined by age-predicted effective diameter was 12.3 % with respect to a 32 cm phantom (range 0.0-52.8 %, SD 8.7 %) and 12.9 % with respect to a 16 cm phantom (range 0.0-56.4 %, SD 9.2 %). In contrast, there is a close correspondence between the automated and manually measured patient effective diameters, with a mean absolute error of 0.6 cm (error range 0.2-1.3 cm). This correspondence translates into a high degree of correspondence between normalization coefficients determined by automated and manual measurements; the mean absolute percentage error was 2.1 % with respect to a 32 cm phantom (range 0.0-8.1 %, SD = 1.4 %) and 2.3 % with respect to a 16 cm phantom (range 0.0-9.3 %, SD = 1.6 %).

  9. Multi-organ segmentation from multi-phase abdominal CT via 4D graphs using enhancement, shape and location optimization.

    PubMed

    Linguraru, Marius George; Pura, John A; Chowdhury, Ananda S; Summers, Ronald M

    2010-01-01

    The interpretation of medical images benefits from anatomical and physiological priors to optimize computer-aided diagnosis (CAD) applications. Diagnosis also relies on the comprehensive analysis of multiple organs and quantitative measures of soft tissue. An automated method optimized for medical image data is presented for the simultaneous segmentation of four abdominal organs from 4D CT data using graph cuts. Contrast-enhanced CT scans were obtained at two phases: non-contrast and portal venous. Intra-patient data were spatially normalized by non-linear registration. Then 4D erosion using population historic information of contrast-enhanced liver, spleen, and kidneys was applied to multi-phase data to initialize the 4D graph and adapt to patient specific data. CT enhancement information and constraints on shape, from Parzen windows, and location, from a probabilistic atlas, were input into a new formulation of a 4D graph. Comparative results demonstrate the effects of appearance and enhancement, and shape and location on organ segmentation.

  10. Segmentation of Costal Cartilage in Abdominal CT Data using Watershed Markers

    NASA Astrophysics Data System (ADS)

    Holbrook, Andrew B.; Pauly, Kim Butts

    2007-05-01

    High Intensity Focused Ultrasound (HIFU) ablation is a promising non-invasive technique that heats a specific tumor region to fatal levels, while minimizing cell death in nearby healthy areas. For liver applications, the rib cage limits the transducer placement. A treatment plan based on CT images would segment the ribs and provide visualization of them and the tumor. A HIFU simulation of deposited heat would also require rib segmentation. Unfortunately, the ribs are difficult to segment on CT as they transition to cartilage, with CT units similar to that of the liver. The purpose of this work was to develop a rib segmentation algorithm based on CT images for HIFU treatment planning. After an initial threshold of the CT data, rib regions were characterized based on their size, and if a region were greater than a predetermined area parameter (i.e. it consisted of rib and liver), a marker based watershed transformation separated the two regions and continued to the next inferior slice. After false positives were removed by a predetermined volume parameter, the remaining objects were reassigned high CT values. Preliminary results from six human CT datasets indicated this segmentation method works well, successfully distinguishing the ribs from nearby organs. Of the fifty-five ribs counted in these datasets, only five contained small errors due to reconstruction shading irregularities, with four of these in one dataset. Once all cartilage was assigned high CT numbers, any commercially available 3D rendering software (e.g. OsiriX) can be used to visualize the ribs and tumor.

  11. Uterus-like mass involving the appendix: US and CT findings.

    PubMed

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won; Kim, Gou Young; Choi, Sung Il; Park, Seong Jin

    2012-10-01

    Uterus-like mass is a rare extrauterine mass composed of a central cavity lined by endometrium and surrounding smooth muscle. Uterus-like mass has frequently been reported in the ovary, but has rarely been found in extraovarian regions. We report a case of uterus-like mass involving the appendix in a woman who presented with right lower abdominal pain indistinguishable from acute appendicitis. Sonography revealed a heterogeneous mass of mixed echogenicity with inner cystic change, abutting the appendix. CT depicted an enhanced mass with inner cystic change abutting the appendix. Histopathologic examination confirmed the diagnosis.

  12. Point Organ Radiation Dose in Abdominal CT: Effect of Patient Off-Centering in an Experimental Human Cadaver Study.

    PubMed

    Ali Khawaja, Ranish Deedar; Singh, Sarabjeet; Padole, Atul; Otrakji, Alexi; Lira, Diego; Zhang, Da; Liu, Bob; Primak, Andrew; Xu, George; Kalra, Mannudeep K

    2017-01-10

    To determine the effect of patient off-centering on point organ radiation dose measurements in a human cadaver scanned with routine abdominal CT protocol. A human cadaver (88 years, body-mass-index 20 kg/m(2)) was scanned with routine abdominal CT protocol on 128-slice dual source MDCT (Definition Flash, Siemens). A total of 18 scans were performed using two scan protocols (a) 120 kV-200 mAs fixed-mA (CTDIvol 14 mGy) (b) 120 kV-125 ref mAs (7 mGy) with automatic exposure control (AEC, CareDose 4D) at three different positions (a) gantry isocenter, (b) upward off-centering and (c) downward off-centering. Scanning was repeated three times at each position. Six thimble (in liver, stomach, kidney, pancreas, colon and urinary bladder) and four MOSFET dosimeters (on cornea, thyroid, testicle and breast) were placed for calculation of measured point organ doses. Organ dose estimations were retrieved from dose-tracking software (eXposure, Radimetrics). Statistical analysis was performed using analysis of variance. There was a significant difference between the trends of point organ doses with AEC and fixed-mA at all three positions (p < 0.01). Variation in point doses between fixed-mA and AEC protocols were statistically significant across all organs at all Table positions (p < 0.001). There was up to 5-6% decrease in point doses with upward off-centering and in downward off-centering. There were statistical significant differences in point doses from dosimeters and dose-tracking software (mean difference for internal organs, 5-36% for fixed-mA & 7-48% for AEC protocols; p < 0.001; mean difference for surface organs, >92% for both protocols; p < 0.0001). For both protocols, the highest mean difference in point doses was found for stomach and lowest for colon. Measured absorbed point doses in abdominal CT vary with patient-centering in the gantry isocenter. Due to lack of consideration of patient positioning in the dose estimation on automatic software-over estimation of

  13. A Method for the Automatic Exposure Control in Pediatric Abdominal CT: Application to the Standard Deviation Value and Tube Current Methods by Using Patient's Age and Body Size.

    PubMed

    Furuya, Ken; Akiyama, Shinji; Nambu, Atushi; Suzuki, Yutaka; Hasebe, Yuusuke

    2017-01-01

    We aimed to apply the pediatric abdominal CT protocol of Donnelly et al. in the United States to the pediatric abdominal CT-AEC. Examining CT images of 100 children, we found that the sectional area of the hepatic portal region (y) was strongly correlated with the body weight (x) as follows: y=7.14x + 84.39 (correlation coefficient=0.9574). We scanned an elliptical cone phantom that simulates the human body using a pediatric abdominal CT scanning method of Donnelly et al. in, and measured SD values. We further scanned the same phantom under the settings for adult CT-AEC scan and obtained the relationship between the sectional areas (y) and the SD values. Using these results, we obtained the following preset noise factors for CT-AEC at each body weight range: 6.90 at 4.5-8.9 kg, 8.40 at 9.0-17.9 kg, 8.68 at 18.0-26.9 kg, 9.89 at 27.0-35.9 kg, 12.22 at 36.0-45.0 kg, 13.52 at 45.1-70.0 kg, 15.29 at more than 70 kg. From the relation between age, weight and the distance of liver and tuber ischiadicum of 500 children, we obtained the CTDIvol values and DLP values under the scanning protocol of Donnelly et al. Almost all of DRL from these values turned out to be smaller than the DRL data of IAEA and various countries. Thus, by setting the maximum current values of CT-AEC to be the Donnelly et al.'s age-wise current values, and using our weight-wise noise factors, we think we can perform pediatric abdominal CT-AEC scans that are consistent with the same radiation safety and the image quality as those proposed by Donnelly et al.

  14. CT findings of pulmonary tuberculosis and tuberculous pleurisy in diabetes mellitus patients

    PubMed Central

    Kim, Jihyun; Lee, In Jae; Kim, Joo-Hee

    2017-01-01

    PURPOSE We aimed to assess computed tomography (CT) findings of pulmonary tuberculosis (TB) and TB pleurisy in diabetes mellitus (DM) patients and to evaluate the effect of duration of DM on radiologic findings of pulmonary TB and TB pleurisy. METHODS Ninety-three consecutive patients diagnosed as active pulmonary TB with underlying DM were enrolled in our study. As a control group, 100 pulmonary TB patients without DM were randomly selected. TB patients with DM were subdivided into two subgroups depending on diabetes duration of ≥10 years or <10 years. Medical records and CT scans of the patients were retrospectively reviewed and compared. RESULTS Bilateral pulmonary involvement (odds ratio [OR]=2.39, P = 0.003), involvement of all lobes (OR=2.79, P = 0.013), and lymph node enlargement (OR=1.98, P = 0.022) were significantly more frequent CT findings among TB patients with DM compared with the controls. There were no statistically significant differences in CT findings of pulmonary TB depending on the duration of DM. CONCLUSION Bilateral pulmonary involvement, involvement of all lobes, and lymph node enlargement are significantly more common CT findings in TB patients with underlying DM than in patients without DM. Familiarity with the CT findings may be helpful to suggest prompt diagnosis of pulmonary TB in DM patients. PMID:28185999

  15. CT and MRI findings in X-linked progressive deafness.

    PubMed

    Altay, Hakan; Savaş, Recep; Oğüt, Fatih; Kirazli, Tayfun; Alper, Hüdaver

    2008-09-01

    Congenital X-linked mixed deafness is a rare anomaly that has typical features and can be diagnosed on the basis of progressive mixed hearing loss and the typical imaging findings. Recognition of these findings may alter the course of treatment and perilymph gushing can be avoided. A 10-year-old male patient presented with a history of progressive hearing loss. Computed tomography of the temporal bones showed bulbous dilatation of the fundi of the internal auditory canals (IAC) and the absence of the bony plates separating the basal turn of the cochleas and IAC. Magnetic resonance imaging demonstrated obliteration of the labyrinthine spaces at the right side.

  16. Mucocele involving the anterior clinoid process: MR and CT findings.

    PubMed

    Lim, C C; Dillon, W P; McDermott, M W

    1999-02-01

    We report two patients with surgically proved mucoceles involving the anterior clinoid process. One patient had a mucocele of an Onodi cell and the other had a mucocele isolated to the anterior clinoid process. The MR signal was increased on both T1- and T2-weighted images in the first patient but was isointense on both sequences in the second patient, a finding that resulted in misdiagnosis. The developmental and anatomic features, as well as the diagnostic pitfalls, are discussed.

  17. Traumatic aortic injury: CT findings, mimics, and therapeutic options

    PubMed Central

    Lantz, Eric J.; Johnson, C. Michael; Young, Philip M.

    2014-01-01

    Objective Traumatic aortic injury (TAI) is rare, but frequently lethal. However, with prompt diagnosis, patients can undergo life-saving open or endovascular repair. Unfortunately, because these injuries are relatively rare, subtle forms of these injuries may be missed, and normal variants may mimic TAI leading to misdiagnosis. Conclusions We will discuss computed tomography findings of typical injury patterns of traumatic aortic injuries as well as treatment options, diagnostic pitfalls and injury mimics. These are highlighted with clinical case examples. PMID:25009793

  18. Usefulness of a metal artifact reduction algorithm for orthopedic implants in abdominal CT: phantom and clinical study results.

    PubMed

    Jeong, Seonji; Kim, Se Hyung; Hwang, Eui Jin; Shin, Cheong-Il; Han, Joon Koo; Choi, Byung Ihn

    2015-02-01

    OBJECTIVE. The purpose of this study was to evaluate the usefulness of a metal artifact reduction (MAR) algorithm for orthopedic prostheses in phantom and clinical CT. MATERIALS AND METHODS. An agar phantom with two sets of spinal screws was scanned at various tube voltage (80-140 kVp) and tube current-time (34-1032 mAs) settings. The orthopedic MAR algorithm was combined with filtered back projection (FBP) or iterative reconstruction. The mean SDs in three ROIs were compared among four datasets (FBP, iterative reconstruction, FBP with orthopedic MAR, and iterative reconstruction with orthopedic MAR). For the clinical study, the mean SDs of three ROIs and 4-point scaled image quality in 52 patients with metallic orthopedic prostheses were compared between CT images acquired with and without orthopedic MAR. The presence and type of image quality improvement with orthopedic MAR and the presence of orthopedic MAR-related new artifacts were also analyzed. RESULTS. In the phantom study, the mean SD with orthopedic MAR was significantly lower than that without orthopedic MAR regardless of dose settings and reconstruction algorithms (FBP versus iterative reconstruction). The mean SD near the metallic prosthesis in 52 patients was significantly lower on CT images with orthopedic MAR (28.04 HU) than those without it (49.21 HU). Image quality regarding metallic artifact was significantly improved with orthopedic MAR (rating of 2.60 versus 1.04). Notable reduction of metallic artifacts and better depiction of abdominal organs were observed in 45 patients. Diagnostic benefit was achieved in six patients, but orthopedic MAR-related new artifacts were seen in 30 patients. CONCLUSION. Use of the orthopedic MAR algorithm significantly reduces metal artifacts in CT of both phantoms and patients and has potential for improving diagnostic performance in patients with severe metallic artifacts.

  19. Imaging of gastrointestinal and abdominal tuberculosis.

    PubMed

    Vanhoenacker, F M; De Backer, A I; Op de, Beeck B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, A M

    2004-03-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic challenge, particularly when pulmonary TB is absent. It may mimic many other abdominal diseases, both clinically and radiologically. An early correct diagnosis, however, is important in order to ensure proper treatment and a favorable outcome. Modern imaging is a cornerstone in the early diagnosis of abdominal TB and may prevent unnecessary morbidity and mortality. Generally, CT appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis, other than gastrointestinal TB. Barium studies remain superior for demonstrating mucosal intestinal lesions. Ultrasound may be used for follow-up to monitor therapy response. The diagnosis of abdominal TB should be considered if suggestive imaging findings are found in patients with a high index of suspicion.

  20. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics.

    PubMed

    Jaffe, Tracy; Thompson, William M

    2015-06-01

    Large-bowel obstruction is an abdominal emergency with high morbidity and mortality rates if left untreated. Although abdominal radiography is usually the initial imaging study performed in patients suspected of having large-bowel obstruction, it may not be sufficient to distinguish obstruction from other causes of colonic dilatation. Computed tomography is the imaging method of choice as it can establish the diagnosis and cause of large-bowel obstruction. A contrast agent enema may be used to confirm or exclude large-bowel obstruction. In this review, the imaging findings in multiple causes of large-bowel obstruction are illustrated and compared with acute colonic pseudo-obstruction.

  1. Metrizamide CT myelography in cervical myelopathy and radiculopathy: correlation with conventional myelography and surgical findings

    SciTech Connect

    Badami, J.P.; Norman, D.; Barbaro, N.M.; Cann, C.E.; Weinstein, P.R.; Sobel, D.F.

    1985-04-01

    Conventional myelography, metrizamide computed tomographic (CT) myelography, and surgical findings were correlated in 30 patients with cervical radiculopathy and/or myelopathy. In 60% of patients, metrizamide CT myelography provided significant additional information including better characterization of the abnormality, lateralization if the conventional myelogram was indeterminate, more definitive demonstration of cord atrophy, foraminal narrowing not appreciated on myelography, and demonstration of abnormalities distal to a myelographic block. In no case was a myelographic abnormality not detected on metrizamide CT meyelography. In patients with cervical myelopathy, a cross-sectional diameter of the cord equaling less than 50% of the subarachnoid space is predictive of poor patient response to surgical intervention.

  2. CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors

    PubMed Central

    Brook, Olga R.; Thornton, Eavan; Mendiratta-Lala, Mishal; Mahadevan, Anand; Raptopoulos, Vassilious; Brook, Alexander; Najarian, Robert; Sheiman, Robert; Siewert, Bettina

    2015-01-01

    Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC), 25 with liver metastases, and seven with cholangiocarcinoma (CCC) were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1%) HCCs and 1/25 (4%) metastases. Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir) occurred in 2/36 (6%) HCCs and 4/25 (17%) metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78%) of HCCs, 19/21 (91%) of metastases, and 7/7 (100%) of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding. PMID:26221135

  3. Endovascular repair of inflammatory abdominal aneurysm: a retrospective analysis of CT follow-up.

    PubMed

    Hechelhammer, Lukas; Wildermuth, Simon; Lachat, Mario L; Pfammatter, Thomas

    2005-05-01

    Retrospective radiologic and clinical midterm follow-up is reported for 10 patients with inflammatory abdominal aortic aneurysm (IAAA) after endovascular aortic aneurysm repair (EVAR). At a mean follow-up of 33 months, regression of the thickness of the perianeurysmal fibrosis (PAF) and decrease of aneurysmal sac diameter was observed in nine patients. Four EVAR-associated complications were observed: periinterventional dissection of femoral artery (n = 1), blue toe syndrome (n = 1), and stent-graft disconnection (n = 2). EVAR is the less invasive method of aneurysm exclusion in patients with IAAA with a comparable evolution of the PAF as reported after open repair.

  4. Patient-specific models of wall stress in abdominal aortic aneurysm: a comparison between MR and CT

    NASA Astrophysics Data System (ADS)

    de Putter, Sander; Breeuwer, Marcel; van de Vosse, Frans N.; Kose, Ursula; Gerritsen, Frans A.

    2006-03-01

    Finite element method based patient-specific wall stress in abdominal aortic aneurysm (AAA) may provide a more accurate rupture risk predictor than the currently used maximum transverse diameter. In this study, we have investigated the sensitivity of the wall stress in AAA with respect to geometrical variations. We have acquired MR and CT images for four patients with AAA. Three individual users have delineated the AAA vessel wall contours on the image slices. These contours were used to generate synthetic feature images for a deformable model based segmentation method. We investigated the reproducibility and the influence of the user variability on the wall stress. For sufficiently smooth models of the AAA wall, the peak wall stress is reproducible for three out of the four AAA geometries. The 0.99 percentiles of the wall stress show excellent reproducibility for all four AAAs. The variations induced by user variability are larger than the errors caused by the segmentation variability. The influence of the user variability appears to be similar for MR and CT. We conclude that the peak wall stress in AAA is sensitive to small geometrical variations. To increase reproducibility it appears to be best not to allow too much geometrical detail in the simulations. This could be achieved either by using a sufficiently smooth geometry representation or by using a more robust statistical parameter derived from the wall stress distribution.

  5. Longitudinal tube modulation for chest and abdominal CT examinations: impact on effective patient doses calculations

    NASA Astrophysics Data System (ADS)

    Zanca, F.; Michielsen, K.; Depuydt, M.; Jacobs, J.; Nens, J.; Lemmens, K.; Oyen, R.; Bosmans, H.

    2011-03-01

    Purpose: In multi-slice CT, manufacturers have implemented automatic tube current modulation (TCM) algorithms. These adjust tube current in the x-y plane (angular modulation) and/or along the z-axis (z-axis modulation) according to the size and attenuation of the scanned body part. Current methods for estimating effective dose (ED) values in CT do not account for such new developments. This study investigated the need to take TCM into account when calculating ED values, using clinical data. Methods: The effect of TCM algorithms as implemented on a GE BrightSpeed 16, a Philips Brilliance 64 and a Siemens Sensation 64 CT scanners was investigated. Here, only z-axis modulation was addressed, considering thorax and abdomen CT examinations collected from 534 adult patients. Commercially available CT dosimetry software (CT expo v.1.7) was used to compute EDTCM (ED accounting for TCM) as the sum of ED of successive slices. A two-step approach was chosen: first we estimated the relative contribution of each slice assuming a constant tube current. Next a weighted average was taken based upon the slice specific tube current value. EDTCM was than compared to patient ED estimated using average mA of all slices. Results and Conclusions: The proposed method is relatively simple and uses as input: the parameters of each protocol, a fitted polynomial function of weighting factors for each slice along the scan length and mA values of the individual patient examination. Results show that z-axis modulation does not have a strong impact on ED for the Siemens and the GE scanner (difference ranges from -4.1 to 3.3 percent); for the Philips scanner the effect was more important, (difference ranges from -8.5 to 6.9 percent), but still all median values approached zero (except for one case, where the median reached -5.6%), suggesting that ED calculation using average mA is in general a good approximation for EDTCM. Higher difference values for the Philips scanner are due to a stronger

  6. MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications

    PubMed Central

    Sangster, Guillermo P.; Previgliano, Carlos H.; Nader, Mathieu; Chwoschtschinsky, Elisa; Heldmann, Maureen G.

    2013-01-01

    Hepatic cirrhosis is the clinical and pathologic result of a multifactorial chronic liver injury. It is well known that cirrhosis is the origin of multiple extrahepatic abdominal complications and a markedly increased risk of hepatocellular carcinoma (HCC). This tumor is the sixth most common malignancy worldwide and the third most common cause of cancer related death. With the rising incidence of HCC worldwide, awareness of the evolution of cirrhotic nodules into malignancy is critical for an early detection and treatment. Adequate imaging protocol selection with dynamic multiphase Multidetector Computed Tomography (MDCT) and reformatted images is crucial to differentiate and categorize the hepatic nodular dysplasia. Knowledge of the typical and less common extrahepatic abdominal manifestations is essential for accurately assessing patients with known or suspected hepatic disease. The objective of this paper is to illustrate the imaging spectrum of intra- and extrahepatic abdominal manifestations of hepatic cirrhosis seen on MDCT. PMID:23986608

  7. Specific Radiological Findings of Traumatic Gastrointestinal Tract Injuries in Patients With Blunt Chest and Abdominal Trauma.

    PubMed

    Kokabi, Nima; Harmouche, Elie; Xing, Minzhi; Shuaib, Waqas; Mittal, Pardeep K; Wilson, Kenneth; Johnson, Jamlik-Omari; Nicolaou, Savvas; Khosa, Faisal

    2015-05-01

    Gastrointestinal hollow viscus injury after blunt chest and abdominal trauma is uncommon and complicates 0.6%-1.2% of all cases of trauma. Early recognition of such injuries significantly decreases morbidity and mortality. Since physical examination is not accurate in detecting such injuries, contrast-enhanced computed tomography has been the mainstay for diagnosis in many emergency departments. This pictorial essay aims to review the incidence, mechanisms, and signs of gastrointestinal hollow viscus injuries in the setting of blunt chest and abdominal trauma.

  8. CT brain findings in a patient with elevated brain cesium levels.

    PubMed

    Khangure, Simon R; Williams, Eric S; Welman, Christopher J

    2013-12-01

    We describe the CT findings in the brain of a woman with pathologically proven elevated levels of blood and tissue cesium. The 42-year-old woman had been receiving cesium chloride as a non-mainstream treatment for metastatic breast carcinoma. She presented to hospital following a seizure, and died 48 hours after admission. A brain CT performed on hospital admission showed a diffuse increase in attenuation of brain parenchyma. Autopsy revealed elevated levels of cesium in blood and solid organs including the brain. We hypothesize that the imaging findings are attributable to the abnormally elevated level of brain cesium at the time of the CT scan. To our knowledge, this is the first reported case of this imaging finding.

  9. Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis

    PubMed Central

    Sharma, Vishal; Bhatia, Anmol; Malik, Sarthak; Singh, Navjeet; Rana, Surinder S.

    2017-01-01

    Objective: Scalloping of visceral organs is described in pseudomyxoma peritonei, malignant ascites, among other conditions, but not tuberculosis. Methods: We report findings from a retrospective study of patients with abdominal tuberculosis who had visceral scalloping on abdominal computed tomography (CT). Diagnosis of abdominal tuberculosis was made on the basis of combination of clinical, biochemical, radiological and microbiological criteria. The clinical data, hematological and biochemical parameters, and findings of chest X-ray, CT, Mantoux test, and HIV serology were recorded. Results: Of 72 patients with abdominal tuberculosis whose CT scans were included, seven patients had visceral scalloping. The mean age of these patients was 32.14 ± 8.43 years and four were men. While six patients had scalloping of liver, one had splenic scalloping. The patients presented with abdominal pain (all), abdominal distension (five patients), loss of weight or appetite (all), and fever (four patients). Mantoux test was positive in five, while none had HIV infection. The diagnosis was based on fluid (ascitic or collections) evaluation in four patients, ileo-cecal biopsy in one patient, fine needle aspiration from omental thickening in one patient, and sputum positivity for acid fast bacilli (AFB) in one patient. On CT examination, four patients had ascites, five had collections, one had lymphadenopathy, four had peritoneal involvement, three had pleural effusion, and two had ileo-cecal thickening. All except one patient received standard ATT for 6 months or 9 months (one patient). Pigtail drainage for collections was needed for two patients. Discussion: This report is the first description of visceral scalloping of liver and spleen in patients with abdominal tuberculosis. Previously, this finding has been reported primarily with pseudomyxoma peritonei and peritoneal carcinomatosis. Conclusion: Visceral scalloping may not conclusively distinguish peritoneal

  10. 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.

  11. CT Findings in People Who Were Environmentally Exposed to Asbestos in Korea.

    PubMed

    Lee, Eun Kyoung; Kim, Jeung Sook; Kim, Yookyung; Park, Jai Soung

    2015-12-01

    Asbestos related pleuropulmonary disease has been emerging health problem for recent years. It can cause variable clinical symptoms and radiological abnormalities. However, there has been no report for their characteristics in subjects who were environmentally exposed to asbestos. We reviewed the CT images of 35 people who were environmentally exposed to asbestos in Chungnam province, Korea. The study result showed high incidence of pleural plaque and pulmonary fibrosis on chest CT (94% and 77%, respectively). The common CT findings of lung parenchymal lesions were as follows: centrilobular opacities (94%), subpleural dot-like or branching opacities (80%), interlobular septal thickening (57%), intralobular interstitial thickening (46%), parenchymal bands (43%) and subpleural curvilinear line (29%). There were no significant differences in the prevalence of pulmonary fibrosis and pleural plaques according to sex, age and duration of exposure. In conclusion, pleural plaque and pulmonary fibrosis are common asbestos-related CT finding in the exposed people. Asbestos related lung parenchymal CT findings in the participants with environmental exposure show similar to those observed in the occupational exposure.

  12. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    PubMed Central

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P < .001) and positive smoking history (P = .001) were associated with increased likelihood of a recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in

  13. Value of a step-up diagnosis plan: CRP and CT-scan to diagnose and manage postoperative complications after major abdominal surgery.

    PubMed

    Straatman, Jennifer; Cuesta, Miguel A; Gisbertz, Suzanne S; Van der Peet, Donald L

    2014-12-01

    Postoperative complications frequently follow major abdominal surgery and are associated with increased morbidity and mortality. Early diagnosis and treatment of complications is associated with improved patient outcome. In this study we assessed the value of a step-up diagnosis plan by C-reactive protein and CT-scan (computed tomography-scan) imaging for detection of postoperative complications following major abdominal surgery.An observational cohort study was conducted of 399 consecutivepatients undergoing major abdominal surgery between January 2009 and January 2011. Indication for operation, type of surgery, postoperative morbidity, complications according to the Clavien-Dindo classification and mortality were recorded. Clinical parameters were recorded until 14 days postoperatively or until discharge. Regular C-reactive protein (CPR) measurements in peripheral blood and on indication -enhanced CT-scans were performed.Eighty-three out of 399 (20.6 %) patients developed a major complication in the postoperative course after a median of seven days (IQR 4-9 days). One hundred and thirty two patients received additional examination consisting of enhanced CT-scan imaging, and treatment by surgical reintervention or intensive care observation. CRP levels were significantly higher in patients with postoperative complications. On the second postoperative dayCRP levels were on average 197.4 mg/L in the uncomplicated group, 220.9 mg/L in patients with a minor complication and 280.1 mg/L in patients with major complications (p < 0,001).CT-scan imaging showed a sensitivity of 91.7 % and specificity of 100 % in diagnosis of major complications. Based on clinical deterioration and the increase of CRP, an additional enhanced CT-scan offered clear discrimination between patients with major abdominal complications and uncomplicated patients. Adequate treatment could then be accomplished.

  14. Aorta-Left Renal Vein Fistula Complicating an Aortic Aneurysm: Preoperative and Postoperative Multislice CT Findings

    SciTech Connect

    Barrier, Pierre Otal, Philippe; Garcia, Olivier; Vahdat, Olivier; Domenech, Brice; Lannareix, Valerie; Joffre, Francis; Rousseau, Herve

    2007-06-15

    Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnoses to consider when encountering this clinical presentation are reviewed.

  15. 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

  16. Semantic analysis of SNOMED CT for a post-coordinated database of histopathology findings

    PubMed Central

    Campbell, Walter S; Campbell, James R; West, William W; McClay, James C; Hinrichs, Steven H

    2014-01-01

    Objective This research investigated the use of SNOMED CT to represent diagnostic tissue morphologies and notable tissue architectures typically found within a pathologist's microscopic examination report to identify gaps in expressivity of SNOMED CT for use in anatomic pathology. Methods 24 breast biopsy cases were reviewed by two board certified surgical pathologists who independently described the diagnostically important tissue architectures and diagnostic morphologies observed by microscopic examination. In addition, diagnostic comments and details were extracted from the original diagnostic pathology report. 95 unique clinical statements were extracted from 13 malignant and 11 benign breast needle biopsy cases. Results 75% of the inventoried diagnostic terms and statements could be represented by valid SNOMED CT expressions. The expressions included one pre-coordinated expression and 73 post-coordinated expressions. No valid SNOMED CT expressions could be identified or developed to unambiguously assert the meaning of 21 statements (ie, 25% of inventoried clinical statements). Evaluation of the findings indicated that SNOMED CT lacked sufficient definitional expressions or the SNOMED CT concept model prohibited use of certain defined concepts needed to describe the numerous, diagnostically important tissue architectures and morphologic changes found within a surgical pathology microscopic examination. Conclusions Because information gathered during microscopic histopathology examination provides the basis of pathology diagnoses, additional concept definitions for tissue morphometries and modifications to the SNOMED CT concept model are needed and suggested to represent detailed histopathologic findings in computable fashion for purposes of patient information exchange and research. Trial registration number UNMC Institutional Review Board ID# 342-11-EP. PMID:24833774

  17. Sonographic and CT Findings of Sialadenosis in a Child with Leukemia

    PubMed Central

    Wen, Yang

    2012-01-01

    Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings. PMID:22977332

  18. Sonographic and CT findings of sialadenosis in a child with leukemia.

    PubMed

    Wen, Yang; Goo, Hyun Woo

    2012-01-01

    Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings.

  19. CT findings of a unicameral calcaneal bone cyst containing a fluid-fluid level.

    PubMed

    Gallagher, Thomas A; Lim-Dunham, Jennifer E; Vade, Aruna

    2007-03-01

    Calcaneal unicameral bone cysts often contain fluid, but rarely contain fluid-fluid levels. We present a case focusing on the CT findings of a large calcaneal bone cyst with a fluid-fluid level and a review of the literature.

  20. 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.

  1. 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.

  2. SU-F-207-14: Low Contrast Detectability (LCD) at Different Diagnostic Reference Levels for Adult Abdominal CT Procedures

    SciTech Connect

    Mahmood, U; Erdi, Y

    2015-06-15

    Purpose Using diagnostic reference levels (DRL) to optimize CT protocols has potential to reduce radiation dose and meet regulatory requirements. However, DRL’s tend to be misconstrued as dose limits, are typically designed for specific patient populations, and are assumed to have acceptable image quality (AIQ) associated with them. To determine the image quality that is associated with established DRL’s for adult abdominal CT studies, a LCD phantom study was employed. Methods: A CT phantom (CIRS) containing three columns of 7 spherical targets, ranging from 10mm to 2.4 mm, that are 5, 10, and 20 HU below the background (HUBB) matrix was scanned with a GE HD750 64 slice scanner. The phantom was scanned at the NEXT 2006 25th CTDIvol of 12 mGy, the NCRP 172 achievable dose (AD) CTDIvol of 17 mGy and 75th CTDIvol of 25 mGy and at the ACR recommended CTDIvol of 25 mGy. It was also scanned at a CTDIvol 20% greater than the AD at 20 mGy and the ACR maximum threshold of 30 mGy. Results: At the NEXT 2006 25th percentile CTDIvol of 12 mGy, a 6.3 mm low contrast lesion was detectable in the 20 HUBB; 6.3 mm in the 10 HUBB and 10 mm in the 5 HUBB column. Increasing the CTDIvol to the NCRP 172 AD of 17 mGy, an additional 4.8 mm lesion was visualized in the 20 HUBB column. At 20 mGy, an additional 4.8 mm lesion was detectable in the 10 HUBB column. No further lesions were visible between 20 and 30 mGy. However, conspicuity of all lesions increased with each additional step up in CTDI. Conclusion: Optimizing radiation dose to achieve AIQ is a critical aspect of any dose optimization committee. Hence, judicious monitoring of radiation exposure to patients has to be balanced with diagnostic image quality.

  3. CT demonstration of a 5th ventricle--a finding to KO boxers?

    PubMed

    Macpherson, P; Teasdale, E

    1988-01-01

    The reported prevalence of 5th ventricles based on air studies varies from 1-12% and ranges up to 60% as an autopsy finding. The prevalence of what is usually an incidental anomaly has not been determined by computed tomography (CT). 5th ventricles are however known to be more common in brain damaged boxers and with the introduction of compulsory CT scanning for certain boxers it is necessary to know what significance to attach to the finding of a cavum in these individuals. To ascertain the prevalence and morphology of 5th ventricles as detected by CT in the population, a thousand consecutive scans were analysed for the presence or absence of a 5th ventricle and other associated midline developmental abnormalities and correlations made with any pathology found. A 5th ventricle was present in 5.5% of the group and in most cases was less than 3 mm wide. An apparent association with other pathology was found only in patients under the age of 15. A 6th ventricle was found in 0.5% while a cavum velum interpositum was present in 9.5%. The isolated finding of a small 5th ventricle on the CT scan of a young active boxer almost certainly represents a persistent congenital anomaly of no significance.

  4. Postoperative CT findings in acoustic neurinomas operated upon by a translabyrinthine approach.

    PubMed

    Larsson, E M; Cronqvist, S; Sundbärg, G; Mercke, U; Harris, S

    1986-01-01

    The findings at CT examinations, performed on 46 patients with acoustic neurinomas about 6 months after translabyrinthine surgery, were analyzed and compared with preoperative findings. Direct as well as indirect signs of expansion had disappeared postoperatively. Bulging of cerebellar tissue towards the operative defect in the petrous bone, a finding not connected with local adhesions, was notable. Hypodensity in the vicinity of the removed tumor occurred either due to local widening of the subarachnoid space or due to changes within the cerebellar parenchyma. Local and general widening of the fourth ventricle as a sign of atrophy was a frequent finding.

  5. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

    PubMed Central

    Ogbole, Godwin I.; Adeleye, Amos O.; Owolabi, Mayowa O.; Olatunji, Richard B.; Yusuf, Bolutife P.

    2015-01-01

    Background: Incidental findings on computed tomography (CT) scans are occasionally noted in patients presenting with head injury. Since it can be assumed that head injured patients are of normal health status before the accident, these findings may be a representation of their frequency in the general population. Our aim was to determine the prevalence of such incidental findings among head injured patients in Nigeria's foremost center of clinical neurosciences. Materials and Methods: We conducted a retrospective review of CT scan images of 591 consecutive eligible patients over a 5-year period (2006-2010) to identify incidental findings. The images were evaluated by consensus agreement of two radiologists. Associations with gender and age were explored using appropriate statistical tests with an alpha level of 0.05. Results: The mean patient age was 34.6 ± 21.2 years, and male to female ratio was 3.2: 1. Incidental findings were noted in 503/591 (85.1 %) of the scans. Intracranial calcification was the commonest finding occurring in 61.8% of patients. Over 90% of the findings were benign. Compared with older ones, patients under the age of 60 were less likely, (P < 0.001), to have incidental findings. Conclusion: Although the majority of incidental findings in this African cohort of head injury patients are benign some clinically significant lesions were detectable. It is therefore recommended that such findings be adequately described in the radiological reports for proper counseling and follow-up. PMID:25949036

  6. 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.

  7. Mucinous versus nonmucinous solitary pulmonary nodular bronchioloalveolar carcinoma: CT and FDG PET findings and pathologic comparisons.

    PubMed

    Lee, Ho Yun; Lee, Kyung Soo; Han, Joungho; Kim, Byung-Tae; Cho, Young-Seok; Shim, Young Mog; Kim, Jhingook

    2009-08-01

    We aimed to evaluate the CT, PET, and pathologic findings of solitary pulmonary nodular mucinous and nonmucinous bronchioloalveolar carcinomas (BACs). From August 2003 to March 2008, we saw 24 patients with solitary pulmonary nodular mucinous (n=6) or nonmucinous (n=18) BACs that were resected. CT and PET findings of the lesions were assessed in terms of size, solidity, morphologic characteristics, attenuation and maximum standardized uptake value (mSUV). All nonmucinous BACs appeared as a pure ground-glass opacity (GGO) nodule, whereas mucinous BACs appeared as solid (n=4) or part-solid (n=2) nodules. CT attenuation values were significantly higher for mucinous BACs (-21.0 HU+/-4.9) than for nonmucinous BACs (-491.8 HU+/-172.5) (P<.001). Mean mSUVs were 2.3+/-1.9 for mucinous BACs and 0.5+/-0.8 for nonmucinous BACs (P=.007), but mSUVs were not statistically different after size adjustment (r=0.371, P=.081). Mucinous BACs appear as solid or part-solid nodules at CT, whereas nonmucinous BACs present as pure GGO nodules. Both subtypes of tumors show scant FDG uptake at PET.

  8. Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis.

    PubMed

    Chingkoe, Christina M; Jahed, Ali; Loreto, Michael P; Sarrazin, Josée; McGregor, Caitlin T; Blaichman, Jason I; Glanc, Phyllis

    2015-01-01

    Retroperitoneal fasciitis is a rare but potentially lethal complication of infection. Early diagnosis is crucial and is usually made when there is a high degree of clinical suspicion combined with characteristic imaging findings leading to early surgical intervention. Computed tomography (CT) can play a central role in demonstrating early findings, assessing the extent of disease to help determine the best surgical approach, identifying the primary source of infection, and evaluating the treatment response. The possible presence of retroperitoneal fasciitis should be considered in patients presenting with symptoms of sepsis, including pain that is disproportionate with the clinical abnormality. When retroperitoneal fasciitis is suspected, emergency CT can facilitate early diagnosis and evaluation of the extent of disease. Common findings at CT include fascial thickening and enhancement, muscular edema, fat stranding, fluid collections, and abscess formation. Gas tracking along fascial planes in the retroperitoneum is the hallmark of retroperitoneal fasciitis but is not seen in all cases. Another important clue to the diagnosis is asymmetric involvement of the retroperitoneal fascial planes and deep tissues. Fasciitis in the retroperitoneum may originate from infected retroperitoneal organs or from infection that spreads along indirect and/or direct pathways from a primary source elsewhere in the body. Findings of indirect tracking and transgression of fascial planes may indicate more severe infection associated with the necrotizing form of retroperitoneal fasciitis. Despite aggressive antibiotic treatment, early and repeated surgical débridement may be required to remove nonviable tissue in patients with the necrotizing form of retroperitoneal fasciitis. Awareness of the anatomy of the retroperitoneum, potential routes of spread of infection, and the spectrum of CT findings in retroperitoneal fasciitis is needed to achieve prompt diagnosis and guide treatment.

  9. 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.

  10. Small bowel obstruction due to phytobezoar formation within meckel diverticulum: CT findings

    SciTech Connect

    Frazzini, V.I. Jr.; English, W.J.; Bashist, B.; Moore, E.

    1996-05-01

    Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet. 14 refs., 2 figs.

  11. Inhalational pulmonary talcosis: high-resolution CT findings in 3 patients.

    PubMed

    Marchiori, Edson; Souza Júnior, Arthur Soares; Müller, Nestor L

    2004-01-01

    We describe the high-resolution CT findings in 3 patients with pulmonary talcosis acquired by the inhalation of talc. The predominant abnormalities consisted of small centrilobular and subpleural nodules and conglomerated masses containing focal areas of high attenuation consistent with talc deposition. All patients also had focal ground glass opacities. The abnormalities were diffuse but were most severe in the upper and middle lung zones with relative sparing of the lung bases.

  12. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    PubMed

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement.

  13. Clinical and pulmonary thin-section CT findings in acute Klebsiella pneumoniae pneumonia.

    PubMed

    Okada, Fumito; Ando, Yumiko; Honda, Koichi; Nakayama, Tomoko; Kiyonaga, Maki; Ono, Asami; Tanoue, Shuichi; Maeda, Toru; Mori, Hiromu

    2009-04-01

    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit.

  14. CT and MR findings of Krukenberg tumors: Comparison with primary ovarian tumors

    SciTech Connect

    Kim, Seung Hyup; Kim, Won Hong; Park, Kyung Joo

    1996-05-01

    The purposes of this study were to evaluate the CT and MR findings of Krukenberg tumors and to compare them with those of primary ovarian tumors. This study included 20 patients with Krukenberg tumors and 65 patients with various primary ovarian tumors. CT/MR/both imaging studies were available in 15/1/4 patients with Krukenberg tumor and 31/10/24 patients with primary ovarian tumors, respectively. Imaging findings of the tumors were categorized into three subgroups: a solid mass with intratumoral cysts, a solid mass without intratumoral cysts, and a predominantly cystic mass. Among 32 Krukenberg tumors (bilateral in 12 patients), 22 were solid masses with intratumoral cysts, in 14 of which the wall of the intratumoral cysts showed apparently strong contrast enhancement on CT and/or MRI. Six Krukenberg tumors were solid masses without intratumoral cysts, and four were predominantly cystic masses. Imaging findings of 88 primary ovarian tumors (bilateral in 23 patients) were 5 solid masses with intratumoral cysts, 27 solid masses without intratumoral cysts, and 56 predominantly cystic masses. None of the five primary ovarian tumors with solid mass with intratumoral cysts demonstrated apparently strong contrast enhancement of the cyst wall. Krukenberg tumor should be suspected when one sees solid ovarian tumors containing well demarcated intratumoral cystic lesions, especially if the walls of those cysts demonstrate apparently strong contrast enhancement. 11 refs., 4 figs., 1 tab.

  15. Chinese Herbal Medicine for Functional Abdominal Pain Syndrome: From Clinical Findings to Basic Understandings

    PubMed Central

    Liu, Tao; Wang, Ning

    2016-01-01

    Functional abdominal pain syndrome (FAPS) is one of the less common functional gastrointestinal disorders. Conventional therapy has unsatisfactory response to it so people turn to Chinese medicine for help. Currently, we reviewed the whole picture of Chinese herbal medicine (CHM) clinical and basic application in the treatment of FAPS, especially the traditional Chinese medicine (TCM) syndrome, the single herb, and Chinese medicine formulae, thus to provide a solid base to further develop evidence-based study for this common gastrointestinal complaint in the future. We developed the search strategy and set the inclusion and exclusion criteria for article search. From the included articles, we totally retrieved 586 records according to our searching criteria, of which 16 were duplicate records and 291 were excluded for reasons of irrelevance. The full text of 279 articles was retrieved for detailed assessment, of which 123 were excluded for various reasons. The number one used single herb is Radix Ginseng. The most common syndrome was liver qi depression. The most frequently used classic formula was Si-Mo-Tang. This reflected the true situation of clinical practice of Chinese medicine practitioners and could be further systematically synthesized as key points of the therapeutic research for FAPS. PMID:27366194

  16. Chinese Herbal Medicine for Functional Abdominal Pain Syndrome: From Clinical Findings to Basic Understandings.

    PubMed

    Liu, Tao; Wang, Ning; Zhang, Li; Zhong, Linda

    2016-01-01

    Functional abdominal pain syndrome (FAPS) is one of the less common functional gastrointestinal disorders. Conventional therapy has unsatisfactory response to it so people turn to Chinese medicine for help. Currently, we reviewed the whole picture of Chinese herbal medicine (CHM) clinical and basic application in the treatment of FAPS, especially the traditional Chinese medicine (TCM) syndrome, the single herb, and Chinese medicine formulae, thus to provide a solid base to further develop evidence-based study for this common gastrointestinal complaint in the future. We developed the search strategy and set the inclusion and exclusion criteria for article search. From the included articles, we totally retrieved 586 records according to our searching criteria, of which 16 were duplicate records and 291 were excluded for reasons of irrelevance. The full text of 279 articles was retrieved for detailed assessment, of which 123 were excluded for various reasons. The number one used single herb is Radix Ginseng. The most common syndrome was liver qi depression. The most frequently used classic formula was Si-Mo-Tang. This reflected the true situation of clinical practice of Chinese medicine practitioners and could be further systematically synthesized as key points of the therapeutic research for FAPS.

  17. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  18. Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: (18)F-FDG PET/CT findings.

    PubMed

    Dhull, V S; Passah, A; Rana, N; Arora, S; Mallick, S; Kumar, R

    2016-01-01

    A 30-year-old female presented with a 3-month history of erosive stomatitis and bullous lesions, along with recurrent episodes of abdominal pain. She was found to have a retroperitoneal lump in left lumbar region. Skin biopsy revealed bullous disorder. CT guided biopsy of the retroperitoneal mass was suggestive of inflammatory myofibroblastic tumor (IMT). She was started on oral steroids and supportive care, and surgery was being planned when she developed respiratory failure. CT chest revealed vertebral metastases. PET/CT for whole body work up revealed a left para-aortic mass along with multiple skeletal metastases. The patient was kept on conservative management. After 3 months, the patient has shown clinical improvement, and an exploratory laparotomy is now being planned for the excision of the tumor, followed by chemotherapy. This case of retroperitoneal IMT is rare in terms of skeletal metastases with paraneoplastic pemphigus.

  19. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings.

    PubMed

    Gui, Benedetta; Danza, Francesco Maria; Valentini, Anna Lia; Laino, Maria Elena; Caruso, Alessandro; Carducci, Brigida; Rodolfino, Elena; Devicienti, Ersilia; Bonomo, Lorenzo

    2016-01-01

    Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings.

  20. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings

    PubMed Central

    Gui, Benedetta; Danza, Francesco Maria; Valentini, Anna Lia; Laino, Maria Elena; Caruso, Alessandro; Carducci, Brigida; Rodolfino, Elena; Devicienti, Ersilia; Bonomo, Lorenzo

    2016-01-01

    Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings. PMID:27756714

  1. [CT-findings in penetrating captive bolt injuries to the head and brain: analysis of the trauma-related CT-findings and review of the literature].

    PubMed

    Bula-Sternberg, J; Laniado, M; Kittner, T; Bonnaire, F; Lein, T; Bula, P

    2011-11-01

    Penetrating gunshot injuries to the head and brain are rare in Germany and the rest of Western Europe. Due to the small number of cases over here no consistent diagnostic and therapeutic standards exist in this respect. Thus these kinds of injuries present a great challenge to the attending physicians. Most of these violations are a result of a suicidal attempt or an accident. Beside violations by firearms also penetrating injuries to the head and brain due to captive bolt devices, as used in slaughtery business for the "humane" killing of animals, occur from time to time. The impact on the head differs from that caused by firearms because no projectile is leaving the barrel and the used bolt, as a fix part of the device, does not remain in the affected tissue. That implies characteristic results within the radiological imaging that might be pathbreaking for the further treatment, because the origin of such a head injury is often unknown during primary care. Consequently the knowledge of these specific findings is central to the radiologist to make the appropriate diagnosis. Based on some clinical examples the trauma-related CT-findings are introduced and a short overview of the relevant literature is also given.

  2. Abdominal and Pelvic CT

    MedlinePlus

    ... ray beam follows a spiral path. A special computer program processes this large volume of data to create ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ...

  3. CT and clinical findings of peripheral primitive neuroectodermal tumour in children

    PubMed Central

    Xiao, Huijuan; Bao, Fengchang; Tan, Hongna; Wang, Bo; Liu, Wei

    2016-01-01

    Objective: To describe the clinical, CT and pathological findings of paediatric peripheral primitive neuroectodermal tumours (pPNETs) to enhance the recognition of these rare tumours. Methods: The clinical, CT and pathological findings of 18 paediatric patients with pPNETs confirmed by biopsy or surgical pathology were retrospectively reviewed. Results: The age of these 18 paediatric patients with pPNETs ranged from 4 months to 15 years, with a mean age of 7.7 years. The lesions of these 18 paediatric patients with pPNETs were located in the head and neck (n = 4), chest (n = 2), abdomen and pelvic cavity (n = 6), spine (n = 3), ilium (n = 2) and femur (n = 1). Immunohistochemical examination revealed Homer–Wright rosettes in seven lesions, and 94.4% of lesions showed consistent positive staining for CD99. On plain CT images, the majority of pPNETs showed lesions that were ill-defined (72.2%), irregularly shaped (83.3%), heterogeneous (66.7%) or hypodense masses (94.4%), and together with osteolytic bone destruction when the lesion originated in the bone. Calcifications were found in three lesions. After contrast administration, all soft-tissue masses were persistently enhanced heterogeneously with various cystic or necrotic regions, and 71.4% of them had linear enhancement. 94.4% of soft-tissue masses showed a moderate degree of enhancement. Seven cases had lymph node metastasis at diagnosis. Conclusion: Paediatric pPNET can involve any part of the body, and a large, ill-defined, aggressive soft-tissue mass and moderate heterogeneous enhancement with varying cystic regions and linear enhancement, with or without osteolytic bone destruction, on CT images could suggest the diagnosis. Advances in knowledge: Primitive neuroectodermal tumours constitute a rare type of malignant neuroectodermal tumours that have chromosomal translocations identical to Ewing's sarcoma, and reports about radiological characteristics of this disease in children are

  4. Comparison between clinical, ultrasound, CT, MRI, and pathology findings in dogs presented for suspected thyroid carcinoma.

    PubMed

    Taeymans, Olivier; Penninck, Dominique G; Peters, Rachel M

    2013-01-01

    This study compares clinical, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings in 16 prospectively, and seven retrospectively recruited dogs presented for suspected thyroid carcinoma. Of these, 17 were confirmed thyroid carcinoma, while six were initially misdiagnosed. These included four carotid body tumors, one para-esophageal abscess, and one undifferentiated squamous cell carcinoma. Thyroid carcinomas occurred in older dogs without evidence of sex predilection, and were more often unilateral. All were large, heterogeneous, moderately to strongly vascularized, and most commonly contained areas of dystrophic mineralization and/or fluid accumulations. On MRI, thyroid carcinomas appeared hyperintense compared to surrounding musculature in all imaging sequences used, while on CT they had a lower attenuation value than normal thyroid gland tissue. Histologically confirmed tumor capsule disruption with invasion of the surrounding structures was most commonly detected with MRI. Palpation was not an accurate predictor of locally invasive vs. well-encapsulated masses. Computed tomography had the highest specificity (100%) and MRI had the highest sensitivity (93%) in diagnosing thyroid carcinoma, while ultrasound had considerably lower results. We conclude that ultrasound is adequate for use as a screening tool for dogs with suspected thyroid carcinoma, but recommend either CT or MRI for preoperative diagnosis and staging.

  5. 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.

  6. [Case of spontaneous ventriculocisternostomy: with special reference to a CT finding].

    PubMed

    Yamane, K; Yoshimoto, H; Harada, K; Uozumi, T; Kuwabara, S

    1983-05-01

    Spontaneous ventriculocisternostomy rarely occurs in obstructive hydrocephalus. The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300 mmH2O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. In the literature, arrest of hydrocephalus was noted in 50 per cent of 14 cases of obstructive hydrocephalus with spontaneous ventriculocisternostomy. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy.

  7. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult. PMID:27635170

  8. 3D documentation and visualization of external injury findings by integration of simple photography in CT/MRI data sets (IprojeCT).

    PubMed

    Campana, Lorenzo; Breitbeck, Robert; Bauer-Kreuz, Regula; Buck, Ursula

    2016-05-01

    This study evaluated the feasibility of documenting patterned injury using three dimensions and true colour photography without complex 3D surface documentation methods. This method is based on a generated 3D surface model using radiologic slice images (CT) while the colour information is derived from photographs taken with commercially available cameras. The external patterned injuries were documented in 16 cases using digital photography as well as highly precise photogrammetry-supported 3D structured light scanning. The internal findings of these deceased were recorded using CT and MRI. For registration of the internal with the external data, two different types of radiographic markers were used and compared. The 3D surface model generated from CT slice images was linked with the photographs, and thereby digital true-colour 3D models of the patterned injuries could be created (Image projection onto CT/IprojeCT). In addition, these external models were merged with the models of the somatic interior. We demonstrated that 3D documentation and visualization of external injury findings by integration of digital photography in CT/MRI data sets is suitable for the 3D documentation of individual patterned injuries to a body. Nevertheless, this documentation method is not a substitution for photogrammetry and surface scanning, especially when the entire bodily surface is to be recorded in three dimensions including all external findings, and when precise data is required for comparing highly detailed injury features with the injury-inflicting tool.

  9. 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.

  10. Secreted frizzled-related protein 1 overexpression in gastric cancer: Relationship with radiological findings of dual-energy spectral CT and PET-CT

    PubMed Central

    Lin, Huimin; Yang, Guoyuan; Ding, Bei; Zhang, Miao; Zhang, Mingjun; Yan, Fuhua; Qu, Ying; Zhang, Huan

    2017-01-01

    We explored the role of secreted frizzled-related protein 1 (sFRP1) overexpression in gastric cancer and its relationship with radiological findings from dual-energy spectral CT(DEsCT) and positron emission tomography/computed tomography (PET/CT). We established mouse metastatic models using the SGC-7901/sFRP1 gastric cancer cell line. A control group was established using the SGC-7901/vector cell line. The models were then scanned with dual-energy spectral CT and PET-CT. Subsequent analysis, including immunohistochemistry and Transferase-mediated deoxyuridine triphosphate-biotin nick end labelling (TUNEL), was performed to confirm the role of sFRP1. Transwell chamber and angiogenesis assays were conducted to verify the effect of sFRP1 in vitro. We found that the control group showed negative radiological performance with successful implantation. Concurrently, the treated group showed visible lesions, a higher FDG uptake and increasing enhancement. The immunological and histological analysis confirmed the positive radiological performance with larger size, increasing proliferation, more microvessels and less apoptosis. The angiogenic up-regulation of sFRP1 overexpression were further verified with in vitro cell models. This preliminary study demonstrates that sFRP1 overexpression in gastric cancer cells leads to increased cell proliferation and angiogenesis, which may, in turn, contribute to positive PET/CT and CT performances. PMID:28169332

  11. Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma.

    PubMed

    Camera, Luigi; Severino, Rosa; Faggiano, Antongiulio; Masone, Stefania; Mansueto, Gelsomina; Maurea, Simone; Fonti, Rosa; Salvatore, Marco

    2014-10-28

    Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography (CT) or magnetic resonance (MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved by somatostatin-receptor scintigraphy (SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR (Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT (Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure (3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.

  12. Prediction of intracranial findings on CT-scans by alternative modelling techniques

    PubMed Central

    2011-01-01

    Background Prediction rules for intracranial traumatic findings in patients with minor head injury are designed to reduce the use of computed tomography (CT) without missing patients at risk for complications. This study investigates whether alternative modelling techniques might improve the applicability and simplicity of such prediction rules. Methods We included 3181 patients with minor head injury who had received CT scans between February 2002 and August 2004. Of these patients 243 (7.6%) had intracranial traumatic findings and 17 (0.5%) underwent neurosurgical intervention. We analyzed sensitivity, specificity and area under the ROC curve (AUC-value) to compare the performance of various modelling techniques by 10 × 10 cross-validation. The techniques included logistic regression, Bayes network, Chi-squared Automatic Interaction Detection (CHAID), neural net, support vector machines, Classification And Regression Trees (CART) and "decision list" models. Results The cross-validated performance was best for the logistic regression model (AUC 0.78), followed by the Bayes network model and the neural net model (both AUC 0.74). The other models performed poorly (AUC < 0.70). The advantage of the Bayes network model was that it provided a graphical representation of the relationships between the predictors and the outcome. Conclusions No alternative modelling technique outperformed the logistic regression model. However, the Bayes network model had a presentation format which provided more detailed insights into the structure of the prediction problem. The search for methods with good predictive performance and an attractive presentation format should continue. PMID:22026551

  13. CT findings in malignant pleural mesothelioma related to nonoccupational exposure to asbestos and fibrous zeolite (erionite)

    SciTech Connect

    Erzen, C.; Eryilmaz, M.; Kalyoncu, F.; Bilir, N.; Sahin, A.; Baris, Y.I. )

    1991-03-01

    Endemic malignant pleural mesothelioma (MPM) in Turkey is related to two mineral fibers, tremolite asbestos and fibrous zeolite (erionite). Thirteen cases of MPM from the Cappadocian area, where the soil is rich in erionite, and 29 cases of MPM, from villages whose occupants have high asbestos exposure, were examined by CT. The CT findings of the two groups of MPM were compared with respect to the configuration of the pleural lesions, stage of disease, fissural involvement, pleural effusion, presence of calcified pleural plaques, and chronic fibrosing pleuritis. In erionite-related MPM the pleural lesions were flat and smooth in 69.1%; in asbestos-related MPM the lesions were nodular in 55.1%. Stage IV disease, calcified pleural plaques, and chronic fibrosing pleuritis were more common in the erionite-related MPM. The rest of the findings were similar in both groups. The early radiological diagnosis of erionite-related MPM may be even more difficult because of the similarity of the pleural lesions to chronic fibrosing pleuritis.

  14. 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).

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

    PubMed

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

    2009-04-07

    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 LCD(1%) assessed in a Catphan phantom and a constant central absorbed dose. The required variations of CTDIvol(16) 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 CNR(2.8%)), 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 rLCD(1%) for abdominal diameters of 10, 13, 16, 20 and 25 cm, tube current-time product should be adjusted in order to obtain CTDIvol(16) values of 6.2, 7.2, 8.8, 11.6 and 17.7 mGy, respectively).

  16. Suture Granuloma With False-Positive Findings on FDG-PET/CT Resected via Laparoscopic Surgery.

    PubMed

    Takeshita, Nobuyoshi; Tohma, Takayuki; Miyauchi, Hideaki; Suzuki, Kazufumi; Nishimori, Takanori; Ohira, Gaku; Narushima, Kazuo; Imanishi, Shunsuke; Toyozumi, Takeshi; Matsubara, Hisahiro

    2015-04-01

    A 61-year-old woman who had undergone total hysterectomy 16 years previously exhibited a pelvic tumor on computed tomography (CT). F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/CT imaging revealed a solitary small focus of increased FDG activity in the pelvis. A gastrointestinal stromal tumor originating in the small intestine or another type of tumor originating in the mesentery (desmoid, schwannoma, or foreign body granuloma) was suspected; therefore, laparoscopic resection was conducted. A white, hard tumor was found to originate from the mesentery of the sigmoid colon and adhered slightly to the small intestine. The tumor was resected with a negative margin, and the pathologic diagnosis was suture granuloma. The possibility of suture granuloma should be kept in mind in cases of tumors with positive PET findings and a history of surgery close to the lesion. However, it is difficult to preoperatively diagnose pelvic tumors using a biopsy. Therefore, considering the possibility of malignancy, it is necessary to achieve complete resection without exposing the tumor.

  17. CT Findings of Patients Treated with Irreversible Electroporation for Locally Advanced Pancreatic Cancer

    PubMed Central

    Akinwande, Olaguoke; Ahmad, Shakeeb S.; Van Meter, Tracy; Schulz, Brittany; Martin, Robert C. G.

    2015-01-01

    Introduction. In patients with locally advanced pancreatic cancer (LAPC), IRE has been shown to be safe for local disease control and palliation. As IRE continues to gain acceptance it is important to characterize the expected imaging findings. Materials and Methods. A review of our prospective soft tissue ablation registry from July 2010 to June 2013 was performed on patients who had undergone IRE for LAPC. Five masses treated with intraoperative IRE ablation for pancreatic tumors that underwent CT imaging before and after ablation were reviewed. Results and Discussion. Following IRE, the postablation bed is larger than the original ablated tumor. This ablation zone may get smaller in size (due to decreased edema and hyperemia) in the following months and more importantly remains stable provided there is no recurrence. In cases of recurrent disease there is increased size of the ablation bed, mass effect, and new or worsening vascular encasement or occlusion. Conclusion. CT imaging remains the best current imaging modality to assess post-IRE ablation changes. Serial imaging over at least 2–6 months must be employed to detect recurrence by comparing with prior studies in conjunction with clinical and serum studies. Larger imaging studies are underway to evaluate a more ideal imaging modality for this unique patient population. PMID:26649039

  18. [Significance of abdominal wall CT-angiography in planning DIEA perforator flaps, TRAM flaps and SIEA flaps].

    PubMed

    Fansa, H; Schirmer, S; Frerichs, O; Gehl, H B

    2011-04-01

    Muscle sparing TRAM flaps and DIEA perforator flaps are standard procedures for breast reconstruction. Recently CT-angiography has been established to evaluate perforator vessels pre-operatively. CT-angiography was introduced to our department in July 2009. In a retrospective analysis data of the last 20 patients (altogether 22 flaps) before CT-angiography introduction and the following 20 (also 22 flaps) patients after introduction of CT-angiography were analysed with regard to the ratio of TRAM to DIEP flaps, and the time required to raise the flaps. The same surgeon raised all flaps. As different surgeons performed dissection of the recipient site, anastomoses, and insertion of flaps, and patients received primary (with sentinel or complete lymphadenctomy) or secondary reconstructions, only the time required harvesting the flap was compared. Thus other influences on raising the flap were eliminated. DIEP flaps were harvested with one single perforator. If perfusion or was considered not to be safe via one single perforator a muscle sparing TRAM flap (ms2) was raised. Angiography was performed using a 64-slice multi-detector CT scanner. CT-angiography did not lead to an increased rate of DIEP flaps in relation to ms2-TRAM flaps. Harvesting time of all flap types with CT-angiography on average was 121 min, without CT-angiography 135 min. This was not significantly different. However, separate analysis of DIEP flaps and ms2-TRAM flaps revealed a significant advantage of CT-angiography based harvesting of DIEP flaps of 26 min: with CT-angiography 101 min vs. 127 min without CT-angiography (p<0.028). There were no significant differences for ms2-TRAM flaps. All scans showed course and branching, diameter and size of the inferior epigastric artery. If evident the superficial inferior epigastric artery (SIEA) was marked. Dosage was 292 mGy-606 mGy×cm dependent on body weight. CTDI was 6.8-14.7 mGy. CT-angiography is a reproducible and observer independent procedure

  19. Effect of Low Tube Voltage on Image Quality, Radiation Dose, and Low-Contrast Detectability at Abdominal Multidetector CT: Phantom Study

    PubMed Central

    Tang, Kun; Wang, Ling; Li, Rui; Lin, Jie; Zheng, Xiangwu; Cao, Guoquan

    2012-01-01

    Purpose. To investigate the effect of low tube voltage (80 kV) on image quality, radiation dose, and low-contrast detectability (LCD) at abdominal computed tomography (CT). Materials and Methods. A phantom containing low-contrast objects was scanned with a CT scanner at 80 and 120 kV, with tube current-time product settings at 150–650 mAs. The differences between image noise, contrast-to-noise ratio (CNR), and scores of LCD obtained with 80 kV at 150–650 mAs and those obtained with 120 kV at 300 mAs were compared respectively. Results. The image noise substantially increased with low tube voltage. However, with identical dose, use of 80 kV resulted in higher CNR compared with CNR at 120 kV. There were no statistically significant difference in CNR and scores of LCD between 120 kV at 300 mAs and 80 kV at 550–650 mAs (P > 0.05). The relative dose delivered at 80 kV ranged from 58% at 550 mAs to 68% at 650 mAs. Conclusion. With a reduction of the tube voltage from 120 kV to 80 kV at abdominal CT, the radiation dose can be reduced by 32% to 42% without degradation of CNR and LCD. PMID:22619490

  20. SU-F-207-02: Use of Postmortem Subjects for Subjective Image Quality Assessment in Abdominal CT Protocols with Iterative Reconstruction

    SciTech Connect

    Mench, A; Lipnharski, I; Carranza, C; Lamoureux, R; Smajdor, L; Cormack, B; Mohammed, T; Rill, L; Arreola, M; Sinclair, L

    2015-06-15

    Purpose: New radiation dose reduction technologies are emerging constantly in the medical imaging field. The latest of these technologies, iterative reconstruction (IR) in CT, presents the ability to reduce dose significantly and hence provides great opportunity for CT protocol optimization. However, without effective analysis of image quality, the reduction in radiation exposure becomes irrelevant. This work explores the use of postmortem subjects as an image quality assessment medium for protocol optimizations in abdominal CT. Methods: Three female postmortem subjects were scanned using the Abdomen-Pelvis (AP) protocol at reduced minimum tube current and target noise index (SD) settings of 12.5, 17.5, 20.0, and 25.0. Images were reconstructed using two strengths of iterative reconstruction. Radiologists and radiology residents from several subspecialties were asked to evaluate 8 AP image sets including the current facility default scan protocol and 7 scans with the parameters varied as listed above. Images were viewed in the soft tissue window and scored on a 3-point scale as acceptable, borderline acceptable, and unacceptable for diagnosis. The facility default AP scan was identified to the reviewer while the 7 remaining AP scans were randomized and de-identified of acquisition and reconstruction details. The observers were also asked to comment on the subjective image quality criteria they used for scoring images. This included visibility of specific anatomical structures and tissue textures. Results: Radiologists scored images as acceptable or borderline acceptable for target noise index settings of up to 20. Due to the postmortem subjects’ close representation of living human anatomy, readers were able to evaluate images as they would those of actual patients. Conclusion: Postmortem subjects have already been proven useful for direct CT organ dose measurements. This work illustrates the validity of their use for the crucial evaluation of image quality

  1. [Why should an abdominal CT scan be performed for suspected appendicitis in the adult patient? Lessons from ten clinical cases].

    PubMed

    Pautrat, K; Soyer, P; Pocard, M

    2009-10-01

    Ten years after its introduction, the contribution and indications for computed tomography (CT) in the diagnosis of appendicitis remain the subject of controversy among surgeons. Many argue that CT is frequently superfluous and costly, results in excessive radiation exposure, and delays surgical treatment. On our service, we perform 150 to 180 adult appendectomies annually. We feel that CT helps us to avoid unnecessary appendectomy, to clear up diagnostic uncertainty, and, most importantly, to guide the choice of surgical approach. We illustrate our experience through ten clinical cases in which the use of preoperative imaging has resulted in improved care.

  2. PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings.

    PubMed

    Froehner, Michael; Toma, Marieta; Zöphel, Klaus; Novotny, Vladimir; Laniado, Michael; Wirth, Manfred P

    2017-01-01

    A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with (68)Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

  3. PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

    PubMed Central

    Toma, Marieta; Zöphel, Klaus; Novotny, Vladimir; Laniado, Michael

    2017-01-01

    A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

  4. Abdominal involvement in tuberculosis.

    PubMed

    Neyman, Edward G; Georgiades, Christos S; Fishman, Elliot K

    2002-10-01

    Rising incidence of disseminated and extrapulmonary tuberculosis (TB), especially in immunocompromised hosts and patients with multi-drug-resistant tuberculosis, has resulted in an increase of unusual clinical and radiographic presentations of TB. With CT being a common part of emergency room (ER) evaluation of abdominal pain, it is imperative that radiologists be able to recognize abdominal presentations of TB. We discuss and illustrate typical and less common CT manifestations of tuberculosis in the abdomen to help ER radiologists in this task.

  5. Case report highlighting how wound path identification on CT can help identify organ damage in abdominal blast injuries.

    PubMed

    Fischer, Tatjana V; Folio, Les R; Backus, Christopher E; Bunger, Rolf

    2012-01-01

    Penetrating trauma is frequently encountered in forward deployed military combat hospitals. Abdominal blast injuries represent nearly 11% of combat injuries, and multiplanar computed tomography imaging is optimal for injury assessment and surgical planning. We describe a multiplanar approach to assessment of blast and ballistic injuries, which allows for more expeditious detection of missile tracts and damage caused along the path. Precise delineation of the trajectory path and localization of retained fragments enables time-saving and detailed evaluation of associated tissue and vascular injury. For consistent and reproducible documentation of fragment locations in the body, we propose a localization scheme based on Cartesian coordinates to report 3-dimensional locations of fragments and demonstrating the application in three cases of abdominal blast injury.

  6. CT enteroclysis/enterography findings in drug-induced small-bowel damage

    PubMed Central

    Shimizu, K; Hashimoto, S; Onoda, H; Washida, Y; Sakaida, I; Matsunaga, N

    2014-01-01

    Objective: To evaluate the CT enteroclysis (CTE)/enterography findings of patients with small-bowel mucosal damage induced by aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) and to compare these findings with the duration of drug use and endoscopic findings. Methods: CTE findings of 11 patients (22 lesions) with drug-induced small-bowel damage were reviewed, including 8 NSAID users and 3 aspirin users. Three patients were short-term users (6 months or shorter) and eight were long-term users (3 years or longer). Nine patients also underwent videocapsule endoscopy (VCE) or double-balloon enteroscopy (DBE). Results: Small-bowel abnormalities were visible in 8 of 11 patients (73%) on CTE. Multiple lesions were seen in five patients, including all short-term users. Lesions were classified into three types. Type 1 (mucosal patchy enhancement) was found in four of eight patients (50%, 12 lesions) all were short-term users. Small erosions with mild oedema/redness were shown by DBE. Type 2 (homogeneous hyperenhancement) was found in two of eight patients (25%, four lesions) who were long-term users. Large ulcers with marked oedema/redness were shown by DBE. Type 3 (stratification enhancement) was found in four of eight patients (50%, six lesions), both short-term and long-term users. Annular or large ulcers with strictures were shown by VCE or DBE. Conclusion: On CTE, Type 1 lesions in patients with mostly short-term aspirin or NSAID use, Type 2 lesions in patients with long-term use and Type 3 lesions in both types of patients were detected. CTE may have usefulness for the detection of mild damage. Advances in knowledge: Small-bowel abnormalities owing to aspirin or NSAID present with three different patterns on CTE. PMID:25348282

  7. Probable atypical cat scratch disease presenting as isolated posterior pancreatic duodenal lymphadenitis and abdominal pain.

    PubMed

    Dzelalija, B; Petrovec, M; Avsic-Zupanc, T

    2001-09-15

    We report a case involving a 15-year-old girl with atypical, clinically unsuspected cat scratch disease (CSD) presenting as isolated posterior pancreatic duodenal lymphadenitis, fever, and abdominal pain. The serological, abdominal ultrasonographic, and CT findings, as well as clinical and epidemiological data, indicate that B. henselae was likely an etiologic agent of CSD in our patient.

  8. 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.

  9. Indirect CT venography of the abdominal cavity and lower limbs in patients with the suspicion of pulmonary embolism--indications, technique, diagnostic possibilities.

    PubMed

    Czekajska-Chehab, Elzbieta; Drop, Andrzej; Terlecka, Barbara; Trzeciak, Jadwiga; Trojanowska, Agnieszka; Odój, Magdalena

    2004-01-01

    Multi-slice computed tomography has become the main method to diagnose and evaluate the intensity of acute pulmonary embolism (PE). The most common cause of PE is thrombosis of veins of the lower limbs and pelvis. The paper presents various aspects of the use of combined pulmonary artery arteriography and indirect venography performed using multi-slice tomography in relation to other methods imaging the venous system used so far. The authors presented the techniques of CT examination of venous vessels of the lower limbs, abdominal cavity and pelvis in patients with the suspicion of PE, typical images of lesions, results of studies concerning these issues conducted to date and their own experience based on clinical practice.

  10. Thoracic computerized tomographic (CT) findings in 2009 influenza A (H1N1) virus infection in Isfahan, Iran

    PubMed Central

    Rostami, Mojtaba; Javadi, Abbas-Ali; Khorvash, Farzin; Mostafavizadeh, Kamyar; Adibi, Atoosa; Babak, Anahita; Ataei, Behrooz; Meidani, Mohsen; Naeini, Alireza Emami; Salehi, Hasan; Avijgan, Majid; Yazdani, Mohammad Reza; Rezaei, Farshid

    2011-01-01

    BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23rd 2009 to February 20th 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific. PMID:22091280

  11. Study on Neurological Manifestations of Eclampsia & Findings of CT scan of Brain.

    PubMed

    Begum, F; Nahar, K; Ahmed, M U; Ferdousi, R A; Akter, F A; Rahman, M M

    2015-10-01

    This cross sectional study was carried out in the Department of Obstetrics & Gynaecology in Mymensingh Medical College Hospital during the period of January 2011 to December 2012 to evaluate neurological manifestations in eclampsia by CT scan of brain. A total 35 patients with eclampsia were studied, who underwent CT scan of brain in Radiology & Imaging Department of Mymensingh Medical College Hospital. The study patients were divided into two groups, those who had changes in brain on CT scan (Group A) & those who had no changes in brain on CT scan (Group B). Finally the study variables were compared between these two groups. Each selected patient fulfilling the criteria was sent to the department of Radiology & Imaging for CT scanning of brain. In antepartum cases of eclampsia CT scan of brain were done after delivery/ termination of pregnancy. In all cases, CT scan of brain was done within 72 hours of admission. Out of 35 patients total 85.72% had changes in brain on CT scan & 14.28% had no changes in brain on CT scan. Among them 45.72% patients had cerebral oedema, 37.14% had cerebral infarct & 2.86% patients had intracerebral haemorrhage. Comparison of neurological parameters were done & showed that there were statistically significant difference between the two groups regarding headache, visual disturbance, hypereflexia & depression of consciousness. There was no statistically significant difference regarding aphasia & hemiplegia between the two groups. So the CT scan of brain has been useful in demonstrating the lesion of brain in patients with eclampsia & also helpful to evaluate the neurological manifestations in eclampsia.

  12. 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.

  13. Primary clear cell carcinoma in the liver: CT and MRI findings

    PubMed Central

    Liu, Qing-Yu; Li, Hai-Gang; Gao, Ming; Lin, Xiao-Feng; Li, Yong; Chen, Jian-Yu

    2011-01-01

    AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups. METHODS: Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study. CT or MRI images from these patients were retrospectively analyzed. The following imaging findings were reviewed: the presence of liver cirrhosis, tumor size, the enhancement pattern on dynamic contrast scanning, the presence of pseudo capsules, tumor rupture, portal vein thrombosis and lymph node metastasis. RESULTS: Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis, the association rate of liver cirrhosis was 80.0% and 78.7%, respectively (P > 0.05). The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm, respectively. Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases. No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803, respectively). Compared with CHCC patients, PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%, P = 0.034). Tumor rupture, typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20), 72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127), 83.6% (97/116) and 17.3% (22/127) of patients with CHCC, respectively. There were no significant differences between the two groups (all P > 0.05). No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05). CONCLUSION: The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such

  14. Management of Accidental Finding of Ascaris Lumbricoides During Emergent Abdominal Surgery: A Case Report and Review of the Literature.

    PubMed

    Esfehani, Maryam Hassan; Jahanshahi, Abdolhadi; Karimi, Amirhossein

    2016-01-01

    Ascariasis lumbricoides is the most common soil-transmitted helminth worldwide and most often is asymptomatic, although it can present with abdominal pain, malabsorption and growth failure, complete or partial obstraction in small bowel and biliary system and etc. Accidental encounters with ascaris during emergent abdominal surgeries are very rare and have been reported in less than a handful of papers. In this report, we describe this rare event from a country with low prevalence of this infection, and then review the literatures and clarify the possible challenges for surgeons during operation and postoperative follow-up.

  15. Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings.

    PubMed

    Asil, Kiyasettin; Gunduz, Yasemin; Yaldiz, Can; Aksoy, Yakup Ersel

    2015-01-01

    A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness.

  16. Primary epiploic appendagitis: CT diagnosis.

    PubMed

    Sandrasegaran, Kumaresan; Maglinte, Dean D; Rajesh, Arumugam; Akisik, Fatih M

    2004-08-01

    The purpose of this study was to analyze the CT signs of primary epiploic appendagitis. A retrospective search of the CT database over 12 months for this diagnosis revealed 11 cases. The clinical findings were recorded. Softcopy CT images were reviewed by two experienced abdominal radiologists (KS, DM) for location of lesion, size, shape, presence of central hyperdense focus, degree of bowel wall thickening, mass effect, and ancillary signs. Abdominal pain was the primary symptom in all patients. Preliminary diagnoses were appendicitis (n=2), diverticulitis (n=5), pancreatitis (n=1), ovarian lesion (n=1), or unknown (n=2). Abdominal examination and white blood cell count were uninformative. CT examination revealed a solitary (n=11), ovoid (n=9) fatty lesion with some soft tissue stranding adjacent to the left colon (n=6), transverse colon (n=3), or right colon (n=2). Central hyperdensity (n=5), mild bowel wall thickening (n=2), and parietal peritoneal thickening (n=4) were also seen. In 4 patients the lesions were not visible on follow-up CT examination performed 23-184 days later. Primary epiploic appendagitis can clinically mimic other, more serious inflammatory conditions. Knowledge of its findings on CT would help the radiologist make the diagnosis and allow a more conservative approach to patient care.

  17. Impact of FDG-PET/CT on Radiotherapy Volume Delineation in Non-Small-Cell Lung Cancer and Correlation of Imaging Stage With Pathologic Findings

    SciTech Connect

    Faria, Sergio L. Menard, Sonia; Devic, Slobodan; Sirois, Christian; Souhami, Luis; Lisbona, Robert; Freeman, Carolyn R.

    2008-03-15

    Purpose: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. Methods and Materials: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. Results: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. Conclusion: The contour of the tumor volume of non-small-cell lung cancer patients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.

  18. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases.

    PubMed

    D'Elia, F; Zingarelli, A; Palli, D; Grani, M

    2000-01-01

    The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400-600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99% in early and advanced gastric cancer, respectively, with overall detection rate of 96% (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78%. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20% (3 of 15) and 87% (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3-pT4 vs pT1-pT2) was 93, 90, and 91.6%, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87%, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5% and specificity of 99 %. The sensitivity of peritoneal involvement was 30% when ascites or peritoneal nodules were absent. Our findings show that dynamic CTcan play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients.

  19. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review.

    PubMed

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen

    2016-06-01

    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  20. [Gene-environment interaction for the HIF1-A 1772C>T polymorphisms and cigarette smoking increase susceptibility to abdominal aortic aneurysm].

    PubMed

    Strauss, Ewa; Waliszewski, Krzysztof; Oszkinis, Grzegorz; Staniszewski, Ryszard

    2012-01-01

    Pathological changes in the vascular vessels, such as the presence of atherosclerotic plaques or aneurysmal dilatations, are associated with the local conditions of ischemial/hypoxia. Polymorphisms in the HIF1A gene, encoding an oxygen-regulated HIF-1 subunit (HIF-1a), determine inter-individual variability in vascular response to hypoxia. Stimulation of selected pathways, related to this response (i.e. angiogenesis) is impaired by cigarette smoke exposure. In this work, we examined the associations between 1772C>T polymorphism (rs11549465) located in the coding region of HIF1A gene (Pro582-Ser), smoking and the occurrence of abdominal aortic aneurysm (AAA). Moreover, the relations of these factors with the presence of peripheral arterial disease (PAD) in patients with AAA were studied. The case-control study was designed, in which a group of 1060 Caucasian subjects: 535 AAA patients and 525 controls, was analyzed. Data regarding smoking status were collected using questionnaire. Past and current smokers were analyzed together. In the group of 220 AAA subjects the coexistence of PAD was characterized. HIF-1A genotypes were assessed by PCR-RFLP method. Genetic-environmental interactions were examined by a two-by-four tables. In these analyzes, logistic regression models were used to adjusting for the relevant covariates. The frequency of HIF1A 1772T allele in AAA group (0,067) was similar to that observed in the control group (0,070). In the analyses of genetic-environmental interactions was observed that the co-occurrence of HIF1A 1772CT and TT genotypes and exposure to tobacco smoke has a strong multiplicative effect on the susceptibility to the AAA development. The age and gender adjusted odds ratios (ORs) were: 7,6 for smoking alone (p<0,0001); 0,65 for 1772CT and TT genotypes alone (p=0,3) and 14,4for smoking plus 1772CT and TT genotypes (p<0,0001). The proportion of smokers carrying 1772T allele was higher among patients with advanced form of PAD (femoro

  1. Peritoneal tuberculosis with elevated CA-125 mimicking ovarian cancer with carcinomatosis peritonei: Crucial CT findings

    PubMed Central

    Chien, Jerry Chin-Wei; Fang, Chia-Lang; Chan, Wing P.

    2016-01-01

    Preoperative diagnosis of peritoneal tuberculosis is often difficult because of confusion with ovarian cancer. A 56-year-old woman was admitted to our hospital with abdominal fullness. Ascites, prominent bilateral ovaries, and elevated CA-125 were noted. Computed tomography showed thickened peritoneum and strandings in the mesentery and omentum. Exploratory laparotomy was performed under the provisional diagnosis of ovarian cancer, but the final diagnosis was peritoneal tuberculosis. Careful evaluation of bilateral fallopian tubes and ovaries and peritoneum are helpful for correct diagnosis.

  2. Peritoneal tuberculosis with elevated CA-125 mimicking ovarian cancer with carcinomatosis peritonei: Crucial CT findings.

    PubMed

    Chien, Jerry Chin-Wei; Fang, Chia-Lang; Chan, Wing P

    2016-01-01

    Preoperative diagnosis of peritoneal tuberculosis is often difficult because of confusion with ovarian cancer. A 56-year-old woman was admitted to our hospital with abdominal fullness. Ascites, prominent bilateral ovaries, and elevated CA-125 were noted. Computed tomography showed thickened peritoneum and strandings in the mesentery and omentum. Exploratory laparotomy was performed under the provisional diagnosis of ovarian cancer, but the final diagnosis was peritoneal tuberculosis. Careful evaluation of bilateral fallopian tubes and ovaries and peritoneum are helpful for correct diagnosis.

  3. Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings

    PubMed Central

    Gunduz, Yasemin; Yaldiz, Can; Aksoy, Yakup Ersel

    2015-01-01

    A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness. PMID:25674346

  4. Cone beam CT findings of retromolar canals: Report of cases and literature review

    PubMed Central

    Han, Sang-Sun

    2013-01-01

    A retromolar canal is an anatomical variation in the mandible. As it includes the neurovascular bundle, local anesthetic insufficiency can occur, and an injury of the retromolar canal during dental surgery in the mandible may result in excessive bleeding, paresthesia, and traumatic neuroma. Using imaging analysis software, we evaluated the cone-beam computed tomography (CT) images of two Korean patients who presented with retromolar canals. Retromolar canals were detectable on the sagittal and cross-sectional images of cone-beam CT, but not on the panoramic radiographs of the patients. Therefore, the clinician should pay particular attention to the identification of retromolar canals by preoperative radiographic examination, and additional cone beam CT scanning would be recommended. PMID:24380072

  5. 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

  6. Intraosseous pneumatocyst of the ilium: CT findings in two cases and literature review.

    PubMed

    Catalano, O; De Rosa, F; Muto, M

    1997-01-01

    Intraosseous pneumatocyst of the ilium is a rare lesion of uncertain origin. It predilects male subjects and may be associated or not with sacroiliac joint degenerative disease, intra-articular gas, sacral pneumatocyst, and communication with the articular space. To our knowledge, only 16 observations have been reported in the literature. We have evaluated with plain radiographs and CT two additional cases. Plain films frequently identify these lesions, but CT is the method of choice in demonstrating their air density and assessing the possible abnormalities of the surrounding bone and sacroiliac joints.

  7. Wegener's granulomatosis: parotid involvement and associated pancreatitis with C.T. findings.

    PubMed

    Stuckey, S L; Smart, P J

    1992-11-01

    Parotid enlargement is an uncommon physical sign and even less commonly the reason for referral for computerised tomography (CT) as the aetiology is usually self-evident. In cases referred for CT examination Wegener's granulomatosis should be considered, particularly if the pathology appears bilateral. This diagnosis may be confirmed by biopsy and/or supported by Anti-Neutrophil Cytoplasmic Antibody (ANCA) assay. A case of Wegener's granulomatosis with parotid gland involvement and temporally related pancreatitis with pseudocyst formation is reported. This is the second reported case of possible pancreatic involvement in Wegeners granulomatosis and approximately the tenth reported case of salivary gland involvement.

  8. Pulmonary Artery Sarcoma Detected on 18F-FDG PET/CT With Unusual Findings.

    PubMed

    Guo, Yuehong; Wang, Tie; Yang, Minfu

    2015-11-01

    A 32-year-old woman, who presented with "sharp pain" in the right chest for more than 1 month and worsening dyspnea and fever for 10 days, was initially thought to have a pulmonary embolism. Cardiac ultrasound showed an ill-defined echogenic mass within the pulmonary trunk. F-FDG PET/CT was performed for further evaluation. PET/CT showed an intense hypermetabolism in the main, bilateral proximal, and the right main pulmonary arteries, suggesting the presence of a malignant lesion. Biopsy confirmed the lesion as a primary pulmonary artery sarcoma.

  9. Normal variations and benign findings in pediatric 18F-FDG-PET/CT.

    PubMed

    Grant, Frederick D

    2014-04-01

    (18)F-FDG PET and PET/CT have a wide variety of indications in children and young adults. Oncologic indications are the most common, but others include neurology, sports medicine, cardiology, and infection imaging. Accurate interpretation of pediatric (18)F-FDG PET and PET/CT requires a technically adequate study and knowledgeable interpretation of the images. A successful pediatric (18)F-FDG PET requires age-appropriate patient preparation and consideration of patient age and developmental stage. Accurate interpretation of the study requires familiarity with normal patterns of physiologic (18)F-FDG uptake in children at all stages of development.

  10. 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.

  11. Study Finds Small Increase in Cancer Risk after Childhood CT Scans

    Cancer.gov

    A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

  12. [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

  13. An hybrid CPU-GPU framework for quantitative follow-up of abdominal aortic aneurysm volume by CT angiography

    NASA Astrophysics Data System (ADS)

    Kauffmann, Claude; Tang, An; Therasse, Eric; Soulez, Gilles

    2010-03-01

    We developed a hybrid CPU-GPU framework enabling semi-automated segmentation of abdominal aortic aneurysm (AAA) on Computed Tomography Angiography (CTA) examinations. AAA maximal diameter (D-max) and volume measurements and their progression between 2 examinations can be generated by this software improving patient followup. In order to improve the workflow efficiency some segmentation tasks were implemented and executed on the graphics processing unit (GPU). A GPU based algorithm is used to automatically segment the lumen of the aneurysm within short computing time. In a second step, the user interacted with the software to validate the boundaries of the intra-luminal thrombus (ILT) on GPU-based curved image reformation. Automatic computation of D-max and volume were performed on the 3D AAA model. Clinical validation was conducted on 34 patients having 2 consecutive MDCT examinations within a minimum interval of 6 months. The AAA segmentation was performed twice by a experienced radiologist (reference standard) and once by 3 unsupervised technologists on all 68 MDCT. The ICC for intra-observer reproducibility was 0.992 (>=0.987) for D-max and 0.998 (>=0.994) for volume measurement. The ICC for inter-observer reproducibility was 0.985 (0.977-0.90) for D-max and 0.998 (0.996- 0.999) for volume measurement. Semi-automated AAA segmentation for volume follow-up was more than twice as sensitive than D-max follow-up, while providing an equivalent reproducibility.

  14. Giant Serous Cystadenoma of the Pancreas (⩾10 cm): The Clinical Features and CT Findings

    PubMed Central

    Zhou, Jun; Zeng, Yu-Rong; Lin, Xiao-Feng; Min, Jun

    2016-01-01

    Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm). Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm–16.5 cm (median value, 13.0 cm). CT imaging revealed that all 6 cases showed microcystic appearances (n = 5) or mixed microcystic and macrocystic appearances (n = 1). Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL). After 6–49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image. PMID:27610132

  15. [Esophageal dilatation in a patient with myotonic dystrophy: a correlative study on CT and pathologic findings].

    PubMed

    Kono, S; Kaida, K; Kawai, M

    1998-03-01

    We reported a 63-year-old woman with myotonic dystrophy (MD), who had frequent swallowing disturbances and died from suffocation asphyxia. Her esophagus on CT image 30 minutes after taking semi-solid meal showed dietary remnants in the middle portion of esophagus with entire esophageal dilatation. At autopsy, there was marked atrophy in the striated muscles in the upper part and smooth muscles in the lower part of the esophagus. The site of dietary stagnation on CT image was identical to the atrophic smooth muscle layer seen at autopsy. We speculate that one of the causes of esophageal motor dysfunctions is smooth muscle atrophy. The dietary stagnation in the esophagus may increase a risk of the asphyxia. Therefore we need to keep patients at the straight position during and after dietary ingestion to prevent respiratory problems.

  16. Multislice CT pulmonary findings in Behçet's disease (report of 16 cases).

    PubMed

    Emad, Y; Abdel-Razek, N; Gheita, T; el-Wakd, M; el-Gohary, T; Samadoni, A

    2007-06-01

    Pulmonary artery aneurysm is the best-defined type of pulmonary disease in Behçet's disease (BD) with an important morbidity and mortality. The objective of this study was to assess the contribution of high-resolution dynamic chest CT imaging for one of the most serious aspects of BD: pulmonary artery aneurysm and other pulmonary parenchymal involvement. Sixteen BD patients were recruited for this study, (14 men, 87.5%, and 2 women, 12.5%). All patients fulfilled the 1990 American College of Rheumatology criteria for classification of BD [International Study Group for Behçet's Disease, Lancet 335:1078-1080, (1990)]. All patients underwent thorough history taking, full clinical examination, and routine laboratory investigations. Plain chest X-rays and pulmonary CT angiography were performed on all patients in an attempt to assess the pulmonary vasculature and lung parenchyma. Pulmonary vascular abnormalities were as follows: pulmonary artery aneurysms of varying sizes in nine patients (56.3%), main pulmonary artery ectasia in two patients (12.5%), pulmonary artery embolism in two patients (12.5%), venacaval thrombosis in seven patients (43.8%), and pulmonary venous varices in four patients (25%). Pulmonary parenchymal abnormalities were as follows: three patients (18.8%) with mild central bronchiectasis, one patient (6.3%) with atelectasis, one patient (6.3%) with subpleural nodule, and four patients (25%) with interstitial lung disease. Eight of the male patients were smokers. Multislice CT is useful in demonstrating the entire spectrum of thoracic manifestations of BD. Multislice CT is noninvasive and provides excellent delineation of the vessel lumen and wall and perivascular tissues, as well as detailed information concerning the lung parenchyma, pleura, and mediastinal structures.

  17. Capillary Hemangioma of Thoracic Spinal Cord: PET/CT and MR Findings.

    PubMed

    Shen, Guohua; Su, Minggang; Zhao, Junyi; Liu, Bin; Kuang, Anren

    2017-02-13

    Capillary hemangiomas are frequently encountered superficially in the cutaneous, subcutaneous, or mucosal tissues during the childhood and early adulthood, but the occurrence of spinal intradural capillary hemangioma is relatively rare. Herein, we report a case with capillary hemangioma of the thoracic spine. MR and PET/CT features of this lesion are presented, and awareness of this entity may help differentiate it from other spinal intradural tumors.

  18. Current CT/MRI examination of the upper intestinal tract.

    PubMed

    Taourel, P; Pradel, J; Bruel, J M

    1994-12-01

    When properly performed, CT of the abdomen can provide valuable information about mural diseases of the alimentary tract. It can demonstrate the digestive origin of an abdominal mass, categorize a given lesion on the basis of its specific CT appearance and any associated CT findings, assess the extramural spread of gastrointestinal lesion, guide various interventional procedures (biopsy, drainage) and follow a patient's response to therapy.

  19. Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in The COPDGene® Study

    PubMed Central

    Kim, Song Soo; Yagihashi, Kunihiro; Stinson, Douglas S.; Zach, Jordan A.; McKenzie, Alexander S.; Curran-Everett, Douglas; Wan, Emily S.; Silverman, Edwin K.; Crapo, James D.; Lynch, David A.

    2014-01-01

    Within the COPD Genetic Epidemiology (COPDGene®) study population of cigarette smokers, 9% were found to be unclassifiable by the Global Initiative for chronic Obstructive Lung Disease (GOLD) criteria. This study was to identify the differences in computed tomography (CT) findings between this nonobstructed (GOLDU) group and a control group of smokers with normal lung function. This research was approved by the institutional review board of each institution. CT images of 400 participants in the COPDGene® study (200 GOLDU, 200 smokers with normal lung function) were retrospectively evaluated in a blinded fashion. Visual CT assessment included lobar analysis of emphysema (type, extent), presence of paraseptal emphysema, airway wall thickening, expiratory air trapping, centrilobular nodules, atelectasis, non-fibrotic and fibrotic interstitial lung disease (ILD), pleural thickening, diaphragmatic eventration, vertebral body changes and internal thoracic diameters (in mm). Univariate comparisons of groups for each CT parameter and multiple logistic regression were performed to determine the imaging features associated with GOLDU. When compared with the control group, GOLDU participants had a significantly higher prevalence of unilateral diaphragm eventration (30% vs. 16%), airway wall thickening, centrilobular nodules, reticular abnormality, paraseptal emphysema (33% vs. 17%), linear atelectasis (60% vs. 35.6%), kyphosis (12% vs. 4%), and a smaller internal transverse thoracic diameter (255 ± 22.5 [standard deviation] vs. 264.8 ± 22.4, mm) (all p<0.05). With multiple logistic regression, all of these CT parameters, except non-fibrotic ILD and kyphosis, remained significantly associated with GOLDU status (p<0.05). In cigarette smokers, chest wall abnormalities and parenchymal lung disease, which contribute to restrictive physiologic impairment, are associated with GOLD-nonobstructed status. PMID:25197723

  20. Aneurysms of the portal venous system. Gray-scale and color Doppler ultrasonographic findings with CT and MRI correlation.

    PubMed

    Atasoy, K C; Fitoz, S; Akyar, G; Aytaç, S; Erden, I

    1998-01-01

    Two cases of incidentally detected aneurysms involving the portal venous system are described with emphasis on gray-scale and color Doppler ultrasonographic (US) findings. Appearing on US as anechoic masses showing direct luminal continuity with the right portal vein and superior mesenteric vein, the lesions displayed spectral findings characteristic of portal venous system on color Doppler US. Dynamic helical computed tomography (CT) demonstrated simultaneous enhancement with the portal system, while the aneurysms were hypointense owing to flow void on T1-weighted spin-echo magnetic resonance (MR) images.

  1. 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

  2. CT findings for intracerebral hemorrhage have little incremental impact on post-stroke mortality prediction model performance

    PubMed Central

    Zahuranec, Darin B.; Sánchez, Brisa N.; Brown, Devin L.; Wing, Jeffrey J.; Smith, Melinda A.; Garcia, Nelda M.; Meurer, William J.; Morgenstern, Lewis B.; Lisabeth, Lynda D.

    2012-01-01

    Background Stroke outcome studies often combine cases of intracerebral hemorrhage (ICH) and ischemic stroke (IS). These studies of mixed stroke typically ignore computed tomography (CT) findings for ICH cases, though the impact of omitting these traditional predictors of ICH mortality is unknown. We investigated the incremental impact of ICH CT findings on mortality prediction model performance. Methods Cases of ICH and IS (2000–2003) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project. Base models predicting 30-day mortality included demographics, stroke type, and clinical findings (National Institutes of Health Stroke Scale (NIHSS) +/− Glasgow coma scale (GCS)). The impact of adding CT data (volume, intraventricular hemorrhage, infratentorial location) was assessed with the area under the curve (AUC), unweighted sum of squared residuals (Ŝ), and integrated discrimination improvement (IDI). The model assessment was performed first for the mixed case of IS and ICH, and then repeated for ICH cases alone to determine whether any lack of improvement in model performance with CT data for mixed stroke type was due to IS cases naturally forming a larger proportion of the total sample than ICH. Results A total of 1,256 cases were included (86% IS, 14% ICH). Thirty-day mortality was 16% overall (11% for IS; 43% for ICH). When both clinical scales (NIHSS and GCS) were included, none of the model performance measures showed improvement with the addition of CT findings whether considering IS and ICH together (ΔAUC: 0.002, 95% CI −0.01, 0.02; ΔŜ: −3.0, 95% CI −9.1, 2.6; IDI: 0.017, 95% CI −0.004, 0.05) or considering ICH cases alone (ΔAUC: 0.02, 95% CI −0.02, 0.08; Δ Ŝ: −2.0, 95% CI −9.7, 3.4); IDI 0.065, 95% CI −0.03, 0.21). If NIHSS was the only clinical scale included, there was still no improvement in AUC or Ŝ when CT findings were added for the sample with IS/ICH combined (ΔAUC: 0.005, 95%CI −0.01, 0.02;

  3. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study

    PubMed Central

    López-Sobaler, Ana M.; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18–64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415–2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045–1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m2, WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m2, WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  4. Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules

    PubMed Central

    Chaudhry, Ammar; Grechushkin, Vadim; Hoshmand, Mahsa; Kim, Choo Won; Pena, Andres; Huston, Brett; Chaya, Yair; Bilfinger, Thomas; Moore, William

    2015-01-01

    Abstract Assess computed tomography (CT) imaging characteristics after percutaneous cryotherapy for lung cancer. A retrospective IRB-approved analysis of 40 patients who underwent nonsurgical treatment for primary stage 1 lung cancer performed from January 2007 to March 2011 was included in this study. All procedures were performed using general anesthesia and CT guidance. Follow-up imaging with CT of the chest was obtained at 1 month, 3 months, 6 months, and 12 months postprocedure to evaluate the ablated lung nodule. Nodule surface area, density (in Hounsfield units), and presence or absence of cavitations were recorded. In addition, the degree of nodule enhancement was also recorded. Patients who were unable to obtain the aforementioned follow-up were excluded from the study. Thirty-six patients underwent percutaneous cryoablation with men to women ratio of 75% with mean age for men 74.6 and mean age for women 74.3 years of age. The average nodule surface area preablation and postcryoablation at 1-, 3-, 6-, and 12-month follow-ups were 2.99, 7.86, 3.89, 3.18 and 3.07�cm2, respectively. The average precontrast nodule density before cryoablation was 8.9 and average precontrast nodule density postprocedure at 1, 3, 6, and 12 months follow-ups were 8.5, −5.9, −9.4, and −3.8 HU, respectively. There is increased attenuation of lung nodules over time with an average postcontrast enhancement of 11.4, 18.5, 16.1, and 25.7 HU at the aforementioned time intervals. Cavitations occurred in the cryoablation zone in 53% (19/36) of patients. 80.6% (29/36) of the cavitations in the cryoablation zone resolved within 12 months. Four patients (11%) had recurrence of tumor at the site of cryoablation and none of the patients had satellite or distant metastasis. Our study shows that patients who underwent cryotherapy for lung nodules treatment had characteristic changes on follow-up CT including. The surface area of the nodule increases at the 1-month follow-up with

  5. Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules.

    PubMed

    Chaudhry, Ammar; Grechushkin, Vadim; Hoshmand, Mahsa; Kim, Choo Won; Pena, Andres; Huston, Brett; Chaya, Yair; Bilfinger, Thomas; Moore, William

    2015-10-01

    Assess computed tomography (CT) imaging characteristics after percutaneous cryotherapy for lung cancer.A retrospective IRB-approved analysis of 40 patients who underwent nonsurgical treatment for primary stage 1 lung cancer performed from January 2007 to March 2011 was included in this study. All procedures were performed using general anesthesia and CT guidance. Follow-up imaging with CT of the chest was obtained at 1 month, 3 months, 6 months, and 12 months postprocedure to evaluate the ablated lung nodule. Nodule surface area, density (in Hounsfield units), and presence or absence of cavitations were recorded. In addition, the degree of nodule enhancement was also recorded. Patients who were unable to obtain the aforementioned follow-up were excluded from the study.Thirty-six patients underwent percutaneous cryoablation with men to women ratio of 75% with mean age for men 74.6 and mean age for women 74.3 years of age. The average nodule surface area preablation and postcryoablation at 1-, 3-, 6-, and 12-month follow-ups were 2.99, 7.86, 3.89, 3.18 and 3.07[REPLACEMENT CHARACTER]cm, respectively. The average precontrast nodule density before cryoablation was 8.9 and average precontrast nodule density postprocedure at 1, 3, 6, and 12 months follow-ups were 8.5, -5.9, -9.4, and -3.8 HU, respectively. There is increased attenuation of lung nodules over time with an average postcontrast enhancement of 11.4, 18.5, 16.1, and 25.7 HU at the aforementioned time intervals. Cavitations occurred in the cryoablation zone in 53% (19/36) of patients. 80.6% (29/36) of the cavitations in the cryoablation zone resolved within 12 months. Four patients (11%) had recurrence of tumor at the site of cryoablation and none of the patients had satellite or distant metastasis.Our study shows that patients who underwent cryotherapy for lung nodules treatment had characteristic changes on follow-up CT including. The surface area of the nodule increases at the 1-month follow-up with

  6. Scintigraphic and CT findings of Tietze's syndrome: Report of a case and review of the literature

    SciTech Connect

    Honda, N.; Machida, K.; Mamiya, T.; Takahashi, T.; Takishima, T.; Hasegawa, N.; Kamano, T.; Hashimoto, M.; Ohno, K.; Itoyama, S.; )

    1989-08-01

    A case of Tietze's syndrome is reported. A 43-year-old woman, who had experienced right anterior chest pain and tender swelling of the right first costosternal junction for seven months, showed increased accumulation of the right first, the right fourth, and the left first costochondral junction on bone imaging. Ga-67 imaging showed increased accumulation at the right first costosternal junction. CT showed sclerosis of the sternal manubrium, partial calcification of costal cartilage, and soft tissue swelling. Biopsy of the right first costal cartilage showed chronic inflammation with fibrosis and ossification. Increased uptake of bone gallium imaging is consistent with Tietze's syndrome.15 references.

  7. 99mTc(V)-DMSA SPECT-CT findings in a case of Gorham-Stout disease.

    PubMed

    Alves, Victor M; Vieira, Tiago S; Amorim, Nelson S; Oliveira, Ana; Rodrigues, André; Pereira, Jorge G

    2015-01-01

    The Gorham-Stout disease is a very rare condition, characterized by lymphovascular proliferation and massive bone resorption. We present a 48-year-old male patient with osteolysis involving the left femoral head and neck, as well as to the ipsilateral acetabulum. Besides the morphological imaging, he underwent bone scintigraphy, technetium-99m-V-dimercaptosuccinic acid [99mTc(V)-DMSA] single photon emission computed tomography/computed tomography (SPECT/CT) and histological examination. Together these findings gave the definitive diagnosis. This is the first case ever published with 99mTc(V)-DMSA SPECT-CT. Advances on the knowledge of disease suggests that this imaging procedure could have utility in diagnosis and evaluation of the disease activity and therapy response.

  8. Common and unexpected findings in mummies from ancient Egypt and South America as revealed by CT.

    PubMed

    Jackowski, Christian; Bolliger, Stephan; Thali, Michael J

    2008-01-01

    Computed tomography (CT) has proved to be a valuable investigative tool for mummy research and is the method of choice for examining mummies. It allows for noninvasive insight, especially with virtual endoscopy, which reveals detailed information about the mummy's sex, age, constitution, injuries, health, and mummification techniques used. CT also supplies three-dimensional information about the scanned object. Mummification processes can be summarized as "artificial," when the procedure was performed on a body with the aim of preservation, or as "natural," when the body's natural environment resulted in preservation. The purpose of artificial mummification was to preserve that person's morphologic features by delaying or arresting the decay of the body. The ancient Egyptians are most famous for this. Their use of evisceration followed by desiccation with natron (a compound of sodium salts) to halt putrefaction and prevent rehydration was so effective that their embalmed bodies have survived for nearly 4500 years. First, the body was cleaned with a natron solution; then internal organs were removed through the cribriform plate and abdomen. The most important, and probably the most lengthy, phase was desiccation. After the body was dehydrated, the body cavities were rinsed and packed to restore the body's former shape. Finally, the body was wrapped. Animals were also mummified to provide food for the deceased, to accompany the deceased as pets, because they were seen as corporal manifestations of deities, and as votive offerings. Artificial mummification was performed on every continent, especially in South and Central America.

  9. Soft-tissue changes after head and neck radiation: CT findings.

    PubMed

    Bronstein, A D; Nyberg, D A; Schwartz, A N; Shuman, W P; Griffin, B R

    1989-01-01

    To identify possible soft-tissue changes of the head and neck after radiation therapy, 102 CT scans from 78 patients with head and neck tumors were reviewed to assess (1) skin thickening, (2) epiglottic thickening, (3) stranding of subcutaneous fat, and (4) stranding of deep cervical fat. Scans were obtained after radiation therapy alone (10 cases), after radiation and surgery (27 cases), after surgery alone (24 cases), or before either surgery or radiation (41 cases). Skin thickening, epiglottic thickening, and stranding of subcutaneous fat were seen more frequently after radiation therapy than before such treatment. However, skin thickening and stranding of subcutaneous fat were sometimes also associated with tumor involvement and/or previous surgery, while epiglottic thickening was only occasionally associated with tumor involvement. Stranding of deep cervical fat was noted with increased frequency after radiation or surgery, but postradiation effects could not be reliably distinguished from postsurgical or tumor effects. We conclude that soft-tissue changes of the head and neck on CT may commonly be associated with previous radiation therapy, but these postradiation effects are not always distinguishable from postsurgical effects or tumor.

  10. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    SciTech Connect

    Fukuda, Hozumi Ibukuro, Kenji; Tsukiyama, Toshitaka; Ishii, Rei

    2004-09-15

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis.

  11. Extracolonic Findings on CT Colonography Increases Yield of Colorectal Cancer Screening

    DTIC Science & Technology

    2010-09-01

    gallstones; hiatal hernia E3 Likely unimportant finding, incompletely characterized: workup may be indicated Complex renal cyst; lung nodule E4...of which were renal cysts, neph­ rolithiasis, hiatal hernias , or benign liver cysts. The majority of findings for patients in the E3 group (n = 211

  12. Chest radiographic and CT findings in hyperleukocytic acute myeloid leukemia: A retrospective cohort study of 73 patients.

    PubMed

    Stefanski, Michael; Jamis-Dow, Carlos; Bayerl, Michael; Desai, Ruchi J; Claxton, David F; Van de Louw, Andry

    2016-11-01

    Hyperleukocytic acute myeloid leukemia (AML) is associated with pulmonary complications and high early mortality rate, but given its rarity, data on chest radiographic presentation are scarce.We retrospectively reviewed the charts of 73 AML patients admitted with white blood cell count >100 × 10/L between 2003 and 2014 in order to describe the chest radiographic and computed tomography (CT) findings and to correlate them with AML subtype and respiratory symptoms.Forty-two of the 73 patients (58%) overall and 36 of the 54 patients (67%) with clinical signs of pulmonary leukostasis had abnormal radiographs on admission. The presence of radiographic abnormalities was significantly associated with dyspnea and oxygen/ventilatory support requirements (P < 0.01) and with day 28 mortality (45% vs 13%, P = 0.005) but not with monocytic subtype of AML. Sixteen patients had isolated focal basilar airspace opacities, unilateral (n = 13) or bilateral (n = 3), while 16 patients had bilateral diffuse opacities, interstitial (n = 12) or airspace and interstitial (n = 4). Two patients had isolated pleural effusion, 2 patients had unilateral midlung airspace opacities, and 6 patients had a combination of focal airspace and diffuse interstitial opacities. Overall, 2 patterns accounted for 75% of abnormal findings: bilateral diffuse opacities tended to be associated with monocytic AML, whereas basilar focal airspace opacities were more frequent in nonmonocytic AML (P < 0.05). Eighteen patients had CT scans, revealing interlobular septal thickening (n = 12), airspace (n = 11) and ground-glass (n = 9) opacities, pleural effusions (n = 12), and acute pulmonary embolism (n = 2).Hyperleukocytic AML is frequently associated with abnormal chest radiographs, involving mostly focal basilar airspace opacities (more frequent in nonmonocytic AML) or diffuse bilateral opacities. CT scan should be considered broadly due to the suboptimal

  13. Abdominal perfusion computed tomography.

    PubMed

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  14. Abdominal Perfusion Computed Tomography

    PubMed Central

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M. Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-01-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis. PMID:25610249

  15. [Diagnostic imaging and acute abdominal pain].

    PubMed

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  16. Multi-detector CT assessment in pulmonary hypertension: techniques, systematic approach to interpretation and key findings.

    PubMed

    Lewis, Gareth; Hoey, Edward T D; Reynolds, John H; Ganeshan, Arul; Ment, Jerome

    2015-06-01

    Pulmonary arterial hypertension (PAH) may be suspected based on the clinical history, physical examination and electrocardiogram findings but imaging is usually central to confirming the diagnosis, establishing a cause and guiding therapy. The diagnostic pathway of PAH involves a variety of complimentary investigations of which computed tomography pulmonary angiography (CTPA) has established a central role both in helping identify an underlying cause for PAH and assessing resulting functional compromise. In particular CTPA is considered as the gold standard technique for the diagnosis of thromboembolic disease. This article reviews the CTPA evaluation in PAH, describing CTPA techniques, a systematic approach to interpretation and spectrum of key imaging findings.

  17. Inflammatory abdominal aortic aneurysm: a persistent painful hip

    PubMed Central

    Baskaran, Dinnish; Ashraf, Nadeem; Ahmad, Adil; Menon, Jay

    2013-01-01

    The presentation of an abdominal aortic aneurysm (AAA) with isolated hip pain is a rare phenomenon. We present an atypical case of a 58-year-old previously fit man who presented with a 6-month history of progressively worsening left hip pain associated with unintentional weight loss, tender bilateral testicular swellings and a large non-tender palpable mass on abdominal examination. Urgent abdominal CT scan findings revealed a 15 cm infrarenal abdominal aortic aneurysm extending to the aortic bifurcation associated with an extensive left hydronephrosis. In theatre, the diagnosis of inflammatory AAA (IAAA) was confirmed following the presence of pyuria and a successful repair with an open approach using a bifurcated dacron graft was performed. PMID:24038286

  18. Inflammatory abdominal aortic aneurysm: a persistent painful hip.

    PubMed

    Baskaran, Dinnish; Ashraf, Nadeem; Ahmad, Adil; Menon, Jay

    2013-09-13

    The presentation of an abdominal aortic aneurysm (AAA) with isolated hip pain is a rare phenomenon. We present an atypical case of a 58-year-old previously fit man who presented with a 6-month history of progressively worsening left hip pain associated with unintentional weight loss, tender bilateral testicular swellings and a large non-tender palpable mass on abdominal examination. Urgent abdominal CT scan findings revealed a 15 cm infrarenal abdominal aortic aneurysm extending to the aortic bifurcation associated with an extensive left hydronephrosis. In theatre, the diagnosis of inflammatory AAA (IAAA) was confirmed following the presence of pyuria and a successful repair with an open approach using a bifurcated dacron graft was performed.

  19. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  20. Ultrasonography and contrast-enhanced CT findings of tularemia in the neck

    PubMed Central

    Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Kılıç, Ayşegül Ulu; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

    2016-01-01

    PURPOSE We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. METHODS US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients. RESULTS Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC. CONCLUSION Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas. PMID:27498683

  1. CT demonstration of peripelvic and periureteral non-Hodgkin lymphoma

    SciTech Connect

    McMillin, K.I.; Gross, B.H.

    1985-05-01

    Abdominal CT is often performed for the staging of lymphoma. Retroperitoneal lymphadenopathy is the most common abnormality identified, but various extranodal sites of lymphomatous involvement have been reported, especially in non-Hodgkin lymphoma. Renal involvement is not rare, but peripelvic or periureteral involvement in the absence of renal parenchymal involvement or contiguous abdominal adenopathy is extremely unusual. Two recent patients with non-Hodgkin lymphoma who did show these findings are presented.

  2. A Comparison between 18F-FDG PET/CT Imaging and Biological and Radiological Findings in Restaging of Hepatoblastoma Patients

    PubMed Central

    Treglia, Giorgio; Pagano, Manuela; Fania, Piercarlo; Basso, Maria Eleonora; Fagioli, Franca; Ficola, Umberto

    2013-01-01

    Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients. PMID:24063012

  3. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    PubMed

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU < 30) in mismatching cases. The majority of causes of death were cardiac related in the matching cases and skull/brain trauma in the mismatching cases. In mismatching cases, frequency of pulmonary edema was significantly higher than in matching cases. It can be concluded that discrepancies in tracheobronchial contents observed between PMCT and routine forensic autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  4. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings.

    PubMed

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil

    2013-11-01

    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  5. CT findings of a thoracic vertebral hemangioma presenting with acute neurological symptoms.

    PubMed

    Tan, Sinan; Kurt, Aydın; Okutan, Ozerk; Keskin, Suat

    2011-01-01

    Vertebral body hemangiomas are benign lesions and account for 4% of all spinal tumors. The most common histological type is cavernous hemangioma. These tumors generally locate in the vertebral body as a solitary lesion. Multiple lesions are seen in approximately 25-30% of vertebral hemangiomas. Mostly they are asymptomatic and incidentally found with radiological studies. Symptomatic vertebral hemangiomas are rare and represent < 1% of all hemangiomas; however, if untreated, they may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis. In this case we aim to present preoperative and postoperative Computed Tomography findings of a cavernous hemangioma that caused sudden motor deficit and was localised to the thoracic vertebra corpus and posterior elements.

  6. CT findings of the temporal bone in CHARGE syndrome: aspects of importance in cochlear implant surgery.

    PubMed

    Vesseur, A C; Verbist, B M; Westerlaan, H E; Kloostra, F J J; Admiraal, R J C; van Ravenswaaij-Arts, C M A; Free, R H; Mylanus, E A M

    2016-12-01

    To provide an overview of anomalies of the temporal bone in CHARGE syndrome relevant to cochlear implantation (CI), anatomical structures of the temporal bone and the respective genotypes were analysed. In this retrospective study, 42 CTs of the temporal bone of 42 patients with CHARGE syndrome were reviewed in consensus by two head-and-neck radiologists and two otological surgeons. Anatomical structures of the temporal bone were evaluated and correlated with genetic data. Abnormalities that might affect CI surgery were seen, such as a vascular structure, a petrosquamosal sinus (13 %), an underdeveloped mastoid (8 %) and an aberrant course of the facial nerve crossing the round window (9 %) and/or the promontory (18 %). The appearance of the inner ear varied widely: in 77 % of patients all semicircular canals were absent and the cochlea varied from normal to hypoplastic. A stenotic cochlear aperture was observed in 37 %. The middle ear was often affected with a stenotic round (14 %) or oval window (71 %). More anomalies were observed in patients with truncating mutations than with non-truncating mutations. Temporal bone findings in CHARGE syndrome vary widely. Vascular variants, aberrant route of the facial nerve, an underdeveloped mastoid, aplasia of the semicircular canals, and stenotic round window may complicate cochlear implantation.

  7. Abdominal ultrasound

    MedlinePlus

    ... Kidney - blood and urine flow Abdominal ultrasound References Chen L. Abdominal ultrasound imaging. In: Sahani DV, Samir ... the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used ...

  8. Abdominal tap

    MedlinePlus

    ... tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap Images Digestive system Peritoneal sample References Garcia-Tiso G. ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  9. 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.

  10. Use of abdominal computed tomography in blunt trauma: Do we scan too much?

    PubMed Central

    Garber, Bryan G.; Bigelow, Eric; Yelle, Jean-Denis; Pagliarello, Guiseppe

    2000-01-01

    Objectives To determine what proportion of abdominal computed tomography (CT) scans ordered after blunt trauma are positive and the applicability and accuracy of existing clinical prediction rules for obtaining a CT scan of the abdomen in this setting. Setting A leading trauma hospital, affiliated with the University of Ottawa. Design A retrospective cohort study. Patients and methods All patients with blunt trauma admitted to hospital over a 1-year period having an Injury Severity Score (ISS) greater than 12 who underwent CT of the abdomen during the initial assessment. Recorded data included age, sex, Glasgow Coma Scale (GCS) score, ISS, type of injuries, number of abdominal CT scans ordered, and scan results. Two clinical prediction rules were found in the literature that identify patients likely to have intra-abdominal injuries. These rules were applied retrospectively to the cohort. The predicted proportion of positive CT scans was compared with the observed proportion, and the sensitivity, specificity, and accuracy were estimated. Results Of the 297 patients entered in the study, 109 underwent abdominal CT. The median age was 32 years, 71% were male and the median ISS was 24. In only 36.7% (40 of 109) of scans were findings suggestive of intra-abdominal injuries. Application of one of the clinical prediction rules gave a sensitivity of 93.8% and specificity of 25.5% but excluded 23% of patients because of a GCS score less than 11. The second prediction rule tested could be applied to all patients and was highly sensitive (92.5%) and specific (100.0%). Conclusions The assessment of the abdomen in blunt trauma remains a challenge. Accuracy in predicting positive scans in equivocal cases is poor. Retrospective application of an existing clinical prediction rule was found to be highly accurate in identifying patients with positive CT findings. Prospective use of such a rule could reduce the number of CT scans ordered without missing significant injuries. PMID

  11. Abdominal Pain

    MedlinePlus

    ... call your doctor. In Spanish— Dolor abdominal en niños menores de 12 años What is recurrent abdominal ... Functional abdominal pain (FAP) typically affects kids ages 4-12, and is quite common, affecting up to ...

  12. A challenging diagnosis of late-onset tumefactive multiple sclerosis associated to cervicodorsal syringomyelia: doubtful CT, MRI, and bioptic findings

    PubMed Central

    Conforti, Renata; Capasso, Raffaella; Galasso, Rosario; Cirillo, Mario; Taglialatela, Gemma; Galasso, Luigi

    2016-01-01

    Abstract Background: Tumefactive multiple sclerosis (MS) is an unusual variant of demyelinating disease characterized by lesions with pseudotumoral appearance on radiological imaging mimicking other space-occupying lesions, such as neoplasms, infections, and infarction. Especially when the patient's medical history is incompatible with MS, the differential diagnosis between these lesions constitutes a diagnostic challenge often requiring histological investigation. An older age at onset makes distinguishing tumefactive demyelinating lesion (TDL) from tumors even more challenging. Methods: We report a case of brain TDL as the initial manifestation of late-onset MS associated with cervico-dorsal syringomyelia. A 66-year-old Caucasian woman with a 15-day history headache was referred to our hospital because of the acute onset of paraphasia. She suffered from noncommunicating syringomyelia associated to basilar impression and she reported a 10-year history of burning dysesthesia of the left side of the chest extended to the internipple line level. Results: Computed tomography (CT) and magnetic resonance imaging (MRI) examinations revealed a left frontal lesion with features suspicious for a tumor. Given the degree of overlap with other pathologic processes, CT and MRI findings failed to provide an unambiguous diagnosis; furthermore, because of the negative cerebrospinal fluid analysis for oligoclonal bands, the absence of other lesions, and the heightened suspicion of neoplasia, the clinicians opted to perform a stereotactic biopsy. Brain specimen analysis did not exclude the possibility of perilesional reactive gliosis and the patient, receiving anitiedemigen therapy, was monthly followed up. In the meanwhile, the second histological opinion of the brain specimen described the absence of pleomorphic glial cells indicating a tumor. These findings were interpreted as destructive inflammatory demyelinating disease and according to the evolution of MRI lesion burden, MS

  13. False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series

    PubMed Central

    Hannoush, Zeina C.; Palacios, Juan D.; Kuker, Russ A.

    2017-01-01

    Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management. PMID:28246564

  14. WE-B-207-01: CT Lung Cancer Screening and the Medical Physicist: Background, Findings and Participant Dosimetry Summary of the National Lung Screening Trial (NLST)

    SciTech Connect

    Kruger, R.

    2015-06-15

    The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan

  15. A rare case of abdominal infection: Emphysematous pyelonephritis without diabetes

    PubMed Central

    Ünlüer, Erden Erol; Şahı̇n, Yusuf; Oyar, Orhan; Tan, Gözde Canan; Karagöz, Arı̇f; Turan, Celaleddı̇n

    2016-01-01

    Emphysematous pyelonephritis (EP) is a rare form of necrotizing pyelonephritis. It is a life-threatening condition that usually affects patients with diabetes, and a small percentage may be due to urinary tract obstruction. Here, we present the case of an EP caused by urinary tract obstruction without diabetes. A 45-year-old woman presented to the emergency department with fever, chills, and abdominal pain. There was no significant past history. Physical examination depicted bilateral lower abdominal and right flank knocking tenderness. Laboratory exams revealed leukocytosis, neutrophilia, a high C-reactive protein level, and pyuria. Abdominal computerized tomography (CT) showed diffuse gas in the right renal collecting system and dilatation of the right renal pelvis compared to the right side, in addition to multiple millimetric stones located in the right kidney and right ureter. After emergent placement of a percutaneous nephrostomy, she was admitted. Control abdominal CT without contrast revealed the absence of gas, hydronephrosis of the right renal pelvis, and the presence of nephrolithiasis. The patient was discharged 10 days of post-procedure with instructions for follow-up. Emergency physicians need to remain alert about this life-threatening disease and the typical CT findings of this disease to make a timely diagnosis and navigate management. PMID:28250980

  16. Clinical significance of mesenteric panniculitis-like abnormalities on abdominal computerized tomography in patients with malignant neoplasms

    PubMed Central

    Ehrenpreis, Eli D; Roginsky, Grigory; Gore, Richard M

    2016-01-01

    AIM To clarify the association of malignancy with mesenteric panniculitis-like changes on computed tomography (CT). METHODS All abdominal CT scans performed at NorthShore University HealthSystem showing mesenteric panniculitis from January 2005 to August 2010 were identified in the Radnet (RadNet Corporation, Los Angeles, CA) database. Patients with a new or known diagnosis of a malignancy were included for this analysis. Longitudinal clinical histories were obtained from electronic medical records. RESULTS In total, 147794 abdominal CT scans were performed during the study period. Three hundred and fifty-nine patients had mesenteric panniculitis (MP)-like abnormalities on their abdominal CT. Of these patients, 81 patients (22.6%) had a known history of cancer at the time of their CT scan. Nineteen (5.3%) had a new diagnosis of cancer in concurrence with their CT, but the majority of these (14/19, 74%) were undergoing CT as part of a malignancy evaluation. Lymphomas were the most common cancers associated with MP-like findings on CT (36 cases, 36%), with follicular lymphoma being the most frequent subtype (17/36). A variety of solid tumors, most commonly prostate (7) and renal cell cancers (6) also were seen. CT follow up was obtained in 56 patients. Findings in the mesentery were unchanged in 45 (80%), worsened in 6 (11%), and improved in 5 patients (9%). Positron emission tomography (PET) scans performed in 44 patients only showed a positive uptake in the mesenteric mass in 2 patients (5%). CONCLUSION A new diagnosis of cancer is uncommon in patients with CT findings suggestive of MP. MP-like mesenteric abnormalities on CT generally remain stable in patients with associated malignancies. PET scanning is not recommended in the evaluation of patients with mesenteric panniculitis-like findings on CT. PMID:28082812

  17. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  18. CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease

    PubMed Central

    Minordi, L M; Vecchioli, A; Mirk, P; Bonomo, L

    2011-01-01

    Objective The aim of the study is to compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease. Methods 145 patients underwent abdominal contrast-enhanced 16-row multidetector CT after administration of 2000 ml of PEG by mouth (n = 75) or after administration of 2000 ml of methylcellulose by nasojejunal tube (n = 70). Small bowel distension, luminal and extraluminal findings were evaluated and compared with small bowel follow-through examination in 60 patients, double contrast enema in 50, surgery in 25 and endoscopy in 35. Statistical evaluation was carried out by χ2 testing. For both techniques we have also calculated the effective dose and the equivalent dose in a standard patient. Results Crohn's disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p<0.05: statistically significant difference). No significant difference was present for others sites (p>0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv). Conclusion PEG-CT shows findings of Crohn's disease as well as CT-E does, although CT-E gives better bowel distension, especially in the jejunum, and has higher specificity than PEG-CT. PMID:20959377

  19. Patients Presenting to the Emergency Unit with Gynaecological Lower Abdominal Pain, with and without Pathological Clinical Findings - Service Utilisation, Pain History, Implications.

    PubMed

    Siedentopf, F; Wowro, E; Möckel, M; Kentenich, H; David, M

    2016-09-01

    Introduction: Few studies have evaluated the utilisation of emergency gynaecological services, although lower abdominal pain (LAP) is one of the most common symptoms prompting emergency presentation. Although such pain may be caused by potentially life-threatening gynaecological diseases, very often no clinical cause is found. The aim of this study was to describe the characteristics of emergency presentations in order to enable quicker identification of real emergencies in routine clinical practice. Materials and Methods: Standardised, so-called first aid cards of 1066 consecutive patients with LAP presenting acutely to one emergency unit were analysed in this retrospective, cross-sectional study. Results: Over one third of cases did not constitute actual medical emergencies on objective criteria, with investigations yielding "no pathological findings". Parameters were identified that more often lead to hospital admission, e.g. palpation of a mass/resistance or at least one pathological ultrasound finding. In addition, it was found that symptoms of longer duration (average 8 days), and not only acute LAP, were also often experienced by patients as emergencies. Conclusion: A diagnosis of "no pathological findings", which was common in our study, suggests a subjective experience of an emergency from the patient's point of view, although the possibility of unrecognised pathology has to be borne in mind. Apart from functional disorders, the origins of symptoms may include psychosomatic causes and psychosocial problems, which cannot be further defined in the emergency care setting. Also, the phenomenon of increased utilisation of emergency services parallel to the assumed opening hours of routine outpatient care facilities must be seen in a critical light.

  20. 75 FR 38148 - Finding of No Significant Impact Related to Approval of the Mallinckrodt C-T Phase 2...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... the Manhattan Engineering District and the Atomic Energy Commission (MED-AEC) to process uranium ore..., NRC must be assured that the areas of the Mallinckrodt facility associated with the C-T project meet NRC(s release criteria stated in 10 CFR 20.1402. Mallinckrodt elected to decommission the C-T...

  1. 18F-FDG PET-CT Findings Before and After Laparoscopic Cryoablation of Small Renal Mass: An Initial Report

    PubMed Central

    Sivro, Ferida; van der Zee, Johan A.; Baars, Phillippe C.

    2015-01-01

    The aim of this study was to describe the characteristics of positron emission tomography (PET) molecular imaging combined with low-dose computed tomography (CT) in small renal mass (SRM) treated with cryoablation (CA). Currently, treatment success is defined by the absence of contrast enhancement at CT. However, the use of contrast is relatively contraindicated in patients with renal function impairment, mandating alternative follow-up strategies. Several reasons were identified as criteria for performing PET-CT before and/or after SRM-CA in 9 patients, and the results were retrospectively studied. The histology revealed renal cell carcinoma in 7 patients and oncocytoma in 2 patients. In 6 patients, a PET-CT was performed before and after CA. In one patient, the PET-CT was performed only before CA and in 2 patients only after CA. Before CA, clearly there was metabolic uptake of fluorine-18 fluorodeoxyglucose (18F-FDG) in the SRM in all patients. Following CA, the absence of 18F-FDG uptakes in the SRM could clearly be noticed. However, the tracer cannot always be distinguished from focal recurrence or reactive inflammatory tissue. In one patient, asymptomatic metastatic bone lesions were noticed when performing PET-CT at follow-up. This pilot study with 18F-FDG PET-CT for the follow-up of SRM cryosurgery showed that 18F-FDG PET-CT imaging could be used to characterize cryoablative tissue injury at different times after CA. PMID:28326272

  2. [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.

  3. [Abdominal paracentesis].

    PubMed

    Glauser, Frédéric; Barras, Anne-Catherine; Pache, Isabelle; Monti, Matteo

    2008-10-29

    Abdominal paracentesis is frequently performed in the clinical setting. Every newly developed ascites need to be investigated by abdominal paracentesis. Any clinical or biological deterioration in patients with chronic ascites also requires a new paracentesis. Therapeutically abdominal paracentesis is performed for refractory or symptomatic ascites. As other invasive procedures, it is critical to master its indications, contra-indications and complications. The aim of this article is to review the basics of abdominal paracentesis in order to help physicians to carry out this technical skill.

  4. Cervix carcinoma and incidental finding of medullary thyroid carcinoma by 18F-FDG PET/CT--clinical case.

    PubMed

    Chaushev, Borislav; Bochev, Pavel; Klisarova, Anelia; Yordanov, Kaloyan; Encheva, Elitsa; Dancheva, Jivka; Yordanova, Cvetelina; Hristozov, Kiril; Krasnaliev, Ivan; Radev, Radoslav; Nenkov, Rumen

    2014-01-01

    Thyroid nodules are encountered in clinical practice during the diagnostic procedures or patients' follow-up due to other diseases quite far from the thyroid gland with prevalence 4-50% in general population, depending on age, diagnostic method and race. The prevalence of thyroid nodules increases with age and their clarification should be done for their adequate treatment. An 18F-FDG PET/CT was done with a PET/CT scanner (Philips Gemini TF), consisting of dedicated lutetium orthosilicate full ring PET scanner and 16 slice CT. The PET/CT scan of the whole-body revealed on the CT portion a hypodense nodular lesion in the left lobe of the thyroid gland with increased uptake of 18F-FDG on the PET with SUVmax 10.3 and demonstrated a complete response to the induction therapy of the main oncological disease of the patient--squamous cell carcinoma. This clinical case demonstrates that whole-body 18F-FDG-PET/CT has an increasingly important role in the early evaluation of thyroid cancer as a second independent malignant localization. Focal thyroid lesion with high risk of thyroid malignancy was incidentally found on 18F-FDG PET/CT.

  5. Imaging for chronic abdominal pain in adults.

    PubMed

    Mendelson, Richard

    2015-04-01

    Diagnostic imaging is often not indicated in chronic abdominal pain. In particular, undifferentiated abdominal pain is rarely an indication for a CT scan. CT scanning is overused even when imaging is required. Other modalities may be preferable. A normal CT scan does not rule out cancer. Alarm symptoms, including anaemia, blood in the stool, waking at night with gastrointestinal symptoms, and weight loss, should be investigated. The most appropriate modality depends on the symptoms. Clinical information on request forms for CT scans should be specific and include the suspected condition as this helps the radiologist to determine an appropriate imaging protocol.

  6. Patients Presenting to the Emergency Unit with Gynaecological Lower Abdominal Pain, with and without Pathological Clinical Findings – Service Utilisation, Pain History, Implications

    PubMed Central

    Siedentopf, F.; Wowro, E.; Möckel, M.; Kentenich, H.; David, M.

    2016-01-01

    Introduction: Few studies have evaluated the utilisation of emergency gynaecological services, although lower abdominal pain (LAP) is one of the most common symptoms prompting emergency presentation. Although such pain may be caused by potentially life-threatening gynaecological diseases, very often no clinical cause is found. The aim of this study was to describe the characteristics of emergency presentations in order to enable quicker identification of real emergencies in routine clinical practice. Materials and Methods: Standardised, so-called first aid cards of 1066 consecutive patients with LAP presenting acutely to one emergency unit were analysed in this retrospective, cross-sectional study. Results: Over one third of cases did not constitute actual medical emergencies on objective criteria, with investigations yielding “no pathological findings”. Parameters were identified that more often lead to hospital admission, e.g. palpation of a mass/resistance or at least one pathological ultrasound finding. In addition, it was found that symptoms of longer duration (average 8 days), and not only acute LAP, were also often experienced by patients as emergencies. Conclusion: A diagnosis of “no pathological findings”, which was common in our study, suggests a subjective experience of an emergency from the patientʼs point of view, although the possibility of unrecognised pathology has to be borne in mind. Apart from functional disorders, the origins of symptoms may include psychosomatic causes and psychosocial problems, which cannot be further defined in the emergency care setting. Also, the phenomenon of increased utilisation of emergency services parallel to the assumed opening hours of routine outpatient care facilities must be seen in a critical light. PMID:27681519

  7. Primary central nervous system lymphoma with lymphomatosis cerebri in an immunocompetent child: MRI and 18F-FDG PET-CT findings.

    PubMed

    Jain, Tarun K; Sharma, Punit; Suman, Sudhir K C; Faizi, Nauroze A; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Primary central nervous system lymphoma (PCNSL) is extremely rare in immunocompetent children. We present the magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) findings of such a case in a 14-year old immunocompetent boy. In this patient, PCNSL was associated with lymphomatosis cerebri. Familiarity with the findings of this rare condition will improve the diagnostic confidence of the nuclear radiologist and avoid misdiagnosis.

  8. It's not a cervical lymph node, it's a vein: CT and MR imaging findings in the veins of the head and neck.

    PubMed

    Escott, Edward J; Branstetter, Barton F

    2006-01-01

    The anatomy and imaging appearances of the veins of the head and neck can vary considerably, and normal veins may mimic disease processes at computed tomography (CT) and magnetic resonance (MR) imaging. On unenhanced CT scans, aberrant veins may be difficult to differentiate from lymph nodes or other pathologic conditions. Even at contrast material-enhanced CT, differences in venous enhancement or the mixing of opacified with nonopacified blood can lead to confusion, particularly if the vein is focally dilated. Similarly, the size and signal intensity of head and neck veins may vary at MR imaging due to slow or turbulent flow or variable enhancement, resulting in misdiagnosis. A thorough understanding of the normal venous anatomy and common variants is necessary to properly differentiate an unopacified or focally dilated vein from lymphadenopathy or some other disease entity and can help the radiologist avoid the erroneous interpretation of findings.

  9. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass

    PubMed Central

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

    Summary Background We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Case Report Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUVmax) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. Conclusions FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy. PMID:28058074

  10. Primary Uterine Peripheral T-cell Lymphoma: A Case Report of MRI and 18F-FDG PET/CT Findings.

    PubMed

    Gong, Jing; Dong, Aisheng; Wang, Yang; Zhang, Xuefeng; Yang, Panpan; Wang, Li; Jing, Wei

    2016-04-01

    Primary uterine non-Hodgkin's lymphoma is extremely rare accounting for <1% of all extranodal non-Hodgkin's lymphomas. Imaging findings of primary uterine lymphoma have rarely been reported before. We present magnetic resonance imaging (MRI) and fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/CT findings in a patient with primary uterine peripheral T-cell lymphoma.A 27-year-old female presented with intermittent fever with neutropenia for 7 months. MRI showed an ill-defined mass involved both the uterine corpus and cervix, resulting in diffuse enlargement of the uterus. This mass showed inhomogeneous hypointensity on unenhanced T1-weighted images, hyperintensity on diffusion-weighted imaging, relative hypointensity compared to the surrounding myometrium on T2-weighted images and lower enhancement than the surrounding myometrium on enhanced T1-weighted images. FDG PET/CT showed intense FDG uptake in the thickened wall of the uterine corpus and cervix with SUVmax of 26.9. There were multiple hypermetabolic lymph nodes in the pelvis and retroperitoneum. Uterine curettage and CT-guided biopsy of the uterine mass revealed peripheral T-cell lymphoma. Bone marrow biopsy revealed no evidence of lymphomatous involvement. The imaging and pathologic findings were consistent with primary uterine lymphoma. After 3 circles of chemotherapy, follow-up enhanced MRI showed decreased thickness of the uterine wall.Despite its rarity, primary uterine non-Hodgkin's lymphoma should be taken into consideration when a uterine tumor shows large size, relative hypointesity on both T2-weighted images and enhanced T1-weighted images compared to the surrounding myometrium, and intense FDG uptake on PET/CT. MRI may be helpful for describing the relationship between the tumor and adjacent structures. FDG PET/CT may be useful for tumor detection and staging.

  11. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  12. [Abdominal pain].

    PubMed

    Gschossmann, J M; Holtmann, G; Netzer, P; Essig, M; Balsiger, B M; Scheurer, U

    2005-10-01

    Abdominal pain can result from a variety of different intra- and extra-abdominal disorders. Given the wide variety of etiological triggers for this pain, the primary task during the first stage of the diagnostic work-up is to determine as soon as possible the underlying cause and the degree of emergency. The aim of this evaluation is to adapt the therapeutic measures which are necessary for a causal treatment to the individual situation. Contrary to somatic causes of abdominal pain, the availability of such a causal therapy for functional bowel disorders is still very limited. Given this dilemma, the therapeutic focus of abdominal pain associated with these functional syndromes has to be placed on symptom-oriented treatment.

  13. Comparison of magnetic resonance imaging and ultrasonography in the evaluation of abdominal aortic aneurysms.

    PubMed

    Amparo, E G; Hoddick, W K; Hricak, H; Sollitto, R; Justich, E; Filly, R A; Higgins, C B

    1985-02-01

    Magnetic resonance imaging (MRI) was used to evaluate abdominal aortic aneurysms in 27 patients. The findings were compared retrospectively with CT, ultrasound (US), and angiography in 17 cases and prospectively with US in 10 cases. MRI identified the renal arteries in all cases, demonstrated involvement at or above the origin of the renal arteries in eight patients, and showed extension of the aneurysm into the iliac arteries in 12 cases. The outer dimension of the aneurysm, the diameter of the residual lumen, and the length of the aneurysm were measured easily from the MR images. The measurements of transverse dimension of the abdominal aortic aneurysm were similar for MRI, CT, and US. MRI more accurately defined extension above the renal arteries and below the aortic bifurcation. It is concluded that MRI provides the necessary information for the surveillance and preoperative evaluation of abdominal aortic aneurysms.

  14. [Abdominal actinomycosis with IUD].

    PubMed

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  15. Ultrasonographic, computed tomographic, and operative findings in dogs infested with giant kidney worms (Dioctophyme renale).

    PubMed

    Rahal, Sheila C; Mamprim, Maria J; Oliveira, Hugo S; Mesquita, Luciane R; Faria, Luis G; Takahira, Regina K; Matsubara, Lídia M; Agostinho, Felipe S

    2014-03-01

    OBJECTIVE--To compare ultrasonographic, CT, and surgical findings in dogs infested with giant kidney worms (Dioctophyme renale). DESIGN--Case series. ANIMALS--15 crossbred dogs infected with D renale. PROCEDURES--Immediately after ultrasonography was performed with dogs in dorsal recumbency, sequential transverse images of the abdomen were acquired with a helical CT scanner. After plain CT, contrast CT was performed with a nonionic iodinated contrast agent. Subsequently, exploratory celiotomy was performed. RESULTS--In the corticomedullary area of the right kidney of 12 dogs, ultrasonography revealed several ring-like structures with an echogenic wall and anechoic central area in the transverse plane and arrayed as bands in the longitudinal plane. Similar structures were observed in the abdominal cavity of 10 dogs. In 13 dogs, CT revealed loss of corticomedullary differentiation in the right kidney, with discrete uptake of contrast material in the periphery of the kidney, and several ring-like or elongated structures with a hyperdense wall and hypodense center. In 11 dogs, the same structures were observed free in the abdominal cavity. Surgery revealed that 13 dogs had a damaged right kidney that required nephrectomy. Parasites were found free in the abdominal cavity of 7 dogs. CONCLUSIONS AND CLINICAL RELEVANCE--Ultrasonography and CT were effective imaging methods for detecting D renale in the kidney and less effective for detecting parasites in the abdominal cavity. Care should be taken to avoid erroneously interpreting normal structures as parasites, especially in the abdominal cavity.

  16. [Findings of the (18)F-FDG PET-CT in a cardiac angiosarcoma complicated by a cardiac rupture].

    PubMed

    Santiago-Chinchilla, Alicia; Ruiz-Carazo, Eduardo; Moral-Ruiz, Antonio; Testart Dardel, Nathalie; Martínez-Martínez, Alberto; López-Fernández, Silvia

    2014-01-01

    Primary malignant tumors of the heart are a rare condition. The most common type is the cardiac angiosarcoma. The symptoms of this disease are very nonspecific and can be very difficult to diagnose by conventional imaging techniques. We report the case of a male patient with cardiac angiosarcoma who also had a rare complication, this being cardiac rupture, which required the use of (18)F-FDG PET-CT to demonstrate the mass malignancy and to reach a definitive diagnosis.

  17. 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

  18. 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.

  19. Abdominal Mass Secondary to Human Toxocariasis

    PubMed Central

    Ghoroobi, Javad; Khoddami, Maliheh; Mirshemirani, Alireza; Sadeghian, Naser; Mahdavi, Alireza; Hatefi, Sayeh

    2017-01-01

    Toxocariasis is an extensive helminthic infection that leads to visceral larva migrans in humans. A 2.5-year-old girl referred for abdominal mass. She had history of pharyngitis for two weeks. There were no other symptoms. Abdominal examination revealed an irregular solid mass in right lower quadrant (RLQ). Abdominal ultrasonography revealed an echohetrogenic large mass in RLQ, liver, and retroperitoneal area. Abdominal CT scan showed a huge mass. At laparotomy a large retroperitoneal mass that involved right liver lobe, bladder, ileocecal valve, small and large intestines was found. At histopathology diagnosis of toxocariasis was made. PMID:28164001

  20. Diagnostic Accuracy of Secondary Ultrasound Exam in Blunt Abdominal Trauma

    PubMed Central

    Rajabzadeh Kanafi, Alireza; Giti, Masoumeh; Gharavi, Mohammad Hossein; Alizadeh, Ahmad; Pourghorban, Ramin; Shekarchi, Babak

    2014-01-01

    Background: In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial. Objectives: To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma. Patients and Methods: We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma patients. All ultrasound exams were performed by four radiology residents who had the experience of more than 400 FAST exams. Five routine intraperitoneal spaces as well as the interloop space were examined by ultrasound in order to find free fluid. All patients who expired or were transferred to the operating room before the second exam were excluded from the study. All positive ultrasound results were compared with intra-operative and computed tomography (CT) findings and/or the clinical status of the patients. Results: Primary ultrasound was performed in 372 patients; 61 of them did not undergo secondary ultrasound exam; thus, were excluded from the study.Three hundred eleven patients underwent both primary and secondary ultrasound exams. One hundred and two of all patients were evaluated by contrast enhanced CT scan and 31 underwent laparotomy. The sensitivity of ultrasound exam in detecting intraperitoneal fluid significantly increased from 70.7% for the primary exam to 92.7% for the secondary exam. Examining the interloop space significantly improved the sensitivity of ultrasonography in both primary (from 36.6% to 70.7%) and secondary (from 65.9% to 92.7%) exams. Conclusions: Performing a secondary ultrasound exam in stable blunt abdominal trauma patients and adding interloop space scan to the routine FAST exam significantly increases the sensitivity of ultrasound in detecting intraperitoneal free fluid. PMID:25763079

  1. Cervical neuroblastoma in eleven infants--a tumor with favorable prognosis. Clinical and radiologic (US, CT, MRI) findings.

    PubMed

    Abramson, S J; Berdon, W E; Ruzal-Shapiro, C; Stolar, C; Garvin, J

    1993-01-01

    Cervical neuroblastoma, a disease primarily of infants, has a favorable prognosis. Eleven patients are reported. Clinical presentations (other than mass) included stridor and swallowing problems. Masses when felt were commonly mistaken for infectious adenitis. Imaging studies (US, CT, MRI) showed solid masses with vascular displacement and narrowing; intraspinal extension was absent though extension into the adjacent sites of mediastinum and skull occurred. Horner syndrome was seen in five patients with accompanying heterochromia iridis in one. Five tumors had calcification. A high index of suspicion will lead to biopsy and less delay in diagnosis once a mass is felt or imaged.

  2. Brain MRI, Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT Findings in a Patient with Wilson Disease: A Case Report.

    PubMed

    Kim, Seungyoo; Song, In Uk; Chung, Yong An; Choi, Eun Kyung; Oh, Jin Kyoung

    2014-12-01

    A 34-year-old female had experienced head and hand tremors with a dystonic component for 8 months. Brain MRI showed T2 high signal intensity in the periaqueductal region, dorsal midbrain and dorsal upper pons. No abnormal uptake was noted on Tc-99m HMPAO SPECT or F-18 FP-CIT PET/CT. Wilson disease was diagnosed according to the 2008 consensus guideline from the American Association for the Study of Liver Disease and 2012 guideline from the European Association for the Study of the Liver. This case demonstrates T2 signal change in the basal ganglia, excluding the putamen, in a Wilson disease patient with relatively severe clinical findings, but normal Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT.

  3. Brain hemorrhage after endovascular reperfusion therapy of ischemic stroke: a threshold-finding whole-brain perfusion CT study.

    PubMed

    Renú, Arturo; Laredo, Carlos; Tudela, Raúl; Urra, Xabier; Lopez-Rueda, Antonio; Llull, Laura; Oleaga, Laura; Amaro, Sergio; Chamorro, Ángel

    2017-01-01

    Endovascular reperfusion therapy is increasingly used for acute ischemic stroke treatment. The occurrence of parenchymal hemorrhage is clinically relevant and increases with reperfusion therapies. Herein we aimed to examine the optimal perfusion CT-derived parameters and the impact of the duration of brain ischemia for the prediction of parenchymal hemorrhage after endovascular therapy. A cohort of 146 consecutive patients with anterior circulation occlusions and treated with endovascular reperfusion therapy was analyzed. Recanalization was assessed at the end of reperfusion treatment, and the rate of parenchymal hemorrhage at follow-up neuroimaging. In regression analyses, cerebral blood volume and cerebral blood flow performed better than Delay Time maps for the prediction of parenchymal hemorrhage. The most informative thresholds (receiver operating curves) for relative cerebral blood volume and relative cerebral blood flow were values lower than 2.5% of normal brain. In binary regression analyses, the volume of regions with reduced relative cerebral blood volume and/or relative cerebral blood flow was significantly associated with an increased risk of parenchymal hemorrhage, as well as delayed vessel recanalization. These results highlight the relevance of the severity and duration of ischemia as drivers of blood-brain barrier disruption in acute ischemic stroke and support the role of perfusion CT for the prediction of parenchymal hemorrhage.

  4. 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 ...

  5. Abdominal exploration

    MedlinePlus

    ... and CT scans , have not provided an accurate diagnosis. Exploratory laparotomy may be used to help diagnose and treat many health conditions, including: Cancer of the ovary, colon, pancreas, liver Endometriosis Gallstones Hole in the intestine (intestinal ...

  6. Liver echinococcus - CT scan (image)

    MedlinePlus

    This upper abdominal CT scan shows multiple cysts in the liver, caused by dog tapeworm (echinococcus). Note the large circular cyst (seen on the left side of the screen) and multiple smaller cysts throughout ...

  7. Comparison of chest CT findings in nontuberculous mycobacterial diseases vs. Mycobacterium tuberculosis lung disease in HIV-negative patients with cavities

    PubMed Central

    Kim, Cherry; Park, So Hee; Oh, Sang Young; Kim, Sung-Soo; Jo, Kyung-Wook; Shim, Tae Sun

    2017-01-01

    Objectives This article focuses on the differences between CT findings of HIV-negative patients who have cavities with nontuberculous mycobacteria (NTM) disease and those with Mycobacterium tuberculosis infections (TB). Methods We retrospectively reviewed 128 NTM disease patients (79 males and 49 females) with cavities in chest CT, matched for age and gender with 128 TB patients in the same period. Sputum cultures of all patients were positive for pathogens. Two independent chest radiologists evaluated the characteristics of the largest cavity and related factors. Results Interobserver agreement was excellent (κ value, 0.853–0.938). Cavity walls in NTM disease were significantly thinner (6.9±4 mm vs 10.9±6 mm, P<0.001) and more even (the ratio of thickness, 2.6±1 vs 3.7±2, P<0.001) than those in TB. The thickening of adjacent pleura next to the cavity was also significantly thicker in NTM than TB (P<0.001). However, in the multivariate analysis, thickening of adjacent pleura was the only significant factor among the representative cavity findings (Odds ratio [OR], 6.49; P<0.001). In addition, ill-defined tree-in-bud nodules (OR, 8.82; P<0.001), number of non-cavitary nodules (≥10mm) (OR, 0.72; P = 0.003), and bronchiectasis in the RUL (OR, 5.3; P = 0.002) were significantly associated ancillary findings with NTM disease in the multivariate analysis. Conclusions The major cavities in NTM disease generally have thinner and more even walls than those in TB. When cavities are associated with adjacent pleural thickening, ill-defined satellite tree-in-bud nodules, or fewer non-cavitary nodules ≥10 mm, these CT findings are highly suggestive of NTM disease rather than TB. PMID:28346488

  8. Leptomeningeal carcinomatosis as only pathological finding at FDG-PET/CT in case of tumor marker elevation in breast cancer.

    PubMed

    Grande, Maria Luz Dominguez; Rayo, Juan Ignacio; Serrano, Justo; Infante, Jose Rafael; Garcia, Lucia; Duran, Carmen; Gomez-Caminero, Felipe

    2014-01-01

    Leptomeningeal carcinomatosis is an infrequent disease and although its treatment is palliative, earlier diagnosis will lead to prolonged survival and improve functional outcome. Whole-body FDG-PET allows the entire spinal cord to be examined noninvasively, so close attention should be paid to the spinal canal, since these lesions can easily be mistaken for physiologic uptake, sometimes there is no clinical suspicion and may occur without concurrent active cancer. We present a female patient with a history of carcinoma of the breast, who presented an elevation of serum tumor marker CA 15-3. An FDG-PET/CT study only revealed multiple abnormal uptake at the vertebral foramen at thoracic and lumbosacral regions suggesting leptomeningeal metastases that were confirmed by MRI and cerebrospinal fluid cytology.

  9. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study

    PubMed Central

    van der Linden, Vanessa; Brainer-Lima, Alessandra Mertens; Coeli, Regina Ramos; Rocha, Maria Angela; Sobral da Silva, Paula; Durce Costa Gomes de Carvalho, Maria; van der Linden, Ana; Cesario de Holanda, Arthur; Valenca, Marcelo Moraes

    2016-01-01

    Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans. Results Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus—the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases. Conclusion Severe cerebral damage was

  10. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    PubMed

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  11. Unusual ¹⁸F-FDG PET/CT finding of an oxyphil parathyroid adenoma in a patient with Hodgkin's Lymphoma.

    PubMed

    Niccoli-Asabella, Artor; Ferrari, Cristina; Antonica, Filippo; Scardapane, Arnaldo; Rubini, Domenico; Rubini, Giuseppe

    2014-01-01

    Malignancy-associated hypercalcemia is a complication of advanced tumours that is associated to a poor prognosis. Thorough evaluation to establish its cause is essential because some patients may actually have undiagnosed primary hyperparathyroidism. We report a case of a patient affected by Hodgkin's Lymphoma and persistent hypercalcemia with an incidental (18)F-FDG PET/CT finding in the anterior neck region, not ascribable to malignancy, confirmed with (99m)Tc-sestamibi scintigraphy. It was removed by minimally invasive surgery. It was shown to be an oxyphil parathyroid adenoma localized in an unusual site.

  12. 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.

  13. CT and MRI findings of radiation-induced external auditory canal carcinoma in patients with nasopharyngeal carcinoma after radiotherapy

    PubMed Central

    Zhang, X; Bai, S; Li, H; Hu, H; Duan, X; Chen, M; Wang, D; Chen, Y; Zhang, F

    2015-01-01

    Objective: To summarize the radiological and clinical features of radiation-induced external auditory canal carcinomas (RIEACCs) in patients with nasopharyngeal carcinomas (NPCs) after radiation therapy. Methods: CT, MRI and clinical features in 16 patients with histologically proven RIEACCs were retrospectively reviewed. There were 2 females and 14 males, with a median age of 52.5 years at the time of diagnosis of RIEACC. Imaging parameters including lesion extent, size, margin, shape, bone destruction, adjacent structure invasion, density/signal intensity, and pattern and degree of enhancement were assessed. Clinical features including clinical staging, histological type, treatment and radiation dose (RD) of primary NPC as well as the histological type, staging of radiation-induced tumour and the latent period between NPC and RIT were recorded. Results: All patients had a single RIEACC. The lesions had a size of 3.5 ± 1.4 cm and were localized (n = 7) or extensive (n = 9). Most of the lesions were partially or ill defined with an irregular shape and had an intermediate density/signal pattern and moderate homogeneous enhancement. The latent period of RIEACCs ranged from 10 to 20 years in nine patients with a RD of 68–70 Gy; from 2 to 10 years in five patients with a RD of 68–74 Gy; and more than 20 years in two patients with a RD of 70 or 72 Gy. Conclusion: An external auditory canal (EAC) mass with homogeneous, intermediate CT density or signal intensity in patients with NPC after radiotherapy is highly suggestive of RIEACC, which should be included in the routine surveillance for patients with NPC after radiotherapy. Advances in knowledge: RIEACCs could occur as short as 2 years after radiotherapy in patients with NPC and have distinct features from otitis media and sarcomas. This EAC malignancy should be included in routine surveillance for patients with NPC after radiotherapy. PMID:25827205

  14. Renal Artery Injury Secondary to Blunt Abdominal Trauma – Two Case Reports

    PubMed Central

    Ahmed, Zahoor; Nabir, Syed; Ahmed, Mohamed Nadeem; Al Hilli, Shatha; Ravikumar, Vajjala; Momin, Umais Zaid

    2016-01-01

    Summary Background Blunt abdominal trauma is routinely encountered in the Emergency Department. It is one of the main causes of morbidity and mortality amongst the population below the age of 35 years worldwide. Renal artery injury secondary to blunt abdominal trauma however, is a rare occurrence. Here, we present two such cases, encountered in the emergency department sustaining polytrauma following motor vehicle accidents. Case Report We hereby report two interesting cases of renal artery injury sustained in polytrauma patients. In these two cases we revealed almost the entire spectrum of findings that one would expect in renal arterial injuries. Conclusions Traumatic renal artery occlusion is a rare occurrence with devastating consequences if missed on imaging. Emergency radiologists need to be aware of the CT findings so as to accurately identify renal artery injury. This case report stresses the need for immediate CT assessment of polytrauma patients with suspected renal injury, leading to timely diagnosis and urgent surgical or endovascular intervention. PMID:28058071

  15. CT imaging signs of surgically proven bowel trauma.

    PubMed

    LeBedis, Christina A; Anderson, Stephan W; Bates, David D B; Khalil, Ramy; Matherly, David; Wing, Heidi; Burke, Peter A; Soto, Jorge A

    2016-06-01

    The objective of this study was to determine the incidence and interobserver agreement of individual CT findings as well as the bowel injury prediction score (BIPS) in surgically proven bowel injury after blunt abdominal trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients 14 years or older who sustained surgically proven bowel injury after blunt abdominal trauma between 1/1/2004 and 6/30/2015 were included. Admission trauma MDCT scans were independently interpreted by two abdominal fellowship-trained radiologists who recorded the following CT findings: intraperitoneal fluid, mesenteric hematoma/fat stranding, bowel wall thickening/hematoma, active intravenous contrast extravasation, free intraperitoneal air, bowel wall discontinuity, and focal bowel hypoenhancement. Subsequently, the electronic medical records of the included patients, admission abdominal physical exam results, admission white blood cell count, and findings at exploratory laparotomy of the included patients were recorded. Thirty-three patients met the inclusion criteria. The incidence and interobserver agreement of the CT findings were as follows: intraperitoneal fluid 93.9 %, kappa = 0.784 (good); mesenteric hematoma/fat stranding 84.8 %, kappa = 0.718 (good); bowel wall thickening/hematoma 42.4 %, kappa = 0.491 (moderate); active IV contrast extravasation 36.3 %, kappa = 1.00 (perfect); free intraperitoneal air 21.2 %, kappa = 0.904 (very good), bowel wall discontinuity 6.1 %, kappa = 1.00 (perfect); and focal bowel hypoenhancement 6.1 %, kappa = 0.468 (moderate). An absence of the specified CT findings was encountered in 9.1 % with surgically proven bowel injuries (kappa = 1.00, perfect). In our study, 9/16 patients or 56.3 % had a bowel injury prediction score (BIPS) of 2 or more as defined by McNutt et al. (J Trauma Acute Care Surg 78(1):105-111, 2014). The presence of intraperitoneal fluid and

  16. Primary diagnosis of abdominal arteriovenous fistula by MR imaging.

    PubMed

    Amparo, E G; Higgins, C B; Hricak, H

    1984-12-01

    Two cases of abdominal arteriovenous (AV) fistula were imaged by magnetic resonance (MR). Magnetic resonance imaging showed abnormally increased flow with resultant dilatation of the veins draining the site of the fistula. Findings were correlated with CT, digital subtraction angiography, and arteriography. This report suggests the usefulness of MR imaging as the initial imaging technique of choice in clinically suspected cases of AV fistula. The diagnosis can be made within 30 to 45 min of imaging time and does not require administration of contrast material.

  17. 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

  18. Gastric Intramural and Portal Venous Gas Following Blunt Abdominal Injury

    PubMed Central

    Sen, Indrani; Samarasam, Inian; Chandran, Sudhakar; Mathew, George

    2013-01-01

    Introduction Gastric emphysema or pneumatosis is a rare finding. Early endoscopy and urgent laparotomy is advised in post-trauma patients. Case Presentation A 29 year old man presented with blunt abdominal injury following a high-speed motorbike crash He complained of abdominal pain and abdomen was distended. CT abdomen revealed air in the gastric wall with disruption of gastric mucosa. He had normal white cell counts, bleeding parameters and blood gases. He was treated conservatively with nasogastric decompression, intravenous analgesics and antibiotics with which he recovered well. Conclusions Early surgical management is indicated in post-trauma patients in whom bowel infarction is suspected. In a stable patient, a negative laparotomy is a major additional stress post trauma - conservative management with close clinical observation is a suitable management alternative. PMID:24396802

  19. General and Abdominal Obesity Is Related to Physical Activity, Smoking and Sleeping Behaviours and Mediated by the Educational Level: Findings from the ANIBES Study in Spain

    PubMed Central

    López-Sobaler, Ana M.; Rodríguez-Rodríguez, Elena; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

    2016-01-01

    The aim of the present study was to analyze the association of socioeconomic (SES) and lifestyle factors, with the conditions of overweight (OW), general (OB) and abdominal obesity (AO) in Spanish adults. A representative sample of 1655 Spanish adults (18 to 65 years) from the ANIBES Study was investigated. Collected data included measured anthropometry (weight, height and waist circumference), demographic and SES data (region and habitant population size, educational level, family income, unemployment rate), physical activity (PA) and other lifestyle factors (sleeping time and frequency of viewing television). OW, OB and AO were determined in each participant. Being male, older than 40 years, and watching television more frequently were associated with higher risk of OB and AO, whereas those with a higher level of education, smokers, and more time in sleeping and in vigorous PA, but not in moderate-vigorous PA, were associated with a lower risk. Living in the Atlantic region and stating no answer to the question regarding family income were also associated with lower risk of AO. Strategies for preventing and reducing OB and AO should consider improving sleeping habits and PA. They should also pay more attention to the most vulnerable groups such as those less educated. PMID:28033380

  20. CT Imaging Findings and Their Relevance to the Clinical Outcomes After Stent Graft Repair of Penetrating Aortic Ulcers: Six-year, Single-center Experience

    SciTech Connect

    Shin, Ji Hoon; Angle, John F.; Park, Auh Whan; Anderson, Curtis; Sabri, Saher S.; Turba, Ulku C.; Kern, John A.; Cherry, Kenneth J.; Matsumoto, Alan H.

    2012-12-15

    Purpose: To present the computed tomographic (CT) imaging findings and their relevance to clinical outcomes related to stent graft placement in patients with penetrating aortic ulcers (PAUs). Methods: Medical and imaging records and imaging studies were reviewed for consecutive patients who underwent stent graft repair of a PAU. The distribution and characteristics of the PAU, technical success of stent graft repair, procedure-related complications, associated aortic wall abnormalities, and outcomes of the PAUs at follow-up CT scans were evaluated. Results: Fifteen patients underwent endovascular treatment for PAU. A total of 87% of the PAUs were in the proximal (n = 8) or distal (n = 5) descending thoracic aorta. There was a broad spectrum of PAU depth (mean, 7.9 {+-} 5.6 mm; range 1.5-25.0 mm) and diameter (mean, 13.5 {+-} 9.7 mm; range 2.2-41.0 mm). Atherosclerosis of the thoracic aorta and intramural hematoma were associated in 53 and 93% of the patients, respectively. Technical success was achieved in 100%. Two or more stent grafts were used in five patients. Endoleaks were observed in two patients within 2 weeks of the procedure, both of which resolved spontaneously. At follow-up CT scanning, regression and thrombosis of the PAUs were observed in all patients. The average patient survival was 61.8 months, with an overall mortality of 13% (2 of 15) at follow-up. Neither death was related to the endograft device or the PAU. Conclusion: Endovascular stent graft placement was safe and effective in causing regression and thrombosis of PAUs in this small series of patients. Two or more stent grafts were used in five patients (33%) with associated long-segmental atherosclerotic changes of the thoracic aorta or intramural hematoma.

  1. An unusual case of disseminated toxoplasmosis in a previously healthy pregnant patient: radiographic, CT, and MRI findings.

    PubMed

    Paruthikunnan, Samir; Shankar, Balasubramanyam; Kadavigere, Rajagopal; Prabhu, Mukhyaprana; Narayanan, Ramakrishna; Jain, Harshwardhan

    2014-11-01

    Toxoplasmosis is a ubiquitous protozoal infection that during pregnancy commonly affects the fetus severely, with maternal infection usually being mild self-limiting. Disseminated toxoplasmosis in a healthy pregnant woman has, to the best of our knowledge, not been reported before. We present a case of disseminated toxoplasmosis involving pulmonary, central nervous system, and lymph nodes in a pregnant woman and imaging findings on radiography, computed tomography, and magnetic resonance imaging.

  2. Clinically-important brain injury and CT findings in pediatric mild traumatic brain injuries: a prospective study in a Chinese reference hospital.

    PubMed

    Zhu, Huiping; Gao, Qi; Xia, Xin; Xiang, Joe; Yao, Hongli; Shao, Jianbo

    2014-03-26

    This study investigated injury patterns and the use of computed tomography (CT) among Chinese children with mild traumatic brain injury (MTBI). We enrolled children with MTBI who were treated within 24 hours of head trauma in the emergency department of Wuhan Medical Care Center for Women and Children in Wuhan, China. Characteristics of MTBIs were analyzed by age and gender. Results of cranial CT scan and clinically-important brain injury (ciTBI) for children were obtained. The definition of ciTBI was: death from TBI, intubation for more than 24 h for TBI, neurosurgery, or hospital admission of 2 nights or more. Of 455 eligible patients with MTBI, ciTBI occurred in two, and no one underwent neurosurgical intervention. CT scans were performed for 441 TBI patients (96.9%), and abnormal findings were reported for 147 patients (33.3%, 95% CI 29.0-37.8). Falls were the leading cause of MTBI (61.5%), followed by blows (18.9%) and traffic collisions (14.1%) for children in the 0-2 group and 10-14 group. For children aged between 3 and 9, the top three causes of TBI were falls, traffic collisions and blows. Leisure activity was the most reported activity when injuries occurred for all age groups. Sleeping/resting and walking ranked in the second and third place for children between 0 and 2 years of age, and walking and riding for the other two groups. The places where the majority injuries occurred were the home for the 0-2 and 3-9 years of age groups, and school for the 10-14 years of age group. There was no statistical difference between boys and girls with regard to the activity that caused the MTBI. This study highlights the important roles that parents and school administrators in the development of preventive measures to reduce the risk of traumatic brain injury in children. Also, identifying children who had a head trauma at very low risk of clinically important TBI for whom CT might be unnecessary is a priority area of research in China.

  3. [Recommendations for reporting benign asbestos-related findings in chest X-ray and CT to the accident insurances].

    PubMed

    Kraus, T; Borsch-Galetke, E; Elliehausen, H J; Frank, K; Hering, K G; Hieckel, H G; Hofmann-Preiss, K; Jacques, W; Jeremie, U; Kotschy-Lang, N; Mannes, E; Otten, H; Raab, W; Raithel, H J; Schneider, W D; Tuengerthal, S

    2009-12-01

    Asbestos-related diseases still play an important role in occupational medicine. The detection of benign asbestos-related diseases is one condition for the compensation of asbestos-related lung cancer in Germany. Due to the increasing use of computed tomography, asbestos-related diseases are more frequently detected in the early stages. The present article proposes recommendations for the findings which have to be reported as suspicious for being asbestos-related based on a) chest X-rays and b) computed tomography using the International Classification System for Occupational and Environmental Respiratory Diseases (ICOERD).

  4. Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

    PubMed Central

    Neves, F S; Souza, T C; Almeida, S M; Haiter-Neto, F; Freitas, D Q; Bóscolo, F N

    2012-01-01

    Objectives The aim of this study was to assess the reliability of four panoramic radiographic findings, both individually and in association, in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam CT (CBCT) images. Methods The sample consisted of 72 individuals (142 mandibular third molars) who underwent pre-operative radiographic evaluation before extraction of impacted mandibular third molars. On panoramic radiographs, the most common signs of corticalization (darkening of roots, diversion of mandibular canal, narrowing of mandibular canal and interruption of white line) and the presence or absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were evaluated. Results Darkening of roots and interruption of white line associated with the absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were statistically significant, both as isolated findings (p = 0.0001 and p = 0.0006, respectively) and in association (p = 0.002). No statistically significant association was observed for the other panoramic radiographic findings, either individually or in association (p > 0.05). Conclusion Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal, requiring three-dimensional evaluation of the case. PMID:22282507

  5. A familial case of Coffin-Lowry syndrome caused by RPS6KA3 C.898C>T mutation associated with multiple abnormal brain imaging findings.

    PubMed

    Tos, T; Alp, M Y; Aksoy, A; Ceylaner, S; Hanauer, A

    2015-01-01

    Coffin-Lowry syndrome (CLS) is a rare X linked mental retardation syndrome characterised by severe psychomotor and growth retardation, distinct facial phenotype, and progressive skeletal malformations. It is caused by mutations in the RPS6KA3 gene located at Xp22.2. In this report we describe a family with CLS consists of three affected males, and two affected females, arising from c.898C>T mutation in RPS6KA3 gene. A 6 year-old, and a 3 year-old boy both had distinct clinical features of Coffin-Lowry syndrome; severe mental and motor retardation, microcephaly, prominent forehead, hypertelorism, large mouth, large ears, large soft hands, puffy tapered fingers, and pectus carinatum. In addition, they had multiple abnormal brain MRI findings. Other siblings presented with a mild and variable phenotype.

  6. Abdominal tuberculosis.

    PubMed Central

    Kapoor, V. K.

    1998-01-01

    Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 PMID:9926119

  7. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used.

    PubMed

    Jögi, Jonas; Markstad, Hanna; Tufvesson, Ellen; Bjermer, Leif; Bajc, Marika

    2015-01-01

    Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I-IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying

  8. 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.

  9. Spontaneous abscesses of the abdominal wall, omentum and abdominal cavity caused by group G streptococci: a case report.

    PubMed

    De Brabandere, K; Vanpaemel, G; Verheyen, L

    2008-01-01

    We report the first case, to our knowledge, of spontaneous abscess of the abdominal wall, omentum and abdominal cavity caused by group G streptococci. A 52-year-old diabetic woman presented with abdominal tenderness and weight loss that had persisted for a few weeks. CT scan showed several abscesses of the abdominal wall, omentum and abdominal cavity. The abscesses were drained laparoscopically and antibiotics were given postoperatively. Biopsies and cultures showed group G streptococci. The patient recovered without any complication and left our hospital on the 17th postoperative day.

  10. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    PubMed Central

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  11. Relationship between -889 C/T polymorphism in interleukin-1A gene and risk of chronic periodontitis: Evidence from a meta-analysis with new published findings

    PubMed Central

    da Silva, Felipe-Rodolfo-Pereira; Guimarães-Vasconcelos, Any-Carolina-Cardoso; de-Carvalho-França, Luiz-Felipe; di-Lenardo, David; Rodrigues, Luana-Silva; Barreto-do-Nascimento, Maria-Luísa-Lima

    2017-01-01

    Background Periodontitis results from an inflammatory response caused by accumulative microorganisms in periodontal sites. Several factors are involved in pathogenesis of periodontitis, for example the -889 C/T polymorphism in interleukin-1A gene. This study aimed to evaluate the relationship between this polymorphism and risk of development of chronic periodontitis by a meta-analysis based in new published findings. Material and Methods Thereunto a review in literature was performed in the electronic biomedical and education databases (Cochrane Library, Google Scholar, MEDLINE and PubMed) to studies published before August 2, 2015, the abstracts were evaluated and the data extraction performed by two calibrated examiners. The calculations of the meta-analysis were obtained through statistical software Review Manager version 5.2 with calculation of Odds Ratio (OR), heterogeneity (I²) and Funnel plots with P <0.05. Results In overall, twenty-one case/control studies were selected with 2,174 patients with chronic periodontitis and 1, 756 controls. The meta-analysis showed T allele was associated with chronic periodontitis (OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004) with decreased value to heterogeneity (I² = 15%, P = 0.28). TT genotype was associated to patients with chronic periodontitis (OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01). No publication bias was found in this meta-analysis by asymmetry in Funnel plots. Conclusions This meta-analysis with 2,174 patients with chronic periodontitis and 1, 756 controls evidenced the -889 C/T polymorphism is associated to risk of development of chronic periodontitis with no significant value to heterogeneity to allelic evaluation. Key words:Alleles, odds ratio, periodontal disease, cytokines. PMID:27918732

  12. Multidetector CT of emergent biliary pathologic conditions.

    PubMed

    Patel, Neel B; Oto, Aytekin; Thomas, Stephen

    2013-01-01

    Various biliary pathologic conditions can lead to acute abdominal pain. Specific diagnosis is not always possible clinically because many biliary diseases have overlapping signs and symptoms. Imaging can help narrow the differential diagnosis and lead to a specific diagnosis. Although ultrasonography (US) is the most useful imaging modality for initial evaluation of the biliary system, multidetector computed tomography (CT) is helpful when US findings are equivocal or when biliary disease is suspected. Diagnostic accuracy can be increased by optimizing the CT protocol and using multiplanar reformations to localize biliary obstruction. CT can be used to diagnose and stage acute cholecystitis, including complications such as emphysematous, gangrenous, and hemorrhagic cholecystitis; gallbladder perforation; gallstone pancreatitis; gallstone ileus; and Mirizzi syndrome. CT also can be used to evaluate acute biliary diseases such as biliary stone disease, benign and malignant biliary obstruction, acute cholangitis, pyogenic hepatic abscess, hemobilia, and biliary necrosis and iatrogenic complications such as biliary leaks and malfunctioning biliary drains and stents. Treatment includes radiologic, endoscopic, or surgical intervention. Familiarity with CT imaging appearances of emergent biliary pathologic conditions is important for prompt diagnosis and appropriate clinical referral and treatment.

  13. The Abdominal Circulatory Pump

    PubMed Central

    Aliverti, Andrea; Bovio, Dario; Fullin, Irene; Dellacà, Raffaele L.; Lo Mauro, Antonella; Pedotti, Antonio; Macklem, Peter T.

    2009-01-01

    Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs) is the difference between changes in trunk and body volume. This is so because both trunk and body volume change identically with breathing and gas expansion or compression. During tidal breathing Vbs was 50–75 ml with an ejection fraction of 4–6% and an output of 750–1500 ml/min. Step increases in abdominal pressure resulted in rapid emptying presumably from the liver with a time constant of 0.61±0.1SE sec. followed by slower flow from non-hepatic viscera. The filling time constant was 0.57±0.09SE sec. Splanchnic emptying shifted up to 650 ml blood. With emptying, the increased hepatic vein flow increases the blood pressure at its entry into the inferior vena cava (IVC) and abolishes the pressure gradient producing flow between the femoral vein and the IVC inducing blood pooling in the legs. The findings are important for exercise because the larger the Vbs the greater the perfusion of locomotor muscles. During asystolic cardiac arrest we calculate that appropriate timing of abdominal compression could produce an output of 6 L/min. so that the abdominal circulatory pump might act as an auxiliary heart. PMID:19440240

  14. Abdominal ultrasonographic findings in typhoid fever: a comparison between typhoid patients and those with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis.

    PubMed

    Kobayashi, Akira; Adachi, Yasuo; Iwata, Yoshinori; Sakai, Yoshiyuki; Shigemitu, Kazuaki; Todoroki, Miwako; Ide, Mituru

    2012-03-01

    Typhoid fever is a major health problem in many developing countries and its clinical features are similar to other types of bacterial enterocolitis. Definitive diagnosis by blood culture requires several days and is often unfeasible to perform in developing countries. More efficient and rapid diagnostic methods for typhoid are needed. We compared the pathological changes in the bowel and adjacent tissues of patients having typhoid fever with those having bacterial enterocolitis using ultrasonography. A characteristic of patients with non-typhoidal Salmonella and Campylobacter jejuni enterocolitis was mural thickening of the terminal ileum; only mild mural swelling or no swelling was observed in patients with typhoid fever. Mesenteric lymph nodes in patients with typhoid fever were significantly more enlarged compared to patients with other types of bacterial enterocolitis. Our findings suggest typhoid fever is not fundamentally an enteric disease but rather resembles mesenteric lymphadenopathy and ultrasound is a promising modality for diagnosing typhoid fever in developing countries.

  15. 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.

  16. Clues to vascular disorders at non-contrast CT of the chest, abdomen, and pelvis.

    PubMed

    Esterson, Yonah B; Berkowitz, Jennifer L; Friedman, Barak; Hines, John J; Shah, Priya K; Grimaldi, Gregory M

    2017-04-01

    Non-contrast chest CT scans are commonly performed while CT scans of the abdomen and pelvis are performed in a select subset of patients; those with limited renal function, an allergy to iodinated contrast, in the setting of suspected renal calculus, retroperitoneal hematoma, common duct calculus, abdominal aortic aneurysm with or without rupture, and in patients undergoing a PET-CT scan. In the absence of intravenous contrast, vascular structures may prove challenging to evaluate, yet their assessment is an important component of every non-contrast CT examination. We describe the key imaging features of both arterial and venous pathology, and review clues and common associated non-vascular findings, which can help the radiologist identify vascular disorders at non-contrast CT. Briefly, alternative imaging options are discussed.

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

    PubMed

    Otomaru, Konosuke; Fujikawa, Takuro; Saito, Yasuo; Ando, Takaaki; Obi, Takeshi; Miura, Naoki; Kubota, Chikara

    2015-09-01

    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.

  18. CT Enterography

    MedlinePlus

    ... obstructions and Crohn’s disease. CT scanning is fast, painless, noninvasive and accurate. CT enterography is better able ... the benefits vs. risks? Benefits CT scanning is painless, noninvasive and accurate. A major advantage of CT ...

  19. Factors affecting uncertainty in lung nodule volume estimation with CT: comparisons of findings from two estimation methods in a phantom study

    NASA Astrophysics Data System (ADS)

    Li, Qin; Gavrielides, Marios A.; Zeng, Rongping; Myers, Kyle J.; Sahiner, Berkman; Petrick, Nicholas

    2015-03-01

    This work aimed to compare two different types of volume estimation methods (a model-based and a segmentationbased method) in terms of identifying factors affecting measurement uncertainty. Twenty-nine synthetic nodules with varying size, radiodensity, and shape were placed in an anthropomorphic thoracic phantom and scanned with a 16- detector row CT scanner. Ten repeat scans were acquired using three exposures and two slice collimations, and were reconstructed with varying slice thicknesses. Nodule volumes were estimated from the reconstructed data using a matched-filter and a segmentation approach. Log transformed volumes were used to obtain measurement error with truth obtained through micro-CT. ANOVA and multiple linear regression were applied to measurement error to identify significant factors affecting volume estimation for each method. Root mean square of measurement errors (RMSE) for meaningful subgroups, repeatability coefficients (RC) for different imaging protocols, and reproducibility coefficients (RDC) for thin and thick collimation conditions were evaluated. Results showed that for both methods, nodule size, shape and slice thickness were significant factors. Collimation was significant for the matched-filter method. RMSEs for matched-filter measurements were in general smaller than segmentation. To achieve RMSE on the order of 15% or less for {5, 8, 9, 10mm} nodules, the corresponding maximum allowable slice thicknesses were {3, 5, 5, 5mm} for the matched-filter and {0.8, 3, 3, 3mm} for the segmentation method. RCs showed similar patterns for both methods, increasing with slice thickness. For 8-10mm nodules, the measurements were highly repeatable provided the slice thickness was ≤3mm, regardless of method and across varying acquisition conditions. RDCs were lower for thin collimation than thick collimation protocols. While RDC of matched filter volume estimation results was always lower than segmentation results, for 8-10mm nodules with thin

  20. [Intra-abdominal mycoses].

    PubMed

    Boos, C; Kujath, P; Bruch, H-P

    2005-01-01

    The incidence of invasive mycoses in patients undergoing abdominal surgery amounts to approximately 8% and shows an upward trend in epidemiological studies. The lethality of these systemic mycoses, which are mostly based on Candida infections constitutes up to 60%. The development of a sytemic mycosis is marked by exogenic, endogenic and iatrogenic risk factors and typically displays tissue invasion after an initial fungal contamination or systemic dissemination via fungal sepsis. Fungal peritonitis is generally a monoinfection with Candida spp., where Candida albicans outweighs in 70% of cases. Aspergillus spp. are only detected abdominally in rare cases. The histological verification of a fungal invasion is regarded as proof of the existence of an invasive mycosis, but typical macroscopic findings with corresponding cultural findings can also confirm the diagnosis. Systemic mycosis requires an early initiation of a consistent antimycotic therapy as well as definitive surgical eradication of the focus in order to reduce high lethal rate. Resistances or incorrect dosages can be validated objectively by means of histological monitoring of the antimycotic therapy, thus affording early recognition of the need to change the substance class.

  1. [Indications for low-dose CT in the emergency setting].

    PubMed

    Poletti, Pierre-Alexandre; Andereggen, Elisabeth; Rutschmann, Olivier; de Perrot, Thomas; Caviezel, Alessandro; Platon, Alexandra

    2009-08-19

    CT delivers a large dose of radiation, especially in abdominal imaging. Recently, a low-dose abdominal CT protocol (low-dose CT) has been set-up in our institution. "Low-dose CT" is almost equivalent to a single standard abdominal radiograph in term of dose of radiation (about one sixth of those delivered by a standard CT). "Low-dose CT" is now used routinely in our emergency service in two main indications: patients with a suspicion of renal colic and those with right lower quadrant pain. It is obtained without intravenous contrast media. Oral contrast is given to patients with suspicion of appendicitis. "Low-dose CT" is used in the frame of well defined clinical algorithms, and does only replace standard CT when it can reach a comparable diagnostic quality.

  2. To Find a Better Dosimetric Parameter in the Predicting of Radiation-Induced Lung Toxicity Individually: Ventilation, Perfusion or CT based

    PubMed Central

    Xiao, Lin-Lin; Yang, Guoren; Chen, Jinhu; Wang, Xiaohui; Wu, Qingwei; Huo, Zongwei; Yu, Qingxi; Yu, Jinming; Yuan, Shuanghu

    2017-01-01

    This study aimed to find a better dosimetric parameter in predicting of radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) individually: ventilation(V), perfusion (Q) or computerized tomography (CT) based. V/Q single-photon emission computerized tomography (SPECT) was performed within 1 week prior to radiotherapy (RT). All V/Q imaging data was integrated into RT planning system, generating functional parameters based on V/Q SPECT. Fifty-seven NSCLC patients were enrolled in this prospective study. Fifteen (26.3%) patients underwent grade ≥2 RILT, the remaining forty-two (73.7%) patients didn’t. Q-MLD, Q-V20, V-MLD, V-V20 of functional parameters correlated more significantly with the occurrence of RILT compared to V20, MLD of anatomical parameters (r = 0.630; r = 0.644; r = 0.617; r = 0.651 vs. r = 0.424; r = 0.520 p < 0.05, respectively). In patients with chronic obstructive pulmonary diseases (COPD), V functional parameters reflected significant advantage in predicting RILT; while in patients without COPD, Q functional parameters reflected significant advantage. Analogous results were existed in fractimal analysis of global pulmonary function test (PFT). In patients with central-type NSCLC, V parameters were better than Q parameters; while in patients with peripheral-type NSCLC, the results were inverse. Therefore, this study demonstrated that choosing a suitable dosimetric parameter individually can help us predict RILT accurately. PMID:28294159

  3. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  4. Abdominal aortic aneurysm

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  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 crunch"-induced rhabdomyolysis presenting as right upper quadrant pain.

    PubMed

    Haas, D C; Bohnker, B K

    1999-02-01

    A young, active duty sailor presented with right upper quadrant abdominal pain. History, physical, and laboratory findings initially suggested cholecystitis or related disease. Further evaluation found myoglobinuria and a recently increased exercise program, leading to the diagnosis of exercise-induced right upper abdominal wall rhabdomyolysis. Although not a common cause of abdominal pain, this diagnosis should be considered in the patient with abdominal pain and a recently increased exercise program, particularly exercises of the abdominal wall such as "abdominal crunches."

  7. Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

    PubMed

    Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

    2014-02-01

    Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

  8. The accordion sign at CT: report of a case of Crohn's disease with diffuse colonic involvement.

    PubMed

    Mountanos, G I; Manolakakis, I S

    2001-01-01

    The accordion sign is a finding that could be seen on CT scans of the abdomen in patients who have received oral contrast material. Initially, it was described as a sign specific of Clostridium difficile colitis, but it is also reported to represent a sign of diffuse colonic edema of several other etiologies. We report a case of a patient with Crohn's pancolitis whose abdominal CT scan presented the accordion sign throughout the entire large bowel together with signs of Crohn's disease of the small bowel.

  9. [Duodenal perforation after blunt abdominal trauma].

    PubMed

    Schneider, R; Moebius, C; Thelen, A; Jonas, S

    2009-12-01

    Duodenal perforation after a blunt abdominal trauma is a rare emergency situation that can result in life-threatening complications. We report on a woman who had a perforation of the duodenum after a supposed mild blunt abdominal trauma. Unremarkable at the initial presentation, the patient presented with acute abdominal pain and a retroperitoneal abscess five days after the initial trauma. The duodenal repair was performed with a Roux-Y anastomosis. Difficulties in diagnosis are very common, but the early recognition of the rupture is essential. The contrast-enhanced CT scan is the gold standard for diagnosis. Surgical management depends on the severity of the trauma and must be chosen on an individual basis.

  10. Low-dose Computed Tomography in a Pregnant Woman with a Ruptured Pseudoaneurysm of the Abdominal Aorta.

    PubMed

    Ramac, Jelena Popić; Vidjak, Vinko; Skegro, Dinko; Duić, Zeljko; Blasković, Darko; Erdelez, Lidija; Skopljanac-Macina, Andrija; Suknaić, Slaven; Slavica, Marko; Leder, Nikola Ivan

    2015-09-01

    Imaging the pregnant patient presents a unique challenge to radiologist due to the risk of radiation to the conceptus (embryo/fetus). A rare case of a successfully recognized and treated pseudoaneurysm (PA) of the abdominal aorta is to be presented. The pseudoaneurysm occurred in the third trimester and had a favorable outcome for the mother and the baby. Emergent abdominal ultrasound (US) is the first modality in diagnostic algorithm for the rupture of aortic aneurysm in a pregnant woman. It provides the most rapid diagnostic information, although intestinal gas and abdominal tenderness may limit its accuracy. To confirm the findings, magnetic resonance angiography (MRA) or CT angiography (CTA) can be used. In our case, the diagnosis was established using a color Doppler ultrasonography of the abdomen and was later confirmed by a low dose CT scan of the abdominal aorta. MRA in such cases have some disadvantages. At many health centers, the monitoring of patients with acute ruptures is more difficult in the MR suite than at the CT scanner. MRA angiographic images are also subject to degradation by multiple artifacts and the visualization of the distal vasculature is suboptimal and inferior to the one done by CTA. Due to fetal movements, a small quantity of fresh blood can be overlooked by MR. MRA is often not available on a 24-hours basis, and the time required for making a diagnosis can preclude the use of MRA in an unstable patient. For this reason, we used a low dose CTA protocol to confirm the diagnosis. Low dose scanning protocols in CT can obtain sufficient diagnostic information while reducing the risk of radiation. A particular focus is put on the outline of new concepts for dose management and optimization. We used new approaches based on tube current modulation. The birth was induced by an urgent Caesarean section followed by a resection of a pseudoaneurysm and a reconstruction of the aorta with an end-to-end vascular prosthesis.

  11. Helical CT in emergency radiology.

    PubMed

    Novelline, R A; Rhea, J T; Rao, P M; Stuk, J L

    1999-11-01

    Today, a wide range of traumatic and nontraumatic emergency conditions are quickly and accurately diagnosed with helical computed tomography (CT). Many traditional emergency imaging procedures have been replaced with newer helical CT techniques that can be performed in less time and with greater accuracy, less patient discomfort, and decreased cost. The speed of helical technology permits CT examination of seriously ill patients in the emergency department, as well as patients who might not have been taken to CT previously because of the length of the examinations of the past. Also, helical technology permits multiple, sequential CT scans to be quickly obtained in the same patient, a great advance for the multiple-trauma patient. Higher quality CT examinations result from decreased respiratory misregistration, enhanced intravenous contrast material opacification of vascular structures and parenchymal organs, greater flexibility in image reconstruction, and improved multiplanar and three-dimensional reformations. This report summarizes the role and recommended protocols for the helical CT diagnosis of thoracic aortic trauma; aortic dissection; pulmonary embolism; acute conditions of the neck soft tissues; abdominal trauma; urinary tract stones; appendicitis; diverticulitis; abdominal aortic aneurysm; fractures of the face, spine, and extremities; and acute stroke.

  12. Sudden onset abdominal pain and distension: an imaging sparkler.

    PubMed

    Klair, Jagpal Singh; Girotra, M; Medarametla, S; Shah, H R

    2014-11-01

    We present a case of a middle-aged patient presenting with acute onset abdominal pain and distension who had signs of bowel obstruction on physical exam. He was afebrile, hemodynamically stable with no peritoneal signs. Abdominal radiograph and CT scan were pathognomic for sigmoid volvulus. Through this case report we want to discuss the presentation, diagnosis, management options for sigmoid volvulus and importance of features suggestive of ischemic bowel that necessitates different management options.

  13. Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography.

    PubMed

    Coche, Emmanuel; Vlassenbroek, Alain; Roelants, Véronique; D'Hoore, William; Verschuren, Franck; Goncette, Louis; Maldague, Baudouin

    2005-07-01

    This study aimed to assess the feasibility of cardiac global function evaluation during a whole-chest multi-slice CT (MSCT) acquisition in patients referred for suspicion of pulmonary embolism (PE), and to compare the results with planar equilibrium radionuclide ventriculography (ERNA). Ten consecutive haemodynamically stable patients (six female, four male; mean age 69.7 years; heart rate 65-99 bpm) with suspicion of PE underwent an MSCT and ERNA within a 6 h period. CT acquisition was performed after contrast medium injection by using 16x1.5 mm collimation and retrospective ECG gating. Left ventricular (LVEF) and right ventricular (RVEF) ejection fractions were calculated using dedicated three-dimensional software. Relationships between measurements obtained with MSCT and ERNA were assessed using linear regression analysis and reliability of MSCT was assessed with intra-class correlation coefficient. Bland-Altman analysis was performed to calculate limits of agreement between MSCT and ERNA. MSCT was performed successfully in ten patients with a mean acquisition time of 16.5+/-2.8 s. Functional cardiac evaluation was possible on CT for all patients except for one due to poor opacification of right ventricle. Linear regression analysis showed a good correlation between MSCT and ERNA for the LVEF (R=0.91) and the RVEF (R=0.89) measurements. Intra-class correlation was superior for LVEF (0.92) than for the RVEF (0.68). Bland-Altman plots demonstrated that MSCT substantially overestimated the ERNA RVEF. Morphological CT data demonstrated PE in four of ten of patients and alternative diagnoses in five of ten patients. Our study reveals that MSCT with retrospective ECG gating may provide in one modality a morphological and a functional cardiopulmonary evaluation. Comparison with ERNA demonstrated a good correlation for both ventricular ejection fractions.

  14. A new 3-D diagnosis strategy for duodenal malignant lesions using multidetector row CT, CT virtual duodenoscopy, duodenography, and 3-D multicholangiography.

    PubMed

    Sata, N; Endo, K; Shimura, K; Koizumi, M; Nagai, H

    2007-01-01

    Recent advances in multidetector row computed tomography (MD-CT) technology provide new opportunities for clinical diagnoses of various diseases. Here we assessed CT virtual duodenoscopy, duodenography, and three-dimensional (3D) multicholangiography created by MD-CT for clinical diagnosis of duodenal malignant lesions. The study involved seven cases of periduodenal carcinoma (four ampullary carcinomas, two duodenal carcinomas, one pancreatic carcinoma). Biliary contrast medium was administered intravenously, followed by intravenous administration of an anticholinergic agent and oral administration of effervescent granules for expanding the upper gastrointestinal tract. Following intravenous administration of a nonionic contrast medium, an upper abdominal MD-CT scan was performed in the left lateral position. Scan data were processed on a workstation to create CT virtual duodenoscopy, duodenography, 3D multicholangiography, and various postprocessing images, which were then evaluated for their effectiveness as preoperative diagnostic tools. Carcinoma location and extent were clearly demonstrated as defects or colored low-density areas in 3-D multicholangiography images and as protruding lesions in virtual duodenography and duodenoscopy images. These findings were confirmed using multiplanar or curved planar reformation images. In conclusion, CT virtual duodenoscopy, doudenography, 3-D multicholangiography, and various images created by MD-CT alone provided necessary and adequate preoperative diagnostic information.

  15. Primary lower extremity lymphedema: CT diagnosis

    SciTech Connect

    Gamba, J.L.; Silverman, P.M.; Ling, D.; Dunnick, N.R.; Korobkin, M.

    1983-10-01

    The CT findings of two cases of primary lymphedema of the lower extremities are presented. CT showed a coarse, nonenhancing, reticular pattern in an enlarged subcutaneous compartment. CT excluded the diagnosis of secondary lymphedema from an obstructing mass by demonstrating a normal retroperitoneum and pelvis. The CT findings are correlated with pedal lymphangiograms.

  16. Ascending retrocecal appendicitis presenting with right upper abdominal pain: Utility of computed tomography

    PubMed Central

    Ong, Eugene Mun Wai; Venkatesh, Sudhakar Kundapur

    2009-01-01

    Acute appendicitis is a common surgical condition that is usually managed with early surgery, and is associated with low morbidity and mortality. However, some patients may have atypical symptoms and physical findings that may lead to a delay in diagnosis and increased complications. Atypical presentation may be related to the position of the appendix. Ascending retrocecal appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from acute pathology in the gallbladder, liver, biliary tree, right kidney and right urinary tract. We report a series of four patients with retrocecal appendicitis who presented with acute right upper abdominal pain. The clinical diagnoses at presentation were acute cholecystitis in two patients, pyelonephritis in one, and ureteric colic in one. Ultrasound examination of the abdomen at presentation showed subhepatic collections in two patients and normal findings in the other two. Computed tomography (CT) identified correctly retrocecal appendicitis and inflammation in the retroperitoneum in all cases. In addition, abscesses in the retrocecal space (n = 2) and subhepatic collections (n = 2) were also demonstrated. Emergency appendectomy was performed in two patients, interval appendectomy in one, and hemicolectomy in another. Surgical findings confirmed the presence of appendicitis and its retroperitoneal extensions. Our case series illustrates the usefulness of CT in diagnosing ascending retrocecal appendicitis and its extension, and excluding other inflammatory conditions that mimic appendicitis. PMID:19630119

  17. Diagnostic imaging of acute abdominal pain in adults.

    PubMed

    Cartwright, Sarah L; Knudson, Mark P

    2015-04-01

    Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains a clinical concern, diagnostic imaging is indicated. The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, based on the location of abdominal pain to help physicians choose the most appropriate imaging study. Ultrasonography is the initial imaging test of choice for patients presenting with right upper quadrant pain. Computed tomography (CT) is recommended for evaluating right or left lower quadrant pain. Conventional radiography has limited diagnostic value in the assessment of most patients with abdominal pain. The widespread use of CT raises concerns about patient exposure to ionizing radiation. Strategies to reduce exposure are currently being studied, such as using ultrasonography as an initial study for suspected appendicitis before obtaining CT and using low-dose CT rather than standard-dose CT. Magnetic resonance imaging is another emerging technique for the evaluation of abdominal pain that avoids ionizing radiation.

  18. Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary?

    PubMed

    Yitta, Silaja; Mausner, Elizabeth V; Kim, Alice; Kim, Danny; Babb, James S; Hecht, Elizabeth M; Bennett, Genevieve L

    2011-10-01

    To determine the added value of reimaging the female pelvis with ultrasound (US) immediately following multidetector CT (MDCT) in the emergent setting. CT and US exams of 70 patients who underwent MDCT for evaluation of abdominal/pelvic pain followed by pelvic ultrasound within 48 h were retrospectively reviewed by three readers. Initially, only the CT images were reviewed followed by evaluation of CT images in conjunction with US images. Diagnostic confidence was recorded for each reading and an exact Wilcoxon signed rank test was performed to compare the two. Changes in diagnosis based on combined CT and US readings versus CT readings alone were identified. Confidence intervals (95%) were derived for the percentage of times US reimaging can be expected to lead to a change in diagnosis relative to the diagnosis based on CT interpretation alone. Ultrasound changed the diagnosis for the ovaries/adnexa 8.1% of the time (three reader average); the majority being cases of a suspected CT abnormality found to be normal on US. Ultrasound changed the diagnosis for the uterus 11.9% of the time (three reader average); the majority related to the endometrial canal. The 95% confidence intervals for the ovaries/adnexa and uterus were 5-12.5% and 8-17%, respectively. Ten cases of a normal CT were followed by a normal US with 100% agreement across all three readers. Experienced readers correctly diagnosed ruptured ovarian cysts and tubo-ovarian abscesses (TOA) based on CT alone with 100% agreement. US reimaging after MDCT of the abdomen and pelvis is not helpful: (1) following a normal CT of the pelvic organs or (2) when CT findings are diagnostic and/or characteristic of certain entities such as ruptured cysts and TOA. Reimaging with ultrasound is warranted for (1) less-experienced readers to improve diagnostic confidence or when CT findings are not definitive, (2) further evaluation of suspected endometrial abnormalities. A distinction should be made between the need for

  19. Abdominal Pain Caused by a Potentially Fatal Attraction.

    PubMed

    Mercurio, Danielle Claire; Scace, Candace; Shah, Bhairav; Weiner, Evan; Prasad, Rajeev

    2016-11-19

    Abdominal pain is a challenging presentation in children. Examination findings and etiology vary greatly, spanning a vast spectrum from flatulence to frank peritonitis with septic shock. Here, we discuss a 10-year-old boy with 24 hours of progressively worsening lower abdominal pain, nausea, and subjective fevers. History and physical examination findings were consistent with appendicitis. However, physicians were surprised when the single-view abdominal radiograph showed an unanticipated, somewhat perplexing discovery.

  20. CT and ultrasound of gastric and duodenal duplications

    SciTech Connect

    Guibaud, L.; Genin, G.; Fouque, P.

    1996-05-01

    We present the radiological findings of gastric and duodenal duplications in four adults, in whom abdominal ultrasound, endoscopic ultrasound (EUS), and CT were primarily used for diagnosis. The diagnosis was surgically confirmed in all cases. Preoperative diagnosis of duplications was possible with ultrasound in three patients, in whom CT showed a nonspecific cystic structure. Ultrasound demonstrated a pathognomonic multilayered wall appearance suggestive of a digestive origin, including an echogenic inner mucosal layer and a hypoechoic muscular layer, better appreciated using EUS in one patient. In one case, digestive origin was confirmed by direct visualization of a peristaltic activity within the cystic wall after water ingestion. In the last patient, a non-specific heterogeneous mainly solid mass of the esophagogastric junction was found to be an adenocarcinoma arising from a duplication on the histological analysis of the surgical specimen. 10 refs., 4 figs.

  1. CT angiography in the abdomen: a pictorial review and update.

    PubMed

    Liu, Peter S; Platt, Joel F

    2014-02-01

    The development of multidetector CT technology and helical scanning techniques has revolutionized the use of CT for primary diagnostic evaluation of the abdominal vasculature, particularly the arterial system. CT angiography has numerous benefits relative to conventional catheter angiography, and has largely replaced catheter-based techniques in many clinical algorithms. This pictorial review and update will cover important technical principles related to modern CT angiography (including contrast delivery and dose considerations), discuss relevant anatomy and variants, and illustrate numerous arterial conditions related to the abdominal aorta and branch vessels.

  2. ACR Appropriateness Criteria® pulsatile abdominal mass, suspected abdominal aortic aneurysm.

    PubMed

    Desjardins, Benoit; Dill, Karin E; Flamm, Scott D; Francois, Christopher J; Gerhard-Herman, Marie D; Kalva, Sanjeeva P; Mansour, M Ashraf; Mohler, Emile R; Oliva, Isabel B; Schenker, Matthew P; Weiss, Clifford; Rybicki, Frank J

    2013-01-01

    Clinical palpation of a pulsating abdominal mass alerts the clinician to the presence of a possible abdominal aortic aneurysm (AAA). Generally an arterial aneurysm is defined as a localized arterial dilatation ≥50% greater than the normal diameter. Imaging studies are important in diagnosing the cause of a pulsatile abdominal mass and, if an AAA is found, in determining its size and involvement of abdominal branches. Ultrasound (US) is the initial imaging modality of choice when a pulsatile abdominal mass is present. Noncontrast computed tomography (CT) may be substituted in patients for whom US is not suitable. When aneurysms have reached the size threshold for intervention or are clinically symptomatic, contrast-enhanced multidetector CT angiography (CTA) is the best diagnostic and preintervention planning study, accurately delineating the location, size, and extent of aneurysm and the involvement of branch vessels. Magnetic resonance angiography (MRA) may be substituted if CT cannot be performed. Catheter arteriography has some utility in patients with significant contraindications to both CTA and MRA. The American College of Radiology Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  3. Torsion of an intra-abdominal testis.

    PubMed

    Lewis; Roller; Parra; Cotlar

    2000-09-01

    To present a case of torsion of a nonneoplastic intra-abdominal testis with an unusual clinical presentation.A 26-year-old active duty Navy Petty Officer presented to the emergency department on 3 occasions over a 5-day period with lower abdominal pain. Physical examination demonstrated acute tenderness in the left lower quadrant with sugestion of a normal spermatic cord and atrophic testis in the left scrotum. Computed tomography scan demonstrated an intra-abdominal lesion near the internal inguinal ring. The patient underwent surgical exploration through an inguinal incision. Torsion of a nonviable intra-abdominal testis was present. The scrotum contained only the vas deferens and cremasteric muscle. An orchiectomy was performed with removal of the vas deferens and other cord structures.The unusual clinical finding of acute torsion of an intra-abdominal testis, associated with an apparent atrophic scrotal testis, presented a confusing clinical picture. Computed tomography scan did not clarify the issue sufficiently to establish a definite preoperative diagnosis. Clinical suspicion prompted early surgical intervention. Review of the current literature produced 60 reported cases of torsion of an intra-abdominal testis. Two thirds of these involved testicular neoplasm, usually seminoma. Although the clinical presentation varied, most patients had recent onset of lower abdominal pain associated with tenderness and, in half the cases, a mass. Patients almost always presented with an absent scrotal testis on the involved side, and not infrequently reported previous surgery thought to be an orchiectomy.Diagnosis of an intra-abdominal testicular torsion is rare, particularly when no neoplasm is present. A high index of suspicion must be maintained whenever there is abdominal pain and undescended testis. The surgical history and imaging studies may not clarify a confusing clinical picture.

  4. 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 ...

  5. A sign on CT that predicts a hazardous ureteral anomaly

    PubMed Central

    Allam, E.S.; Johnson, D.Y.; Grewal, S.G.; Johnson, F.E.

    2016-01-01

    Introduction An aberrant course of the distal ureter can pose a risk of ureteral injury during surgery for inguinal hernia repair and other groin operations. In a recent case series of inguinoscrotal hernation of the ureter, we found that each affected ureter was markedly anterior to the psoas muscle at its mid-point on abdominal CT. We hypothesized that this abnormality in the abdominal course of the ureter would predict the potentially hazardous aberrant course of the distal ureter. Presentation of cases We reviewed all evaluable CT urograms performed at St. Louis University Hospital from June 2012 to July 2013 and measured the ureteral course at several anatomically fixed points. Discussion 93% (50/54) of ureters deviated by less than 1 cm from the psoas muscle in their mid-course (at the level of the L4 vertebra). Reasons for anterior deviation of the ureter in this study included morbid obesity with prominent retroperitoneal fat, congenital renal abnormality, and post-traumatic renal/retroperitoneal hematoma. We determined that the optimal level on abdominal CT to detect the displaced ureter was the mid-body of the L4 vertebra. Conclusion Anterior deviation of the ureter in its mid-course appears to predict inguinoscrotal herniation of the ureter. This finding is a sensitive predictor and should raise concern for this anomaly in the appropriate clinical setting. It is not entirely specific as morbid obesity and congenital anomalies may result in a similar imaging appearance. We believe that this association has not been reported previously. Awareness of this anomaly can have significant operative implications. PMID:27046105

  6. Evaluating an Ultrasound Algorithm for Patients with Blunt Abdominal Trauma

    DTIC Science & Technology

    2004-09-01

    19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified Standard Form 298 (Rev. 8-98...Algorithm for Patients with Blunt Abdominal Trauma RTO-MP-HFM-109 P6 - 7 Table 1: Patients undergoing laparotomy U S US results C T CT result...11] Henneman PL, Marx JA, Moore EE. 1990. Diagnostic

  7. Abdominal Pain Syndrome

    MedlinePlus

    ... or cancer Infection of the tubes (salpingitis) Ectopic pregnancy Fibroid tumors of the uterus (womb) Malignant tumors of the uterus or cervix Endometriosis Adhesions (scars) Screening and Diagnosis How is the cause of abdominal pain determined? ...

  8. [The abdominal catastrophe].

    PubMed

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  9. 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 ...

  10. Acute abdominal pain.

    PubMed

    Stone, R

    1998-01-01

    Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice. Also, it is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments. There are several common sources for acute abdominal pain and many for subacute and chronic abdominal pain. This article explores the history-taking, initial evaluation, and examination of the patient presenting with acute abdominal pain. The goal of this article is to help differentiate one source of pain from another. Discussion of acute cholecystitis, pancreatitis, appendicitis, ectopic pregnancy, diverticulitis, gastritis, and gastroenteritis are undertaken. Additionally, there is discussion of common laboratory studies, diagnostic studies, and treatment of the patient with the above entities.

  11. Abdominal wall surgery

    MedlinePlus

    ... the results of abdominoplasty. Many feel a new sense of self-confidence. Alternative Names Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty Images Abdominoplasty - series Abdominal muscles References McGrath MH, Pomerantz J. Plastic surgery. In: Townsend ...

  12. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  13. Acute chest pain in emergency room. Preliminary findings with 40-64-slice CT ECG-gated of the whole chest.

    PubMed

    Coche, E

    2007-01-01

    ECG-gated MDCT of the entire chest represents the latest technical advance in the diagnostic work-up of atypical chest pain. The authors report their preliminary experience with the use of 40 and 64-slice CT in the emergency room and recommend to study only patients with moderate likelihood of coronary artery disease. ECG-gated MDCT of the entire chest will be preferentially performed on 64-slice MDCT rather than 40-slice MDCT because it enable to reduce the scan time (18 seconds versus 28 seconds acquisition time), the volume of contrast medium (82 mL + 15 mL versus 97 mL + 15 mL of highly concentrated contrast agent for a patient of 70 kgs) and radiation exposure (17 mSv versus 19 mSv). Approximately 1500 to 2000 of images are produced and need to be analysed on a dedicated workstation by a radiologist expert in cardiac and thoracic disorders. At the present time, only a few studies exist in the literature showing some promising results but further large clinical studies are needed before to implement such sophisticated protocol in emergency room.

  14. Inflammatory abdominal aortic aneurysm.

    PubMed

    Savarese, R P; Rosenfeld, J C; DeLaurentis, D A

    1986-05-01

    Between January 1976 and December 1982, 181 patients with abdominal aortic aneurysms were treated surgically, and in 13 patients the aneurysms were found to be inflammatory. Inflammatory aneurysms of the abdominal aorta (IAAA) share important characteristics with typical atherosclerotic abdominal aortic aneurysms. Diagnosis and surgical management of IAAA are distinctive which suggests that IAAA should be considered separately, as a varient of typical abdominal aortic aneurysms. IAAA occur predominantly in males. The presenting symptoms are often idiosyncratic and include severe abdominal or back pain, or both, and ureteral obstruction; the diagnosis of IAAA should be considered when these symptoms are present. Although grossly and microscopically, the perianeurysmal fibrosis resembles idiopathic retroperitoneal fibrosis, the two conditions can be differentiated. At the present time, ultrasonography and computed tomography appear to offer reliable means for diagnosing IAAA. The presence of IAAA, whether established preoperatively or discovered unexpectedly at operation, necessitate certain modifications in the surgical approach, in order to avoid injuring the duodenum and the venous structures. Most patients can be successfully treated by resection and graft replacement. Rupture of the aneurysm in IAAA appears to be less frequent than in typical atherosclerotic abdominal aortic aneurysm.

  15. Refractory Abdominal Pain in a Hemodialysis Patient

    PubMed Central

    Qian, Ying; Chen, Xiao-nong; Shi, Hao; Xie, Jingyuan; Chen, Nan

    2015-01-01

    Nonocclusive mesenteric ischemia (NOMI) is a rare disorder. Failure of an early diagnosis may cause progressive intestinal ischemia, leading to abdominal pain, sepsis, and death. Patients with end-stage renal disease are among the highest risk populations for developing this lethal complication. The key to a correct diagnosis at an early stage is a high index of suspicion in predisposed patients. In our case, we present a 62-year-old female undergoing maintenance hemodialysis for 8 years; she complained of abdominal pain after hemodialysis in the last 3 months; NOMI was suspected after a CT angiography. She partially recovered after multiple clinical interventions such as decreased ultrafiltration, an increased dose of low molecular-weight heparin and the use of vasoactive drugs. In conclusion, NOMI can be reversible if it is diagnosed as early as possible and after the necessary diagnostic measurements are initiated. PMID:26266246

  16. Abdominal abscesses in adolescents with Crohn's disease.

    PubMed

    Biller, J A; Grand, R J; Harris, B H

    1987-09-01

    Little information is available about the development of abdominal abscesses in adolescents with Crohn's disease. We report the clinical presentation of five adolescents with Crohn's disease who developed this complication. The mean time from diagnosis until development of an abdominal abscess was 1.7 years. The admitting diagnosis was an acute abdomen in two patients and recurrent Crohn's disease in the other three. No features of the clinical presentation or laboratory data distinguished this group from other adolescents with Crohn's disease. The use of ultrasound and CT scanning was helpful in making this diagnosis preoperatively. Those patients with active Crohn's disease who do not respond promptly to medical therapy should be evaluated for the development of this complication.

  17. Doses metrics and patient age in CT.

    PubMed

    Huda, Walter; Tipnis, Sameer V

    2016-03-01

    The aim of this study was to investigate how effective dose and size-specific dose estimate (SSDE) change with patient age (size) for routine head and abdominal/pelvic CT examinations. Heads and abdomens of patients were modelled as a mass-equivalent cylinder of water corresponding to the patient 'effective diameter'. Head CT scans were performed at CTDIvol(S) of 40 mGy, and abdominal CT scans were performed at CTDIvol(L) of 10 mGy. Values of SSDE were obtained using conversion factors in AAPM Task Group Report 204. Age-specific scan lengths for head and abdominal CT scans obtained from the authors' clinical practice were used to estimate the dose-length product for each CT examination. Effective doses were calculated from previously published age- and sex-specific E/DLP conversion factors, based on ICRP 103 organ-weighting factors. For head CT examinations, the scan length increased from 15 cm in a newborn to 20 cm in adults, and for an abdominal/pelvic CT, the scan length increased from 20 cm in a newborn to 45 cm in adults. For head CT scans, SSDE ranged from 37.2 mGy in adults to 48.8 mGy in a newborn, an increase of 31 %. The corresponding head CT effective doses range from 1.4 mSv in adults to 5.2 mSv in a newborn, an increase of 270 %. For abdomen CT scans, SSDE ranged from 13.7 mGy in adults to 23.0 mGy in a newborn, an increase of 68 %. The corresponding abdominal CT effective doses ranged from 6.3 mSv in adults to 15.4 mSv in a newborn, an increase of 140 %. SSDE increases much less than effective dose in paediatric patients compared with adults because it does not account for scan length or scattered radiation. Size- and age-specific effective doses better quantify the total radiation received by patients in CT by explicitly accounting for all organ doses, as well as their relative radio sensitivity.

  18. Abdominal aortic aneurysm: A comprehensive review

    PubMed Central

    Aggarwal, Sourabh; Qamar, Arman; Sharma, Vishal; Sharma, Alka

    2011-01-01

    An arterial aneurysm is defined as a focal dilation of a blood vessel with respect to the original artery. The risk of abdominal aortic aneurysms (AAAs) increases dramatically in the presence of the following factors: age older than 60 years, smoking, hypertension and Caucasian ethnicity. The likelihood that an aneurysm will rupture is influenced by the aneurysm size, expansion rate, continued smoking and persistent hypertension. The majority of AAAs are asymptomatic and are detected as an incidental finding on ultrasonography, abdominal computed tomography or magnetic resonance imaging performed for other purposes. It can also present with abdominal pain or complications such as thrombosis, embolization and rupture. Approximately 30% of asymptomatic AAAs are discovered as a pulsatile abdominal mass on routine physical examination. Abdominal ultrasonography is considered the screening modality of choice for detecting AAAs because of its high sensitivity and specificity, as well as its safety and relatively lower cost. The decision to screen for AAAs is challenging. The United States Preventive Services Task Force recommended that men between the age of 65 to 75 years who have ever smoked should be screened at least once for AAAs by abdominal ultrasonography. Management options for patients with an asymptomatic AAA include reduction of risk factors such as smoking, hypertension and dyslipidemia; medical therapy with beta-blockers; watchful waiting; endovascular stenting; and surgical repair depending on the size and expansion rate of the aneurysm and underlying comorbidities. PMID:21523201

  19. [The computed tomographic diagnosis of inflammatory abdominal aortic aneurysms].

    PubMed

    Koch, J A; Grützner, G; Jungblut, R M; Kniemeyer, H W; Mödder, U

    1994-07-01

    Amongst 1599 patients undergoing surgery for abdominal aortic aneurysm, there were 89 patients (5.6%) who showed typical features of inflammatory aneurysms of the abdominal aorta (IAAA). 37 of the 89 patients had been examined preoperatively by CT. In 73% of the cases (27/37) a correct diagnosis had been made. Localisation, width and extent of the IAAA was correctly diagnosed in all patients. Involvement of the renal arteries by the inflammatory process, the extent of thrombus and of mural calcification were accurately shown. The inflammatory tissues were typically ventral and lateral to the aorta. Frequently, there were adhesions to neighbouring structures. Aortic rupture, aortic dissection and retroperitoneal lymphoma may produce similar CT appearances; nevertheless, CT remains at present the method of choice for the diagnosis of IAAA because of its high sensitivity.

  20. Spectrum of imaging findings on MDCT enterography in patients with small bowel tuberculosis.

    PubMed

    Kalra, N; Agrawal, P; Mittal, V; Kochhar, R; Gupta, V; Nada, R; Singh, R; Khandelwal, N

    2014-03-01

    Abdominal tuberculosis (TB) is the sixth most common extrapulmonary site of involvement. The sites of involvement in abdominal tuberculosis, in descending order of frequency, are lymph nodes, genitourinary tract, peritoneal cavity, and gastrointestinal tract. The radiological armamentarium for evaluating tuberculosis of the small bowel (SBTB) includes barium studies (small bowel follow-through, SBFT), CT (multidetector CT, CT enterography, and CT enteroclysis), ultrasound (sonoenteroclysis), and magnetic resonance imaging (MRI; enterography and enteroclysis). In this review, we illustrate the abnormalities at MDCT enterography in 20 consecutive patients with SB TB and also describe extraluminal findings in these patients. MDCT enterography allows non-invasive good-quality assessment of well-distended bowel loops and the adjacent soft tissues. It displays the thickness and enhancement of the entire bowel wall in all three planes and allows examination of all bowel loops, especially the ileal loops, which are mostly superimposed. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement in intestinal TB. The most common abnormality is short-segment strictures with symmetrical concentric mural thickening and homogeneous mural enhancement. Other findings include lymphadenopathy, ascites, enteroliths, peritoneal thickening, and enhancement. In conclusion, MDCT enterography is a comprehensive technique for the evaluation of SB TB.

  1. Advances in abdominal MR imaging.

    PubMed

    Ferrucci, J T

    1998-01-01

    Major technical advances in MR imaging have led to its wider use in the evaluation of abdominal disease. The principle new pulse sequence is the RARE sequence for T2-weighted imaging. Multishot and breath-hold single-shot RARE techniques are now widely used, and both have performed as well as conventional spin-echo imaging with far shorter acquisition times. The most notable improvements have been in the detection and characterization of hepatic lesions. Two liver-specific contrast agents received FDA approval during 1997: SPIO particles or ferumoxide and mangafodipir trisodium, a hepatocyte-specific agent. Both of these agents provide considerable benefit in the detection and characterization of hepatic lesions. Manganese enhancement has also proved useful in MR imaging of the pancreas, although fat-suppressed T1-weighted imaging with dynamic gadolinium enhancement has also yielded results comparable with those of contrast-enhanced CT. MR hydrography, a generic term for static fluid imaging, is another derivative of RARE fast T2-weighted imaging. MRCP, the best known example of MR hydrography, has been rapidly and widely employed as a primary method for imaging the biliary and pancreatic ducts and has become competitive with ERCP. MR vascular imaging, especially portal venography, has been used for noninvasive imaging of portal venous disease in Budd Chiari disease, before placement of transjugular intrahepatic portosystemic shunts, and for pancreatic cancer staging. Finally, the development of conventional phased-array body coils and endorectal coils has enabled high-quality MR imaging of perirectal disease (including Crohn disease, fistula in ano, and postpartum sphincter dysfunction). Future abdominal applications of MR imaging will involve second-generation MR interventional techniques, including use of open systems, functional or diffusion-weighted imaging exploiting the molecular activity of tissues, and virtual MR endoscopy. Although CT continues to evolve

  2. Head CT scan

    MedlinePlus

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... conditions: Birth (congenital) defect of the head or brain Brain infection Brain tumor Buildup of fluid inside ...

  3. Imaging the Abdominal Manifestations of Cystic Fibrosis

    PubMed Central

    McDermott, S.; Chan, V. O.; Ridge, C. A.

    2017-01-01

    Cystic fibrosis (CF) is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis. PMID:28250993

  4. 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

  5. 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.

  6. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Mikami, Y; Kyogoku, M

    1994-08-01

    Inflammatory abdominal aortic aneurysm (IAAA) is a distinct clinicopathological entity, characterized by: (1) clinical presentation, such as back pain, weight loss, and increased ESR, (2) patchy and/or diffuse lymphoplasmacytic infiltration, and (3) marked periaortic fibrosis resulting in thickening of the aneurysmal wall and occasional retroperitoneal fibrosis. Its pathogenesis is unknown, but some authors support the theory that IAAA is a subtype of atherosclerotic abdominal aortic aneurysm because of close relationship between IAAA and atherosclerotic change. In this article, we describe clinical and histological features of IAAA on the basis of the literature and our review of 6 cases of IAAA, emphasizing the similarity and difference between IAAA and atherosclerotic abdominal aortic aneurysm. Our review supports that marked lamellar fibrosis completely replacing the media and adventitia, patchy lymphocytic infiltration (mostly B cells) and endarteritis obliterans are characteristic features of IAAA.

  7. Comparison of Cone-Beam CT Incidental Findings between Moderate/Severe Obstructive Sleep Apnea patients and Mild/Normal patients

    PubMed Central

    Enciso, Reyes; Shigeta, Yuko; Nguyen, Manuel; Clark, Glenn T.

    2012-01-01

    Objective To compare the incidental radiographic findings in the maxillofacial structures and the pharyngeal airway between moderate/severe Obstructive Sleep Apnea (OSA) subjects and mild OSA/normal subjects using Cone-Beam Computed Tomography (CBCT) scans. Study Design 53 moderate/severe OSA subjects (with a Respiratory Disturbance Index [RDI]≥15 events/hr) and 33 mild OSA/normal subjects, (RDI<15) based on ambulatory somnographic assessment were recruited. Supine CBCT’s were taken and sent for radiological report. The incidental findings were compared between the two groups. Results Moderate/severe subjects had larger prevalence of conchae bullosa, hypertrophic turbinates, hypertrophic tonsils, elongated or posteriorly placed soft palate, narrower airway, enlarged tongue, and focal calcifications, though no significant differences were found. Conclusions CBCT is useful in identifying maxillofacial and airway anomalies that could interfere with normal breathing. However, no significant difference was found in prevalence of incidental findings between moderate/severe OSA and mild/normal subjects. Further studies are necessary to generalize our results. PMID:22862979

  8. Endovascular Repair of a Blunt Abdominal Aortic Injury

    PubMed Central

    Tobler, William D.; Tan, Tze-Woei; Farber, Alik

    2012-01-01

    Blunt abdominal aortic injury is an uncommon traumatic finding. In the past, treatment options have traditionally consisted of open operative repair; however, the development of endovascular surgery has created new interventional possibilities. This case is presented to demonstrate the applications of endovascular abdominal aortic repair for a blunt traumatic injury. PMID:23730142

  9. Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation

    PubMed Central

    Demir, Mustafa Kemal; Yapıcıer, Özlem; Onat, Elif; Toktaş, Zafer Orkun; Akakın, Akın; Urgun, Kamran; Kılıç, Türker

    2014-01-01

    There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated dural neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clinico-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management. PMID:25010368

  10. 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.

  11. [Albert Einstein and his abdominal aortic aneurysm].

    PubMed

    Cervantes Castro, Jorge

    2011-01-01

    The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

  12. Prevalence of CT features of axial spondyloarthritis in patients with Crohn's disease.

    PubMed

    De Kock, Isabelle; Hindryckx, Pieter; De Vos, Martine; Delrue, Louke; Verstraete, Koenraad; Jans, Lennart

    2017-05-01

    Background The sacroiliac joint and spine are seen on abdominal computed tomography (CT) and may show structural lesions as part of spondyloarthritis. Purpose To determine the prevalence of CT features of spondyloarthritis in patients with Crohn's disease (CD). Material and Methods A retrospective study of structural lesions of spondyloarthritis on abdominal CT was performed. The sacroiliac joints and spine of 120 patients were studied: study group I consisted of 40 patients with known CD and inflammatory back pain, group II involved 40 patients with CD without inflammatory back pain, and group III consisted of 40 patients without known joint or inflammatory bowel disease. Recorded CT features included sclerosis, erosions or ankylosis of the sacroiliac joint, enthesopathy, spinal syndesmophytes, and costovertebral joint lesions. Results CT showed structural lesions of the sacroiliac joints in 19/40 (48%) patients with CD and inflammatory back pain (sclerosis [n = 14; 35%], erosions [n = 14; 35%], ankylosis [n = 3; 8%]), in 8/40 (8%) patients with CD without inflammatory back pain (sclerosis [n = 3; 8%], erosions [n = 4; 10%], ankylosis [n = 3; 8%]), and in 3/40 (8%) patients without known joint or bowel disease (sclerosis [n = 2; 5%], ankylosis [n = 1; 3%]). Syndesmophytes were exclusively seen in group I (n = 6; 15%). Conclusion CT of the abdomen in patients with CD and inflammatory back pain shows structural lesions of the sacroiliac joint, entheses, or spine in almost half of the patients. Awareness and knowledge of these findings may guide the referring clinician to further clinical evaluation, imaging, and biomarker evaluation of the disease.

  13. [A Case of Abdominal Wall Hernia Rupture during Bevacizumab Treatment].

    PubMed

    Sugimoto, Satoshi; Miyazaki, Yasuaki; Hirose, Sou; Michiura, Toshiya; Fujita, Shigeo; Yamabe, Kazuo; Miyazaki, Satoru; Nagaoka, Makio

    2015-11-01

    A 78 -year-old man with rectal cancer underwent abdominoperineal resection of the rectum. In the postoperative period, the patient experienced wound infection, leading to an abdominal wall hernia. Two years following surgery, a rise in the serum CEA level was seen. A metastatic tumor was detected in the right lung on chest CT. VATS right lung inferior lobe segmental resection was performed. After lobectomy, the serum CEA level continued to increase. Another metastatic tumor was detected in the right lung on chest CT. Chemotherapy with capecitabine, oxaliplatin, and bevacizumab was commenced. The erosive part of the abdominal wall scar hernia extended during the nine weeks of chemotherapy. The chemotherapy was then discontinued. In the follow-up CT scan, a right pleural recurrence, local recurrence in the pelvis, and a liver metastasis were detected. Chemotherapy was re-introduced 3 years after surgery. The erosive part of the abdominal wall hernia again began to spread with chemotherapy recommencement. Four months after restarting chemotherapy, the hernia ruptured, with a loop of the small intestine protruding out of it. The patient covered this with a sheet of vinyl and was taken by the ambulance to our hospital. The erosive part of the abdominal wall hernia had split by 10 cm, and a loop of the small intestine was protruding. As ischemia of the small intestine was not observed, we replaced it into the abdominal cavity, and performed a temporary suture repair of the hernia sac. Following this, bevacizumab was discontinued, and the erosive part reduced. We performed a radical operation for abdominal wall scar hernia repair 11 weeks after the discontinuation of bevacizumab.

  14. 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

    Purpose: With the continuous development of new stent grafts and implantation techniques, it has now become technically feasible to treat abdominal aortic aneurysms (AAA) with challenging anatomy using endovascular repair with standard, fenestrated, or branched stent-grafts. In vitro experimentations are very useful to improve stent-graft design and conformability or imaging guidance for stent-graft delivery or follow-up. Vascular replicas also help to better understand the limitation of endovascular approaches in challenging anatomy and possibly improve surgical planning or training by practicing high risk clinical procedures in the laboratory to improve outcomes in the operating room. Most AAA phantoms available have a very basic anatomy, which is not representative of the clinical reality. This paper presents a method of fabrication of a realistic AAA phantom with a visible thrombus, as well as some mechanical properties characterizing such phantom. Methods: A realistic AAA geometry replica of a real patient anatomy taken from a multidetector computed tomography (CT) scan was manufactured. To demonstrate the multimodality imaging capability of this new phantom with a thrombus visible in magnetic resonance (MR) angiography, CT angiography (CTA), digital subtraction angiography (DSA), and ultrasound, image acquisitions with all these modalities were performed by using standard clinical protocols. Potential use of this phantom for stent deployment was also tested. A rheometer allowed defining hyperelastic and viscoelastic properties of phantom materials. Results: MR imaging measurements of SNR and CNR values on T1 and T2-weighted sequences and MR angiography indicated reasonable agreement with published values of AAA thrombus and abdominal components in vivo. X-ray absorption also lay within normal ranges of AAA patients and was representative of findings observed on CTA, fluoroscopy, and DSA. Ultrasound propagation speeds for developed materials were also in

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

    PubMed

    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.

  16. Abdominal exploration - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100049.htm Abdominal exploration - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  17. Incision for abdominal laparoscopy (image)

    MedlinePlus

    Abdominal laparoscopy is a useful aid in diagnosing disease or trauma in the abdominal cavity with less scarring than ... as liver and pancreatic resections may begin with laparoscopy to exclude the presence of additional tumors (metastatic ...

  18. A reappraisal of adult abdominal surface anatomy.

    PubMed

    Mirjalili, S Ali; McFadden, Sara L; Buckenham, Tim; Stringer, Mark D

    2012-10-01

    Descriptions of clinically important surface landmarks often vary between and within contemporary anatomical texts. The aim of this study was to investigate the surface anatomy of major abdominal vessels, kidneys, spleen, gastroesophageal junction, and duodenojejunal flexure in living adults using computed tomography (CT). After excluding patients with distorting space-occupying lesions, scoliosis, abnormal lordosis, and obvious visceromegaly, 108 abdominal CT scans of supine adults (mean age 60 years, range 18-97 years; 64 female) at end tidal inspiration were available for analysis by dual consensus reporting. Intra-observer agreement was assessed by repeat blind assessment of a random sample of scans. The vertebral level of the aortic bifurcation and almost all of its major branches, and the origin of the inferior vena cava were consistent with current descriptions. Important differences from contemporary descriptions of surface anatomy were as follows: the renal arteries were most commonly at the L1 vertebral level (left 55%, right 43%); the midpoint of the renal hila was most frequently at L2 (left 68%, right 40%); the 11th rib was a posterior relation of the left kidney in only 28% of scans; and the spleen was most frequently located between the 10th and 12th ribs (48%) with its long axis in line with the 11th rib (55%). Although the majority of vascular surface landmarks are consistent with standard descriptions, the surface anatomy of the kidneys, renal arteries, and spleen needs to be revised in accordance with observations using modern imaging techniques in vivo.

  19. Mesh Sutured Repairs of Abdominal Wall Defects

    PubMed Central

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

  20. 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.

  1. Prognostication of traumatic brain injury outcomes in older trauma patients: A novel risk assessment tool based on initial cranial CT findings

    PubMed Central

    Stawicki, Stanislaw P.; Wojda, Thomas R.; Nuschke, John D.; Mubang, Ronnie N.; Cipolla, James; Hoff, William S.; Hoey, Brian A.; Thomas, Peter G.; Sweeney, Joan; Ackerman, Daniel; Hosey, Jonathan; Falowski, Steven

    2017-01-01

    Introduction: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e.g., morbidity and mortality) in the older (age 45+ years) TBI patient subset. We hypothesized that increasing number of categorical CCT findings is independently associated with NSI, morbidity, and mortality in older patients with severe TBI. Methods: After IRB approval, a retrospective study of patients 45 years and older was performed using our Regional Level 1 Trauma Center registry data between June 2003 and December 2013. Collected variables included patient demographics, Injury Severity Score (ISS), Abbreviated Injury Scale Head (AISh), brain injury characteristics on CCT, Glasgow Coma Scale (GCS), Intensive Care Unit (ICU) and hospital length of stay (LOS), all-cause morbidity and mortality, functional independence scores, as well as discharge disposition. A novel CCT scoring tool (CCTST, scored from 1 to 8+) was devised, with one point given for each of the following findings: subdural hematoma, epidural hematoma, subarachnoid blood, intraventricular blood, cerebral contusion/intraparenchymal blood, skull fracture, pneumocephalus, brain edema/herniation, midline shift, and external (skin/face) trauma. Descriptive statistics and univariate analyses were conducted with 30-day mortality, in-hospital morbidity, and need for NSI as primary end-points. Secondary end-points included the length of stay in the ICU (ICULOS), step-down unit (SDLOS), and the hospital (HLOS) as well as patient functional outcomes, and postdischarge destination. Factors associated with the need

  2. [Myxofibrosarcoma in the abdominal cavity].

    PubMed

    Janů, F

    2016-01-01

    A number of benign and malignant tumors may develop in the abdominal cavity. Sarcomas are rather rare tumors of the abdominal cavity. They are often diagnosed at advanced growth stages as their local growth can cause clinical problems to the patients. The author presents a case report of myxofibrosarcoma in the abdominal cavity.Key words: myxofibrosarcoma.

  3. Computed tomography findings of hepatic veno-occlusive disease caused by Sedum aizoon with histopathological correlation

    PubMed Central

    Shao, H.; Chen, H. Z.; Zhu, J. S.; Ruan, B.; Zhang, Z. Q.; Lin, X.; Gan, M. F.

    2015-01-01

    This study investigated the value of computed tomography (CT) in the diagnosis and treatment of hepatic veno-occlusive disease (HVOD) caused by Sedum aizoon (SA). The clinical manifestations, treatment results, imaging findings, and histological findings of the liver were analyzed in 39 patients with HVOD caused by SA. Hepatomegaly, liver dysfunction, abdominal effusion, and geographic density changes on liver CT scans were found in all 39 patients. The pathological findings of histological liver examination included swelling and point-like necrosis of liver cells, significant expansion and congestion of the sinuses, endothelial swelling, and wall thickening with incomplete lumen occlusion of small liver vessels. CT geographic density changes were confirmed by histological examination of the liver in 18 patients. Sixteen patients with small amounts of ascites that started within 4 weeks of treatment recovered completely or significantly improved after symptomatic and supportive treatment. However, only 43.75% of the patients with larger amounts of ascites improved following symptomatic and supportive treatment. In conclusion, liver CT examination is a valuable, safe, and noninvasive tool for the diagnosis of HVOD caused by SA. In selected cases, liver CT examination may replace liver biopsy and histological analysis. PMID:26517336

  4. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  5. 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.

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

    PubMed

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

    2015-03-17

    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.

  7. Ruptured abdominal aortic aneurysm.

    PubMed

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  8. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  9. [Abdominal catastrophe--surgeon's view].

    PubMed

    Vyhnánek, F

    2010-07-01

    Abdominal catastrophe is a serious clinical condition, usually being a complication arising during treatment of intraabdominal nontraumatic disorders or abdominal injuries. Most commonly, inflamation- secondary peritonitis, is concerned. Abdominal catastrophe also includes secondary signs of sepsis, abdominal compartment syndrome and enterocutaneous fistules. Most septic abdominal disorders which show signs of abdominal catastrophy, require surgical intervention and reinterventions--planned or "on demand" laparotomies. During the postoperative period, the patient requires intensive care management, including steps taken to stabilize his/hers condition, management of sepsis and metabolic and nutritional support measures, as well as adequate indication for reoperations. New technologies aimed at prevention of complications in laparostomies and to improve conditions for final laparotomy closure are used in phase procedures for surgical management of intraabdominal infections. Despite the new technologies, abdominal catastrophe has higher morbidity and lethality risk rates.

  10. Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

    PubMed Central

    Lee, Jeong Eun; Shin, Kyung Sook; Kim, Song Soo; You, Sun Kyoung; Park, Jae Woo; Shin, Hye Soo; Yoon, Yeo Chang

    2016-01-01

    Objective To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). Materials and Methods One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. Results Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). Conclusion Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma. PMID:27587962

  11. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  12. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  13. Functional abdominal pain

    PubMed Central

    Matthews, P; Aziz, Q

    2005-01-01

    Functional abdominal pain or functional abdominal pain syndrome (FAPS) is an uncommon functional gut disorder characterised by chronic or recurrent abdominal pain attributed to the gut but poorly related to gut function. It is associated with abnormal illness behaviour and patients show psychological morbidity that is often minimised or denied in an attempt to discover an organic cause for symptoms. Thus the conventional biomedical approach to the management of such patients is unhelpful and a person's symptom experience is more usefully investigated using a biopsychosocial evaluation, which necessarily entails a multidisciplinary system of healthcare provision. Currently the pathophysiology of the disorder is poorly understood but is most likely to involve a dysfunction of central pain mechanisms either in terms of attentional bias, for example, hypervigilance or a failure of central pain modulation/inhibition. Although modern neurophysiological investigation of patients is promising and may provide important insights into the pathophysiology of FAPS, current clinical management relies on an effective physician-patient relationship in which limits on clinical investigation are set and achievable treatment goals tailored to the patient's needs are pursued. PMID:15998821

  14. [Abdominal tuberculosis in children. A review apropos of 13 cases].

    PubMed

    Vidal, M L; del Castillo, F; Arroba, M L; Borque, C; García Hortelano, J

    1986-04-01

    Thirteen cases of abdominal tuberculosis are presented; some of them in active or symptomatic stage and others in latent or abdominal calcification form. Many of these patients were diagnosed through the finding of a source of infected cattle after diagnosis of one of symptomatic patients. Pathogenesis, clinical findings and diagnostic difficulty are commented, as well a sanitary importance of the problem, since M. bovis is still a currently found organism in daily practice.

  15. 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

  16. Abdominal tumors in children

    PubMed Central

    Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Kim, Hyun-Young; Jung, Sung-Eun

    2016-01-01

    Abstract The use of minimally invasive surgery (MIS) in pediatric patients has been steadily increasing in recent years. However, its use for diagnosing and treating abdominal tumors in children is still limited compared with adults, especially when malignancy is a matter of debate. Here, we describe the experience at our center with pediatric abdominal tumors to show the safety and feasibility of MIS. Based on a retrospective review of patient records, we selected for study those pediatric patients who had undergone diagnostic exploration or curative resection for abdominal tumors at a single center from January 2010 through August 2015. Diagnostic exploration for abdominal tumors was performed in 32 cases and curative resection in 173 cases (205 operations). MIS was performed in 11 cases of diagnostic exploration (34.4%) and 38 cases of curative resection (21.9%). The mean age of the children who underwent MIS was 6.09 ± 5.2 years. With regard to diagnostic exploration, patient characteristics and surgical outcomes were found to be similar for MIS and open surgery. With regard to curative resection, however, the mean age was significantly lower among the patients who underwent open surgery (4.21 ± 4.20 vs 6.02 ± 4.99 for MIS, P = 0.047), and the proportion of malignancies was significantly higher (80% vs 39.4% for MIS, P < 0.001). MIS compared favorably with open surgery with respect to the rate of recurrence (6.7% vs 35.1%, P = 0.035), the rate of intraoperative transfusions (34.2% vs 58.5%, P = 0.01), the median amount of blood transfused (14 vs 22 mL/kg, P = 0.001), and the mean number of hospital days (4.66 ± 2.36 vs 7.21 ± 5.09, P < 0.001). Complication rates did not differ significantly between the MIS and open surgery groups. The operation was converted to open surgery in 3 cases (27.2%) of diagnostic MIS and in 5 cases (13.1%) of curative MIS. MIS was found to be both feasible and effective for the

  17. Leiomyosarcoma: computed tomographic findings

    SciTech Connect

    McLeod, A.J.; Zornoza, J.; Shirkhoda, A.

    1984-07-01

    The computed tomographic (CT) findings in 118 patients with the diagnosis of leiomyosarcoma were reviewed. The tumor masses visualized in these patients were often quite large; extensive necrotic or cystic change was a frequent finding. Calcification was not observed in these tumors. The liver was the most common site of metastasis in these patients, with marked necrosis of the liver lesions a common finding. Other manifestations of tumor spread included pulmonary metastases, mesenteric or omental metastases, retroperitoneal lymphadenopathy, soft-tissue metastases, bone metastases, splenic metastases, and ascites. Although the CT appearance of leiomyosarcoma is not specific, these findings, when present, suggest consideration of this diagnosis.

  18. Abdominopelvic actinomycosis: spectrum of imaging findings and common mimickers

    PubMed Central

    der Molen, Aart Van; Es, Ad CMG Van; Giannila, Maria

    2014-01-01

    Background Actinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult. Purpose To describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases. Material and Methods In our study we analyzed 18 patients (15 women, 3 men; age range, 25–75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT. Results The sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination. Conclusion Actinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation. PMID:24778807

  19. Bowel and mesenteric injuries from blunt abdominal trauma: a review.

    PubMed

    Iaselli, Francesco; Mazzei, Maria Antonietta; Firetto, Cristina; D'Elia, Domenico; Squitieri, Nevada Cioffi; Biondetti, Pietro Raimondo; Danza, Francesco Maria; Scaglione, Mariano

    2015-01-01

    The bowel and the mesentery represent the third most frequently involved structures in blunt abdominal trauma after the liver and the spleen. Clinical assessment alone in patients with suspected intestinal and/or mesenteric injury from blunt abdominal trauma is associated with unacceptable diagnostic delays. Multi-detector computed tomography, thanks to its high spatial, time and contrast resolutions, allows a prompt identification and proper classification of such conditions. The radiologist, in fact, is asked not only to identify the signs of trauma but also to provide an indication of their clinical significance, suggesting the chance of conservative treatment in the cases of mild and moderate, non-complicated or self-limiting injuries and focusing on life-threatening conditions which may benefit from immediate surgical or interventional procedures. Specific and non-specific CT signs of bowel and mesenteric injuries from blunt abdominal trauma are reviewed in this paper.

  20. [Abdominal gunshot wound: description of 86 cases in Cameroon].

    PubMed

    Bahebeck, J; Masso-Misse, P; Essomba, A; Takongmo, S; Ngo-Nonga, B; Ngo-Nyeki, A R; Sosso, M; Malong, E

    2005-11-01

    Abdominal gunshot wound (AGSW) is a trauma emergency. The purpose of this report is to describe our experience with managing AGSW largely without modem investigational modalities. Data was collected retrospectively by reviewing the surgical reports and clinical charts of patients admitted to live hospitals dealing with AGSW over a 5-year period. Incomplete files and wounds not involving the abdomen were not included. A total of 86 files were analyzed. Patients ranged in age from 10 to 63 years ivith mean age of 32 years and a sex ratio of 5.5. Most patients (87%) underwent surgical exploration. Laboratory revealed no lesions in 22.5% of cases, minor lesions in 9.5% and major lesions justifying surgical repair in 68%. A total of 86 visceral lesions were found in the patients who underwent surgical exploration. The lesion involved the small intestine in 31.5% of case, colon in 24.5%, liver in 23.5%, spleen in 7%, stomach in 6%, and uterus in 2%. The kidney, pancreas, mesenteries, large momentum, and transverse mescaline each accounted for 1% of lesions. Conventional operative techniques were used with a mortality of 5.5% and morbidity of 4%. Based on our findings we conclude that when investigational tools (CT-scan, peritoneal lavage and laparoscopy) are unavailable prolonged watchful waiting increases the risk of mortality and morbidity in patients presenting AGSW associated with suspicious clinical signs. Prompt surgical treatment improves prognosis but is associated with a high rate of cases showing no lesions.

  1. Inflammatory abdominal aortic aneurysm presenting as bilateral hydroureteronephrosis: a case report and review of literature.

    PubMed

    Galosi, Andrea Benedetto; Grilli Cicilioni, Carlo; Sbrollini, Giulia; Angelini, Andrea; Maselli, Guevar; Carbonari, Luciano

    2014-12-30

    We report a case of Inflammatory Abdominal Aortic Aneurysm (IAAA) producing bilateral hydro-ureteronephrosis. A 74-year-old patient presented to urologist office for bilateral hydronephrosis detected by kidney and bladder ultrasound (US). Patient reported lower urinary tract symptoms and inconstant and slight low back pain irradiated to inguinal region dating 3 weeks. Renal function, urine analysis and abdominal examination were normal. However the repeated ultrasound in the urologist office revealed abdominal aortic aneurism extended to iliac vessels. The patient was sent directly to vascular surgery unit where contrast computerized tomography (CT) and successful surgical repair were done. Final diagnosis was IAAA. The post-operative course was uneventful. Renal function was regular and the hydronephrosis reduced spontaneously under monitoring by CT and US. We review diagnosis and management of hydronephrosis that is sometimes linked to IAAA rather than standard AAA. Abdominal ultrasound is mandatory in any bilateral hydronephrosis and it could save lives.

  2. Abdominal wall abscess: more than meets the eye.

    PubMed

    Gandhi, Jamish; Gandhi, Natasha

    2010-01-01

    An 83-year-old, mildly demented rest home resident presented to the emergency department with a 2 day history of a right sided abdominal wall mass. He had a mechanical fall 2 days previously and landed on his right side and had attributed the mass to this. He had no symptoms apart from feeling bloated and not being able to pass wind for a day. He had passed a normal bowel motion the day before presentation. On abdominal examination there was an 11 × 4 cm mass in the right lower quadrant. It was firm in consistency, non-fluctuant and non-tender to touch. There was mild erythema over the area but no skin breaks. Chest radiograph was unremarkable. The abdominal film showed dilated small bowel and no large bowel could be seen. A computed tomography (CT) scan showed a thick walled gallbladder with multiple calculi and air present. There was also an extensive air and fluid collection in the layers of the abdominal wall and subcutaneous fat which arose from a perforation of the gallbladder. The patient was not a surgical candidate due to multiple comorbidities. The patient was treated with antibiotics and underwent a CT guided percutaneous cholecystostomy. Despite the radiological intervention and antibiotics the patient progressively deteriorated and died peacefully 5 days after admission.

  3. An uncommon cause of abdominal pain: Mesenteric cyst

    PubMed Central

    Ünlüer, Erden Erol; Ünlüer, Seran; Şahı̇n, Yusuf; Kamer, Kemal Erdı̇nç; Karagöz, Arı̇f; Tan, Gözde Canan

    2016-01-01

    Mesenteric cysts are benign cystic lesions. Here, we present the case of a patient with abdominal pain, which was diagnosed as mesenteric cyst. A 28-year-old male patient was admitted to the emergency department (ED) with abdominal pain and distention. Abdominal palpation revealed a smooth-surfaced mass palpable in the left upper quadrant. Ultrasonography depicted a hypoechoic heterogeneous mass-like structure with a size of 15 × 12 cm. Computerized tomography (CT) showed a well-defined cystic structure with a size of 12 × 12.5 cm near to the duodenum and pancreas. The patient was admitted, and the cystic structure was drained with a percutaneous drainage catheter; then, sclerotherapy was performed using ethyl alcohol with the aid of ultrasonography. The material was sent to the pathology lab and revealed negative results for malignant cell and mucin. The patient underwent a control CT with contrast, which revealed the catheter at the site of the operation and no cystic lesion after procedure. He was discharged 1 week after the procedure. Mesenteric cysts are extremely rare benign lesions of the abdomen, and emergency physicians must consider this disease in the differential diagnosis of abdominal pain. The percutaneous drainage technique performed on our patient is a safe technique for the treatment of selected patients. PMID:28250978

  4. Determination of dosimetric quantities in pediatric abdominal computed tomography scans*

    PubMed Central

    Jornada, Tiago da Silva; da Silva, Teógenes Augusto

    2014-01-01

    Objective Aiming at contributing to the knowledge on doses in computed tomography (CT), this study has the objective of determining dosimetric quantities associated with pediatric abdominal CT scans, comparing the data with diagnostic reference levels (DRL). Materials and methods The study was developed with a Toshiba Asteion single-slice CT scanner and a GE BrightSpeed multi-slice CT unit in two hospitals. Measurements were performed with a pencil-type ionization chamber and a 16 cm-diameter polymethylmethacrylate trunk phantom. Results No significant difference was observed in the values for weighted air kerma index (CW), but the differences were relevant in values for volumetric air kerma index (CVOL), air kerma-length product (PKL,CT) and effective dose. Conclusion Only the CW values were lower than the DRL, suggesting that dose optimization might not be necessary. However, PKL,CT and effective dose values stressed that there still is room for reducing pediatric radiation doses. The present study emphasizes the importance of determining all dosimetric quantities associated with CT scans. PMID:25741103

  5. Multidetector CT of Surgically Proven Blunt Bowel and Mesenteric Injury.

    PubMed

    Bates, David D B; Wasserman, Michael; Malek, Anita; Gorantla, Varun; Anderson, Stephan W; Soto, Jorge A; LeBedis, Christina A

    2017-01-01

    Blunt traumatic injury is one of the leading causes of morbidity and mortality in the United States. Unintentional injury represents the leading cause of death in the United States for all persons between the ages of 1 and 44 years. In the setting of blunt abdominal trauma, the reported rate of occurrence of bowel and mesenteric injuries ranges from 1% to 5%. Despite the relatively low rate of blunt bowel and mesenteric injury in patients with abdominal and pelvic trauma, delays in diagnosis are associated with increased rates of sepsis, a prolonged course in the intensive care unit, and increased mortality. During the past 2 decades, as multidetector computed tomography (CT) has emerged as an essential tool in emergency radiology, several direct and indirect imaging features have been identified that are associated with blunt bowel and mesenteric injury. The imaging findings in cases of blunt bowel and mesenteric injury can be subtle and may be seen in the setting of multiple complex injuries, such as multiple solid-organ injuries and spinal fractures. Familiarity with the various imaging features of blunt bowel and mesenteric injury, as well as an understanding of their clinical importance with regard to the care of the patient, is essential to making a timely diagnosis. Once radiologists are familiar with the spectrum of findings of blunt bowel and mesenteric injury, they will be able to make timely diagnoses that will lead to improved patient outcomes. (©)RSNA, 2017.

  6. Computer aided lytic bone metastasis detection using regular CT images

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; O'Connor, Stacy D.; Summers, Ronald

    2006-03-01

    This paper presents a computer aided detection system to find lytic bone metastases in the spine. The CAD system is designed to run on routine chest and/or abdominal CT exams (5mm slice thickness) obtained during a patient's evaluation for other indications. The system can therefore serve as a background procedure to detect bone metastases. The spine is first automatically extracted based on adaptive thresholding, morphological operation, and region growing. The spinal cord is then traced from thoracic spine to lumbar spine using a dynamic graph search to set up a local spine coordinate system. A watershed algorithm is then applied to detect potential lytic bone lesions. A set of 26 quantitative features (density, shape and location) are computed for each detection. After a filter on the features, Support Vector Machines (SVM) are used as classifiers to determine if a detection is a true lesion. The SVM was trained using ground truth segmentation manually defined by experts.

  7. Recurrent pneumothorax following abdominal paracentesis.

    PubMed Central

    Stafford, P. J.

    1990-01-01

    A 62 year old man presented with abdominal ascites, without pleural effusion, due to peritoneal mesothelioma. He had chronic obstructive airways disease and a past history of right upper lobectomy for tuberculosis. On two occasions abdominal paracentesis was followed within 72 hours by pneumothorax. This previously unreported complication of abdominal paracentesis may be due to increased diaphragmatic excursion following the procedure and should be considered in patients with preexisting lung disease. PMID:2385561

  8. Abdominal Tuberculosis in Cairo, Egypt

    DTIC Science & Technology

    1994-01-01

    COW 03 PUBLICATION REPORT 94-30227 * ABDOMINAL TUBERCULOSIS IN CAIRO, BY RWIavni 0. IHibbs6 M. Kuanmm ad Z. Fun .Y .~ ... W I Form ApprovedREPORT...Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED 8 April 1993 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Abdominal Tuberculosis in Cairo...abdominal tuberculosis patients seen at Abbassia Fever Hospital in Cairo, Egypt from January 1990 to August 1992 are described; their mean age was 21.5

  9. Abdominal pregnancy- a case report.

    PubMed

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  10. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Siebenmann, R; Schneider, K; von Segesser, L; Turina, M

    1988-06-11

    348 cases of abdominal aortic aneurysm were reviewed for typical features of inflammatory aneurysm (IAAA) (marked thickening of aneurysm wall, retroperitoneal fibrosis and rigid adherence of adjacent structures). IAAA was present in 15 cases (14 male, 1 female). When compared with patients who had ordinary aneurysms, significantly more patients complained of back or abdominal pain (p less than 0.01). Erythrocyte sedimentation rate was highly elevated. Diagnosis was established in 7 of 10 computed tomographies. 2 patients underwent emergency repair for ruptured aneurysm. Unilateral ureteral obstruction was present in 4 cases and bilateral in 1. Repair of IAAA was performed by a modified technique. Histological examination revealed thickening of the aortic wall, mainly of the adventitial layer, infiltrated by plasma cells and lymphocytes. One 71-year-old patient operated on for rupture of IAAA died early, and another 78-year-old patient after 5 1/2 months. Control computed tomographies revealed spontaneous regression of inflammatory infiltration after repair. Equally, hydronephrosis due to ureteral obstruction could be shown to disappear or at least to decrease. IAAA can be diagnosed by computed tomography with high sensitivity. Repair involves low risk, but modification of technique is necessary. The etiology of IAAA remains unclear.

  11. Fertility after abdominal myomectomy.

    PubMed

    Connolly, G; Doyle, M; Barrett, T; Byrne, P; De Mello, M; Harrison, R F

    2000-07-01

    This study aimed to evaluate the morbidity and pregnancy outcome of myomectomy in infertile women with uterine fibroids. This was a cross-sectional study. Records were reviewed for 100 consecutive women in the Rotunda Hospital who underwent myomectomy in the years 1995-1996. A questionnaire regarding subsequent fertility was sent. The study was carried out in the infertility unit at the Rotunda Hospital, Dublin, Ireland. Seventy-five women responded. Multiple myomectomy was performed in 52 (70%). Mean fibroid size was 6.8 cm (range 2-14.5 cm). Nine women (12%) developed complications; five had menstrual problems, two had wound discomfort and two had abdominal discomfort. Twenty-five women (33%) became pregnant. Seven (28%) were IVF pregnancies. Overall six (24%) miscarried. In 19 of 25, pregnancy occurred where fibroids were the only identifiable cause of infertility. We conclude that abdominal myomectomy is associated with a favourable outcome in infertile women particularly if no other confounding variable is present.

  12. Fulminant abdominal gas gangrene in metastatic colon cancer.

    PubMed

    Bozkurt, Mustafa; Okutur, Kerem; Aydin, Kübra; Namal, Esat; Oztürk, Akin; Balci, Cem; Demir, Gökhan

    2012-02-01

    We report a case of fulminant abdominal gas gangrene in a patient with metastatic colon cancer. A 39-year-old patient with descending colon, high-grade adenocarcinoma and coexisting liver and lymph node metastases received two courses of chemotherapy. The patient developed sudden acute abdominal symptoms accompanied by septic shock parameters. The imaging findings on computed tomography were characteristic for abdominal gas gangrene, involving liver metastases, portal vein and lymph nodes with associated pneumoperitoneum. The patient succumbed to the disease within hours following the onset of symptoms.

  13. Retroperitoneal abscess: an extra-abdominal manifestation

    PubMed Central

    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias

    2015-01-01

    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission. PMID:25576509

  14. Retroperitoneal abscess: an extra-abdominal manifestation.

    PubMed

    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias

    2015-01-09

    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.

  15. Diagnostic ultrasonography in cattle with abdominal fat necrosis.

    PubMed

    Tharwat, Mohamed; Buczinski, Sébastien

    2012-01-01

    This study describes the ultrasonographic findings in 14 cows with abdominal fat necrosis. Ultrasonography of the abdomen revealed the presence of heterogeneous hyperechoic masses and hyperechoic omentum with localized masses floating in a hypoechoic peritoneal fluid. A hyperechogenic rim was imaged around both kidneys. The intestines were coated with hyperechoic capsules and the intestinal lumens were constricted. Ultrasonographic examination of the pancreatic parenchyma showed an overall increased echogenicity which was homogenously distributed in 3 cases. A diagnosis of abdominal fat necrosis was made with ultrasound-guided biopsy of the echogenic masses, and thereafter at postmortem examination. Results from this study demonstrate the efficacy of ultrasonography as an imaging modality for antemortem diagnosis of abdominal lipomatosis in cattle. To the authors' knowledge, this study is the first that illustrates ultrasonographic findings in cattle affected with abdominal lipomatosis.

  16. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  17. Resection and Abdominal Wall Reconstruction of a Desmoid Tumor with Endometrioma Features

    PubMed Central

    Majors, Jaqueline; Stoikes, Nathaniel F.; Nejati, Reza

    2016-01-01

    Desmoid tumors are rare, musculoaponeurotic mesenchymal origin tumors arising from the proliferation of well-differentiated fibroblasts. Desmoid tumors may arise from any location with the abdominal cavity, abdominal wall and extremity locations being most frequent. We present the case of a 35-year-old female with a history of endometriosis who presented palpable abdominal mass and cyclic abdominal pain. Resection was performed for a presumed desmoid soft tissue tumor. Final pathology demonstrated desmoid histology admixed with abdominal wall endometriosis (endometrioma). This unique pathologic finding has only been rarely reported and is discussed with a brief review of the literature. PMID:27247824

  18. CT Colonography (Virtual Colonoscopy)

    MedlinePlus

    ... Z CT Colonography Computed tomography (CT) colonography or virtual colonoscopy uses special x-ray equipment to examine ... and blood vessels. CT colonography, also known as virtual colonoscopy, uses low dose radiation CT scanning to ...

  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. 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)

  1. Malignant fibrous histiocytoma of the abdominal cavity: report of a case.

    PubMed

    Atmatzidis, Konstantinos S; Pavlidis, Theodoros E; Galanis, Ioannis N; Papaziogas, Basilios T; Papaziogas, Thomas B

    2003-01-01

    Malignant fibrous histiocytoma (MFH) is a soft-tissue sarcoma originating from fibroblast cells, characterized by a high rate of metastasis or recurrence. This tumor rarely develops in the gastrointestinal tract, with no more than 30 cases described in the literature. We report a case of MFH of the abdominal cavity in a 45-year-old woman who presented with epigastric pain, anorexia, and weight loss. A computed tomography (CT) scan of the abdomen revealed multiple solid tumors in the peritoneal cavity. We performed exploratory laparotomy and found at least 15 solid whitish tumors attached to the wall of the small intestine, as well as to the parietal peritoneum. There were three metastases in the liver. All of the tumors were excised, most of which were about 10 cm in diameter. Histopathological findings indicated a stromal tumor consisting of spindle cells, and immunohistochemical examination of the resected specimens established the definite diagnosis of a pleomorphic MFH. The patient had an uneventful postoperative course and was given adjuvant chemotherapy. She is currently well 2 years after her operation. We review the clinical picture of this tumor in the abdominal cavity, and discuss its diagnosis, pathogenesis, and treatment.

  2. Does Lower Limb Exercise Worsen Renal Artery Hemodynamics in Patients with Abdominal Aortic Aneurysm?

    PubMed Central

    Zhang, Nan; Xu, Zaipin; Deng, Xiaoyan; Liu, Ming; Liu, Xiao

    2015-01-01

    Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS), increased the oscillatory shear index (OSI) and increased the relative residence time (RRT). EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients. PMID:25946196

  3. Extensive Erosion of Vertebral Bodies Due to a Chronic Contained Ruptured Abdominal Aortic Aneurysm

    PubMed Central

    Lombardi, Alecio Fernando; Cardoso, Fabiano Nassar; da Rocha Fernandes, Artur

    2016-01-01

    This report describes a case of chronically ruptured abdominal aortic aneurysm contained within the lumbar vertebral bodies that presented with dull abdominal pain. Sudden, massive hemorrhage is an uncommon, yet well-known complication of an untreated abdominal aortic aneurysm. In addition, misleading clinical and radiological findings present difficult diagnostic challenges in such cases. This report emphasizes the findings obtained with multidetector computed tomography and delineates the differentiation of this condition from similar pathologies. PMID:27200153

  4. Reconstruction filters and contrast detail curves in CT

    NASA Astrophysics Data System (ADS)

    Huda, W.; Ogden, K. M.; Samei, E.; Scalzetti, E. M.; Lavallee, R. L.; Roskopf, M. L.; Groat, G. E.

    2008-03-01

    In this study, we investigated the effect of CT reconstruction filters in abdominal CT images of a male anthropomorphic phantom. A GE Light Speed CT 4-slice scanner was used to scan the abdomen of an adult Rando phantom. Cross sectional images of the phantom were reconstructed using four reconstruction filters: (1) soft tissue with the lowest noise; (2) detail (relative noise 1.7); (3) bone (relative noise 4.5); and (4) edge (relative noise 7.7). A two Alternate Forced Choice (AFC) experimental paradigm was used to estimate the intensity needed to achieve 92% correct (i.e., I 92%). Four observers measured detection performance for five lesions with size ranging from 2.5 to 12.5 mm for each of these four reconstruction filters. Contrast detail curves obtained in images of an anthropomorphic phantom were not straight lines, but best fitted to a second order polynomial. Results from four readers show similar trends with modest inter-observer differences with the measured coefficient of variation of the absolute performance levels of ~22%. All reconstruction filters had similar shaped contrast detail curves except for smallest details where the frequency response of filters differed most significantly. Increasing the noise level always reduced detection performance, and a doubling of image noise resulted in an average drop in detection performance of ~20%. The key findings of this study are that (a) the Rose model can provide reasonable predictions as to how changes in lesion size affect observer detection; (b) the shape of CT contrast detail curves is affected only very slightly with reconstruction filter; (c) changes in reconstruction filter noise can predict qualitative changes in observer detection performance, but are poor direct predictors of the quantitative changes of imaging performance.

  5. Epithelioid inflammatory myofibroblastic sarcoma in abdominal cavity: a case report and review of literature.

    PubMed

    Wu, Hui; Meng, Yu-Hong; Lu, Ping; Ning, Hao-Yong; Hong, Liu; Kang, Xiao-Ling; Duan, Min-Gang

    2015-01-01

    In this study, we present a rare and difficult case of epithelioid inflammatory myofibroblastic sarcoma (EIMS) in abdominal cavity. A 47-year-old female presented as left upper abdominal pain for 6 months and abdominal distention for 1 month. CT examination showed a solid mass in the left upper intra-abdomen. Grossly, the tumor was found in the mesenterium of colon with the size of 7.5 × 6.5 × 3.5 cm, and was solid and gray-yellowish in the cut surface. Focal myxomatous appearance was observed. Microscopically, stromal myxoid change together with prominant infiltrated lymphocytes, neutrophils and eosinophils were found in the tumor, and the tumor cells were round, epithelioid with vesicular nuclei, large prominant nucleoli and high mitotic rate. Immunohistochemically, strong diffused positive for vimentin, desmin, ALK (nuclear membrane staining pattern) and AAT, focally positive for CD99 and CD30, were showed, Ki67 index was about 20%; Especially, WT-1 and D240 were focally expressed in this tumor. FISH analysis showed rearrangement of ALK, and reverse-transcription polymerase chain reaction (RT-PCR) analysis was used to detect the fusion location of the RANBP2 and ALK gene. The diagnosis of EMIS was made based on its location, typical morphology, the immunohistochemical features especially the nuclear membranous immunostaining of ALK and rearrangement of RANBP2-ALK. The tumor showed higher aggressive behaviors and a poor prognosis. The differential diagnosis and other treatments of EMIS are also discussed in the present study. This finding may increase the case information of EMIS.

  6. 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.

  7. 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.

  8. A bizarre abdominal cystic lesion.

    PubMed

    Zucchini, Giorgia; Pezzilli, Raffaele; Ricci, Claudio; Casadei, Riccardo; Santini, Donatella; Calculli, Lucia; Corinaldesi, Roberto

    2010-09-06

    In spite of careful intraoperative precautions and gauze counts, mistakes can still occur during surgery. In the case reported, a retained gauze leaved during a surgical approach for removing a solid-cystic papillary tumor localized in the pancreatic tail, caused both persistent abdominal discomfort and the presence of an abdominal cystic lesion at imaging techniques. When a previous operative history is present, a foreign body should be taken into account in the differential diagnosis of a patient with an intra-abdominal cystic mass. Finally, radio-opaque marker should be routinely used by surgeons in order to reach a correct diagnosis in operated patients having retained gauze.

  9. 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

  10. [Penetrating abdominal injuries].

    PubMed

    Nesbakken, A; Pillgram-Larsen, J; Naess, F; Gerner, T; Solheim, K; Stadaas, J O; Gjøra, O

    1990-02-28

    We have reviewed the medical records of 111 patients treated for abdominal stab wounds during the period 1980-87. Our two hospitals serve a catchment area of about 450,000 people. Exploratory laparotomy was performed in 89 patients with suspected peritoneal penetration. In 16 patients the laparotomy was negative, and in 15 patients only minor injuries were noted. There were no serious complications in these 31 patients. Twenty-seven patients had thoracic wounds below the fourth intercostal space, 15 with intraabdominal injuries. The most common injuries were lacerations of the liver, the small bowel and the diaphragm. The mortality in the series was 2%. Stab wounds are infrequent in Norway, and most surgeons have limited experience of such injuries. We discuss whether to employ immediate exploratory laparotomy or selective management when the peritoneum has been penetrated. When there is no evidence of evisceration or omental protrusion, local exploration of the wound should be performed in order to confirm or exclude peritoneal penetration. Injury to the diaphragm and intraabdominal viscera should always be suspected in thoracic stab wounds below the fourth intercostal space.

  11. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    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.

  12. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    ... signs or symptoms of an abdominal aortic aneurysm (AAA). The final recommendation statement summarizes what the Task ... the potential benefits and harms of screening for AAA: (1) Men ages 65 to 75 who smoke ...

  13. Children's (Pediatric) Abdominal Ultrasound Imaging

    MedlinePlus Videos and Cool Tools

    ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...

  14. Incentive spirometry after abdominal surgery.

    PubMed

    Davis, Suja P

    Patients face various possible complications after abdominal surgery. This article examines best practice in guiding and teaching them how to use an incentive spirometer to facilitate recovery and prevent respiratory complications.

  15. Abdominal Complications after Severe Burns

    DTIC Science & Technology

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease, peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease, peptic lcer disease and gastritis, large...70%); 13 for other compli- ations, such as biliary or perineal conditions (26%); and 4 or feeding access (8%). For the civilians, 2 had trauma

  16. Abdominal actinomycosis masquerading as an omental tumor in a 12-year-old female.

    PubMed

    Hirayama, Yutaka; Iinuma, Yasushi; Hashizume, Naoki; Yoshida, Motomu; Iida, Hisataka; Shibuya, Hiroyuki; Naito, Shinichi; Nitta, Koju

    2013-02-01

    We herein report a case of abdominal actinomycosis in a 12-year-old girl in whom an omental primary tumor was suspected before surgery. The patient began to experience intermittent lower left abdominal pain. Abdominal computed tomography (CT) scans were inconclusive at this time, but 6 months later, CT and magnetic resonance imaging (MRI) examinations showed a 7-cm, tumor-like lesion in the left abdominal cavity; malignancy could not be ruled out. The tumor, which originated in the omentum and adhered strongly to the left abdominal wall, was resected along with approximately 90 % of the omentum, the peritoneum in contact with the mass, and the posterior layer of the rectus abdominal sheath, under suspicion of a malignant tumor. However, omental actinomycosis was the final pathological diagnosis. The patient's antibiotic treatment was changed to a penicillin-series oral antibiotic to prevent recurrence of the actinomycosis. The patient was discharged from our hospital 16 days after the first surgery, but she developed three episodes of ileus; the first two required surgery. The patient has had no further recurrences of actinomycosis or postoperative ileus 20 months after discharge.

  17. Abdominal Pain in the Presence of Small Abdominal Aortic Aneurysms: If in Doubt, Cut It Out!

    PubMed

    Georgakarakos, Efstratios; Schoretsanitis, Nikolaos; Koufopoulos, Georgios; Paulou, Konstantinos; Lazarides, Miltos K

    2017-02-03

    Although small (<5 cm) abdominal aortic aneurysms (AAA) have been associated with symptoms and indication for intervention scarcely, the clinicians should never exclude such potential association especially in the absence of other overt pathological findings. In such cases, a surgical exploration with consequent intervention, if feasible, should be justified to prevent a detrimental evolution in a dubious scenario. In this article, we present 2 cases of patients with small AAA presenting with severe abdominal pain. In the absence of other solid clinical and radiological pathological findings, both patients underwent laparotomy where an inflammatory small AAA was identified and subjected either to resection and restoration with a tube graft or secondary endovascular repair because the periaortic fibrosis precluded the open repair. The characteristics and rationale of treatment modalities are exemplified and discussed.

  18. Common abdominal emergencies in children.

    PubMed

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  19. 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.

  20. Hereditary angioedema (HAE): a cause for recurrent abdominal pain.

    PubMed

    Soni, Parita; Kumar, Vivek; Alliu, Samson; Shetty, Vijay

    2016-11-14

    A 44-year-old Hispanic woman presented to the emergency room with a 2-day history of sudden onset of severe cramping left lower quadrant abdominal pain associated with ∼20 episodes diarrhoea. Abdominal CT scan exhibited bowel wall oedema and acute extensive colitis. On the basis of the preliminary diagnosis of acute abdomen, the patient was admitted under the surgical team and treated for acute colitis. Since her family history was significant for hereditary angioedema (HAE), complement studies were performed which revealed low complement C4 levels and abnormally low values of C1q esterase inhibitor. Thus, the diagnosis of HAE type I was established. This case report summarises that the symptoms of HAE are often non-specific, hence making the underlying cause difficult to diagnose.

  1. Observer Performance in the Detection and Classification of Malignant Hepatic Nodules and Masses with CT Image-Space Denoising and Iterative Reconstruction

    PubMed Central

    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 jackknife 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:

  2. A case of pneumoperitoneum and retropneumoperitoneum without bowel perforation due to extensive intestinal necrosis as a complication to chemotherapy: CT evaluation

    PubMed Central

    Antonopoulos, Petros; Siaperas, Petros; Demonakou, Maria; Alexiou, Kostas; Economou, Nikos

    2013-01-01

    Acute intestinal ischemia continues to be a challenging diagnostic problem with high mortality. We describe a rare case of acute intestinal necrosis, due to vasculitis, related with chemotherapy. A patient was examined in our emergency department, presenting with abdominal pain. Three months before he had undergone an operation for lung carcinoma (lobectomy) and received chemotherapy. CT of the abdomen demonstrated free air in 10 different locations: hepatic part of the portal vein, branches of mesenteric veins, femoral and iliac veins, the bowel wall, peritoneal cavity and retroperitoneal space, abdominal muscles, inguinal canals, meso-sigmoid space, and in the para-rectal space. Moreover, pathological findings revealed that the free air in the peritoneum and retropneumoperitoneum occurred without intestinal perforation, but with transudation through the necrotic bowel wall. This is a rare complication of chemotherapy. This case refers to the unusual CT findings which appeared in this patient. The key to a better outcome is early diagnosis of this condition and the CT examination of the abdomen plays an important role. PMID:24349710

  3. Texture analysis improves level set segmentation of the anterior abdominal wall

    PubMed Central

    Xu, Zhoubing; Allen, Wade M.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-01-01

    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

  4. 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

  5. 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.

  6. Computed Tomography (CT) - Spine

    MedlinePlus

    ... test used to help diagnose—or rule out—spinal column damage in injured patients. CT scanning is fast, ... CT is to detect—or to rule out—spinal column damage in patients who have been injured. CT ...

  7. Abdominal compartment syndrome after endovascular repair for ruptured abdominal aortic aneurysm leads to acute intestinal necrosis

    PubMed Central

    Chen, Xiyang; Zhao, Jichun; Huang, Bin; Yuan, Ding; Yang, Yi; Ma, Yukui

    2016-01-01

    Abstract Introduction: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. Clinical Finding: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause. He had a history of hypertension for 20 years without any regular anti-hypertensive therapy. Physical Examination revealed that the blood pressure was 89/54 mmHg, pulse was 120/min, oxygen saturation was 91%. The abdominal ultrasound and the CTA (computed tomography angiography) scan revealed a rAAA. Emergency EVAR under general anesthesia was performed for this patient. Diagnosis: Fourteen hours after endovascular repair, sudden decreased of blood pressure (70/50 mmHg) and oxygen saturation (70%) was observed. ACS or bleeding of retroperitoneal space was diagnosed. Interventions: Abdominal laparotomy was immediately performed. ACS was verified and a severe complication (acute intestinal necrosis) was observed, intestinal resection was performed for this patient. Outcomes: Unfortunately, this patient died after operation because of multi-organ failure in a very short period, which is very rare regarding to this condition. Surgical pathology, diagnosis and management were discussed. Conclusion: ACS was occurred with a severe complication (acute intestinal necrosis) in a very short period, which is very rare regarding to this condition after EVAR, it reminds us the severe result of ACS and more methods to prevent it happened after surgical management. PMID:27893667

  8. Right upper quadrant abdominal pain as the initial presentation of polyarteritis nodosa.

    PubMed

    Gago, Ricardo; Shum, Lee Ming; Vilá, Luis M

    2017-02-22

    Polyarteritis nodosa (PAN) is a necrotising vasculitis that involves medium and small vessels. PAN generally presents with constitutional, cutaneous, neurological, renal and gastrointestinal manifestations. However, PAN initially involving a single organ/system is uncommon. Here, we present a 42-year-old man who was hospitalised because of severe right upper quadrant abdominal pain that started 2 months before. Physical examination was remarkable for right upper quadrant abdominal tenderness. Abdominopelvic CT showed lymphadenopathy but no hepatic, gallbladder, pancreatic, intestinal or renal abnormalities. Abdominal angiography showed multiple small aneurysms located in the jejunal and hepatic arteries characteristic of PAN. He had a prompt and remarkable response to high-dose corticosteroids and oral cyclophosphamide. Our case, together with other reports, suggests that PAN should be considered in patients presenting with right upper abdominal pain. Timely diagnosis and treatment reduce the overall morbidity and mortality of the disease.

  9. Volumetric analysis of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Baskin, Kevin M.; Kusnick, Catherine A.; Shamsolkottabi, Susanne; Lang, Elvira V.; Corson, J. D.; Stanford, William; Thompson, Brad H.; Hoffman, Eric A.

    1996-04-01

    The purpose of this study was to develop a valid, reliable and accurate system of measurement of abdominal aortic aneurysms, using volumetric analysis of x-ray computed tomographic data. This study evaluates illustrative cases, and compares measurements of AAA phantoms, using standard 2D versus volumetric methods. To validate the volumetric analysis, four phantom aneurysms were constructed in a range of diameters (4.5 - 7.0 cm) which presents the greatest management challenge to the clinician. These phantoms were imaged using a Toshiba Xpress SX helical CT. Separate scans were obtained at conventional (10 mm X 10 mm) and thin slice (5 mm X 5 mm) collimations. The thin slices were reconstructed at 2 mm intervals. Data from each of the 96 scans were interpreted using a standard 2D approach, then analyzed using task-oriented volumetric software. We evaluate patient assessments, and compare greatest outer diameters of phantoms, by standard versus volumetric methods. Qualitative differences between solutions based on standard versus volumetric analysis of illustrative patient cases are substantial. Expert radiologists' standard measurements of phantom aneurysms are highly reliable (r2 equals 0.901 - 0.958; p < 0.001), but biased toward significant overestimation of aneurysm diameters in the range of clinical interest. For the same phantoms, volumetric analysis was both more reliable (r2 equals 0.986 - 0.996; p < 0.001), and more accurate, with no significant bias in the range of interest. Volumetric analysis promotes selection of more valid management strategies, by providing vital information not otherwise available, and allowing more reliable and accurate assessment of abdominal aortic aneurysms. It is particularly valuable in the presence of aortic tortuosity, vessel eccentricity, and uncertain involvement of critical vessels.

  10. The relationship of abdominal fat mass assessed by helical or conventional computed tomography to serum leptin concentration.

    PubMed

    Kobayashi, Junji; Sasaki, Takeyoshi; Watanabe, Mitsuyo

    2004-01-01

    In the present study, we focused on the relationship of intra-abdominal visceral fat (VF) or subcutaneous fat (SF) mass to serum leptin levels, and also on the relationship of leptin to serum lipid and lipoprotein concentration. Subjects with obesity (26 men, 26 women) were recruited for this study. We obtained helical CT scans with a tube current of 150 mA, voltage of 120 kV and 2:1 pitch (table speed in relation to slice thickness), starting at the upper edge of the liver and continuing to the pelvis. The intra-abdominal visceral fat (VF) volume was measured by drawing a line within the muscle wall surrounding the abdominal cavity. The abdominal SF volume was calculated by subtracting the VF volume from the total abdominal fat volume. By comparison, the abdominal VF and SF areas were determined at the umbilical level by the established slice-by-slice CT scanning technique. We found: 1) abdominal SF mass, either as volume or area, was a more important determinant of serum leptin than was VF mass; 2) among TC, TG, HDL-C and LDL-C, only TG had a positive correlation to serum leptin levels in men, whereas in women no lipid parameters had any relationship with leptin; and 3) VF mass had a positive correlation to serum TC and TG in men, whereas SF did not. The present study provides considerable evidence on the relationship between abdominal fat mass and serum leptin, and shows that the relationships between serum leptin and serum lipids and lipoproteins are not straightforward. We also suggest that fat area measured by conventional CT is a better indicator than its corresponding volume assessed by helical CT, based on the present results showing its closer association to serum lipids.

  11. [A case of fulminant amoebic colitis with an abscess in the abdominal cavity rescued by conservative management].

    PubMed

    Matsui, Akira; Nomura, Kousuke; Odagiri, Hiroyuki; Yamada, Akihiro; Domon, Kaoru; Yamashita, Satoshi; Furuhata, Tsukasa; Kikuchi, Daisuke; Nakamura, Masanori; Mitani, Toshifumi; Ogawa, Osamu; Iizuka, Toshiro; Hoteya, Shu; Kaise, Mitsuru; Matoba, Shuichirou; Fujii, Takeshi

    2012-05-01

    A 75-year-old man was admitted because of watery diarrhea, hematochezia and right lower abdominal pain. Many deep undermining colonic ulcers were found by colonoscopy, and we detected trophozoite amoeba pathologically. Metronidazole was administered orally from 3 days after admission. However, since CT demonstrated a huge abscess in the abdominal cavity, we performed percutaneous drainage from 17 days after admission. On day 157, the patient was discharged, because the colonic ulcers had almost healed, and trophozoite amoebas were not recognized pathologically.

  12. Rectus sheath haematoma: a rare masquerader for abdominal pain.

    PubMed

    Changal, Khalid Hamid; Saleem, Saad; Ghous, Ghulam

    2017-04-13

    Rectus sheath haematoma is a rare cause of abdominal pain. It can be easily confused for other causes of acute abdomen and may even lead to unnecessary laparotomies. Our patient has the rectus sheath haematoma because of violent coughing and on presentation had no obvious clinical sign pointing to the same. Diagnosis was made by a CT scan of the abdomen, and patient was treated conservatively. Rectus sheath haematomas are usually present on the posterior aspect of the rectus muscles and thus may not be clinically appreciable.

  13. Inflammatory abdominal aortic aneurysm: report of seven cases.

    PubMed

    Nagahama, Hiroyuki; Nakamura, Kunihide; Matsuyama, Masakazu; Endou, Jouji; Nishimura, Masanori; Ishii, Hirohito; Yokota, Atsuko; Ikenoue, Makoto

    2013-01-01

    We reviewed 575 cases of abdominal aortic aneurysm (AAA) repair performed in our institution from 1979 to 2010. In this group, 7 (1.2%) patients (mean age, 72.6 years) had evidence of inflammatory AAA (IAAA). Mean aneurysmal diameter was 70.4 mm as measured on CT, and the mantle sign was present in all cases. They were male smokers. Two patients had hydronephrosis, and required a ureteral stent before surgery. All patients underwent laparotomy, and no perioperative deaths occured. We suggest that operative technique should be modified to avoid excessive dissection on both the proximal and distal sides of the IAAA.

  14. Inflammatory Abdominal Aortic Aneurysm: Report of Seven Cases

    PubMed Central

    2013-01-01

    We reviewed 575 cases of abdominal aortic aneurysm (AAA) repair performed in our institution from 1979 to 2010. In this group, 7 (1.2%) patients (mean age, 72.6 years) had evidence of inflammatory AAA (IAAA). Mean aneurysmal diameter was 70.4 mm as measured on CT, and the mantle sign was present in all cases. They were male smokers. Two patients had hydronephrosis, and required a ureteral stent before surgery. All patients underwent laparotomy, and no perioperative deaths occured. We suggest that operative technique should be modified to avoid excessive dissection on both the proximal and distal sides of the IAAA. PMID:24386030

  15. Uncluttered single-image visualization of the abdominal aortic vessel tree: Method and evaluation

    SciTech Connect

    Won, Joong-Ho; Rosenberg, Jarrett; Rubin, Geoffrey D.; Napel, Sandy

    2009-11-15

    Purpose: The authors develop a method to visualize the abdominal aorta and its branches, obtained by CT or MR angiography, in a single 2D stylistic image without overlap among branches. Methods: The abdominal aortic vasculature is modeled as an articulated object whose underlying topology is a rooted tree. The inputs to the algorithm are the 3D centerlines of the abdominal aorta, its branches, and their associated diameter information. The visualization problem is formulated as an optimization problem that finds a spatial configuration of the bounding boxes of the centerlines most similar to the projection of the input into a given viewing direction (e.g., anteroposterior), while not introducing intersections among the boxes. The optimization algorithm minimizes a score function regarding the overlap of the bounding boxes and the deviation from the input. The output of the algorithm is used to produce a stylistic visualization, made of the 2D centerlines modulated by the associated diameter information, on a plane. The authors performed a preliminary evaluation by asking three radiologists to label 366 arterial branches from the 30 visualizations of five cases produced by the method. Each of the five patients was presented in six different variant images, selected from ten variants with the three lowest and three highest scores. For each label, they assigned confidence and distortion ratings (low/medium/high). They studied the association between the quantitative metrics measured from the visualization and the subjective ratings by the radiologists. Results: All resulting visualizations were free from branch overlaps. Labeling accuracies of the three readers were 93.4%, 94.5%, and 95.4%, respectively. For the total of 1098 samples, the distortion ratings were low: 77.39%, medium: 10.48%, and high: 12.12%. The confidence ratings were low: 5.56%, medium: 16.50%, and high: 77.94%. The association study shows that the proposed quantitative metrics can predict a reader

  16. The Role of Computed Tomography in the Diagnostics of Diaphragmatic Injury After Blunt Thoraco-Abdominal Trauma

    PubMed Central

    Gmachowska, Agata; Pacho, Ryszard; Anysz-Grodzicka, Agnieszka; Bakoń, Leopold; Gorycka, Maria; Jakuczun, Wawrzyniec; Patkowski, Waldemar

    2016-01-01

    Summary Background Diaphragmatic injuries occur in 0.8–8% of patients with blunt trauma. The clinical diagnosis of diaphragmatic rupture is difficult and may be overshadowed by associated injuries. Diaphragmatic rupture does not resolve spontaneously and may cause life-threatening complications. The aim of this study was to present radiological findings in patients with diaphragmatic injury. Material/Methods The analysis of computed tomography examinations performed between 2007 and 2012 revealed 200 patients after blunt thoraco-abdominal trauma. Diaphragmatic rupture was diagnosed in 13 patients. Twelve of these patients had suffered traumatic injuries and underwent a surgical procedure that confirmed the rupture of the diaphragm. Most of diaphragmatic ruptures were left-sided (10) while only 2 of them were right-sided. In addition to those 12 patients there, another patient was admitted to the emergency department with left-sided abdominal and chest pain. That patient had undergone a blunt thoracoabdominal trauma 5 years earlier and complained of recurring pain. During surgery there was only partial relaxation of the diaphragm, without rupture. The most important signs of the diaphragmatic rupture in computed tomography include: segmental discontinuity of the diaphragm with herniation through the rupture, dependent viscera sign, collar sign and other signs (sinus cut-off sign, hump sign, band sign). Results In our study blunt diaphragmatic rupture occurred in 6% of cases as confirmed intraoperatively. In all patients, coronal and sagittal reformatted images showed herniation through the diaphragmatic rupture. In left-sided ruptures, herniation was accompanied by segmental discontinuity of the diaphragm and collar sign. In right-sided ruptures, predominance of hump sign and band sign was observed. Other signs were less common. Conclusions The knowledge of the CT findings suggesting diaphragmatic rupture improves the detection of injuries in thoraco-abdominal

  17. High correlation between in vivo [123I]β-CIT SPECT/CT imaging and post-mortem immunohistochemical findings in the evaluation of lesions induced by 6-OHDA in rats

    PubMed Central

    2013-01-01

    Background 6-Hydroxydopamine (6-OHDA) is widely used in pre-clinical animal studies to induce degeneration of midbrain dopamine neurons to create animal models of Parkinson's disease. The aim of our study was to evaluate the potential of combined single-photon emission computed tomography/computed tomography (SPECT/CT) for the detection of differences in 6-OHDA-induced partial lesions in a dose- and time-dependent manner using the dopamine transporter (DAT) ligand 2β-carbomethoxy-3β-(4-[123I]iodophenyl)tropane ([123I]β-CIT). Methods Rats were unilaterally lesioned with intrastriatal injections of 8 or 2 × 10 μg 6-OHDA. At 2 or 4 weeks post-lesion, 40 to 50 MBq [123I]β-CIT was administered intravenously and rats were imaged with small-animal SPECT/CT under isoflurane anesthesia. The striatum was delineated and mean striatal activity in the lesioned side was compared to the intact side. After the [123I]β-CIT SPECT/CT scan, the rats were tested for amphetamine-induced rotation asymmetry, and their brains were immunohistochemically stained for DAT and tyrosine hydroxylase (TH). The fiber density of DAT- and TH-stained striata was estimated, and TH-immunoreactive cells in the rat substantia nigra pars compacta (SNpc) were stereologically counted. Results The striatal uptake of [123I]β-CIT differed significantly between the lesion groups and the results were highly correlated to both striatal DAT- and TH-immunoreactive fiber densities and to TH-immunoreactive cell numbers in the rat SNpc. No clear progression of the lesion could be seen. Conclusions [123I]β-CIT SPECT/CT is a valuable tool in predicting the condition of the rat midbrain dopaminergic pathway in the unilateral partial 6-OHDA lesion model of Parkinson's disease and it offers many advantages, allowing repeated non-invasive analysis of living animals. PMID:23758882

  18. [Abdominal pregnancy care. Case report].

    PubMed

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  19. 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

  20. Atypical abdominal pain: post-traumatic transverse colon stricture.

    PubMed

    Rotar, Raluca; Uwechue, Raphael; Sasapu, Kishore Kumar

    2013-08-23

    A driver presented to the emergency department 1 day after an accident driving his excavator with abdominal pain and vomiting. He was admitted to the surgical ward 2 days later, after reattending. A CT scan revealed wall thickening and oedema in the transverse colon. This was supported by a subsequent CT virtual colonoscopy which raised the suspicion of neoplasia. A follow-up colonoscopy was not carried further than the transverse colon due to an indurated, tight stricture. Biopsies from that area showed ulceration and inflammatory changes non-specific for ischaemia, drug-induced changes or inflammatory bowel disease. As a consequence of the subocclusive symptoms and the possibility of a neoplastic diagnosis, a laparoscopic-assisted transverse colectomy was performed. The histology of the resected segment revealed post-traumatic inflammation and fibrosis with no evidence of neoplasia.

  1. Diagnostic imaging of abdominal fluid collections and abscesses.

    PubMed

    Baker, M E; Blinder, R A; Rice, R P

    1986-01-01

    With today's advanced technology, the clinician and radiologist have a number of techniques with which to evaluate the abdomen for fluid collections and/or abscesses. Three points are clear from the plethora of literature concerning this subject: the need to individualize the clinical and imaging approach to each patient suspected of an abnormal fluid collection or abscess, the need to individualize the imaging procedure based upon what is done best at the institution, and the need for percutaneous aspiration of all fluid collections for diagnosis. No single imaging test is totally sensitive or specific for the detection of an infected fluid collection. Overall, CT probably does provide the most accurate means to detect an intra-abdominal abscess. Because of this, and because it is less operator dependent than ultrasound, CT is used most often as the procedure of choice at our institution.

  2. Congenital Extrahepatic Abdominal Arteriovenous Fistula and Apparent Patent Ductus Venosus in a Dog.

    PubMed

    White, Robert N; Murphy, Kate; Renfrew, Helen; Shales, Chris

    2015-01-01

    A 3 mo old male German shepherd dog presented with a 2 wk history of diarrhea with possible melena followed by inappetence and progressive abdominal distension. Clinical findings, serum biochemical analysis, and abdominal ultrasound were highly suggestive of an extrahepatic abdominal arteriovenous fistula and concurrent patent ductus venosus, which were confirmed during an abdominal exploratory surgery. Renal biopsies taken at the time of surgery confirmed a chronic glomerulopathy. The dog made a good initial recovery from the procedure but was euthanatized 6 wk postoperatively for medically unresponsive renal disease.

  3. Abdominal and hepatic uptake of /sup 99m/Tc-pyrophosphate in neonatal necrotizing enterocolitis

    SciTech Connect

    Caride, V.J.; Touloukian, R.J.; Ablow, R.C.; Lange, R.C.; Matthews, T.

    1981-04-01

    Abdominal /sup 99m/Tc-pyrophosphate (/sup 99m/Tc-PYP) scans were obtained in 15 neonates: 12 with neonatal necrotizing enterocolitis (NEC), two with osteomyelitis, and one with myocarditis. Ten of the babies with NEC had at least one positive scan; of these 10 studies, seven (Group A) showed both diffuse abdominal uptake and localized hepatic activity, two (Group B) showed abdominal uptake and questionable hepatic uptake, and one (Group C) demonstrated diffuse abdominal uptake only. The other two babies with NEC had normal scans (Group D). All NEC patients had normal scans. A patient with myocarditis had hepatic uptake of /sup 99m/Tc-PYP while the abdominal scan in the two infants with osteomyelitis was normal. These preliminary observations suggest that further study of a relationship between abdominal scan findings and the course of NEC is warranted.

  4. Thermography Examination of Abdominal Area Skin Temperatures in Individuals With and Without Focal-Onset Epilepsy.

    PubMed

    King, Hollis H; Cayce, Charles Thomas; Herrin, Jeph

    Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures. Following two hypotheses were formulated to evaluate any abdominal temperature phenomena: (1) an abdominal quadrant division analysis would find one or more quadrants "colder" in the focal-onset epilepsy group (ICD9-CM 345.4 and 345.5) compared to controls. (2) Total abdominal areas of individuals with focal-onset epilepsy wound be colder than a control group.

  5. Recovery after abdominal wall reconstruction.

    PubMed

    Jensen, Kristian Kiim

    2017-03-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study I was a systematic review of the existing standardized methods for assessing quality of life after incisional hernia repair. After a systematic search in the electronic databases Embase and PubMed, a total of 26 studies using standardized measures for assessment of quality of life after incisional hernia repair were found. The most commonly used questionnaire was the generic Short-Form 36, which assesses overall health-related quality of life, addressing both physical and mental health. The second-most common questionnaire was the Carolinas Comfort Scale, which is a disease specific questionnaire addressing pain, movement limitation and mesh sensation in relation to a current or previous hernia. In total, eight different questionnaires were used at varying time points in the 26 studies. In conclusion, standardization of timing and method of quality of life assessment after incisional hernia repair was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery pathway at the Digestive Disease Center, Bispebjerg Hospital, and compared to a control group of 16 patients included retrospectively in the period immediately prior to the

  6. 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.

  7. Anorexia Nervosa: Analysis of Trabecular Texture with CT.

    PubMed

    Tabari, Azadeh; Torriani, Martin; Miller, Karen K; Klibanski, Anne; Kalra, Mannudeep K; Bredella, Miriam A

    2016-10-31

    Purpose To determine indexes of skeletal integrity by using computed tomographic (CT) trabecular texture analysis of the lumbar spine in patients with anorexia nervosa and normal-weight control subjects and to determine body composition predictors of trabecular texture. Materials and Methods This cross-sectional study was approved by the institutional review board and compliant with HIPAA. Written informed consent was obtained. The study included 30 women with anorexia nervosa (mean age ± standard deviation, 26 years ± 6) and 30 normal-weight age-matched women (control group). All participants underwent low-dose single-section quantitative CT of the L4 vertebral body with use of a calibration phantom. Trabecular texture analysis was performed by using software. Skewness (asymmetry of gray-level pixel distribution), kurtosis (pointiness of pixel distribution), entropy (inhomogeneity of pixel distribution), and mean value of positive pixels (MPP) were assessed. Bone mineral density and abdominal fat and paraspinal muscle areas were quantified with quantitative CT. Women with anorexia nervosa and normal-weight control subjects were compared by using the Student t test. Linear regression analyses were performed to determine associations between trabecular texture and body composition. Results Women with anorexia nervosa had higher skewness and kurtosis, lower MPP (P < .001), and a trend toward lower entropy (P = .07) compared with control subjects. Bone mineral density, abdominal fat area, and paraspinal muscle area were inversely associated with skewness and kurtosis and positively associated with MPP and entropy. Texture parameters, but not bone mineral density, were associated with lowest lifetime weight and duration of amenorrhea in anorexia nervosa. Conclusion Patients with anorexia nervosa had increased skewness and kurtosis and decreased entropy and MPP compared with normal-weight control subjects. These parameters were associated with lowest lifetime weight

  8. Malignant external otitis: CT evaluation

    SciTech Connect

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-11-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.

  9. Abdominal x-ray

    MedlinePlus

    ... a kidney stone Identify blockage in the intestine Locate an object that has been swallowed Help diagnose diseases, such as tumors or other conditions Normal Results The x-ray will show normal structures for a person your age. What Abnormal Results Mean Abnormal findings ...

  10. CT demonstration of bilateral adrenal hemorrhage

    SciTech Connect

    Ling, D.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.

    1983-08-01

    Bilateral adrenal hemorrhage with subsequent adrenal insufficiency is a recognized complication of anticoagulant therapy. Because the clinical manifestations are often nonspecific, the antemortem diagnosis of adrenal hemorrhage has been a difficult clinical problem. Computed tomography (CT) provides detailed images of the adrenal glands that are not possible with conventional imaging methods. The CT findings of bilateral adrenal hemorrhage in an anticoagulated patient are reported.

  11. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    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

  12. Abdominal obesity and metabolic syndrome.

    PubMed

    Després, Jean-Pierre; Lemieux, Isabelle

    2006-12-14

    Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity - the most prevalent manifestation of metabolic syndrome - is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.

  13. Abdominal surgery in neonatal foals.

    PubMed

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  14. Fully automatic algorithm for segmenting full human diaphragm in non-contrast CT Images

    NASA Astrophysics Data System (ADS)

    Karami, Elham; Gaede, Stewart; Lee, Ting-Yim; Samani, Abbas

    2015-03-01

    The diaphragm is a sheet of muscle which separates the thorax from the abdomen and it acts as the most important muscle of the respiratory system. As such, an accurate segmentation of the diaphragm, not only provides key information for functional analysis of the respiratory system, but also can be used for locating other abdominal organs such as the liver. However, diaphragm segmentation is extremely challenging in non-contrast CT images due to the diaphragm's similar appearance to other abdominal organs. In this paper, we present a fully automatic algorithm for diaphragm segmentation in non-contrast CT images. The method is mainly based on a priori knowledge about the human diaphragm anatomy. The diaphragm domes are in contact with the lungs and the heart while its circumference runs along the lumbar vertebrae of the spine as well as the inferior border of the ribs and sternum. As such, the diaphragm can be delineated by segmentation of these organs followed by connecting relevant parts of their outline properly. More specifically, the bottom surface of the lungs and heart, the spine borders and the ribs are delineated, leading to a set of scattered points which represent the diaphragm's geometry. Next, a B-spline filter is used to find the smoothest surface which pass through these points. This algorithm was tested on a noncontrast CT image of a lung cancer patient. The results indicate that there is an average Hausdorff distance of 2.96 mm between the automatic and manually segmented diaphragms which implies a favourable accuracy.

  15. Computed Tomographic Findings of Syphilitic Aortitis: A Case Report

    SciTech Connect

    Kimura, Fumiko; Satoh, Hideyuki; Sakai, Fumikazu; Nishii, Noriko; Tohda, Joe; Fujimura, Mikihiko; Haruta, Shoji; Yamazaki, Kenji; Endo, Masahiro; Sakomura, Yasunari; Kurosama, Hiromi; Kasanuki, Hiroshi

    2004-03-15

    We describe the computerized tomographic (CT) findings of the aortic wall in a case of acute-phase syphilitic arteritis. The delayed phase of the contrast-enhanced CT shows a double-ring configuration of the thick thoracic aortic wall, which is similar to CT findings previously reported for Takayasu arteritis. We speculate that the resemblance of the CT findings for these two diseases accounts for their similar histopathological features.

  16. Electromyographic investigation of abdominal exercises and the effects of fatigue.

    PubMed

    Robinson, Mark; Lees, Adrian; Barton, Gabor

    URA muscles but not for the EO (p > 0.05). It was concluded that exercises can be constructed to provide a greater challenge to abdominal muscles, commercially available roller-type equipment appears to be little different from the standard abdominal crunch with bent knees, and fatiguing exercise results in the LRA and URA being more highly activated. These findings provide more detailed knowledge and understanding of the effects of different forms of abdominal exercise.

  17. Assessment of Abdominal Pain in School-Age Children

    ERIC Educational Resources Information Center

    Zimmermann, Polly Gerber

    2003-01-01

    Pediatric abdominal pain can be a difficult condition to accurately assess for the nurse to determine whether the child's need is for teaching, treating, or transferring. This article describes the process as well as practical tips to be used by the nurse in the school setting. Distinguishing characteristics and findings, including key physical…

  18. Diffuse abdominal gallium-67 citrate uptake in salmonella infections

    SciTech Connect

    Garty, I.; Koren, A.

    1987-11-01

    Two pediatric patients with salmonella infections (one with typhoid fever and the second with salmonella C2 gastroenteritis), had a diffuse abdominal uptake of Ga-67 citrate. The possible explanation for this finding is discussed. Salmonella infection should be included as a cause in the differential diagnosis of diffuse accumulation of Ga-67 citrate.

  19. [Right atrial thrombosis with acute abdominal onset].

    PubMed

    Petcu, D P; Petcu, C; Roşu, M

    2009-01-01

    Intracardiac masses are detected more frequently due to the availability of echocardiography. Right atrial thrombosis is rare comparatively with that of the left atrium. The clinical presentation of the patient with right atrial thrombosis is linked with a misleading association between cardiovascular signs and digestive signs (acute abdominal pain, vomiting and marmorated skin of flanks). Initial clinical suspicions of acute pancreatitis, entero-mesenteric infarction and complicated gastro-duodenal ulcer were invalidated by imagistic investigations -- echocardiography and CT. The massive thrombus located in the right atrium, prolapsing during diastole through the tricuspid valve, was associated with the increase in plasmatic D-dimers and new ECG modifications type right bundle block (hemodynamic straining of the right ventricle). The evolution was favorable, after heparin-therapy by infusing pump, with relief of cardiovascular and digestive symptoms after the first 6 hours; after 36 h from the beginning of the treatment the thrombus was lysed. Sudden death likelihood through complete obstruction of the tricuspid ostium was prevented due to the early diagnosis offered by imagistic methods.

  20. Computed tomography of blunt and penetrating diaphragmatic injury: sensitivity and inter-observer agreement of CT Signs.

    PubMed

    Hammer, Mark M; Flagg, Eric; Mellnick, Vincent M; Cummings, Kristopher W; Bhalla, Sanjeev; Raptis, Constantine A

    2014-04-01

    Diaphragmatic injury is an uncommon but clinically important entity in the setting of trauma. Computed tomography (CT) is widely used to evaluate hemodynamically stable trauma patients. While prior studies have identified CT signs of diaphragm injury in blunt or penetrating trauma, no study has directly compared signs across these two types of injuries. We identified patients with surgically proven diaphragm injuries who underwent CT at presentation. Three reviewers examined each for 12 signs of diaphragm injury, as well as for an overall impression of diaphragm injury. We reviewed a total of 84 patients (37 % blunt trauma, 63 % penetrating). The initial interpreting radiologists discovered 77 % of blunt and 47 % of penetrating injuries (p = 0.01). We found that the majority of signs of diaphragmatic injury were split between those common in blunt trauma and those common in penetrating trauma, with minimal overlap. The presence of at least one blunt injury sign has 90 % sensitivity for diaphragm injury in blunt trauma; the presence of a wound tract traversing the diaphragm has 92 % sensitivity in penetrating trauma. Inter-observer reliability of these signs is also high (κ > 0.65). Penetrating diaphragm injuries present a different spectrum of imaging findings from those in blunt trauma and are underdiagnosed at CT; looking for a wound tract traversing the diaphragm is highly sensitive for diaphragm injury in these cases. Signs of organ or diaphragm fragment displacement are sensitive for blunt diaphragm injuries, consistent with these injuries being caused by increased intra-abdominal pressure.