Biomedical subjects

E F Halpern

Publications and source records attributed to E F Halpern.

At least 55 records · Page 3Linked to original sources

PubMed1997

Routine addition of an automated biopsy device to fine-needle aspiration of the lung: a prospective assessment.

OBJECTIVE: The purpose of this study was to prospectively assess the usefulness of the routine addition of an automated biopsy device (ABD) to fine-needle aspiration (FNA) of the lung and to examine the complication rate of this procedure. SUBJECTS AND METHODS: Fifty biopsies were performed under CT guidance using a coaxial technique with a 19-gauge introducer needle and a 22-gauge aspirating needle followed by a 20-gauge ABD. An average of 3.5 FNA specimens and 2.5 core specimens were obtained. Cytology and histology specimens were interpreted separately by two experienced pathologists who were unaware of the other's interpretation. Final diagnoses were based on surgery, microbiology, definitive biopsy diagnosis, and clinical follow-up. All complications were recorded. RESULTS: Of 34 malignant lesions, we achieved a diagnostic accuracy of 94% for FNA and 59% for core biopsy (p < .01). Combined accuracy was 94%. Of 16 benign lesions, an accurate definitive diagnosis was made in 31% of cases using FNA and in 69% of cases using core biopsy (p = .08). Combined accuracy was 69%. In the subset of benign lesions that were not acute infections (n = 8), an accurate definitive benign diagnosis was made in 12% of cases using FNA and in 75% of cases using core biopsy (p < .05). No false-positive diagnoses of malignancy occurred. Complications included pneumothorax, nine (18%) of 50 cases; chest tube, one (2%) of 50 cases minor pulmonary hemorrhage, seven (14%) of 50 cases; and minor hemoptysis, two (4%) of 50 cases. CONCLUSION: The complication rates of FNA with the addition of an ABD are similar to those reported in the literature for FNA alone. The addition of an ABD significantly increases the diagnostic accuracy only for the subset of benign lesions that are not acute infections.

Adolescent↗

PubMed1997

Imaging of fallopian tube tumors.

OBJECTIVE: The purposes of this study were to investigate the imaging findings in patients with primary fallopian tube neoplasms and to determine whether specific imaging features favor the preoperative diagnosis of fallopian tube tumors (FTT). MATERIALS AND METHODS: Computerized search of medical records from 1984 to 1994 identified 20 patients with a discharge diagnosis of primary fallopian tube carcinoma. Medical records, imaging studies, and pathology findings were reviewed. Eleven patients had available preoperative imaging. RESULTS: Seventeen of 20 patients with primary FTT had unilateral disease. Of these 17, preoperative imaging was available in nine, showing four solid adnexal masses, four complex cystic adnexal masses, and one normal adnexa. The preoperative imaging of these nine patients included six sonographic and five CT studies. Three patients with primary FTT had bilateral tumors, and preoperative imaging was available for two patients: Two sonographic studies and one CT study showed one complex cystic adnexal mass and three normal adnexa. CONCLUSION: Primary FTT commonly presents as an adnexal mass on preoperative imaging and mimics other pelvic malignancies, especially ovarian carcinoma. Making a specific preoperative diagnosis is difficult; however, because primary FTT is unlikely to be confused with a benign process, delay in diagnosis is rare.

Adult↗

PubMed1996

Radiofrequency tissue ablation: importance of local temperature along the electrode tip exposure in determining lesion shape and size.

RATIONALE AND OBJECTIVES: We determined whether heat distribution along a radiofrequency (RF) electrode would be uniform when longer tip exposures are used and whether local temperature effects would influence the shape of induced tissue coagulation. METHODS: Thermistors were embedded within 18-gauge RF electrodes at both ends and in the middle of the exposed tip. The length of tip exposure varied from 1 to 7 cm. RF was applied in vitro to pig liver for 6 min using a constant tip temperature, which was varied in 10 degrees C increments from 60 degrees C to 110 degrees C. Experiments were performed in triplicate. The 3- and 5-cm probes were used at a 90 degrees C tip temperature to create lesions in live pig liver and muscle using similar parameters. Temperature was measured throughout the procedure. Observable coagulation necrosis was measured at the end of the treatment. Regression analysis was used to evaluate the local temperature-lesion diameter relationship. RESULTS: Temperatures were not uniform along the tip exposure for any given trial. Temperature variation increased with higher tip temperatures and longer tip exposures. The diameter of local coagulation necrosis was a function of the local mean temperature. For in vitro trials, no coagulation was seen when the local temperature was less than 50 degrees C. Temperatures above this threshold resulted in progressively greater lesion diameter, with a minimum of 1 cm of necrosis occurring at 71 degrees C. Additional increases in lesion diameter (1.4-1.6 cm) were observed at approximately 90 degrees C. Mathematical modeling demonstrated a best-fit curve: lesion diameter (in cm) = ¿1.4 + 0.03 (tip exposure)¿ ¿1 - e [-0.067(local temp - 49.5 degrees C)]¿, r2 = .986, SD = 0.14 cm for each curve. In living tissue, less uniformity in the shape of coagulation necrosis was seen around the electrodes. Local temperature-lesion diameter data fit the same logarithmic relation, but the threshold for coagulation necrosis was 8.5 degrees C higher than for in vitro specimens. CONCLUSION: Using a single-probe technique for RF-induced tissue necrosis, the diameter of tissue coagulation may be predicted by the local temperature along the exposed electrode. The uniformity of temperature decreases with increased tip exposures. This effect may be partially corrected by creating lesions at higher tip temperatures, where necrosis diameter is increased. Because effects are more pronounced in vivo, uniform volumes of tissue necrosis are limited to tip exposures of 3 cm or less.

Animals↗

PubMed1996

Evaluation of selected two-dimensional segmentation techniques for computed tomography quantitation of lymph nodes.

RATIONALE AND OBJECTIVES: As contrast agents that selectively target normal lymph nodes are undergoing development and evaluation, it has become important to accurately and reproducibly determine nodal boundaries to study the agents and determine such values as lymph node area or mean nodal contrast concentration. This study was performed to evaluate the accuracy of different two-dimensional computer segmentation methods, tested on acrylic phantoms constructed to imitate the appearance of lymph nodes surrounded by fat. METHODS: Five segmentation techniques (manual tracing, semiautomatic local criteria threshold selection, Sobel/watershed technique, interactive deformable contour algorithm and thresholding) were evaluated using phantoms. Subsequently, the first three methods were applied to the images of enhanced lymph nodes in rabbits. RESULTS: Minimum errors in phantom area measurement (< 5%) and interoperator variation (< 5%) were seen with the Sobel/watershed technique and the interactive deformable contour algorithm. These two techniques were significantly better than thresholding and semiautomated thresholding based on local properties. CONCLUSION: Methods based on Sobel edge detection offer more objective tools than thresholding methods for segmenting objects similar to lymph nodes in computed tomography images. Both methods, Sobel/watershed and interactive deformable contour algorithm, are fast and have simple user interfaces.

Algorithms↗

PubMed1996

Secondary elevation of extracellular neurotransmitter amino acids in the reperfusion phase following focal cerebral ischemia.

The purpose of this study was to evaluate amino acid neurotransmitter dynamics in the reperfusion phase after transient cerebral ischemia. In vivo microdialysis was used to measure extracellular amino acid levels in a rabbit model of focal ischemia. During 30 min of transient ischemia (n = 5), small but significant (p < 0.05) increases in glutamate, aspartate, gamma-aminobutyric acid (GABA), and taurine were noted. These elevations rapidly returned to baseline levels upon recirculation and remained constant for up to 5.5 h of reperfusion. In rabbits subjected to 2 h of transient ischemia (n = 5), two phases of amino acid release were seen. During ischemia, large (5- to 50-fold) elevations in glutamate, aspartate, GABA, and taurine occurred, as expected. These elevations rapidly normalized upon unocclusion. However, significant (p < 0.05) secondary elevations in glutamate, aspartate, and GABA occurred after 2-4 h of reperfusion. Regression analysis demonstrated significant correlations between primary (ischemic) and secondary (reperfusion) efflux. In permanent ischemia (n = 5), amino acid levels remained elevated throughout the entire experiment. Secondary elevations in excitatory amino acids may further contribute to the excitotoxic cascade during reperfusion.

Amino Acids↗

PubMed1996

Positive predictive value of breast biopsy performed as a result of mammography: there is no abrupt change at age 50 years.

PURPOSE: To determine if the positive predictive value (PPV) of a biopsy initiated because of an abnormal mammogram changes abruptly at age 50 years. MATERIALS AND METHODS: The PPV and its variation with age was analyzed for 4,778 women who underwent biopsy for a clinically occult abnormality detected at mammography. The relationship of the results to the patient's age was analyzed with age represented as a continuous and two-categorized (< 50, > 50) measure. The latter measure represented an abrupt change, which distinguished those aged 49 years and younger from those aged 50 years and over. With this measure, the patients in each of the two age groups were statistically indistinguishable. RESULTS: The results were consistent with a steady increase in PPV and the yield of cancers with age, and there was no abrupt change at age 50 years. The modeled PPV for all cancers for these 4,778 patients was approximately 12% for women aged 40 years and increased to 46% by age 79 years. CONCLUSION: The PPV did not change abruptly at any age for women aged 40-79 years but increased steadily, which reflects the prior probability of breast cancer at each age. Inappropriate grouping of data can lead to misinterpretation of results. Screening guidelines should not be predicated on the false assumption that this variable changes at age 50 years.

Adult↗

PubMed1996

Preoperative staging of cancer of the pancreas: value of MR angiography versus conventional angiography in detecting portal venous invasion.

OBJECTIVE: The purpose of this study was to compare contrast-enhanced MR angiography with conventional catheter angiography for detecting portal venous invasion in the preoperative staging of pancreatic cancer, using the surgical confirmation of vascular involvement as the standard of truth. SUBJECTS AND METHODS: MR and conventional angiography were performed in 20 patients with pancreatic carcinoma, with surgical confirmation in all cases. MR angiography was performed at 1.5 T, with coronal (2.9 mm) and axial (6.0 mm) contrast-enhanced breath-hold two-dimensional time-of-flight imaging. Data from each imaging technique were collected prospectively and analyzed in a blinded fashion by expert vascular radiologists. Vascular involvement in each patient and in each vessel (main portal vein, confluence, splenic vein, and superior mesenteric vein) determined whether the tumor was resectable (normal, abutment) or nonresectable (encased, occluded). Surgical confirmation of the vascular involvement of the portal venous structures was used as the standard of truth in all patients. RESULTS: Among the 20 patients, 11 tumors were surgically resectable and seven were nonresectable with performance of a palliative bypass. MR angiography and conventional angiography had an overall concordance in 65% of patients (13/20; seven resectable, four nonresectable, two false-negatives) on the basis of the vascular status in each patient of the portal venous structures and in 84% (47/56) of the individual vessels surgically confirmed. MR angiography correctly identified 11 of 11 resectable patients and five of nine nonresectable patients, with four false-negative cases. Conventional angiography correctly identified seven of 11 resectable patients and six of nine nonresectable patients, with three false-negative cases and four false-positive cases. CONCLUSION: The lack of false-positives by MR angiography suggests that MR imaging may provide a noninvasive screen for nonresectability on the basis of vascular involvement, with no patients with potentially resectable tumors being denied surgery by MR angiography in this cohort. However, the presence of false-negatives using MR angiography indicates the procedure would still not fully eliminate unnecessary laparotomies.

Aged↗

PubMed1996

Physicians' opinions on the delivery of mammographic screening services: immediate interpretation versus double reading.

OBJECTIVE: Mammographic services are delivered in many ways. Emphasis has been placed on providing women with immediate reports of their screening mammograms. We believe that double reading of mammograms is more important than an immediate report. We sought to determine physicians' attitudes toward this issue and if education affects their opinions. MATERIALS AND METHODS: Questionnaires were mailed to 1000 physicians in Massachusetts who were randomly selected from 16,000 members of the state medical society. The questionnaire had four sections, of which two were pertinent to this subject. The first section collected general information on the physician's practice and experience. The second section described two common delivery systems for mammographic screening services and asked physicians to choose the delivery system that would most benefit their patients. RESULTS: Of the 1000 physicians, 294 returned the questionnaire, giving a response rate of 29%. Of these, 16 physicians returned blank surveys, leaving 278 for analysis. Two hundred forty-nine (90%) valued off-site, delayed interpretation of mammographic screening for their patients over on-site reading by a single radiologist if an off-site, delayed reading made double reading possible. CONCLUSION: An off-site, double-reading delivery system for mammographic screening services is preferred by many physicians for their patients once they are educated as to the benefits of double reading.

Adult↗

PubMed1996

Vertebral morphometry derived from digital images.

OBJECTIVE: We describe a method for capturing measurement data directly from digitized images using specialized software and high-resolution workstations. We have evaluated the reliability, accuracy, and reproducibility of this method in an international clinical trial involving vertebral morphometry. MATERIALS AND METHODS: Accuracy was determined using clinical radiographs measured with vernier calipers and a film phantom. Intra- and interobserver variabilities were assessed, and longitudinal reproducibility was evaluated. As part of the trial, spinal radiographs were collected from more than 200 international health care facilities and digitized at four screening centers. Digitized images were stored and sent to our central facility for morphometry and archiving. Timeliness and variability of the process were tracked. RESULTS: Relative accuracy was nearly 100%. Correlation with clinical measurements was high (r = .96; p < .05). The mean coefficient of variation for interobserver variability was 2%. Intraobserver variation was 3-5%. The coefficient of variation for longitudinal reproducibility ranged from 4% to 6%. After 9 months of operation, our trial included 9494 patients. Of approximately 36,000 radiographs, 98% passed quality review. Only 1% of vertebral levels were not measurable. Hardware and software problems were minimal. CONCLUSION: The use of digitized images for morphometry is accurate, reproducible, and convenient. When applied to a large-scale clinical trial, it offers unique advantages that may justify the cost and complexity that exceed those of conventional radiographs.

Female↗

PubMed1996

Quantitative high-resolution measurement of cerebrovascular physiology with slip-ring CT.

PURPOSE: To implement and validate spiral slip-ring CT for use in cerebrovascular studies. METHODS: Continuous data were acquired from an experimental, first-pass, iodine contrast, bolus study by unidirectional X-ray tube rotation, and images were reconstructed at 100-millisecond intervals. Functional maps of cerebral blood volume (CBV) and cerebral blood flow (CBF) were constructed with voxel-by-voxel gamma variate fitting. Reproducibility studies, different injection volumes and sites, and CO2 challenge were applied to verify the technique. RESULTS: Average absolute cortical gray and white matter and basal ganglia results were reproducible within +/- 0.8 ml/100 g for CBV and +/- 20 ml/100 g per minute for CBF, CBV response to changing arterial CO2 tension was significant only in cortical gray matter and basal ganglia; CBF response was significant in gray and white matter, as well as in the basal ganglia. CONCLUSION: Functional CT and constructed functional maps provide an optimal, high-resolution tool with which to visualize cerebrovascular parameters and their changes.

Animals↗

PubMed1995

Hepatic imaging with iodinated nanoparticles: a comparison with iohexol in rabbits.

RATIONALE AND OBJECTIVES: We evaluated the efficacy of a particulate computed tomography (CT) contrast agent in an animal model of focal liver disease. METHODS: Ethyl ester of diatrizoic acid (EEDA) is an iodinated (89 mg I/ml) nanoparticulate (200 nm) contrast agent intended for intravenous use that is currently undergoing preclinical testing in our laboratory. Focal liver abscesses were created in 11 New Zealand White rabbits. Iohexol and EEDA were administered to each animal on different days. CT scanning was performed at intervals following contrast agent administration. Liver and abscess enhancement were measured and compared. Dynamic imaging experiments in normal animals were also performed using both agents. RESULTS: EEDA resulted in significantly greater enhancement of the liver and liver-to-abscess contrast than did iohexol at all time points beyond 5 min at approximately 25% of the total iodine load. During dynamic imaging, liver and aortic enhancement were greater with EEDA than with iohexol, except during a 20- to 40-sec period immediately following contrast agent administration. CONCLUSION: EEDA is superior to iohexol for imaging liver abscesses. Our results suggest that liver-directed agents such as EEDA may prove to be more efficacious than currently available extracellular agents designed for liver CT scanning.

Animals↗

PubMed1995

Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. The Iohexol Cooperative Study.

The incidence of nephrotoxicity occurring with the nonionic contrast agent, iohexol, and the ionic contrast agent, meglumine/sodium diatrizoate, was compared in 1196 patients undergoing cardiac angiography in a prospective, randomized, double-blind multicenter trial. Patients were stratified into four groups: renal insufficiency (RI), diabetes mellitus (DM) both absent (N = 364); RI absent, DM present (N = 318); RI present, DM absent (N = 298); and RI and DM both present (N = 216). Serum creatinine levels were measured at -18 to 24, 0, and 24, 48, and 72 hours following contrast administration. Prophylactic hydration was administered pre- and post-angiography. Acute nephrotoxicity (increase in serum creatinine of > or = 1 mg/dl 48 to 72 hours post-contrast) was observed in 42 (7%) patients receiving diatrizoate compared to 19 (3%) patients receiving iohexol, P < 0.002. Differences in nephrotoxicity between the two contrast groups were confined to patients with RI alone or combined with DM. In a multivariate analysis, baseline serum creatinine, male gender, DM, volume of contrast agent, and RI were independently related to the risk of nephrotoxicity. Patients with RI receiving diatrizoate were 3.3 times as likely to develop acute nephrotoxicity compared to those receiving iohexol. Clinically severe adverse renal events were uncommon (N = 15) and did not differ in incidence between contrast groups (iohexol N = 6; diatrizoate N = 9). In conclusion, in patients undergoing cardiac angiography, only those with pre-existing RI alone or combined with DM are at higher risk for acute contrast nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗

PubMed1995

Functional MR in the evaluation of dementia: correlation of abnormal dynamic cerebral blood volume measurements with changes in cerebral metabolism on positron emission tomography with fludeoxyglucose F 18.

PURPOSE: To determine whether magnetic susceptibility functional MR imaging of cerebral blood volumes provides information similar to fludeoxyglucose F 18 positron emission tomography (PET) brain images in patients undergoing evaluation for dementia. METHODS: Ten subjects were studied with both PET and functional MR. Clinical diagnoses included probable Alzheimer disease (n = 5), possible Alzheimer disease (n = 1), Pick disease (n = 2), and primary progressive aphasia (n = 2). The studies were quantitatively evaluated by coregistration of PET and functional MR images followed by regression analyses of corresponding regions of interest. Qualitatively, each brain was categorized into eight regions, and each was classified as normal or abnormal by visual inspection. RESULTS: Correlation coefficients between registered functional MR and PET images were excellent (mean, r = 0.58) in most of the cerebrum. Significant correlations were observed in 72 of 74 brain sections. Qualitatively, 16 brain regions were judged to be abnormal by both MR imaging and PET; 46 regions were normal by both; 10 regions were abnormal by PET only; and 8 regions were abnormal only by functional MR. The concordance between functional MR and PET was 78%, which was highly significant. CONCLUSION: Cerebral blood volumes images derived from magnetic susceptibility (functional MR) provide information similar to fludeoxyglucose F 18 PET images in demented patients undergoing evaluation for dementia.

Aged↗

PubMed1994

Nanoparticulate computed tomography contrast agents for blood pool and liver-spleen imaging.

RATIONALE AND OBJECTIVES: We investigated the properties of a group of iodine-containing, insoluble compounds formulated as nanoparticles for use as potential blood pool and liver-spleen contrast agents. METHODS: High-resolution, quantitative computed tomography (CT) was performed prior to and at intervals following the intravenous administration of the contrast agents to rabbits. Time-density characteristics for three organs were evaluated. RESULTS: Excellent enhancement of blood (< or = 232 Hounsfield units [HU]), liver (< or = 263 HU), and spleen (< or = 350 HU) was achieved at the administered dose of 3.0 ml/kg. The composition of the agents influenced the biodistribution, as well as the residence time in blood, and time to peak enhancement in liver. CONCLUSION: Iodinated nanoparticulate compounds are promising CT contrast agents. Development of agents with desirable pharmacokinetic and biodistribution profiles may permit application-specific contrast enhancement.

Animals↗

PubMed1994

Inadequacy of sample sizes in clinical trials of laboratory parameters attributable to invalid statistical assumptions.

Clinical trials often determine the sample size based on the use of statistical methods such as analysis of variance, t tests, and rank sum tests, which compare mean or median values. The resulting studies rarely are big enough to show that the method is based on mistaken assumptions. Data from a recent clinical trial of nephrotoxicity associated with the use of contrast agents during angiography found a significant difference on the order of the difference that previous studies had intended to detect. It also showed that a central assumption does not apply to changes in serum creatinine. As a result, the previous studies had considerably lower power than believed. Their lack of significance reflected only the mistaken assumption. Analysis of variance, t tests, and rank sum tests may be just as invalid for other clinical parameters. Lack of significance cannot be automatically taken to imply a small treatment effect.

Analysis of Variance↗

PubMed1994

Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings.

PURPOSE: To assess the utility of magnetic resonance (MR) cerebral blood volume (CBV) maps in the evaluation of gliomas. MATERIALS AND METHODS: CBV maps from 19 patients with histologically proved gliomas were calculated from dynamic MR image sets acquired with echo-planar spin-echo imaging after intravenous injection of gadolinium-based contrast material. RESULTS: The maximum CBV varied from 0.82 to 5.40 in the high-grade group (n = 13) and from 1.01 to 1.21 in the low-grade group (n = 6). The difference was statistically significant. Maximum CBV was associated with mitotic activity and vascularity, but not with cellular atypia, endothelial proliferation, necrosis, or cellularity. CONCLUSION: MR CBV maps provided diagnostic information not available with conventional MR imaging in six cases and offers a functional parameter for assessing glioma grade and regions of focal activity.

Adult↗

PubMed1994

Percutaneous CT lymphography with perflubron: imaging efficacy in rabbits and monkeys.

PURPOSE: To evaluate the imaging efficacy of percutaneous lymphography performed with injection of perflubron emulsions and computed tomography (CT). MATERIALS AND METHODS: Thin-section CT was used to image lymph nodes in 116 rabbits and six monkeys. Quantitative measures of regional lymph node enhancement were obtained 4 hours to 21 days after subcutaneous injection of perflubron (0.1-0.5 mL per injection site). Lymph node enhancement was calculated in Hounsfield units and converted to bromine concentration with standards that were imaged at the same time. RESULTS: Excellent enhancement of regional lymph nodes in both groups of animals was obtained. Nodal enhancement was linearly related to dose and was sustained for 20 days; maximum enhancement was seen 2 days after injection. Massage of the injection site increased delivery of the perflubron emulsion to regional lymph nodes. CONCLUSION: In rabbits and monkeys, percutaneous CT lymphography effectively depicts the intranodal distribution of macrophages in normal lymph nodes.

Animals↗

PubMed1994

Efficacy of CT in distinguishing small-bowel obstruction from other causes of small-bowel dilatation.

OBJECTIVE: Dilatation of the small bowel is a common finding on plain abdominal radiographs. In such cases, it is often difficult to determine if the cause of the dilatation is small-bowel obstruction, paralytic ileus, or another intraabdominal disorder. Accordingly, we studied the efficacy of CT in making this distinction. MATERIALS AND METHODS: The medical records of 75 patients with small-bowel dilatation seen on CT scans (more than three segments > 2.5 cm in diameter) were reviewed. The patients were divided into three groups (obstruction [27 patients], other surgical diagnosis [16 patients], and no surgery [32 patients]) on the basis of clinical course, findings at surgery, or both. CT scans were retrospectively evaluated by two gastrointestinal radiologists who did not know the results of the chart review. They evaluated the images with regard to the following specific criteria for obstruction: presence/continuity of duodenal, small-bowel, and colonic dilatation; presence of air-fluid levels; amount of intestinal fluid; presence of prestenotic dilatation; presence of transition zone; and cause of obstruction. In addition, each radiologist gave an overall impression regarding the presence or absence of obstruction (criteria not specified to the observers) and its site, or other cause of bowel dilatation. The CT interpretations of each of the radiologists were compared with the patients' subsequent clinical course. RESULTS: Observer A was correct in 89%, 88%, and 72% of cases in the obstruction, other surgical diagnosis, and no surgery groups, respectively. Observer B was correct in 78%, 81%, and 69% of cases in the obstruction, other surgical diagnosis, and no surgery groups, respectively. Observer agreement regarding the proposed criteria for obstruction ranged from 65% to 91%. For both observers, only the presence of continuous small-bowel dilatation, prestenotic dilatation, and a transition zone correlated significantly with the presence of small-bowel obstruction. CONCLUSION: CT can be a useful test for evaluating small-bowel dilatation and can aid both the diagnosis of small-bowel obstruction and its differentiation from other conditions resulting in small-bowel dilatation.

Adolescent↗