Cholecystosonography: the initial diagnostic test for chronic gallbladder disease.
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Chronic Disease↗
Biomedical subjects
J G Bova
Publications and source records attributed to J G Bova.
Adult acquired antral web.
Gastric antral webs in adults have been considered to be either congenital or acquired lesions. We present the first radiographically documented progression from a normal antrum to the development of an antral ulcer followed by healing with web formation. In a single study we feel that irregularity of the web and deformity or eccentricity of the antrum favor an acquired rather than a congenital web. Obtaining prior radiographs as well as follow-up examinations may be the only way to prove association with peptic disease.
Cicatrix↗
Imaging prior to second-look surgery for carcinoma.
Technical advances in imaging are barely keeping pace with the need for detailed pre-operative imaging in second-look surgery. Although the majority of intra-abdominal recurrence can be detected at surgery, pre-operative knowledge of possible sites of involvement will provide more efficient use of operative time. Dynamic incremental bolus CT is the modality of choice when evaluating these patients, even though magnetic resonance imaging is approaching, and may exceed, computed tomography in utility in the abdomen. Monoclonal antibody radioimmunoscintigraphy is useful for extra-abdominal sites of recurrence. Further technical advancement is needed to make it useful in the abdomen.
Abdominal Neoplasms↗
Radiographic manifestations of eosinophilic gastroenteritis.
Eosinophilic gastroenteritis (EG) is a rare inflammatory disease of unknown etiology, characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract. Although little over 250 cases of EG have been reported in the literature, EG is probably more common than reports in the literature would indicate. A retrospective review of 25 patients with EG along with a review of the literature was done to identify clinical, laboratory, radiographic, and therapeutic features. An allergic disorder was present in 14 (56%) and a peripheral eosinophilia was present in 24 (96%) of our patients. The most common radiographic manifestations of the stomach and small bowel included stenosis and fold thickening, respectively. Thirteen patients had esophageal involvement, with the esophageal stricture being the most common abnormality found in these patients. Steroids produced a good therapeutic result in most patients; the remaining patients responded to cromolyn and/or surgery.
Adult↗
Cirrhosis: spectrum of findings on unenhanced and dynamic gadolinium-enhanced MR imaging.
The appearance of the cirrhotic liver on computed tomography can be difficult to evaluate and can frustrate the radiologist distinguishing benign from malignant lesions. Hepatic edema, fibrosis, atrophy, and vascular abnormalities are common in the cirrhotic liver and produce derangements in morphology, attenuation, and perfusion, limiting the accurate characterization of hepatic masses. With the development of fast magnetic resonance (MR) sequences and dynamic postgadolinium-enhanced imaging, most hepatic lesions with uncertain etiology on computed tomography can be accurately characterized on MR imaging. We describe MR imaging techniques useful for imaging cirrhosis and its complications. We also illustrate the spectrum of findings in the cirrhotic liver on dynamic gadolinium-enhanced MR imaging, including reticular and confluent fibrosis, fatty infiltration, hemochromatosis, regenerating nodules, dysplastic nodules, hepatocellular carcinoma, and sequela of portal hypertension.
Carcinoma, Hepatocellular↗
Primary angiosarcoma of the spleen--CT, MR, and sonographic characteristics: report of two cases.
Primary angiosarcoma of the spleen is a rare entity, but it is the most common primary splenic malignancy. These tumors demonstrate an aggressive growth pattern and can be single or multiple. The diagnosis should be suspected in a patient who presents with splenomegaly but without evidence of lymphoma, malaria, leukemia, or portal hypertension. The tumor may also present with acute abdominal symptoms secondary to spontaneous splenic rupture. We describe two cases of primary angiosarcoma of the spleen with computed tomographic, magnetic resonance, and sonographic features.
Adult↗
Radiography of ileal adaptation in the rat following jejunectomy.
Six Sprague-Dawley rats were evaluated radiographically and histologically for adaptive changes in the ileum following total jejunal resection. Additionally, six rats were used as controls and six rats had sham operations. Marked hypertrophy of the ileum and hyperplasia of the mucosa with thickening of the ileal wall were documented in all six of the jejunectomized rats, compared with sham and unoperated controls. Radiographic changes were demonstrated in the bowel wall in three of six resected animals. These consisted of an irregular, serrated lumen that was normal to narrowed in caliber. No radiographic or histologic changes were seen in the control or sham rats. These results correlate radiographic changes with adaptive morphology of rat ileum after jejunal resection and resemble changes of adaptation seen in humans who have had jejunal-ileal bypass, jejunal resection, or nontropical sprue.
Adaptation, Physiological↗
Preoperative 3D rendering of MR imaging in liver metastases.
In 15 patients who were to undergo resection of hepatic metastases, three-dimensional (3D) images of the liver were rendered from axial T2-weighted MR images by a dedicated 3D workstation. This report assesses the utility of these images in preoperative planning and intraoperative guidance. In three patients, the preoperative 3D images convinced the surgeon of resectability. All patients had laparotomies and in 12 patients, in whom the liver lesions were evaluated, there was good to excellent spatial correlation. Intraoperatively, the 3D images aided the surgeon by allowing early detection of unresectability, by showing relationships of lesions to major vessels, and by directing the surgeon to lesions otherwise difficult to find. In two patients, the original MR images failed to show multiple small lesions, thus limiting the usefulness of the 3D images.
Colonic Neoplasms↗
CT of superior mesenteric vein thrombosis complicating periappendiceal abscess.
Acute mesenteric vein thrombosis is a rare complication of appendicitis. In this report we describe the clinical association of these entities and emphasize how early diagnosis by CT can expedite treatment.
Abscess↗
CT vs MRI in diagnosis of recurrent rectosigmoid carcinoma.
OBJECTIVE: Our goal was to compare the relative values of MRI vs. CT in diagnosing recurrent rectosigmoid cancer. MATERIALS AND METHODS: We conducted a retrospective review of 18 patients who had surgical resection of primary rectosigmoid carcinoma and suspected recurrence. They were studied with CT and MR and followed for up to 4 years. RESULTS: At the time of the initial imaging, 10 patients had recurrent tumor and 4 of the remaining 8 patients later demonstrated local recurrence. Magnetic resonance demonstrated 91% sensitivity, 100% specificity, a positive predictive value (PPV) of 100%, and a negative predictive value (NPV) of 89% with a 95% accuracy. Computed tomography demonstrated a sensitivity of 82% and a specificity of 50% with a PPV of 69% and an NPV of 67% with an accuracy of 68%. In three cases interpreted on CT as presacral masses, all were shown on MR to represent displaced but normal pelvic structures. In four cases MR revealed tumor involving the sacrum and sacral nerves not apparent on CT. CONCLUSION: Magnetic resonance showed superior sensitivity, specificity, and accuracy to CT and better definition of the extent of tumor.
Adult↗
Detection of bile duct leaks using MR cholangiography with mangfodipir trisodium (Teslascan).
Mangafodipir trisodium (Teslascan), a hepatobiliary contrast agent, has the potential of providing functional biliary imaging similar to hepatobiliary scintigraphy. To our knowledge. the potential role of this biliary contrast agent in the detection of bile duct leaks has not been reported. In this case report, we report the first case of a bile duct leak diagnosed with enhanced MRI with mangafodipir trisodium in a patient following laparoscopic cholecystectomy. Our case illustrates that functional MR cholangiography images can be successfully acquired by using a post-mangafodipir fat-suppressed GRE technique and that bile duct leaks can be detected.
Aged↗
Canine abdominal MRI at 8 Tesla: initial experience with conventional gradient-recalled echo and rapid acquisition with relaxation enhancement (RARE) techniques.
PURPOSE: In this manuscript, we present our initial experience with MRI of the abdomen at 8 T of canine subjects both alive and dead. Our hypothesis is that abdominal imaging at 8 T should be possible and should demonstrate unique information. To our knowledge, this is the first description of imaging characteristics of the abdomen at such field strengths using a human MR scanner. METHOD: An 8 T, 80 cm magnet housed in our department since 1998 was used for our study. GRE and rapid acquisition by relaxation enhancement (RARE) pulse sequences were selected to give reasonable slice profiles with relatively low power. Three dogs were imaged alive and after being killed. RESULTS: Our initial results show excellent signal-to-noise ratio and good RF penetration. Structures in the center of the abdomen were well visualized. Homogeneous signal was noted throughout each image without dielectric resonance artifact. Magnetic susceptibility artifacts were most severe on the GRE sequences. On the GRE sequences, the images appeared relatively T2 weighted. Signal voids were seen due to gas in the lung and bowel and susceptibility artifact at subcutaneous fat-muscle boundaries. The liver and spleen showed similar signal intensity, hypointense to subcutaneous muscle at low TE values. There was little internal anatomy of the liver or spleen visible except for the vessels. The kidney, in contrast, demonstrated very good internal structure with visualization of the cortex and medulla. Linear signal voids were depicted in the expected location of normal renal vascular anatomy on the GRE sequences. On the RARE sequences, the images also appeared T2 weighted. Magnetic susceptibility artifacts at subcutaneous fat-muscle boundaries were absent. Signal voids were noted in vessels with blood flow and gas. The liver and spleen were of similar signal intensity and slightly hypointense to muscle. The kidney and pancreas were of higher signal intensity than liver and subcutaneous muscle. The gallbladder wall demonstrated a striated pattern of two layers, with an inner hypointense and an outer hyperintense layer on the RARE sequence. The gastric wall demonstrated a striated pattern of five layers on the RARE sequence. CONCLUSION: Images of the dog abdomen with the world's first ultra high field 8 T magnet show robust image quality and excellent spatial resolution. Image contrast is greatest on the RARE sequence, and susceptibility artifact is strongest on the GRE sequence.
Abdomen↗