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PubMed1969

The use of ultrasound in the diagnosis of cystic lesions of the liver and upper abdomen and in the detection of ascites.

The use of ultrasonic A- and B-scans has been evaluated in the diagnosis of fluid-filled lesions in the liver and abdomen, and in the detection of intraperitoneal fluid. Six patients with polycystic livers or suspected polycystic livers, three with solitary cysts, four with liver abscesses, and three with miscellaneous intraabdominal cystic lesions were scanned. The lesions could be clearly distinguished from solid masses by either technique. The presence of as little as 300 to 800 ml of intraperitoneal fluid could be detected by either the A- or B-scan.

Adult↗
PubMed1975

Computed tomography of the thorax and abdomen; a preliminary report.

The utility of computed tomography (CT) in the study of the anatomy, physiology, and pathology of the human body has been the subject of considerable interest since the introduction of CT scanning. The advent of a new prototype scanning device has made it possible to examine a variety of abnormalities in the abdomen and thorax in a manner not previously possible. This development permits a remarkable insight into the study of human disease in vivo.

Aortography↗
PubMed1976

Recognition of vertebral abnormalities in computed tomography of the chest and abdomen.

Computed tomography of the chest or abdomen may reveal vertebral abnormalities. Images in multiple projections of dry and fresh specimens of the spine demonstrate that osteophytes, end-plate irregularities, and marked obliquity fail to mimic true osteoblastic vertebral lesions. Disk calcification may simulate a metastatic deposit if the section includes both disk and vertebral body. Abdominal or chest "window" settings produce an apparent increase in bone density. Analysis of the bony spine from abdominal and chest images requires gray scale settings different from those used for the study of visceral organs.

Cervical Vertebrae↗
PubMed1990

CT of malignant melanoma in the chest, abdomen, and musculoskeletal system.

Malignant melanoma is an aggressive neoplasm that can involve virtually every organ system. This article provides a review of the various appearances on computed tomographic (CT) scans of melanoma involving the chest, abdomen, and musculoskeletal system. Specific emphasis is placed on the typical and atypical CT manifestations of disease as well as the similarity of these findings to those for other disease entities. The importance of accurate staging of melanoma is stressed.

Abdominal Neoplasms↗
PubMedDate not supplied

Emphysematous infections of the abdomen and pelvis: a pictorial review.

Emphysematous (gas-forming) infections of the abdomen and pelvis represent potentially life-threatening conditions that require aggressive medical and often surgical management. The initial clinical manifestation of these entities may be insidious, but rapid progression to sepsis will occur in the absence of early therapeutic intervention. Conventional radiography and ultrasonography are often the initial imaging modalities used to evaluate patients with abdominopelvic complaints. However, when a differential diagnosis remains, or if further localization or confirmation of tentative findings is needed, computed tomography (CT) should be considered the imaging modality of choice. CT is both highly sensitive and specific in the detection of abnormal gas and well suited to reliable depiction of the anatomic location and extent of the gas. Of equal importance may be the capability of CT to help reliably identify benign sources of gas, because treatment (if any) varies dramatically depending on the source. Knowledge of the pathophysiologic characteristics, common predisposing conditions, and typical imaging features associated with gas-forming infections of the gallbladder, stomach, pancreas, and genitourinary system will help make early diagnosis and successful treatment possible. In addition, such knowledge will aid in further diagnostic work-up, surveillance of potential complications, and evaluation of therapeutic response.

Aged↗
PubMed1986

Direct coronal and direct sagittal CT of abdomen and pelvis: an approach to staging malignancies.

Direct coronal and sagittal CT images are of high quality and are applicable to a majority of patients in daily practice. Because of the fact that transverse scans alone can be misleading, direct CT images in two or more different planes greatly enhance one's capability to stage neoplasms that are complex and extensive. The integrity of the margins of an organ, in the presence of tumor, is best determined by coronal or sagittal scanning. Lesions of the adrenal and kidney and retroperitoneal processes with possible extension into liver or other adjacent organs can be evaluated best using the combination of transverse and coronal or sagittal scans of the upper abdomen. Depending on the origin of pelvic lesions, the radiologist must consider in every individual case the performance of either direct coronal or sagittal sections or both. This judgment is based on the findings on the transverse scans, understanding of anatomic relationships of the pelvic viscera and knowledge of staging systems and their implications with respect to therapeutic decisions. In such a tailored approach, multiplanar CT facilitates improved presurgical evaluation. In some cases, the true extent of the lesion can only be seen in the coronal or sagittal planes. A potential new role for direct multiplanar CT is that it may be used as a sort of "gold standard" for the analysis of multiplanar ultrasound and MRI studies.

Abdominal Neoplasms↗
PubMed2003

Low-dose CT of the abdomen: evaluation of image improvement with use of noise reduction filters pilot study.

A prospective assessment of improvement in image quality at low-radiation-dose computed tomography (CT) of the abdomen by using noise reduction filters was performed. CT images acquired at standard and 50% reduced tube current were processed with six noise reduction filters and evaluated by three radiologists for image noise, sharpness, contrast, and overall image quality in terms of abdominal organ depiction. Quantitative image noise and contrast-to-noise ratio were measured. Baseline low-dose CT images were significantly worse than standard-dose CT images (P <.05). A statistically significant reduction of noise in low-dose images processed with three filters was noted. In conclusion, use of noise reduction filters decreased image noise at low-dose CT.

Aged↗
PubMed2004

Gunshot wounds of abdomen: evaluation of stable patients with triple-contrast helical CT.

PURPOSE: To assess helical computed tomography (CT) with contrast material administered intravenously, orally, and rectally (triple contrast helical CT)) in the prospective evaluation of stable patients with abdominal gunshot wounds in whom there is no clinical indication for immediate exploratory laparotomy. MATERIALS AND METHODS: The study was conducted for 19 months. All patients met the following inclusion criteria: age of 16 years or older, hemodynamic stability, no clinical signs of peritoneal irritation, and signed consent to participate. Patients with obvious indications for laparotomy, such as gastrointestinal bleeding or evisceration, were excluded from the study. Forty-seven patients fulfilled the criteria and underwent abdominal triple-contrast helical CT. CT findings were evaluated by one of four radiologists for evidence of peritoneal penetration and injury to solid organs or hollow viscera. Patients were followed up clinically for 13 weeks. CT findings were compared with those at surgery and/or clinical follow-up. RESULTS: CT demonstrated abnormalities in 27 (57%) patients. Laparotomy was performed in 11 (23%) patients; 10 procedures were therapeutic and one was nontherapeutic. The remaining 20 patients had a negative CT scan. These patients were treated conservatively. One injury was missed at CT. For prediction of the need for laparotomy, sensitivity of CT was 96%; specificity, 95%; positive predictive value, 96%; negative predictive value, 95%; and accuracy, 96%. CONCLUSION: In stable patients with gunshot wounds to the abdomen in whom there is no indication for immediate surgery, triple-contrast helical CT can help reduce the number of cases of unnecessary or nontherapeutic laparotomy (negative laparotomy) and can help identify patients with injuries that may be safely treated without surgery.

Abdominal Injuries↗
PubMed2005

Telomerase activity predicts malignancy in percutaneous image-guided needle biopsy specimens of the abdomen and pelvis.

PURPOSE: To determine prospectively if assessment of telomerase activity in percutaneous needle biopsy specimens improves sensitivity and specificity in the diagnosis of abdominal and pelvic malignancy. MATERIALS AND METHODS: The study was approved by the institutional review board, and written informed consent was obtained from all patients. A prospective double-blinded design was used to assess telomerase activity in abdominal and pelvic biopsy specimens from 99 patients (64 men, 35 women; age range, 22-87 years). After the clinical sample was retrieved, a study specimen from an extra needle pass was divided and independently analyzed for cytologic characteristics and telomerase activity. The final diagnosis was based on chart review at a minimum 1-year follow-up. Statistical analyses included sensitivity, specificity, and accuracy of cytologic examination and/or telomerase activity in predicting malignancy. RESULTS: Data from study specimens indicated that the sensitivity, specificity, and accuracy of telomerase activity (n=99) in predicting malignancy were 55%, 79%, and 60%, respectively. For cytologic examination (n=86), the sensitivity, specificity, and accuracy in predicting malignancy were 74%, 94%, and 78%, respectively. Combining the two tests (n=86) and classifying a positive reading with either test as malignant improved sensitivity (83%) (P <.05) without altering specificity (76%). In 20 patients who had clinical sample reports that were classified as indeterminate, telomerase activity (n=20) yielded a higher sensitivity (62%) (P <.05) and similar specificity (86%) compared with cytologic examination (n=15), which yielded a sensitivity of 11% and a specificity of 83%. CONCLUSION: In percutaneous biopsy specimens of the abdomen and pelvis, the combination of cytologic examination and telomerase activity yielded an increased sensitivity in predicting malignancy. In addition, assessing telomerase activity can help identify cancer even when cytologic results are indeterminate.

Abdominal Neoplasms↗
PubMed1984

Sonographic examination of the mediastinum and upper abdomen by fiberoptic gastroscope.

A prototype fiberoptic gastroscope with a 9 MHz transducer 7 cm from its tip was used to evaluate intrinsic and extrinsic abnormalities of the upper abdomen and mediastinum. Small hepatic and pancreatic tumors were identified, often with more clarity than when other imaging modalities were used. The instrument clearly defined intrinsic bowel wall lesions including focal and diffuse disease. Bowel wall thickness was identified, and exact wall dimensions were measured. In addition, unsuspected pericardial, mitral, and aortic valvular disease was detected. These preliminary results suggest a new complementary imaging modality.

Adult↗
PubMed1988

Upper abdomen: CT findings following partial hepatectomy.

The appearance on computed tomographic (CT) scans of the upper abdomen after partial hepatectomy is complex. The findings expected at CT should not be confused with those of surgical complications, such as abscess, biloma, or hematoma. The findings on CT scans and the records of 17 patients who had undergone partial hepatectomy for malignancy were reviewed. Operations included wedge resection, left medial and lateral segmentectomies, left lobectomy, right subsegmentectomy, right lobectomy, and extended right lobectomy (trisegmentectomy). When partial hepatectomy had been performed with no complications, findings at CT included a small region of low attenuation at the surgical margin, probably due to transient accumulation of blood and bile; a right pleural effusion; extraluminal gas; shift of abdominal organs; hepatic regeneration; and fat attenuation at the resection margin representing the omental patch placed at surgery. Findings associated with surgical complications--such as abscess, biloma, and hematoma--included large or high-attenuation perihepatic and subphrenic fluid collections that did not conform to the resection margin.

Adolescent↗
PubMed1991

Oral magnetic particles in MR imaging of the abdomen and pelvis.

Two phase 2 clinical trials of an oral superparamagnetic contrast agent for enhancement on magnetic resonance images of the intestine were performed. In trial 1, 31 male patients with cancer of the testis underwent follow-up examinations of the abdomen at 0.5 and 1.5 T after oral administration of magnetic particles. In trial 2, 31 female patients with pelvic and lower abdominal disease were examined at 1.5 T after administration of the contrast material. The patients each ingested 800 mL of contrast material over approximately 2 hours. Concentrations of 0.25 and 0.5 g/L did not induce blurring or metallic artifacts. Distribution was homogeneous through the gastrointestinal tract. In all patients, a loss of signal intensity was observed on proton density-, T1-, and T2-weighted images. The diagnostic information from postcontrast images in trial 2 was greater in 16 patients (52%). Contrast enhancement was independent of field strength; no major side effects were observed. Artifacts from moving bowels were less troublesome, and delineation of intraabdominal and pelvic organs was better with the use of oral magnetic particles.

Abdominal Neoplasms↗
PubMed1991

Importance of daily rounds by the radiologist after interventional procedures of the abdomen and chest.

A prospective study was performed to evaluate the clinical utility of daily rounds by the radiologist for patients with indwelling catheters in the chest and abdomen, placed during interventional radiologic procedures. The 7-week evaluation included documentation of the number of patients seen, time spent with each per day, number of problems identified, management of these problems, and consultations for new cases generated by interaction with other staff. During the 268 visits to 37 patients, 59 catheter-related problems were identified; 17 (29%) required further intervention in the radiology department, and 42 (71%) were managed at the patient's bedside. Of the patients who were followed up, 22 (59%) had some catheter-related problem identified during their hospital stay. Daily rounds by the radiologist are an essential component of patient care after catheter-related interventional procedures and should be made by those who perform and understand the procedures.

Catheterization↗
PubMed1996

Upper gastrointestinal tract and abdomen: water as an orally administered contrast agent for helical CT.

PURPOSE: To evaluate the use of orally administered water as a negative contrast agent and intravenously administered glucagon in helical computed tomography (CT) of the upper abdomen. MATERIALS AND METHODS: Ninety-eight adult patients underwent 102 helical CT examinations. Patients received 700 mL of water orally 30 minutes before and another 350 mL of water orally with 1 mg of glucagon intravenously just before CT. The amount of water actually ingested was recorded. Luminal distention at five sites was graded on a three-point scale; depiction of six normal anatomic structures was evaluated. RESULTS: Luminal distention improved with the amount of water ingested in four of the five sites (P < .03 in three sites). Depiction of all six normal anatomic structures improved with increasing luminal distention (P < .001). The normal duodenal papilla was seen in 42% (83 of 198) of the examinations. Of 87 patients who had previously undergone CT with positive oral contrast agents, 89% (n = 77) preferred the water, 11% (n = 10) had no preference, and none preferred the positive agent (P < .001). Upper gastrointestinal tract abnormalities were easily recognized and depicted. CONCLUSION: Water is an efficacious negative contrast agent for evaluation of the upper gastrointestinal tract during helical CT.

Administration, Oral↗
PubMed1999

Desmoplastic small round cell tumor of the abdomen: radiologic-histopathologic correlation.

PURPOSE: To characterize the imaging features of desmoplastic small round cell tumor of the abdomen and correlate them with the histopathologic findings. MATERIALS AND METHODS: Eleven of 14 patients with desmoplastic small round cell tumor had primary abdominal involvement. In nine of these patients (mean age, 20 years), results of imaging studies (computed tomography in nine patients, ultrasonography [US] in three) and histopathologic specimens were retrospectively analyzed. RESULTS: The hallmark imaging feature was lobulated peritoneal masses (mean number, 4.4; range, 1-17) with a mean diameter of 5.0 cm (range, 2-12 cm). Omental and paravesical tumors were each present in six patients. Retroperitoneal masses were present in three patients. The tumors were well defined and hypoechoic at US. Heterogeneity due to tumor hemorrhage or necrosis was seen in seven patients. Ascites was present in five patients. Parenchymal and/or serosal hepatic metastases, punctate calcifications, nodular peritoneal thickening, lymphadenopathy, hydronephrosis, and bowel obstruction were less common associated findings. CONCLUSION: Bulky peritoneal soft-tissue masses without an apparent organ-based primary site are characteristic of intraabdominal desmoplastic small round cell tumor. Although the findings are nonspecific, this diagnosis can be considered in adolescents and young adults with characteristic imaging findings.

Abdominal Neoplasms↗
PubMedDate not supplied

Neurogenic tumors in the abdomen: tumor types and imaging characteristics.

There is a broad spectrum of neurogenic tumors that involve the abdomen. These tumors can be classified as those of (a) ganglion cell origin (ganglioneuromas, ganglioneuroblastomas, neuroblastomas), (b) paraganglionic system origin (pheochromocytomas, paragangliomas), and (c) nerve sheath origin (neurilemmomas, neurofibromas, neurofibromatosis, malignant nerve sheath tumors). Abdominal neurogenic tumors are most commonly located in the retroperitoneum, especially in the paraspinal areas and adrenal glands. All of these tumors except neuroblastomas and ganglioneuroblastomas are seen in adult patients. Abdominal neurogenic tumor commonly manifests radiologically as a well-defined, smooth or lobulated mass. Calcification may be seen in all types of neurogenic tumors. The diagnosis of abdominal neurogenic tumor is suggested by the imaging appearance of the lesion, including its location, shape, and internal architecture. Benign and malignant neurogenic tumors are difficult to differentiate unless distant metastatic foci are seen. For malignant tumors, imaging modalities other than computed tomography (CT) and magnetic resonance (MR) imaging may be necessary for staging. However, because most neurogenic tumors in adults are benign, CT and MR imaging can be used to develop a differential diagnosis and help determine the immediate local extent of tumor.

Abdominal Neoplasms↗
PubMedDate not supplied

Medical devices of the abdomen and pelvis.

Medical devices in the abdomen and pelvis are probably less frequently seen than those in the chest or extremities, but they are important and should be recognized. These devices can be grouped into a few major categories: intestinal tubes, genitourinary devices, postoperative apparatus, and a wide variety of odds and ends. Many of these devices are used to monitor or treat gastrointestinal and genitourinary disease. Some of them, such as inferior vena cava filters and drug infusion pumps, treat systemic problems, and some of them are devices used in treating another anatomic region. It is strongly recommended that scout views for chest, abdominal, and pelvic computed tomographic studies be carefully examined for medical apparatus. Medical devices are often more easily recognized on scout images, and their inappropriate locations and complications can be better appreciated on the subsequent cross-sectional images if one is alerted to their presence in the first place. The evaluation of routine medical devices should be considered as important as any other aspect of a radiologic examination.

Equipment and Supplies↗
PubMed1979

Contribution of rib cage and abdomen-diaphragm to tidal volume during CO2 rebreathing.

In man, there is wide interindividual range in the tidal volume response to CO2. To determine which (rib cage or abdomen-diaphragm) compartment had a greater influence on this range, ventilatory response to CO2 was measured, using Read's method, in eight men and two women seated in a constant-pressure body plethysmograph. Rib cage and abdominal tidal volume was simultaneously measured using magnetometers. Correcting for body size, the tidal volume response of the abdominal compartment was similar in all subjects, whereas that of the rib cage was larger in subjects with high tidal volume response to CO2; a significant correlation was found (P less than 0.01). Rib cage volume displacement lagged behind abdominal in all subjects; phase lag was greatest in the subject with the lowest ventilatory response to CO2. These results suggest that, at high levels of ventilation, a larger volume displacement of the rib cage may reflect a more effective coupling of the diaphragm pressure generator to it or alternatively a reduction in its impedance relative to the abdominal compartment.

Abdominal Muscles↗