Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer.

Purposes: 1. To determine the optimal pelvic nodal clinical target volume for post-operative treatment of endometrial cancer. 2.

Small-bowel obstruction associated with sigmoid diverticulitis: CT evaluation in 16 patients.

Objective: The purpose of this study was to identify acute sigmoid diverticulitis as a cause of small-bowel obstruction and to describe the CT findings.

Conclusion: CT scanning enabled accurate preoperative diagnosis of colonic diverticulitis as the cause of the small-bowel obstruction, thereby allowing proper management and surgical planning.

Prospective evaluation of colonic obstruction with computed tomography.

Background: To determine whether computed tomography (CT) can satisfactorily diagnose and evaluate patients with suspected colonic obstruction.

Methods: Seventy-five patients with suspected colonic obstruction were evaluated prospectively by CT and compared with the gold standards of surgery and/or endoscopy in 65 patients, clinical course in nine, and contrast enema (CE) in one. A limited comparison between CT and CE (26) patients was also made in those patients who had both studies.

Abdominal CT findings when the superior vena cava, brachiocephalic vein, or subclavian vein is obstructed.

Objective: We evaluated findings on contrast-enhanced abdominal CT scans that suggest obstruction of the superior vena cava, brachiocephalic vein, or subclavian vein.

Subjects And Methods: We conducted a retrospective review of 22 patients with superior vena caval, brachiocephalic vein, or subclavian vein obstruction and analyzed the upper abdominal images on a chest CT scan or an abdominal CT scan. We assessed collateral vessels in the upper abdomen to answer the following question: Did enhancement approach undiluted IV contrast or were there other findings? In the second part of our study, we conducted a prospective review of abdominal CT scans of 200 patients without known mediastinal disease or known upper extremity venous occlusion to determine the frequency of abnormal enhancement of these vessels in a healthy population.

Case report. Small bowel obstruction due to phytobezoar formation within Meckel diverticulum: CT findings.

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.

MR urography: technique and application.

Purpose: To evaluate a magnetic resonance (MR) technique for depicting the kidneys and urinary tract.

Materials And Methods: Fourteen patients with urinary tract obstruction and 20 without obstructions were examined with a modified, heavily T2-weighted fast spin-echo pulse sequence (MR urography). In addition, six healthy volunteers underwent modified MR urography with intravenous administration of furosemide and ureteral compression prior to imaging.

Cytologic analysis in fine-needle aspiration biopsy: smears vs cell blocks.

Objective: Imaging-directed fine-needle aspiration biopsy can be performed with or without immediate cytologic assessment (smears). We compared the results obtained immediately from cytologic smears with the results of cell-block analysis. We wished to determine the frequency of false-negative findings on cytologic smears in patients subsequently found to have malignant tumors by cell-block analysis.

Main renal vein invasion by a transitional cell carcinoma of the renal pelvis: documentation with CT.

Invasion of the main renal vein by transitional cell cancer of the renal pelvis is an infrequently reported event. No accurate clinical frequency of this phenomenon is available. Extensive invasion of the renal parenchyma by the tumor usually is present by the time it presents in the renal vein.

Surgical transposition of the ovary: radiologic appearance.

Therapeutic irradiation of the pelvis of a young female patient will result in loss of ovarian function. In a surgical technique termed ovarian transposition, the ovary is repositioned to the iliac fossa or paracolic gutter outside the radiation field. The computed tomographic (CT) scans and sonograms of five patients with cervical carcinoma who underwent this procedure were reviewed.

Computed tomography of bronchial artery aneurysm with erosion into the esophagus.

Bronchial artery aneurysms are rare lesions. A case report is presented in which CT demonstrated a 7 cm enhancing mass that proved to be a mediastinal bronchial artery aneurysm. The aneurysm subsequently eroded into the esophagus, resulting in fatal exsanguination.

Tuberculosis of the rectum in a patient with acquired immune deficiency syndrome. Report of a case.

Tuberculosis of the rectum is a rare disease. A patient with a miliary pattern of pulmonary tuberculosis had a rectal lesion which proved to be tuberculosis. The patient subsequently developed several opportunistic infections characteristic of acquired immune deficiency syndrome.

Left ventricular volume: physical basis for attenuation corrections in radionuclide determinations.

Absolute left ventricular volume has been calculated from gated blood pool studies by estimating an attenuation correction for left ventricular counts. We studied the physical basis of these corrections by evaluating x-ray photon attenuation from CT scans of the thorax (10 second scans, no gating). CT numbers were converted to linear attenuation coefficients (LACs) at 140 keV, and LACs from the center of the left ventricle or esophagus to the chest wall (40 degrees left anterior oblique position) were determined in 12 patients of various body habitus.

Localized ischemic colitis in a young woman with diabetes.

ischemic colitis involving a limited segment of the proximal transverse colon in a young diabetic woman was identified and treated. Important clinical, radiographic, and histopathologic findings are detailed.

Computed tomography of renal lymphoma with ultrasound correlation.

The computed tomography (CT) and ultrasound findings in 18 patients (35 kidneys) with non-Hodgkin lymphoma involving the kidneys are presented. Renal involvement was bilateral in 13 patients. The most common presentation was that of multiple intraparenchymal nodules (15 kidneys).

Computed tomography of intrathoracic goiters.

Ten patients with intrathoracic goiters were evaluated by computed tomography (CT). In comparison with chest radiographs, CT showed additional features helpful in suggesting the correct diagnosis. These observations included: (1) clear continuity with the cervical thyroid gland (8/10 cases); (2) well defined borders (9/10); (3) punctate, coarse, or ringlike calcifications (8/10); (4) nonhomogeneity (9/10) often with discrete, nonenhancing, low-density areas (6/10); (5) precontrast attenuation values at least 15 H greater than adjacent muscles (4/10) with more than 25 H after contrast enhancement (8/8); and (6) characteristic patterns of goiter extension into mediastinum.

Polypoid endometrioma of the rectosigmoid.

Endometriosis of the bowel most often involves the sigmoid and rectosigmoid and appears as an intramural mass protruding into the lumen in a polypoid or constricting fashion. Occasionally there is an intraluminal mass without obvious intramural involvement. Endometriosis of bowel is rarely diagnosed at endoscopic biopsy.

Angiography of upper extremity access fistulas for dialysis.

One-hundred twenty-five cases of upper extremity internal arteriovenous and graft fistulas were reviewed. Clinical problems requiring study were poor fistula flow during dialysis, difficulty in cannulation, diminished graft pulsations, extremity edema or varicosities, the appearance of pulsatile or nonpulsatile masses in the graft or fistula, and distal ischemia. Angiography demonstrated venous occlusion (13 cases), venous stenosis at or near the anastomotic site (32 cases), thrombi within shunts (9 cases), venous aneurysms or pseudoaneurysms related to either proximal obstruction or traumatic dialysis (23 cases), distal venous overdistention due to proximal obstruction or overcirculation (15 cases), and radial artery steal of blood from the distal extremity (15 cases).