When the Appendix Is Not Seen on Ultrasound for Right Lower Quadrant Pain: Does the Interpretation of Emergency Department Physicians Correlate With Diagnostic Performance?

A survey was administered to 166 academic emergency department (ED) physicians to determine their interpretation and practice after receiving an ultrasound (US) report with nonvisualization of the appendix (NVA). Annual incidence of reported NVA from 2 academic hospitals was calculated for 2002-2013. A retrospective review of the same hospitals revealed that 291 (17.

Primary cystic peritoneal masses and mimickers: spectrum of diseases with pathologic correlation.

Cystic lesions within the peritoneum have been classified classically according to their lining on histology into four categories-endothelial, epithelial, mesothelial, and others (germ cell tumors, sex cord gonadal stromal tumors, cystic mesenchymal tumors, fibrous wall tumors, and infectious cystic peritoneal lesions). In this article, we will proceed to classify cystic peritoneal lesions focusing on the degree of radiological complexity into three categories-simple cystic, mildly complex, and cystic with solid component lesions. Many intra-abdominal collections within the peritoneal cavity such as abscess, seroma, biloma, urinoma, or lymphocele may mimic primary peritoneal cystic masses and need to be differentiated.

Small renal oncocytomas: is segmental enhancement inversion a characteristic finding at biphasic MDCT?

Objective: The purpose of this study was to retrospectively determine whether segmental enhancement inversion was a common and characteristic finding in small (≤ 4 cm) renal oncocytomas on biphasic contrast-enhanced CT.

Materials And Methods: This retrospective case-control study included 16 patients with 16 renal oncocytomas and 15 control patients with 15 renal cell carcinomas (RCCs), matched for age and sex, who underwent biphasic contrast-enhanced MDCT at our institution. Three reviewers independently analyzed each tumor for enhancement patterns on MDCT, including the presence or absence of segmental enhancement inversion, homogeneity, and phase of peak enhancement.

Osteogenesis imperfecta, multiple intra-abdominal arterial dissections and a ruptured dissecting-type intracranial aneurysm.

We describe an adult patient with a ruptured dissecting-type superior cerebellar artery aneurysm and known osteogenesis imperfecta. He was successfully treated with coil embolization and intentional parent vessel sacrifice. During his hospital admission, he also suffered from abdominal distension.

Assessing the impact of an emotion regulation booster program for elementary school-aged children.

The purpose of this study was to determine whether children who participated in a booster program 3 years after completing an emotion regulation program show a greater increase between pretest and post-test in the development of emotion regulation skills than children in a comparison group. A booster program was implemented as a pilot project with seven children ages 12-14. The contrast group consisted of eight children ages 10-14.

Ultrasound assessment of gastric content and volume.

Background: Aspiration of gastric contents can be a serious perioperative complication, attributing up to 9% of all anesthesia-related deaths. However, there is currently no practical, noninvasive bedside test to determine gastric content and volume in the perioperative period.

Methods: The current study evaluates the feasibility of using bedside ultrasonography for assessing gastric content and volume.

Renal cortical lesions in patients with autoimmune pancreatitis: a clue to differentiation from pancreatic malignancy.

Aim: To describe the occurrence of renal cortical lesions (RCLs) in patients with autoimmune pancreatitis (AIP).

Methods: This retrospective study was approved by our research ethics board; informed consent was waived. Systematic search of CT scan reports in 5-year interval yielded 17 patients with AIP (male:female; 11:6, age 18-80 years).

Imaging of hepatic infections.

Imaging plays a significant role in the detection, characterization and treatment of hepatic infections. Infectious diseases of the liver include pyogenic and amoebic abscesses and parasitic, fungal, viral and granulomatous infections. With increases in worldwide travel, immunosuppression and changing population demographics, identification of cases of hepatic infection is becoming more common in daily practice.

Triple-phase MDCT of hepatocellular carcinoma.

Objective: The purpose of this study was to describe the appearances of hepatocellular carcinoma including intralesional contrast washout using a triple-phase liver protocol on an MDCT scanner.

Materials And Methods: Fifty-one patients with newly diagnosed hepatocellular carcinoma underwent standardized triple-phase CT using a multidetector scanner. Pathologic proof was obtained in 35 patients (69%); in 16 patients (31%), hepatocellular carcinoma was diagnosed on clinical and laboratory findings.

Hepatic subcapsular steatosis in response to intraperitoneal insulin delivery: CT findings and prevalence.

Objective: The aim of this study was to investigate the CT findings and prevalence of hepatic subcapsular steatosis in patients undergoing peritoneal dialysis with intraperitoneal insulin delivery.

Conclusion: Hepatic subcapsular steatosis appeared as subcapsular nodules and often rindlike areas of low attenuation in seven (18%) of 39 patients who received intraperitoneal insulin with their peritoneal dialysate. Cessation of intraperitoneal insulin therapy led to reversal of the steatosis in three patients.

US of the peritoneum.

Familiarity with the pathophysiology of peritoneal disease is the basis of successful ultrasound (US) study of the peritoneum. The pouch of Douglas, diaphragmatic surfaces, the paracolic gutters, and the regions of the mesentery and omentum should receive careful scrutiny in the patient at risk for a peritoneal disease process. An optimal US technique requires assessment of the entire peritoneum with a transducer selected to reflect the depth of the region of interest.

Dropped gallstones post laparoscopic cholecystectomy mimicking peritoneal seeding: CT and ultrasound features.

Purpose: The purpose of this work was to investigate the ultrasound (US) and CT features of dropped gallstones mimicking peritoneal seeding in patients after laparoscopic cholecystectomy (LCC).

Method: We describe the US and CT features of dropped gallstones mimicking peritoneal seeding in eight patients who underwent LCC. We also conducted a retrospective study of consecutive LCC patients who subsequently had CT to determine the prevalence of this condition.

Multi-detector row helical CT in preoperative assessment of small (< or = 1.5 cm) liver metastases: is thinner collimation better?

Purpose: To determine the value of collimations less than 5 mm in detecting hepatic metastases 1.5 cm or smaller by using multi-detector row helical computed tomography (CT).

Materials And Methods: Thirty-one patients underwent contrast material-enhanced multi-detector row helical CT before hepatic resection in this prospective study.

Radiological features of epiploic appendagitis and segmental omental infarction.

Epiploic appendagitis and segmental omental infarction are more frequently encountered with the increased use of abdominal ultrasound and Computed tomography (CT) in the radiological assessment of the patient who presents clinically with acute abdominal pain. Recognition of specific imaging abnormalities enables the radiologist to make the correct diagnosis. This is important, as the appropriate management of both conditions is often conservative.

Cancer of the pancreas: the best image for early detection--CT, MRI, PET or US?

Pancreatic cancer has a poor prognosis, and the best chance for survival is to diagnose the tumour at an early stage. Abdominal ultrasound, computed tomography, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography are the most commonly used radiological techniques for imaging the pancreas. The diagnostic evaluation should be tailored to the individual patient.

Radiology reports: examining radiologist and clinician preferences regarding style and content.

Objective: The introduction of picture archiving and communication systems (PACS) frequently includes the option of computer-generated itemized reports. This motivated us to reassess the merits of traditional prose dictated reports. This study examines radiologist and clinician preferences regarding report style and content.

Lymphoproliferative disorders after liver transplantation: imaging features.

Background: To define the imaging features of lymphoproliferative disorders that occur after liver transplantation.

Methods: A retrospective review of 605 liver transplantations between 1985 and 1998 showed 20 patients with posttransplantation lymphoproliferative disorders (PTLDs). All relevant clinical, imaging, and pathologic findings were reviewed.

Introduction of an ultrasound picture archiving and communication system: experience in the first year.

Objective: To describe the authors' first year's experience with a picture archiving and communication system (PACS) for the management and storage of ultrasound images and to discuss the financial impact of the system in terms of costs of purchase, installation and operation.

Materials And Methods: The Toronto Hospital, General Division, performs more than 30000 ultrasound studies each year. On June 27, 1994, an Ultra PACS (ALI Technology Incorporated, Richmond, BC) was introduced as the only method of image storage and archiving in the Ultrasound Division.

Case for active physician involvement in US practice.

Purpose: To assess the benefit of active physician involvement in ultrasound (US) examinations.

Materials And Methods: Concordance of findings by technologists and physicians was assessed prospectively for examinations of 1,510 consecutive patients who underwent US during regular working hours.

Results: Overall concordance was generally good (74%).