Closed-loop and strangulating intestinal obstruction: CT signs.

In 19 patients with closed-loop intestinal obstruction, including 16 patients with strangulating obstruction, the findings at examination with computed tomography (CT) were retrospectively correlated with the surgical and pathologic findings and evaluated by two radiologists. Signs of closed-loop obstruction, present in 15 patients, were associated with the configuration of the incarcerated loop of small bowel, abnormalities detected at the site of obstruction, or both. These abnormalities were the following: a U-shaped, distended, fluid-filled bowel loop; the whirl sign; the beak sign; a triangular loop; two adjacent collapsed loops of bowel at the site of obstruction; or all of these.

Ileocecal tuberculosis: CT and radiologic evaluation.

The CT and radiologic findings in 11 patients (five with AIDS and six without AIDS) with ileocecal tuberculosis are described. On CT scans, five cases showed mild circumferential wall thickening of the terminal ileum and cecum, thickening of the ileocecal valve, and a few regional nodes. One case presented as nonspecific small-bowel obstruction.

Renal cell carcinoma: earlier discovery and increased detection.

To document the earlier discovery and increased detection of renal cell carcinoma, the authors reviewed cases of renal cell carcinoma detected at their institution during 1974-1977 and 1982-1985, with particular emphasis on renal tumors 3.0 cm or smaller. Only 5.

CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat.

Six patients were reviewed who had renal angiomyolipoma (1.2-4.0 cm) in which only minimal amounts of fat were evident on CT.

Computed tomography of the abnormal appendix.

This report describes the CT features of 29 abnormal appendices visualized during abdominal CT examinations. There were 22 cases of acute appendicitis, five mucoceles, and two mucinous adenocarcinomas of the appendix. The inflammed appendix appeared either as a fluid-filled slightly distended structure or as a collapsed small tubular structure.

Liver and abdominal screening in patients with cancer: CT versus MR imaging.

A prospective multiinstitutional study was performed to compare the ability of dynamic sequential contrast material-enhanced computed tomography (CT), delayed contrast material-enhanced CT, and two T1-weighted magnetic resonance (MR) sequences (spin echo and inversion recovery) to demonstrate metastatic disease in the liver and abdomen in patients with cancer. All four techniques had comparable rates of hepatic lesion detection when compared individually or when the combined CT techniques were compared with the combined MR techniques. The sensitivity to hepatic disease was 96% (27 of 28 patients) for the combined MR techniques versus 93% (26 of 28 patients) for the combined CT techniques.

Computed tomography of midline cysts of the prostate.

Midline cysts in the male pelvis are a confusing entity due to their relatively infrequent presentation and the uncertainty as to their origin and classification. We report on CT appearance of four cases of midline prostatic cysts. Ultrasound correlation was available in one case.

Epithelioid hemangioendothelioma. A rare tumor with variable prognosis presenting as a pleural effusion.

The chest x-ray film a 22-year-old man showed a large right-sided pleural effusion that was grossly hemorrhagic when aspirated. A computerized tomographic scan showed a complex mass with cystic components contiguous with the diaphragm. On thoracotomy the mass was found to be arising from the diaphragm and had the consistency of an organizing hematoma.

Accuracy of CT in detection of persistent or recurrent ovarian carcinoma: correlation with second-look laparotomy.

Computed tomographic (CT) studies in 39 patients with advanced ovarian carcinoma were retrospectively evaluated to assess their accuracy in detection of persistent or recurrent disease as seen at second-look laparotomy (SLL). Twenty patients were studied before June 1983 (group 1), and 19 patients were studied afterward (group 2). There were 16 true-positive, ten true-negative, two false-positive, and 11 false-negative examinations.

Carcinoma of the colon: detection and preoperative staging by CT.

This report analyzes the detection rate and role of CT in the preoperative evaluation of 90 consecutive, proved cases of colon carcinoma. In this study, the overall detection rate was 84%; however, the rate varied from 68% in unprepared colons to 95% in clean colons that were adequately distended with air. Sensitivity of detection depends mainly on the size of the lesion and the quality of the examination.

The use of computed tomography in the diagnosis of carcinoma of the renal pelvis causing ureteropelvic junction obstruction.

The computed tomographic (CT) appearance of 5 cases of primary malignancy of the renal pelvis causing ureteropelvic junction (UPJ) obstruction is presented. The tumors appeared as enhancing thickened, nodular, and crescentic masses at the UPJ. Comparison is made to the thin, regular wall of the hydronephrotic pelvis caused by congenital UPJ obstruction.

Retroperitoneal fibrosis presenting as colonic dysfunction: CT diagnosis.

In a patient who presented with pelvic pain and changed bowel habits, barium enema and sigmoidoscopic examinations demonstrated a nonspecific asymmetric narrowing of the colon at the rectosigmoid junction with normal mucosal appearance. Computed tomography revealed the etiology to be retroperitoneal fibrosis with pelvic extension and entrapment of the colon at this level. The importance of CT in diagnosis of this unusual manifestation of retroperitoneal fibrosis is discussed.

Right adrenal pseudotumor caused by colon: CT demonstration.

Multiple adrenal pseudotumors have been previously described on CT and routine radiography. In the following case report we demonstrate interposition of normal colon between the liver, kidney, and adrenal in the hepatorenal recess that produced the CT appearance of a pseudotumor of the right adrenal gland.

Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients.

Cytomegalovirus is one of the more common opportunistic organisms implicated in the development of esophagitis in patients with AIDS. A review of the radiographic features of 16 proved cases of cytomegalovirus esophagitis showed a spectrum of abnormalities related to the severity of the inflammatory process. Seven patients had a mild form of esophagitis with segmental involvement characterized by granular mucosa, superficial erosions, and poorly defined, shallow ulcerations.

Perforated colorectal neoplasms: correlation of clinical, contrast enema, and CT examinations.

Results of clinical, contrast enema (CE), and computed tomographic (CT) examinations in 39 patients with perforated colorectal neoplasms were retrospectively reviewed. Twenty patients were toxemic at initial presentation, but in only four patients was the diagnosis of perforated colorectal neoplasm initially suspected clinically. CE study was performed in 22 patients and enabled the diagnosis of perforated neoplasm in 11 cases, neoplasm alone in eight, and neither neoplasm nor perforation in three.

Postpartum renal vein thrombosis with left retroaortic renal vein.

An unusual case of thrombosis in a left retroaortic renal vein is presented. Noninvasive radiologic diagnosis is reviewed.

Cecal diverticulitis: evaluation with CT.

The findings of computed tomographic (CT) examinations in seven patients with cecal diverticulitis are described and correlated with those of barium studies. The CT findings were linear and streaky densities in the pericecal fat compatible with pericecal inflammation (seven cases), intramural abscess (one case), thickening of the cecal wall (two cases), and cecal diverticulum (one case). Barium studies, available in four patients, led to a correct diagnoses of diverticulitis in two cases.

Gastric duplication cyst: GI series and CT correlation.

The radiographic and computed tomographic findings of a communicating gastric duplication first diagnosed in a 55-year-old man are presented and the pertinent literature is reviewed.

Computed tomography of intramural intestinal hemorrhage and bowel ischemia.

The CT findings of eight patients with intramural intestinal hemorrhage are described and illustrated. Two patients had ischemic bowel disease: in the other six cases pertinent clinical histories led to an accurate diagnosis. Computed tomography demonstrated similar findings consisting of circumferential and symmetrical wall thickening homogeneous in density, a slightly narrowed intestinal lumen, and sharp outer contour.

CT of appendicitis.

The CT findings of 38 consecutive patients with acute appendicitis are analyzed, described, and illustrated. CT showed intraabdominal disease in 92% of patients and made a specific diagnosis of appendicitis in 79% of cases. The most common CT findings were pericecal inflammation (68%), abscess (55%), calcified appendicolith (23%), and an abnormal appendix (18%).

"Faceless kidney": CT sign of renal duplicity.

A CT sign of renal duplicity is described. In kidneys with either bifid renal pelvis or complete duplication of the collecting system, a transverse CT section obtained at the mid pole or junction of the fused upper and lower pole cortical moieties may reveal a "faceless" renal appearance lacking vascular or collecting system elements. Recognition of this finding allows a correct diagnosis of partial or complete duplication of the renal collecting system and prevents a false impression of an intrarenal mass lesion.

CT demonstration of rapid improvement of retroperitoneal fibrosis in response to steroid therapy.

A case of retroperitoneal fibrosis with hydronephrosis was treated with cortisone therapy. Computed tomographic images recorded marked and rapid reduction in the size of the soft tissue fibrotic mass and resolution of the hydronephrosis.

Abdominal tuberculosis: CT evaluation.

The computed tomography (CT) scans of 27 patients with abdominal tuberculosis were reviewed retrospectively to determine the range of abdominal involvement. Most patients had been at increased risk because of intravenous drug abuse, alcoholism, acquired immunodeficiency syndrome (AIDS), cirrhosis, or steroid therapy. The etiologic agent was Mycobacterium tuberculosis in 23 patients and M.