Bowel Obstruction.

Small bowel obstruction and large bowel obstruction account for approximately 20% of cases of acute abdominal surgical conditions. The role of the radiologist is to answer several key questions: Is obstruction present? What is the level of the obstruction? What is the cause of the obstruction? What is the severity of the obstruction? Is the obstruction simple or closed loop? Is strangulation, ischemia, or perforation present? In this presentation, the radiologic approach to and imaging findings of patients with known or suspected bowel obstruction are presented.

That liver lesion on MDCT in the oncology patient: is it important?

Multidetector-row computed tomography (MDCT) has become the primary imaging test for the staging and follow-up of most malignancies that originate outside of the central nervous system. Technical advances in this imaging technique have led to significant improvement in the detection of metastatic disease to the liver. An unintended by-product of this improving diagnostic acumen is the discovery of incidental hepatic lesions in oncology patients that in the past remained undetected.

The incidental cystic pancreas mass: a practical approach.

Technical advances in cross-sectional imaging have led to the discovery of incidental cystic pancreatic lesions in the oncology and non-oncology population that in the past remained undetected. These lesions have created a diagnostic and management dilemma for both clinicians and radiologists: should these lesions be ignored, watched, aspirated, or removed? In this review, recommendations concerning the assessment of the more common pancreatic cystic incidental lesions are presented.

Hepatic incidentalomas.

Recent advances in multidetector-row computed tomography, magnetic resonance imaging, and ultrasonography have led to the detection of incidental hepatic lesions in both the oncology and nononcology patient population that in the past remained undiscovered. These incidental hepatic lesions have created a management dilemma for both clinicians and radiologists. In this review, guidelines concerning the diagnosis and management of some of the more common hepatic incidentalomas are presented.

Pelvic incidentalomas.

Recent advances in multi-detector computed tomography, magnetic resonance imaging, and ultrasound have led to the detection of incidental ovarian, uterine, vascular and pelvic nodal abnormalities in both the oncology and non-oncology patient population that in the past remained undiscovered. These incidental pelvic lesions have created a management dilemma for both clinicians and radiologists. Depending on the clinical setting, these lesions may require no further evaluation, additional immediate or serial follow-up imaging, or surgical intervention.

Gallbladder imaging.

The treatment of gallbladder disease has been revolutionized by improvements in laparoscopic surgery as well as endoscopic and radiologic interventional techniques. Therapeutic success is dependent on accurate radiologic assessment of gallbladder pathology. This article describes recent technical advances in ultrasonography, multidetector computed tomography, magnetic resonance imaging, positron emission tomography, and scintigraphy, which have significantly improved the accuracy of noninvasive imaging of benign and malignant gallbladder disease.

Pathways of abdominal tumour spread: the role of the subperitoneal space.

The subperitoneal space is a large, unifying, anatomically continuous potential space that connects the peritoneal cavity with the retroperitoneum. This space is formed by the subserosal areolar tissue that lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis. It contains the branches of the vascular, lymphatic, and nervous systems that supply the viscera.

Imaging in intestinal ischemic disorders.

Intestinal ischemia and infarction are a heterogeneous group of diseases that have as their unifying theme hypoxia of the small bowel or colon. The incidence of bowel ischemia and infarction is on the rise for several reasons: the aging of the population, the ability of intensive care units to salvage critically ill patients, and heightened clinical awareness of these disorders. Improvements in diagnostic imaging techniques have greatly contributed to the earlier diagnosis of intestinal ischemia, which can have a positive influence on patient outcomes.

Imaging in intestinal ischemic disorders.

Intestinal ischemia and infarction are a heterogeneous group of diseases that have as their unifying theme hypoxia of the small bowel and/or colon. The incidence of bowel ischemia is increasing for a number of reasons: the aging of the population, the ability of intensive care units to salvage critically ill patients, and heightened clinical awareness of these disorders. Improvements in diagnostic imaging techniques have contributed greatly to the earlier diagnosis of intestinal ischemia, which can have a positive influence on patient outcomes.

Upper gastrointestinal tumours: diagnosis and staging.

Upper GI tumours have a dismal prognosis. Only early diagnosis and accurate staging can optimize patient management.

Diagnosis and staging of small bowel tumours.

Small bowel neoplasms comprise only 1% of gastrointestinal neoplasms. Despite their rarity, it is important to diagnose small bowel tumours early to maximize patient survival.

Magnetic resonance imaging of the pancreas at 3.0 tesla: qualitative and quantitative comparison with 1.5 tesla.

Objectives: We sought to perform a preliminary comparison of signal-to-noise ratio (SNR) and image quality for magnetic resonance imaging (MRI) of the pancreas at 1.5 and 3 T.

Materials And Methods: Two imaging cohorts were studied using a T2-weighted, single-shot fast spin-echo pulse sequence and a T1-weighted, fat-suppressed 3D gradient-echo pulse sequence.

Determinants of the demand for breast cancer screening among women veterans in the United States.

Demand theory has been applied to use of breast exams for cancer prevention, but not since widespread promotion of mammography screening and managed care. Previous economic analyses may be biased due to inclusion of diagnostic exams and generally fail to consider perceived risk and time costs. The objective was to identify and measure the effect of economic, demographic, and behavioral factors that influence the use of mammography screening among US women veterans aged 50 years and older.

GI carcinoid tumours: appearance of the primary and detecting metastases.

Gastrointestinal carcinoid tumours are notoriously difficult to diagnose in the absence of the carcinoid syndrome. The clinical presentation is typically non-specific, and patients often go undiagnosed for years. Recent advances in computed tomography (CT), magnetic resonance (MR), endoscopic ultrasound, and nuclear scintigraphy have combined to improve the diagnosis and staging of this fascinating tumour.

Imaging benign and malignant disease of the gallbladder.

This article reviews the imaging of various benign and malignant diseases of the gallbladder. Clinical findings and imaging features using ultrasound, CT, and MR for the detection and evaluation of gallstones, acute cholecystitis, xanthogranulomatous cholecystitis, adenomyomatosis, and carcinoma of the gallbladder among other disorders are discussed.

Staging of colorectal cancer.

CT, MR, and TRUS play complementary roles in staging CRC. Further improvements in these techniques will improve the accuracy of preoperative staging and thereby help optimize patient treatment and outcome.

Helical CT examination of potential kidney donors.

Objective: The purpose of our study was to evaluate helical CT using axial, coronal, and three-dimensional (3D) reconstruction in the examination of potential kidney donors and to compare the results with angiography and surgery when possible. We also reviewed previously published reports.

Subjects And Methods: Thirty-six patients underwent unenhanced and enhanced helical CT (3-mm collimation, 150-170 ml of i.

Imaging of pancreatic transplantation using portal venous and enteric exocrine drainage.

Objective: We describe the normal radiologic appearance of pancreatic allografts transplanted using portal venous drainage with enteric drainage of exocrine secretions. We also describe the radiologic appearance of postsurgical complications.

Materials And Methods: Of 56 patients who received pancreatic transplants using the portal-enteric technique, 24 patients subsequently required radiologic examination for suspected complications involving the pancreatic allograft.

Placement of retrograde nephroureteral stents through ileal conduits.

Objective: Our objective was to evaluate retrograde nephroureteral stent placement in patients with ileal conduits.

Conclusion: In patients with ureteral complications after cystectomy and ileal diversion, retrograde nephroureteral stent placement should be the treatment of choice to reduce patient morbidity, increase patient comfort, and facilitate stent care.

Small simulated polyps in pig colon: sensitivity of CT virtual colography.

Purpose: The authors evaluated computed tomographic (CT) virtual colography for the detection of simulated polyps under ideal conditions, as well as the effects on lesion conspicuity of (a) collimation, (b) table pitch, and (c) orientation of the colon lumen with respect to the gantry.

Materials And Methods: Pig colon was resected and cleansed, and polyps with diameters of 3, 7, and 10 mm were created. Each specimen was scanned with collimation of 5 and 7 mm and table pitch of 1.

Spiral CT evaluation of the trachea and bronchi.

Objective: We report two cases in which spiral CT with three-dimensional (3D) reconstruction was used to evaluate abnormalities of the trachea and bronchi.

Materials And Methods: Two patients with known airway abnormalities, one with a carinal tumor and the other with a postoperative bronchial stenosis, had spiral CT of the chest performed. Images were reconstructed in the coronal plane as well as using a curved planar reformat and shaded surface display.

Solitary late recurrence of renal cell carcinoma.

Late recurrence of renal carcinoma is an unusual manifestation of this tumor but can occur in as many as 11 percent of patients surviving ten years. We describe a case of a solitary lesion occurring in the nephrectomy scar ten years following surgery. The literature is reviewed.