Abdominal Imaging

Disease involving the pancreas can be a significant diagnostic challenge to the interpreting radiologist. Moreover, the majority of disease processes involving the pancreas carry high significant morbidity and mortality either due to their natural process or related to their treatment options. As such, it is critical for radiologists to not only provide accurate information from imaging to guide patient management, but also deliver that information in a clear manner so as to aid the referring physician. This is no better exemplified than in the case of pre-operative staging for pancreatic adenocarcinoma...

No abstract text is available yet for this article.

Both restrictive and malabsorptive types of bariatric surgery may be associated with short- and long-term complications. The lack of small bowel obstruction is not necessarily indicative of a normal study, as a variety of non-obstructed complications exist. These include stenosis at the gastrojejunostomy, leaks, abscesses, hemorrhage, internal hernias, and gastric band erosions. Radiologists should be familiar with these complications for early diagnosis and intervention before symptoms become life threatening...

PURPOSE: To determine when 18F-choline PET/CT can truly identify local recurrence of prostate cancer. METHODS: 1031 patients from 3 European centers underwent (18)F-choline PET/CT (FCH PET/CT) for recurrent disease; 131 subjects (12.7%) showed a positive FCH uptake in the prostatic gland or prostatic fossa. Median age was 72 years (range 48-87 years), and the median PSA level at the time of FCH PET/CT scan was 4.41 ng/mL (0.22-18.13 ng/mL). 45 patients (34.4%) had a Gleason score (GS) >7, and the residual subjects had a GS ≤ 7...

OBJECTIVE: To establish highly specific criteria for predicting non-enhancement in T1-hyperintense non-fat-containing (T1-high) renal lesions using unenhanced fat-suppressed T1-weighted (T1-FS) images. MATERIALS AND METHODS: This IRB-approved, HIPAA-compliant, retrospective study included T1-high renal lesions found between 7/1/2012 and 7/1/2014. The largest lesion diameter and heterogeneity, mean signal intensity of lesion, and adjacent renal cortex were recorded from T1-FS images...

The differential diagnosis of splenic masses is broad and often hinges on the enhancement characteristics of the lesions. Most radiologists are familiar with the differential diagnosis of hypovascular lesions such as fungal infections, sarcoidosis/granulomatous disease, infarctions, and cysts. However, to our knowledge, there is no review article that presents the specific multimodality imaging features of vascular splenic lesions as a group. Vascular splenic lesions may be considered those that enhance more or similarly to the background splenic parenchyma...

PURPOSE: To correlate RECIST, volumetric criteria, and tumor growth kinetics at multidetector-computed tomography with tumor metabolic activity at FDG PET in colorectal liver metastases (CRCLM) treated with bevacizumab-based chemotherapy. METHODS: Thirty-two CRCLM in 20 patients treated with bevacizumab-based chemotherapy were evaluated. Pre- and post-treatment CT scans were used to calculate reciprocal of doubling time (RDT), percentage change in the lesion's longest transaxial diameter (RECIST 1...

PURPOSE: The purpose of this study is to evaluate the utility of color Doppler ultrasound (CDU) in the assessment of ovarian torsion following a negative contrast-enhanced computed tomography (CT) examination. METHODS: This is a retrospective study of women who presented to the ED with abdominal pain and received both a contrast-enhanced CT and CDU within a 24-h period. The abdominal/pelvic CT examinations were evaluated for findings specific to torsion, including ovarian size greater than 5 cm, the presence of free fluid, uterine deviation, fallopian tube thickening, ovarian fat stranding, smooth wall thickening, the presence of the "twisted pedicle" sign, and abnormal ovarian enhancement...

OBJECTIVE: To determine the diagnostic performance of imaging criteria for distinguishing Ig-G4-associated autoimmune cholangiopathy (IAC) from primary sclerosing cholangitis (PSC) and bile duct malignancy. METHODS: A medical records search between January 2008 and October 2013 identified 10 patients (8 M, 2 F, mean age 61 years, range 34-82) with a clinical diagnosis of IAC. Fifteen cases of PSC (6 M, 9 F, mean age 50, range 22-65) and 15 cases of biliary malignancy (7 M, 8 F, mean age 65, range 48-84) were randomly selected for comparative analysis...

PURPOSE: To compare the Medicare population cost of colorectal cancer (CRC) screening of average risk individuals by CT colonography (CTC) vs. optical colonoscopy (OC). METHODS: The authors used Medicare claims data, fee schedules, established protocols, and other sources to estimate CTC and OC per-screen costs, including the costs of OC referrals for a subset of CTC patients. They then modeled and compared the Medicare costs of patients who complied with CTC and OC screening recommendations and tested alternative scenarios...

BACKGROUND: The aim of the present study was to investigate the use and value of maximum standardized uptake value (SUV max) on positron emission tomography/computed tomography (PET/CT) images as a prognostic marker for patients with locally advanced pancreatic cancer (LAPC). MATERIALS AND METHODS: The medical records of all consecutive patients who underwent PET/CT examination in our institution were retrospectively reviewed. Inclusion criteria were histologically or cytologically proven LAPC...

PURPOSE: Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion (DWIBS/T2) strongly contrasts cancerous tissue against background healthy tissues. Positron emission tomography/computed tomography (PET/CT) applies the uptake of 18-fluorodeoxyglucose in the diagnosis of cancer. Our aim was to compare DWIBS/T2 and PET/CT in patients with upper gastrointestinal cancers. METHODS: Patient records, including imaging results from July 2012 to March 2015, were analyzed retrospectively...

PURPOSE: Determine intra- and inter-examination repeatability of magnitude-based magnetic resonance imaging (MRI-M), complex-based magnetic resonance imaging (MRI-C), and magnetic resonance spectroscopy (MRS) at 3T for estimating hepatic proton density fat fraction (PDFF), and using MRS as a reference, confirm MRI-M and MRI-C accuracy. METHODS: Twenty-nine overweight and obese pediatric (n = 20) and adult (n = 9) subjects (23 male, 6 female) underwent three same-day 3T MR examinations...

PURPOSE: The purpose of our study was to evaluate the sensitivity, specificity, and accuracy of ultrasound (US) as compared to magnetic resonance imaging (MRI) in pregnant patients with suspected appendicitis for visualization of the appendix, accuracy at diagnosing acute appendicitis, the ability of each modality to identify alternate diagnoses of pain and whether gestational age (GA) has an association with appendix identification rates. METHODS: We retrospectively reviewed the records of 140 pregnant patients with suspected appendicitis to determine the efficacy of US and MRI to identify the appendix, diagnose or exclude acute appendicitis, identify alternative etiologies for clinical presentation, and the affect of GA on identification of the appendix...

No abstract text is available yet for this article.

OBJECTIVE: The purpose of this study is to describe our experience with the role of CT-guided percutaneous drainage of loculated intra-abdominal collections consisting entirely of gas. MATERIALS AND METHODS: An IRB-approved retrospective study analyzing patients with air-only intra-abdominal collections over an 8-year period was undertaken. Seven patients referred for percutaneous drainage were included. Size of collections, subsequent development of fluid, and microbiological yield were determined...

PURPOSE: The objective of this study is to compare MR imaging features of small hepatocellular carcinoma (HCC) (≤ 2 cm) in normal, fibrotic, and cirrhotic liver. METHODS: A total of 215 patients with 235 pathologically proven sHCC were retrospectively analyzed. Patients were classified into three groups according to the patients' liver condition: patients with normal liver (F0, group 1), fibrosis without cirrhosis (F1-3, group 2), and cirrhosis (F4, group 3). The morphological and MR signal features on T1, T2-weighted, dynamic enhanced, and diffusion-weighted imaging were evaluated and compared...

Sarcoidosis is mainly a disease of the respiratory system; however, several other organ systems may be affected in the course of the disease. Liver is one of the most frequently affected organs in the setting of sarcoidosis after lungs and lymph nodes. Microscopic hepatic involvement is common in these patients but is mostly clinically silent. However, in a significant portion of these patients, macroscopic findings can be detected in the course of the disease, and these findings may easily be confused with other benign and malignant conditions of the liver...

PURPOSE: Dual-energy computed tomography (DECT) has shown the capability of differentiating uric acid (UA) from non-UA stones with 90-100% accuracy. With the invention of dual-source (DS) scanners, both low- and high-energy images are acquired simultaneously. However, DECT can also be performed by sequential acquisition of both images on single-source (SS) scanners. The objective of this study is to investigate the effects of motion artifacts on stone classification using both SS-DECT and DS-DECT...

The purpose of this two-part article is to review the cross-sectional imaging features of benign and malignant ampullary conditions with endoscopic and histopathologic correlation and to present the most common pitfalls in the evaluation of the ampulla. In this part, we will review the mesenchymal and secondary neoplasms of the ampulla, a vast array of benign ampullary conditions, causes of bulging papilla, and pitfalls. Familiarity with ampullary pathologic conditions and pitfalls, as well as the use of optimized MDCT and MRI techniques, may improve the diagnostic accuracy of radiologists facing ampullary abnormalities...