September 2010
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1 Read
Radiographics
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September 2010
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1 Read
Radiographics
March 2009
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37 Reads
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43 Citations
Emergency Radiology
Computed tomographic enterography (CTE) is a useful technique for evaluating the small bowel and has the capability to include the colon for evaluation of patients with inflammatory bowel disease (IBD). The aims of this study are (1) to determine if CTE is a sensitive method for detecting Crohn colitis and ulcerative colitis and (2) to assess the accuracy of determining the extent and activity of colonic disease in patients with proven IBD. Seventy patients (35 patients with proven colitis at colonoscopy and 35 negative patients with a proven normal colon) having both a CTE examination and recent colonoscopy formed the retrospective study group. A radiologist evaluated the examinations in a blinded fashion for disease presence, activity, and extent. Sensitivity was 93% for the detection of moderate and severe disease in well-distended colons. Specificity was 91%. In good to excellent distended colons, mild, moderate, and severe disease was detected with a sensitivity of 67%, 90%, and 100%, respectively. Severe disease activity was commonly underestimated, and mild disease when detected was usually overestimated. The full extent of colonic disease at CTE was usually underestimated. CTE is a valid technique for detecting colitis in the colon in patients with IBD. Better methods for assessing disease activity and extent are needed.
July 2008
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46 Reads
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84 Citations
Abdominal Imaging
To estimate the clinical benefit of CT enterography (CTE) in patients with fistulizing Crohn's disease and describe the appearance of fistulas at CTE. Crohn's patients who had undergone CTE, which diagnosed an abscess or fistula, were identified. A gastroenterologist reviewed clinical notes prior to and following CTE to assess the pre-CTE clinical suspicion for fistula/abscess, and post-CTE alteration in patient management. A radiologist reassessed all fistula-positive cases, which were confirmed by a non-CT reference standard, to describe their radiologic appearance. Fifty-six patients had CT exams identifying 19 abscesses and 56 fistulas. There was no or remote suspicion of fistula or abscess at pre-imaging clinical assessment in 50% of patients. Thirty-four patients (61%) required a change in or initiation of medical therapy and another 10 (18%) underwent an interventional procedure based on CT enterography findings. Among 37 fistulas with reference standard confirmation, 30 (81%) were extraenteric tracts, and 32 (86%) were hyperenhancing compared to adjacent bowel loops. Most fistulas (68%) contained no internal air or fluid. CTE detects clinically occult fistulas and abscesses, resulting in changes in medical management and radiologic or surgical intervention. Most fistulas appear as hyperenhancing, extraenteric tracts, usually without internal air or fluid.
January 2005
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1 Read
American Journal of Roentgenology
January 2004
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8 Reads
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2 Citations
American Journal of Roentgenology
January 2004
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8 Reads
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3 Citations
May 2002
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58 Reads
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131 Citations
Abdominal Imaging
We investigated whether flat lesions of the colon could be detected on computed tomographic colonography (CTC). CTC and conventional colonoscopy were performed on 547 consecutive patients. A subset of 22 polyps was described as flat on colonoscopy (n = 16) or CTC (n = 6) and are the basis of this report. CTC was performed with a standard technique (5-mm collimation, 3-mm reconstruction intervals). Patients were scanned in supine and prone positions. Examinations were randomly assigned and reviewed in a blinded fashion by two of three radiologists. Prospective interpretations were recorded. All patients had conventional colonoscopy, which served as the gold standard. Twenty-two flat lesions ranging from 0.4 to 3.5 cm were histologically classified as adenomatous (n = 8) or hyperplastic (n = 14). The sensitivities for detecting all flat lesions and flat adenomas by each reviewer were 43% and 100%, 65% and 100%, and 15% and 13%, respectively. "Double reading" resulted in detection of 68% of all lesions and 100% of adenomas. Of the seven hyperplastic polyps missed by both reviewers, four were identified retrospectively. Flat lesions of the colon represent an important source of false negative CTC examinations. Awareness of their morphology can assist radiologists in finding most of these challenging lesions.
February 2002
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13 Reads
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69 Citations
American Journal of Roentgenology
OBJECTIVE. Contrast-enhanced CT colonography has the potential to detect local recurrence, metachronous disease, and distant metastases in patients with a history of invasive colorectal cancer. The purpose of our study was to determine whether colonic anastomoses prohibit adequate colonic distention on contrast-enhanced CT colonography and to estimate the performance of contrast-enhanced CT colonography in detecting recurrent colorectal carcinoma. MATERIALS AND METHODS. Fifty patients with a history of resected invasive colorectal carcinoma underwent contrast-enhanced CT colonography and colonoscopy. Colonic distention was graded for different colonic segments. Two radiologists evaluated for the presence of local recurrence. metachronous disease, and metastatic disease. Results were compared with colonoscopy, histology, and clinical follow-up. RESULTS. Most patients had adequate colonic inflation (37/50, 74%). Eleven of 13 patients with inadequate distention had collapse in the sigmoid colon, usually associated with ileocolic anastomoses. Contrast-enhanced CT colonography detected local recurrences with an accuracy of 94% (95% confidence interval, 83-99%). The accuracy of contrast-enhanced CT colonography for metachronous lesions greater than or equal to 1 cm was 92% (95% confidence interval, 80-98%), but there was only one such lesion, which was missed on initial colonoscopy. Stool, granulation tissue, and inflammation can mimic the CT appearance of local recurrence or metachronous disease and account for false-positive examinations. Contrast-enhanced CT colonography identified five patients with metastatic disease. CONCLUSION. Suboptimal sigmoid distention can be seen on contrast-enhanced CT colonography, predominantly in patients with right hemicolectomies. Contrast-enhanced CT colonography is a promising method for detecting local recurrence. metachronous disease, and distant metastases in patients with prior invasive colorectal carcinoma. The technique can also serve as a useful adjunct to colonoscopy by detecting local recurrences or metachronous disease that are endoscopically obscure or by serving as a full structural colonic examination when endoscopy is incomplete.
November 2001
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2 Reads
Radiology
May 2001
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85 Reads
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53 Citations
American Journal of Roentgenology
OBJECTIVE: Our purpose is to describe associated and coexistent diseases of gastric carcinoid tumors, the unique biologic behavior of these tumors, the appearance of these tumors on fluoroscopic and CT images, and the radiologic management of these neoplasms. CONCLUSION: First, multiple gastric carcinoid tumors are associated with enterochromaffin-like cell hyperplasia, chronic atrophic gastritis, and pernicious anemia and have a low risk of malignancy. Second, solitary gastric carcinoid tumors, or gastric carcinoid tumors associated with multiple endocrine neoplasia-type I (MEN-I) and Zollinger-Ellison syndrome, have a higher potential for metastatic disease. Third, the radiologic appearance and management of these tumors depend on the clinical background of the patient.
... In a prospective evaluation of a multicenter cohort of moderate-risk, screening patients, Zalis et al [23] demonstrated that the use of C-RADS resulted in approximately 5% of CT colonographic examinations generating subsequent workup for the evaluation of ECFs. Studies estimating the costs related to additional imaging have been remarkably consistent, ranging $28 to $50 per person screened, with the mean per patient cost calculated to be less than $34 [14][15][16]. Many reports detailing clinical trials of CTC and clinical practice experience have reported rates of positive colorectal findings on CTC, which can often be translated into the various C-RADS C categories. ...
May 2000
Radiology
... This imaging technique allowed for a more detailed evaluation of the spread of disease beyond the primary site. [10]. ...
February 2002
American Journal of Roentgenology
... Computed tomographic (CT) enterography has proved to be a valuable diagnostic tool for the evaluation of small bowel disease, particularly in infl ammatory bowel disease ( 11,12 ). In CT enterography, multidetector CT is combined with peroral luminal distention of the small bowel with neutral enteric contrast material. ...
January 2004
American Journal of Roentgenology
... However, they may be iso-or hyperattenuating in patients with hepatic steatosis. On unenhanced images the vascular components of hemangiomas have the same attenuation value as the blood within blood vessels [7,8] . Thrombosed, fibrotic, or degenerated areas that are frequently present within large hemangiomas are lower in attenuation than the vascular components. ...
January 1989
... Adenomatöz polipten kansere dönüflüm, polip boyutu ile yak›ndan iliflkilidir. Malign transformasyon 1cm'den küçük poliplerin %1'inde görülürken bu oran 2 cm düzeyinde iki kat artmaktad›r (11)(12)(13)(14)(15). Tarama programlar›yla henüz kansere dönüflmemifl adenomatöz polipleri ve erken dönem asemptomtik dönemde lokalize kanserleri saptamak ve tedavi ederek prognozu iyilefltirmek mümkündür. ...
January 1997
Proceedings of SPIE - The International Society for Optical Engineering
... There are two main types of fast MRI: (i) methods that require multiple RF excitations such as the FLASH (fast low-angle shot; ref. 12) method and (ii) echo-planar imaging methods (EPI) (13), which require a single RF excitation. Multiple excitation methods require at least one RF pulse for each line of the image matrix (12,14). In the FLASH method, each line is acquired in =5-15 ms, giving a total acquisition time of 1.5-4 s for a 256 x 256 image matrix. ...
March 1987
American Journal of Roentgenology
... There has reasonably been an increasing reliance on CT imaging to guide management; the role of intravenous (i.v.) contrast-enhanced CT is well established, with evidence demonstrating improved speed and accuracy of diagnosis, with resultant reduction in hospital admission rates and length of stay, as well as reduced morbidity and mortality [4][5][6][7][8][9][10]. In a minority of cases, the utility of CT is more limited, Radiological Sciences especially in the diagnosis of early inflammatory changes such as in inflammatory bowel disease, mesenteric ischaemia and mild acute pancreatitis, and in patients who have a history of chronic abdominal disease, with disagreement between the radiological and clinical diagnoses more likely [11,12]. The problem of the study is increasing number of people complaining of abdomen pathology, the abdominal pathology is serious illness an some of it can cause life threating and the general objective is to evaluate the role of CT in diagnosis abdomen pathology with secondary objectives are determine the most common abdomen pathology, to correlate the CT finding with gender and to find out the relation between the final diagnose and patient's age 13. ...
March 1987
American Journal of Roentgenology
... Susan Barlow, one of two review editors, coauthored a PM-funded review paper that, after incorporating comments from PM, questioned the evidence linking secondhand smoke and sudden infant death syndrome [54]. Eleven of the journal's International Editorial Board members had ties to the tobacco industry: three were employees (A.W. Hayes, D.J. Doolittle [55][56][57], and Y.P. Dragan [58][59][60]; two held positions on PM Scientific Advisory Board (M. Pariza and S.L. ...
January 1986
Gastrointestinal Radiology
... Several studies have shown that CT imaging can evaluate the activity and severity of inflammatory bowel disease [44][45][46][47][48]. However, different studies have reported varied sensitivity and specificity of CT in evaluating inflammatory bowel disease [48][49][50][51][52]. EUS is more effective than CT in evaluating the activity of IBD compared to the research described. ...
March 2009
Emergency Radiology
... In the present study, we show that even with the (Ϫ␣/ 2)-(TR/2) preparation scheme commonly used in True-FISP for rapid and smooth stabilization of the magnetization vector (15), the number of "preparatory" RF pulses needed to approach the steady state can exceed 100. As a result, the usual appearance of TrueFISP images should be more appropriately regarded as a transient-state combination of proton-density and T 2 /T 1 contrast, a phenomenon similar to that found in other gradient-echo sequences (16,17). The actual image appearance depends on the number of RF pulses experienced by the magnetization prior to data acquisition near the center portion of the k-space. ...
Reference:
Are trueFISP images T2/T1-weighted?
November 1991
Radiology