CT Diagnosis of venous pseudotumors in the chest and abdomen

Appearances simulating neoplastic masses were found in five patients undergoing computed tomographic (CT) scanning of the chest and abdomen for a variety of indications. In each case the appearance was shown to be due to dilated collateral venous channels in association with portal hypertension or interruption of the inferior vena cava. The vascular origin of the masses was confirmed by CT scanning during intravenous bolus injection of contrast. Angiographic confirmation was obtained in three subjects. Enlarged collateral veins should be considered in the differential diagnosis of appearances suggesting mediastinal or abdominal lymphadenopathy at CT scanning.     

Multidetector CT of the female pelvis

In the emergency room setting, multidetector detector CT (MDCT) offers rapid, noninvasive, multiplanar evaluation of female patients who have acute pelvic pain. MDCT has been integrated into several of the major trauma centers, and its use may surpass the use of ultrasound in the trauma evaluation of the pregnant patient. In the nonemergent setting, MDCT can be used to stage gynecologic malignancy and to evaluate tumor recurrence. Multiplanar MDCT has received some acceptance for evaluation of small primary tumor volume and small metastatic implants. MDCT also has a role in the evaluation of pelvic varices and suspected pelvic congestion syndrome.     

Multidetector CT angiography of the abdomen

Multidetector CT angiography (MDCTA) is redefining traditional imaging strategies of the vascular structures of the abdomen. Angiographic depiction of normal and variant anatomy is becoming the standard for evaluation and has a significant impact in transplant and oncologic surgery. MDCTA is increasingly being used for assessing diseases affecting the vasculature of the abdominal organs, including the abdominal aorta for treatment planning and post therapy follow-up.     

CT imaging of blunt traumatic bowel and mesenteric injuries

Delayed diagnosis of a bowel or mesenteric injury resulting in hollow viscus perforation leads to significant morbidity and mortality from hemorrhage, peritonitis, or abdominal sepsis. The timely diagnosis of bowel and mesenteric injuries requiring operative repair depends almost exclusively on their early detection by the radiologist on computed tomography examination, because the clinical signs and symptoms of these injuries are not specific and usually develop late. Therefore, the radiologist must be familiar with the often-subtle imaging findings of bowel and mesenteric injury that will allow for appropriate triage of a patient who has sustained blunt trauma to the abdomen or pelvis.     

Metastatic lobular carcinoma of the breast: patterns of spread in the chest, abdomen, and pelvis on CT

OBJECTIVE: We determined the pattern of spread of metastatic lobular carcinoma in the chest, abdomen, and pelvis on CT. MATERIALS AND METHODS: We identified 57 women (age range, 30-79 years; mean age, 57 years) with metastatic lobular carcinoma of the breast who underwent CT of the chest, abdomen, or pelvis between 1995 and 1998. Then two experienced oncology radiologists retrospectively reviewed 78 CT examinations of those patients to identify sites of metastatic disease and to identify complications caused by metastases. RESULTS: Metastases were identified in bone in 46 patients (81%), lymph nodes in 27 patients (47%), lung in 19 patients (33%), liver in 18 patients (32%), peritoneum in 17 patients (30%), colon in 15 patients (26%), pleura in 13 patients (23%), adnexa in 12 patients (21%), stomach in nine patients (16%), retroperitoneum in nine patients (16%), and small bowel in six patients (11%). Eighteen patients (32%) had gastrointestinal tract involvement that manifested as bowel wall thickening. Hydronephrosis was present in six patients (11%). CONCLUSION: Although lobular carcinoma metastasized to common metastatic sites of infiltrating ductal carcinoma, lobular carcinoma frequently metastasized to unusual sites, including the gastrointestinal tract, peritoneum, and adnexa. Gastrointestinal tract involvement was as frequent as liver involvement, appearing as bowel wall thickening on CT. Hydronephrosis was a complication of metastatic lobular carcinoma.     

New codes, new rules: CT abdomen and pelvis

With the introduction of new combined CT abdomen and pelvis codes it is important that all organizations ensure correct coding and claim submission for multiple exams and that the orders support the performed exam(s).     

CT of malignant melanoma in the chest, abdomen, and musculoskeletal system

Malignant melanoma is an aggressive neoplasm that can involve virtually every organ system. This article provides a review of the various appearances on computed tomographic (CT) scans of melanoma involving the chest, abdomen, and musculoskeletal system. Specific emphasis is placed on the typical and atypical CT manifestations of disease as well as the similarity of these findings to those for other disease entities. The importance of accurate staging of melanoma is stressed.     

CT features of Castleman disease of the abdomen and pelvis

OBJECTIVE: The purpose of this study was to describe the CT features of Castleman disease in the abdomen and pelvis. CONCLUSION: The most frequent appearance of abdominal or pelvic Castleman disease is of a single, well-defined enhancing mass. Smaller tumors (<5 cm) display homogeneous contrast enhancement; larger tumors (>5 cm) show heterogeneous enhancement and attenuation when correlated with central necrosis and degeneration. Calcification was seen in 31% of the cases. Castleman disease may be considered in the differential diagnosis of a discrete enhancing mass in the abdomen or pelvis.     

Clinical demand for chest/abdomen/pelvis anatomy following thoracic or lumbar spine CT

The purpose of this study is to determine how often CT is repeated to obtain chest/abdomen/pelvis data outside the reconstructed field of view (FOV) on a prior spine CT. Radiology records of 1,239 consecutive thoracic and lumbar spine CT exams of 1,025 patients from January 1, 2006 to December 31, 2008 were retrospectively reviewed to identify patients who subsequently had CT studies of the chest, abdomen, and/or pelvis. The CT data were also evaluated for contrast enhancement, slice thickness, radiation dose, and reason for subsequent CT exam. Over 3 years, 290 of the 1,239 (24%) spine CT exams were followed by CT of the same anatomic region to evaluate extraspinal anatomy. The use or nonuse of contrast in these follow-up studies was the same as the preceding spine study in 91 cases, which were repeated on the same day (n?=?37), within 7 days (n?=?19), within 8-30 days (n?=?15), or after 30 days (n?=?20). Fourteen of 25 (56%) T spine CTs and 34 of 52 (65%) L spine CTs without contrast were followed by a chest CT or abdomen/pelvis CT without contrast within 7 days, respectively. Among 31 pediatric exams, 6 of 31 (19%) spine CTs were followed by a CT of the same anatomic region, all within 7 days. Reconstructing full FOV images of spine CT scans in addition to the standard coned down spine FOV may reduce redundant CT imaging and radiation dose.     

MR image contrast and relaxation times of solid tumors in the chest, abdomen, and pelvis

A retrospective study of 121 patients with tumors in the chest, abdomen, and pelvis was made to assess the degree of contrast between solid tumors and adjacent tissue on magnetic resonance (MR) spin echo (SE) images. Tumors examined were hepatomas (five patients), liver metastases (17), hemangiomas (seven), biliary carcinomas (eight), pancreatic carcinomas (five), renal tumors (15), adrenal tumors (eight), uterine tumors (17), bladder carcinomas (five), prostatic carcinomas (13), bone tumors (six), and lung carcinomas (15). A long repetition time (TR) and a long echo time (TE) were found the most useful to delineate tumors from liver, renal tumors from kidney, lung carcinoma from lung, pelvic tumors from muscle, and uterine tumors from the myometrium. A short TR and short TE provided the best contrast between tumors and fat and bone marrow. Therefore, for detection and staging of tumors, both a sequence with short TR and short TE and one with long TR and long TE are necessary. Pancreatic carcinomas were difficult to differentiate from liver and pancreas on all SE sequences used in the study. Contrast of adrenal tumors was independent of the sequence used. Some adrenal tumors were hypointense and some similar in intensity to the kidney. Further MR characterization of the tumors was limited.