Guide to surgical procedures on hollow viscera: part 1--Esophageal, gastric, and restrictive bariatric procedures

OBJECTIVE: The objective of this article is to explore with a surgical perspective the key radiologic features after common esophageal, gastric, and bariatric procedures. CONCLUSION: An understanding of procedures on the hollow viscera is essential for radiologists at any level. The ability to quickly recognize postoperative anatomy is critical to accurately and efficiently interpret routine imaging studies and to diagnose postoperative complications.     

MR imaging evaluation of the postoperative knee: ligaments, menisci, and articular cartilage

The surgical management of knee injuries has increased in recent years. Postoperative magnetic resonance (MR) imaging of the knee following surgical intervention serves an important role in the diagnostic evaluation of patients with recurrent or residual symptoms following surgical intervention. MR imaging additionally assists in the noninvasive documentation of temporal changes at the surgical site potentially reflective of procedural success, or failure. Background understanding of the common surgical procedures performed, their normal postoperative MR imaging appearance, and imaging features of potential procedural complications are essential in the accurate evaluation of patients following prior knee surgery. The focus of the following article is to review the clinical and MR imaging features of the postoperative knee following prior surgical treatment of ligamentous, meniscal, and articular cartilage injuries of the joint.     

Postoperative radiologic evaluation of the esophagus

A wide range of surgical procedures are performed for either benign and malignant esophageal lesions, that may be classified as demolitive or conservative interventions. The former is characterized by resection and replacement of the esophagus with another organ, whereas conservative surgery is obtained preserving esophageal function without resection. Knowledge of surgical techniques and major complications is extremely important for a correctly performed radiographic study and a proper interpretation of the imaging findings. Functional evaluation of the operated alimentary tract and early detection of postoperative complications are essential for a successful recovery of esophageal surgery patients. We provide a brief overview of the main esophageal surgical procedures, reporting our experience on postoperative imaging of 104 patients submitted to surgery for either benign or malignant esophageal disease during a 6-year period.     

Imaging in bariatric surgery: a guide to postsurgical anatomy and common complications

OBJECTIVE: This article reviews the various bariatric surgical techniques and the associated imaging findings of normal postoperative anatomy and of common complications. CONCLUSION: Bariatric surgery is increasingly performed to control morbid obesity secondary to failed medical approaches. As a result, imaging plays an important role in postoperative evaluation and management. Practical knowledge of postsurgical anatomy allows accurate interpretation of imaging findings related to normal postsurgical anatomy and common postsurgical complications.     

Postoperative cardiopulmonary thoracic imaging

An appreciation of the normal postoperative changes and complications following cardiac surgical procedures is essential when interpreting postoperative imaging studies. This article focuses on both the normal postoperative appearances and the imaging of complications following common cardiac surgical procedures. Irrespective of the specific nature of the surgery, certain common complications may occur, either from the surgery itself,the use of cardiac bypass, or the patient's underlying cardiac disorder. Postoperative imaging after specific thoracic cardiovascular surgeries is also discussed.     

Esophageal resection: indications, techniques, and radiologic assessment.

Various surgical procedures are performed for benign and malignant esophageal lesions. These procedures include transthoracic esophageal resection through a right or left thoracotomy and transhiatal blunt esophageal resection (esophagectomy) without thoracotomy. The whole stomach, colon, gastric tube, jejunum, and free revascularized grafts may be used as substitutes for the resected esophagus. Bypass procedures including substernal stomach bypass surgery and substernal or subcutaneous colon bypass surgery are performed for tracheoesophageal fistula, previous esophagectomy without reconstruction, or obstruction due to lye ingestion. The mortality rate for esophageal resection depends on the stage of the tumor, the patient's condition, and the surgeon's skill and is quite low when the procedure is performed by a highly skilled surgeon. The most frequent sources of morbidity related to esophageal surgery include pneumothorax, pleural effusion, pneumonia, and respiratory failure. Mediastinitis and sepsis due to disruption at an anastomosis site cause serious postoperative morbidity and mortality; therefore, thoracic anastomotic leaks require aggressive surgical treatment. Familiarity with these surgical options, the resultant anatomic changes associated with each option, and the expected findings at postoperative imaging is essential for evaluating the effectiveness of surgical procedures and for the early detection and management of surgery-related complications.     

Imaging of the postoperative shoulder

Imaging plays an important role in evaluation of the shoulder after surgery. In addition to being familiar with the underlying pathologic condition that leads to surgery, it is just as important to have a general understanding of the surgical procedure because it explains the expected postoperative imaging findings. Identification of postoperative complications with imaging is also improved with this information. This article reviews some of the more common surgeries of the shoulder, including rotator cuff repair, acromioplasty, labral repair, Hill-Sachs impaction fracture and glenoid bone augmentation, acromioclavicular joint repair, and shoulder arthroplasty. Each respective surgical technique is briefly reviewed, followed by discussion and examples of normal postoperative appearances and common postoperative complications. Knowledge of these common procedures and their expected postoperative imaging findings will allow an accurate assessment of complications.     

Imaging of the postoperative knee: normal and pathologic findings

Surgical management of lesions of the knee has exponentially increased over the last several years. MRI plays a major role in postoperative follow-up and evaluation of patients with residual symptoms. Familiarity with the different surgical procedures and potential complications and knowledge of normal and abnormal postoperative MRI findings are essential for evaluation of the postoperative knee. The main purpose of this article is to review the postoperative imaging features of ligaments, menisci and cartilage of the knee joint since these MRI features may lead the surgeon to consider repeat surgery.     

Guide to surgical procedures on hollow viscera: part 2--Colorectal, ostomy, and malabsorptive bariatric procedures

OBJECTIVE: The objective of this article is to explore with a surgical perspective the key radiologic features of common bariatric, colorectal, and ostomy procedures. The images and diagrams show relevant postoperative anatomy. CONCLUSION: An understanding of procedures on the hollow viscera is essential for a radiologist at any level. The ability to quickly recognize postoperative anatomy is critical to accurately and efficiently interpret routine imaging studies and to diagnose postoperative complications.     

Imaging of the postoperative middle ear

The aim of this article is twofold: (a) to present the principles and the indications of surgical treatment of middle ear pathologies; and (b) to review the imaging findings after middle ear surgery, including the normal postoperative aspects and imaging findings in patients presenting with unsatisfactory surgical results or with suspicion of postoperative complications. This review is intentionally restricted to the most common diseases involving the middle ear: chronic otitis media and otosclerosis. In these specific fields of interest, CT and MR imaging play a very important role in the postoperative follow-up and in the work-up of surgical failures and complications.     

Essentials on Oncological Imaging: Postoperative Computed Tomography and Magnetic Resonance Imaging of Oral Tongue Cancer

The contribution of diagnostic imaging in evaluating the pre- and postoperative status of tongue cancer is essential. Interpretation of postoperative images is made difficult by deformation; therefore, it is necessary to know how surgical technique, biological reaction, postoperative anatomy, and local recurrence are reflected on the images. This study explains the postoperative imaging features of tongue cancer to help in the early detection of local recurrence and avoid inappropriate treatment. We review schematic drawings of representative surgical procedures for tongue carcinoma, variable radiological features in postoperative conditions with or without complications, and typical features of local failures and their mimics. This article clarifies the important tasks of radiologists and clinicians in the postoperative evaluation of tongue carcinoma.     

Imaging of the postoperative hip

A basic understanding of the surgical approach, technique, and potential complications in addition to the types of hardware used is essential in interpreting postoperative imaging of the hip. This article reviews the various surgical approaches to the hip and hardware components in total hip arthroplasty and hip preservation surgery and the potential complications that may arise. The various surgical treatments in the management of acetabular dysplasia and avascular necrosis and the imaging appearances of these on different imaging modalities are also discussed.     

Spectrum of MR imaging findings of sinonasal mucormycosis in post COVID-19 patients

During rapid spread of coronavirus disease (COVID-19) globally, ever since WHO declared COVID-19 as pandemic, there have been various patterns of disease in terms of diagnosis, management and complications. Secondary infections are reportedly common in hospitalized and severely ill COVID-19 patients among which fungal being 10 times more common. Mucormycosis is amongst the most lethal form of Zygormycosis occurring in post COVID-19 patients. A varied patterns of disease involvement and spectrum of imaging features are observed in patients with mucormycosis in post COVID-19 patients. MRI has better efficacy than CT in detecting early invasion of mucormycosis. The goal of this review is to familiarize radiologists about the MR imaging spectrum of mucormycosis in post COVID-19 patients with potential diagnostic pitfalls in CT.Advances in knowledge:Radiological findings of mucormycosis in post COVID-19 patients show varied patterns of disease involvement and spectrum of imaging features. One should not solely rely on CT imaging to detect the extent of disease. MRI helps in early and accurate detection of invasion into adjacent structures and so helpful in early intervention.     

Diversion ahead: imaging appearance of urinary diversions and reservoirs

The imaging appearance of urinary diversion is determined by the indication and type of surgical procedure performed. These patients often undergo an imaging follow-up to detect complications or recurrence. Understanding the postoperative anatomy and early detection of complications are keys to adept interpretation of radiological evaluation of urinary reservoirs. The purpose of following review is to offer a brief account of commonly used surgical techniques, relevant anatomy, and concise overview of the imaging techniques for evaluation of the urinary diversions and features of their complications.     

Postoperative Bildgebung der Schulter

Correct interpretation of imaging findings in the postoperative shoulder is impaired by surgical distortion of normal anatomy and possible artifacts. Advanced postoperative imaging of the shoulder in addition to the selection of the best suited modality necessitates familiarity with the surgical procedure that has been performed and its consecutive morphological changes. This article reviews the most common arthroscopic and open techniques used for treatment of shoulder instability, lesions of the superior labral-bicipital complex, primary impingement, and rotator cuff tears, their typical postoperative imaging findings, as well as the diagnostic performance of cross sectional imaging techniques in the detection of recurrent lesions and complications.     

Laparoscopic cholecystectomy: postoperative imaging

OBJECTIVE: The purpose of this article is to describe the imaging findings after laparoscopic cholecystectomy, including the normal postoperative findings and the typical appearances of major complications. The relative merits of the imaging techniques available are discussed. CONCLUSION: Laparoscopic cholecystectomy is a commonly performed surgical procedure and radiologists are often called on to identify or rule out postoperative complications. In such cases, the correct diagnosis is crucial in optimizing patient management.     

Imaging of the shoulder after surgery

Postoperative imaging of the shoulder is challenging. This article reviews the radiologic evaluation following surgery for subacromial impingment, rotator cuff lesions and glenohumeral instability, including the common surgical procedures, the expected postoperative findings and potential complications. A specific emphasis is made on magnetic resonance imaging.     

CT and MRI features of ileostomies

OBJECTIVE: The purpose of this article is to describe CT and MRI features of normal anatomy, variants, and pathologic conditions of different ileostomies. CONCLUSION: Multiplanar imaging techniques are useful to identify the complications related to stoma construction and preexisting disease. Understanding the indications for ileostomy construction, surgical techniques, and postoperative anatomy is important for differentiating normal and abnormal imaging features.     

Radiologic guide to surgical treatment of first carpometacarpal joint osteoarthritis

OBJECTIVE: The purpose of this article is to provide a radiologic guide to surgical treatment of first carpometacarpal osteoarthritis, a common problem especially in older women. CONCLUSION: Knowledge of the indications, surgical technique, component design, normal postoperative imaging assessment, and imaging findings of complications is important to providing a meaningful radiologic evaluation of patients after first carpometacarpal joint surgeries, including arthroplasty and arthrodesis.     

Postoperative imaging of the elbow, wrist, and hand

There are many bone and soft tissue injuries to the elbow, wrist, and hand that are treated surgically. The operative techniques can be complicated and their indications may change. This article reviews the common injuries at the elbow, wrist, and hand, the indications for surgical management, the current and previous operative techniques used, the expected postoperative appearance on different imaging modalities, and the important potential complications of each technique.