Computed tomography of the gallbladder.

Computed tomography (CT) was used to study 79 patients with suspected gallbladder disease. First and second generation scanners were used to determine the efficacy of CT in detecting cholecystitis or cholelithiasis. Manifestations of gallbladder disease such as hydrops, opaque and nonopaque gallstones, chronic cholecystitis with thickened inflammatory walls, and secondary liver abscesses can be easily detected. It is a useful technique for individuals in whom the gallbladder has failed to opacity on oral cholecystography. The scanning method is described, and estimates of reliability are given including its accuracy, limitations, and place in the management of gallbladder disease, especially cholelithiasis. When conventional radiographic examinations or ultrasound fail to give definitive diagnostic information, CT can be a useful alternative with an overall diagnostic accuracy greater than 80%.     

Computed tomography of blunt trauma to the gallbladder

The CT findings are reviewed in two patients with injuries to the gallbladder following blunt abdominal trauma. In one patient with a laceration of the cystic artery a large intraluminal clot was identified within the gallbladder associated with extensive hemoperitoneum. Another patient presented with extensive bile leakage into the peritoneal cavity 72 h after blunt trauma due to laceration of the fundus of the gallbladder. The clinical features of blunt trauma to the gallbladder and the utility of CT in this entity are reviewed.     

Computed tomography of thick-walled gallbladder mimicking pericholecystic fluid

We have recently encountered four patients in whom pericholecystic fluid was suspected on CT. However, sonography revealed only a thick-walled gallbladder. Helpful clues to avoid this potential interpretive pitfall are described.     

Computed tomography in chest diseases

The evaluation of mediastinum, lngs, and chest wall diseases can simutaneously be accomplished by computed tomography (CT). A wide range of congenital, inflammatory and neoplastic disorders seen at our institution are presented to show the additional information available by CT as opposed to conventional films. CT has the advantage of being able to detect minor differences in attenuation and its noninvasive.     

Computed tomography of cystic lung diseases

A cystic lesion in the lung is defined as a well-demarcated epithel-lined cavity, that can be mostly filled with air, water, as well as solid material content. This definition includes a wide variety of diseases such as bronchogenic cyst, abscess formation, lymphangioleiomyomatosis, Langerhans cell histiocytosis, emphysema, bronchiectasis, and pneumatoceles. Despite the difficulties in differential diagnosis, there are some diagnostic criteria for CT-scanning helping the radiologist to differentiate between these cystic entities. Moreover, clinical informations are extremely important. The most important clinical parameters include age, sex, clinical history and symptoms. Thus, a better understanding of classic CT appearance of cystic lung disease will allow more definitive diagnosis and could, in some cases, avoid biopsy.     

Computed tomography of cavernous sinus diseases

Summary We retrospectively analyzed CT scans of 21 cavernous sinus lesions in an attempt to discover CT findings helpful to the differential diagnosis. With the integration of various CT observations it was possible to categorize the lesions into inflammatory, vascular, benign neoplastic and malignant metastatic lesions with few exceptions. Four of 5 cases of septic cavernous sinus thrombophlebitis revealed unilateral or bilateral multiple irregular filling defects in the enhancing cavernous sinus with or without orbital inflammatory change. Four of 5 cases of carotid-cavernous fistula demonstrated unilateral or bilateral diffuse bulging and homogeneous enhancement of the cavernous sinus with obliteration of normal low densities of cranial nerves and gasserian ganglion. Dilatation and tortuosity of superior ophthalmic vein were also associated. Four of 5 cases of benign neoplastic lesion showed well-circumscribed enhancing masses confined to the cavernous sinus with pressure erosion or hyperostosis of adjacent bone. Five of 6 cases of malignant metastatic lesion showed changes suggesting malignancy such as destruction of adjacent bone or associated manifestations of intracranial spread. As compared with the axial scan, coronal scans proved to be more sensitive in detection of subtle cavernous sinus expansion, and superior in evaluation of intracavernous neural structures, relationships with the pituitary gland and changes in the skull base. Axial scans, however, were superior in detection of associated orbital and intracranial abnormalities. Scans in both projections are needed in the evaluation of most cavernous sinus diseases.     

Computed tomography manifestations of peritoneal diseases

The peritoneal cavity is a potential space that is divided by the peritoneal reflections into various complex subspaces. It can be involved in many disease processes including developmental, inflammatory, neoplastic and traumatic conditions. Computed tomography is highly sensitive and consistent in detecting peritoneal pathology. This pictorial essay aims to emphasize and illustrate the CT features of the spectrum of peritoneal diseases.     

Computed tomography enteroclysis in the diagnosis of intestinal diseases

The role of computed tomography (CT) enteroclysis in the imaging of small bowel diseases is expanded with recent technological advances in multidetector CT system. Computed tomography enteroclysis is the examination of choice for patients with symptoms of intermittent small bowel obstruction, especially when there is a history of prior complex abdominal surgery, abdominal tumor, radiation therapy, and also in high grade obstructions with suspicion of extraintestinal internal fistula. Computed tomography enteroclysis is becoming the first-line modality for the evaluation of advanced and complicated small bowel Crohn disease. Computed tomography enteroclysis can also become an important complementary imaging technique to capsule endoscopy in the assessment of small bowel neoplasms and occult gastrointestinal hemorrhage. In this study, the technique and clinical applications of CT enteroclysis are reviewed; its advantages and limitations compared with the other imaging techniques and capsule endoscopy are discussed.     

Computed tomography and diagnosis of salivary gland diseases

A study was carried out to compare routine sialography and combination sialo-CT. The results in 36 patients with afflictions of the parotid and submandibular region are discussed. In addition to tumors, regarded as primary indications, inflammatory disorders were also considered. The diagnosis made by routine sialography is regularly confirmed by computed sialography (CTS), which is often an important complementary means. Visualization of the deep parotid lobe and parapharyngeal space (third plane) is very important for making the diagnosis and planning therapy.     

Computed tomography in unilateral extremity swelling of unusual cause.

Computed tomography (CT) were used in the evaluation of unilateral soft tissue swelling of unusual cause. Three patients with unilateral myositis are described and the diagnostic information provided by the CT scan is discussed. A fourth patient with lymphedema praecox and unilateral extremity swelling is presented.     

Computed tomography and angiography in the evaluation of adrenal diseases

Computed tomography, adrenal venous blood sampling, phlebography and arteriography were compared as diagnostic methods in 50 proven cases of adrenal disease. The diagnostic accuracy was 90 per cent for CT, 100 per cent for adrenal venous sampling, 75 per cent for phlebography and 58 per cent for arteriography. It was necessary in some instances to correlate the findings for more than one modality to reach a correct diagnosis. From an analysis of the different examination methods a sequence in the radiologic evaluation of the pathologic adrenal gland is suggested. CT can be used to advantage as the primary imaging method. However, the other modalities, still play an important role.     

Computed tomography for assessing resectability of gallbladder carcinoma: a systematic review and meta-analysis

PurposeThe purpose was to calculate the sensitivity and specificity of computed tomography (CT) in assessing the resectability of gallbladder carcinoma (GBCA) with meta-analysis.Materials and methodsA meta-analysis of the reported sensitivity and specificity of each study with 95% confidence intervals (CI) was performed.ResultsPooled sensitivity was 99% (95% CI), and pooled specificity was 76% (95% CI).ConclusionCT can be used as an appropriate choice for the diagnosis and assessment of resectability of GBCA.     

Computed tomography of portal vein thrombosis: unusual appearances and pitfalls in diagnosis

In a review of 25 cases examined by CT in whom the diagnosis of visceral vein thrombosis had been made, we encountered four cases in which problematic CT findings led to an error in diagnosis by the prospective interpreter. In one case, gas in collateral periportal veins mimicked an abscess; in one case, segmentally occluded portal veins resembled dilated bile ducts; and in one case, expansion of the inferior mesenteric vein was interpreted as a pancreatic pseudocyst. One additional case of multiple intrahepatic stones mimicked calcified portal vein thrombus. Although most cases are straightforward, there is a spectrum of findings in visceral vein thrombosis that may lead to confusion; alternative imaging techniques may be necessary in these situations.