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.     

Scoliosis circa 2000: radiologic imaging perspective

Plain film imaging remains important for the diagnosis and surveillance of scoliosis, as well as for the detection of complications after surgery. New means of treating scoliosis have become established and should be understood by the radiologist. To the well-known postoperative complications, including pneumothorax, pneumonia, and gastrointestinal obstruction, are added new specific potential problems with the new surgical methodology.     

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.     

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.     

EOS~(TM)在青少年脊柱侧凸中的应用

脊柱侧凸是青少年常见的脊柱畸形。传统的X线摄影只能从二维平面评估侧凸畸形,且辐射剂量高。近年来新出现的EOS影像采集系统采用低于传统X线及CT的辐射剂量即可同步获得人体站立位正侧位全脊柱影像,并能通过三维重建获得多种测量参数,从而量化评估脊柱轴面旋转,有助于脊柱侧凸的诊断、分级、手术方案制定及术后随访,尤其适用于青少年特发性脊柱侧凸病人。就EOS的原理、优势及在青少年脊柱侧凸中的应用予以综述。     

后路减压联合不同融合节段固定治疗退变性脊柱侧凸的临床研究

目的比较后路减压联合短节段融合与长节段融合治疗退变性脊柱侧凸的临床疗效。方法回顾性分析50例采用后路减压联合椎弓根钉固定融合治疗的退变性脊柱侧凸患者,按融合范围分为短节段组（28例）和长节段组（22例）。收集患者术前、术后1周影像学指标（侧凸Cobb角、Cobb角矫正率）、ODI评分以及并发症发生率。结果短节段组融合节段2．4个（1～3个）,长节段组5．7个（4～7个）,两组之间差异有统计学意义（P〈0．05）。术前短节段组侧凸Cobb角为（21．4±3．7）°,术后（13．6±214）。,矫正率36．4％;长节段组术前（32．9＋6．2）。,术后（11．3＋3．5）。,矫正率65．7％,两组手术前后差异均有统计学意义,且两组侧凸Cobb角纠正率之间差异有统计学意义。短节段组6例发生并发症,长节段组10例发生并发症,长节段组术后并发症发生率较短节段组高。两组患者ODI评分差异无统计学意义。结论后路加压联合椎弓根螺钉固定融合治疗退变性脊柱侧凸疗效肯定;侧凸Cobb角较小、脊柱平衡保持较好者可以选择短节段融合,侧凸严重甚至侧方严重滑脱者宜选用长节段融合。     

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 Adult ECMO

Adult extracorporal membrane oxygenation utilization in the ICU has rapidly increased. Newer technology and cannulation strategies and the complex hemodynamics make imaging interpretation challenging. There is also a high rate of complications. This review details the common indications, cannulation strategies, relevant hemodynamics and complications which impact imaging interpretation. Recommendations for modifying computed tomography protocols and techniques to obtain diagnostic images and some of the imaging pitfalls are also discussed.     

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI.HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma,bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination.     

Complications of esophageal surgery: role of imaging in diagnosis and treatments

Esophageal surgery is a common and integral component in the management of hiatal hernias, esophageal carcinoma, and esophageal perforation. Understanding the expected postsurgical imaging features of these common esophageal surgeries and postoperative complications is essential. Image-guided intervention can be used to aid the surgeon in the management of many post esophageal surgical complications. We discuss the imaging features of the postoperative esophagus and the use of imaging, including fluoroscopy and computed tomography, in the diagnosis of post esophageal surgical complications and treatment.     

Imaging of postoperative middle ear cholesteatoma

Cholesteatoma is often treated surgically using canal wall-preserving techniques. Clinical and otoscopic diagnosis of residual or recurrent disease after this form of surgery is unreliable and thus radiological imaging is often used prior to mandatory "second-look" surgery. Imaging needs to be able to differentiate residual or recurrent disease from granulation tissue, inflammatory tissue or fluid within the middle ear cavity and mastoid cavity. High-resolution computed tomography (HRCT), conventional magnetic resonance imaging (MRI), and delayed contrast MRI have all been used in detecting postoperative cholesteatoma. Although delayed contrast MRI performs better than HRCT and conventional MRI, the sensitivities and specificities of these different imaging methods are relatively poor. Diffusion-weighted MRI (DWI and, in particular, non-echo planar DWI) has been shown to have a high sensitivity and specificity for detecting recurrent cholesteatoma. In this review we provide examples of postoperative imaging appearances following cholesteatoma surgery and we review the relevant literature with an emphasis on studies evaluating the diagnostic accuracy of DWI.     

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.     

Scoliosis circa 2000: radiologic imaging perspective

Plain film imaging remains important for the diagnosis and surveillance of scoliosis, as well as for the detection of complications after surgery. Advances in CT and MR imaging have greatly improved the ability to detect or confirming nonidiopathic causes of scoliosis, including abnormalities within the spinal canal. Three-dimensional thinking has become more important in evaluating and understanding scoliosis.     

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.     

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.     

Imaging in scoliosis: what,why and how?

Scoliosis may be a spinal manifestation of underlying disease and although most cases of scoliosis are idiopathic, imaging plays a very important role in determining the underlying aetiology and in monitoring the changes of the deformity that take place with growth. As a clinical problem scoliosis may present directly to the radiology department through a primary healthcare referral, or it may be referred from the paediatric, orthopaedic, spinal and neurosurgical hospital services. Growth affects all types of scoliosis irrespective of cause. There are no reliable predetermined algorithmic steps in the management of scoliosis, and treatment decisions require the inclusion of multiple extrinsic (e.g age, menarche) and intrinsic (curve magnitude, vertebral anomaly) factors. It is important to remember that most of what is known about curve behaviour and its progression applies to idiopathic scoliosis, and it is inappropriate to apply these criteria to the other specific types of scoliosis. It is imperative that radiation techniques are used judiciously to minimize the radiation burden. Although magnetic resonance imaging (MRI) has had a significant impact in the understanding of the scoliotic deformity, it is still evolving and it may well eventually play a very important role in uncovering the underlying aetiology of 'idiopathic' scoliosis.     

Interfrontal sinus septal cell: a cause of obstructing inflammation and mucoceles

BACKGROUND AND PURPOSE: Recent interest in the origin and complications associated with frontal intersinus septal cells prompted us to review our material looking for cases of the uncommon occurrence of a mucocele developing within such a cell. The purpose of this article was to present the imaging findings on 4 cases of mucoceles arising within surgically proven frontal intersinus septal cells.MATERIALS AND METHODS: A retrospective review of the case material in our department of otolaryngology since 2000 was made looking for cases of patients with surgically proven frontal intersinus septal cell mucoceles. Institutional review board approval for the review was obtained. Four cases were identified that also had CT and/or MR imaging studies. Examples of 4 additional classic frontal sinus mucoceles and 3 anterior ethmoid mucoceles were also identified for comparison.RESULTS: All 4 of the cases of frontal intersinus septal cell mucoceles had an expanded midline frontal sinus cell, which thinned the posterior and/or anterior frontal sinus tables. The classic frontal sinus mucoceles were either to the left or right side, and any table thinning was off midline. The ethmoid mucoceles were clearly centered below the frontal sinuses.CONCLUSIONS: The rare occurrence of a frontal intersinus septal mucocele can be diagnosed on CT and MR imaging studies, because its appearance in the midline is clearly distinct from the more common classic frontal sinus mucoceles that develop within the left or right frontal sinus proper. Distinction is also routinely made from large anterior ethmoid mucoceles.

There has been some recent interest in the origin of, and complications associated with, frontal intersinus septal cells.^1–6 The complications are the result of disease within these septal cells obstructing the adjacent frontal sinuses. This is especially true in the uncommon occurrence of a mucocele developing within such a cell. The purpose of this article was to present the imaging findings on 4 cases of mucoceles arising within surgically proven frontal intersinus septal cells.     

Postoperative imaging of the knee

The knee is a frequently injured joint and, thus, a common focus of operative intervention. As operative techniques and imaging modalities evolve, radiologists must be aware of the expected postoperative appearance after knee surgeries that are performed commonly and also must be comfortable recognizing complications encountered commonly in the immediate and delayed postoperative period. Drawing on the large amount of attention this subject has received of late in the radiologic and orthopedic literature, this article reviews the knee surgeries performed most commonly and the expected normal and most frequently encountered abnormal postoperative imaging findings with an emphasis on MR imaging.     

En bloc shoulder resection with total shoulder prosthetic replacement: indications and imaging findings

OBJECTIVE: Our purpose was to highlight the importance of radiologic studies in assessing the appropriateness of total scapular resection and total shoulder prosthetic reconstruction and to examine the role of imaging in evaluating for postoperative complications. CONCLUSION: Evolving surgical and reconstructive techniques for treatment of shoulder girdle tumors require radiologists to familiarize themselves with novel imaging findings associated with these procedures. Readers will better understand the indications for limbsparing surgery with total shoulder prosthetic reconstruction, normal postoperative radiologic findings, and common complications.