Computed tomography (CT) is an excellent imaging modality for demonstrating the size, shape, and position of the spleen, as well as for depicting intrasplenic pathologic features. However, it has limited value in the diagnosis of splenic involvement by lymphoma.

Abdominal hernias are a common clinical problem. The main types of abdominal hernias are external or abdominal wall hernias, which involve protrusion of abdominal contents through a defect in the abdominal wall; internal hernias, which involve protrusion of viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity; and diaphragmatic hernias, which involve protrusion of abdominal contents into the chest. Clinical diagnosis of abdominal hernias can be difficult. However, plain radiography, radiography performed after administration of barium, and computed tomography allow evaluation of suspected abdominal hernias and detection of those that are clinically occult. The anatomic location of the hernia, the contents, and complications such as incarceration, bowel obstruction, volvulus, and strangulation can be demonstrated with radiologic examination. Occasionally, complications such as neoplasms or inflammatory conditions can be identified in the hernial contents. With abdominal imaging modalities, a variety of abdominal hernias can be confidently diagnosed.

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This process, which was initiated by forming a radiation dose reduction committee, addressed several different issues to improve patient safety. These include avoidance of unnecessary CT examinations, adjusting individual scanning parameters, revising protocols, use of shielding and dose monitoring, and implementing computer-based dose modulation software as well as educating referring physicians and radiologic technologists.

In a retrospective study of 14 cases of duodenal neoplasms evaluated by computed tomography (CT), there were four primary adenocarcinomas of the duodenum, one lymphoma, five metastatic carcinomas, two duodenal lipomas, one villous adenoma, and one leiomyoma. The CT findings were diagnostic in patients with duodenal lipomas. In 11 cases, a primary origin of the mass was clearly identifiable in the duodenum. Thickening of the bowel wall, tumor necrosis, ulceration, and intraluminal defects were common. The relationship of the masses to adjacent structures was clearly shown on CT scans. Extraluminal extent of the lesion was noted on CT scans in seven patients; however, at surgery only four of six were found to have extramural disease. The presence of adenopathy, liver metastases, and vascular and mesenteric invasion were also demonstrated on CT scans. Twelve patients underwent upper gastrointestinal tract series. A duodenal abnormality was seen in all 12 patients, but the extramural extent and distant metastatic involvement could not be seen on these examinations. CT scans allowed the accurate staging of eight of ten malignant lesions and thus helped in the management of duodenal tumors.