ABSTRACT. We report a case of a large peritoneal loose body (LPLB), diagnosed on CT. The loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. The mass changed its location from the left to the right side of the pelvis within 9 days on repeat imaging. The typical cross-sectional characteristics of a LPLB include a mobile well-circumscribed soft-tissue mass usually with coarse central calcifications. The accurate diagnosis of a LPLB is vital to prevent unnecessary surgical intervention in an asymptomatic patient with an incidentally discovered LPLB.
Foreign objects are not infrequently seen at computed tomography (CT) of the abdomen and pelvis and may pose a diagnostic challenge to the radiologist, who must recognize the object, characterize its nature and location, and determine its clinical significance. Most foreign objects are incidentally detected at CT, but they may mimic a wide range of pathologic conditions. Some foreign objects (eg, an object that has been swallowed either intentionally or unintentionally) are the cause of the patient's signs and symptoms and require prompt medical attention. Other objects, such as a sponge or surgical instrument that has been retained postoperatively, may have medicolegal consequences. Furthermore, certain objects, such as intentionally concealed drug packets, may go undetected unless a high degree of suspicion exists and appropriate window settings are used to review the study. The radiologist should be familiar with the wide range of foreign objects that may be encountered at abdominopelvic CT, be able to recognize them promptly, and understand their implications for patient treatment.
BackgroundThe term "acute aortic syndrome" (AAS) encompasses a spectrum of life-threatening conditions characterized by acute aortic pain. AAS traditionally embraces three abnormalities including classic aortic dissection, intramural haematoma, and penetrating atherosclerotic ulcer. Although the underlying etiologies and conditions predisposing to AAS are diverse, the clinical features are indistinguishable.MethodsMultidetector-row computed tomography (CT) with electrocardiographic gating (ECG-gated MDCT) has greatly improved imaging of acute thoracic aortic diseases by virtually eliminating pulsation artifacts transmitted from cardiac motion and reveals subtle aortic abnormalities, which have been difficult to recognize by conventional non-gated CT.ResultsWhile these advances in imaging technology provide additional discriminating features of acute aortic diseases, they also reveal a range of overlapping features of these life-threatening conditions that not uncommonly are dynamic and evolving. These overlapping and transitional features may be a major source of misunderstanding, confusion, and controversy for diseases that cause AAS.ConclusionIn this pictorial review, we describe the discriminating and typical imaging features as revealed by modern ECG-gated MDCT angiography. In addition to the discriminating features, recognition of the overlapping and transitional features in AAS will allow a more comprehensive understanding of their underlying pathophysiologic conditions and their natural history, and may improve therapeutic management.Main Messages• The superior visualization of ECG-gated CTA improves the diagnostic accuracy of acute aortic syndrome.• ECG-gated CTA provides discriminating features of underlying pathophysiologic conditions of AAS.• Also, recognition of the overlapping features in AAS will allow a more comprehensive understanding.
The purpose of this study was to compare the sensitivity and specificity of breast-specific gamma imaging (BSGI) using a high-resolution breast-specific gamma camera and magnetic resonance imaging (MRI) in patients with indeterminate breast findings. Twenty-three women with an indeterminate breast finding that required BSGI and MRI as deemed necessary by the interpreting radiologist or referring physician were included. MRI was performed on a GE 1.5T scanner and BSGI was performed on a Dilon high-resolution breast-specific gamma camera. All imaging findings were correlated with pathologic diagnosis. Thirty-three indeterminate lesions were evaluated in the study. There were a total of nine pathologically confirmed cancers. There was no statistically significant difference in sensitivity of cancer detection between BSGI and MRI. BSGI demonstrated a greater specificity than MRI, 71% and 25%, respectively. BSGI has equal sensitivity and greater specificity than MRI for the detection of breast cancer.
Major suture breaks and metal-ring fractures are demonstrated with CT and are associated with delayed type I and III endoleaks and with stent-graft migration after EVAR.
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