Computerized Tomography in the Diagnosis of Retroperitoneal Fibrosis.

Feinstein, Richard S.; Gatewood, Olga M. B.; Goldman, Stanford M.; Copeland, Bruce; Walsh, Patrick C.; Siegelman, Stanley S.

doi:10.1097/00004728-198202000-00082

Cited by 11 publications

(19 citation statements)

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“…However, it is not routinely used for follow-up of para-aortic RPF. An examination of four patients with CT diagnosed RPF in the 1980s showed poor diagnostic sensitivity, with corresponding ultrasonographic findings in only one patient (14). To our knowledge, no state-of-the-art US technique evaluation in RPF exists to date.…”

Section: Discussionmentioning

confidence: 90%

“…Two studies in the 1980s indicated that US revealed only a poor overall sensitivity in the detection of RPF (12,13). Feinstein et al (14) reported that only 25% of affected patients with computed tomography (CT)-mediated diagnosis of RPF showed corresponding ultrasonographic abnormalities. Since that time the quality of US scanners has improved dramatically, and modern techniques, such as tissue harmonic imaging (THI) and extended field-of-view US, have significant advantages for routine clinical diagnosis (15)(16)(17).…”

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confidence: 99%

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The potential role of modern US in the follow-up of patients with retroperitoneal fibrosis

Kamper

Brandt

Ekamp³

et al. 2013

Diagn Interv Radiol

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ABDOMINAL IMAGINGORIGINAL ARTICLE PURPOSE We aimed to evaluate a standardized ultrasonography (US) algorithm for the visualization of pathologic para-aortic tissue in retroperitoneal fibrosis (RPF). MATERIALS AND METHODSThirty-five patients with lumbar RPF of typical extent, as determined by abdominal magnetic resonance imaging, were included. Examinations were conducted using standardized abdominal US with axial sections obtained at the levels of the renal arteries, aortic bifurcation, and both common iliac arteries. Imaging of each section was acquired with fundamental B-mode (US) and tissue harmonic imaging, respectively. In addition, we examined RPF visualized using extended fieldof-view US. RESULTSTissue harmonic imaging adequately visualized RPF of typical extent in 33 patients (94.2%). Excellent and good visualization with mild artifacts were achieved in 25 (71.4%) and six (17.1%) patients, respectively. When RPF spread along the iliac arteries, excellent visualization was achieved in 38.7% for the left side and 34.5% for the right side. There were significantly fewer diagnostic examinations for the right iliac (27.6%) than for the left one (9.7%) (P = 0.016). Overall, harmonic imaging achieved significantly better visualization than fundamental B-Mode (P < 0.001). CONCLUSIONWe described the first systematic evaluation of RPF visualization by modern US techniques. The best imaging quality was found in the typical RPF location, at the level of the aortic bifurcation. These results advocate for the presented US algorithm as an efficient follow-up alternative to cross-sectional imaging in RPF patients.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

The potential role of modern US in the follow-up of patients with retroperitoneal fibrosis

Kamper

Brandt

Ekamp³

et al. 2013

Diagn Interv Radiol

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“…Complementary, avid enhancement on CECT (increase about 20-60 HU after contrast administration) is generally considered typical for acute stages of the disease, whereas little or no enhancement is expected in the late fibrous stage. 7 A "double ring" appearance on CECT caused by thickening of the aortic wall is considered typical for the early stages of Takayasu aortitis according to specialist literature. 17 The periaortic soft-tissue distribution was even used to differentiate between benign and malignant retroperitoneal fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…The latter knowingly has less oxygen demands and therefore shows less vascularization. 7 Hence, monitoring of microvascularization (perfusion) of these disorders using modern and accurate imaging techniques such as CT perfusion could represent a good alternative for assessment of the degree of inflammatory activity. As is generally known, all these disorders are mostly incurable, exhibiting a chronical course with flare-ups and thus deserve long-term treatment.…”

Section: Introductionmentioning

confidence: 99%

Perfusion-based assessment of disease activity in untreated and treated patients with aortitis and chronic periaortitis: correlation with CT morphological, clinical and serological data

Bier¹,

Henes²,

Eulenbruch³

et al. 2015

BJR

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Objective: To evaluate the role of perfusion-based assessment of inflammatory activity in patients with treated and untreated aortitis and chronic periaortitis as compared with clinical and serological markers. Methods: 35 patients (20 females; median age 66 years) with (peri) aortitis were retrospectively evaluated. All patients had clinical symptoms prompting at the time of imaging. All patients first underwent whole-body contrastenhanced CT and subsequently segmental volume perfusion CT for assessment of the degree of vascularization of (peri) aortitis as a surrogate marker for inflammatory activity. Blood flow, blood volume, volume transfer constant (k-trans), time to peak and mean transit time were determined. The thickness of the increased connective tissue formation was measured. Perfusion data were correlated with clinical symptoms and acute-phase inflammatory parameters such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocyte number.Results: 21 of 35 patients were untreated and 14 of 35 had previous/ongoing immunosuppression. The interobserver agreement was good (k 5 0.78) for all perfusion parameters. Average values of perfusion parameters were higher in untreated patients but remained abnormally elevated in treated patients as well. Perfusion data and ESR and CRP correlated well both in aortitis (p , 0.05) and in periaortitis (p , 0.05). In periaortitis, perfusion parameters agreed well with ESR and CRP values (p , 0.05) only in untreated patients. Conclusion: Perfusion CT parameters in untreated aortitis and chronic periaortitis correlate well with serological markers with respect to disease activity assessment. However, in treated periaortitis, correlations were weak, suggesting an increased role for (perfusion-based) imaging. Advances in knowledge: Volume perfusion CT may be used for diagnosis of aortitis/periaortitis.

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“…5 The diagnosis is most commonly made using imaging studies, with CT being the exam of choice. 6 There are few effective treatment options available for patients suffering from idiopathic retroperitoneal fibrosis with most cases being managed surgically. Medical therapy is usually not effective unless the fibrosis is in response to an inflammatory condition (ie not idiopathic), in which case steroids may be effective.…”

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confidence: 99%