Herein we report a case of splenic rupture following routine colonoscopy. Splenic injury after colonoscopy is extremely rare; however internists/gastroenterologists should be aware of this possible potentially fatal complication and its delayed and unspecific onset. Lorenz Theilmann, Ulrich Voehringer and Ahmed Abdel Samie* Department of Gastroenterology, HELIOS Hospital, Germany Case Presentation A 44 years old female was admitted to the hospital with Crohn’s disease involving the upper GI tract as well as the terminal ileum. Diagnosis had been attained 4 months before histologically by gastroduodenoscopy and MRI enterography and treatment with corticosteroids had been initiated. The patient was readmitted to complete staging including ileocolonoscopy which she previously had refused. Ileocolonoscopy was performed under conscious sedation using propofol and revealed active Crohn ́s disease of the distal ileum on a length of 10 cm. The entire colon showed normal appearance. These findings were confirmed by histology. The endoscopic procedure was uneventful. Progression of the scope up to the terminal ileum was achieved smoothly with no significant looping with a total procedure time of 12 min and withdrawal time of 8 min. The patient was asymptomatic and mobile following the procedure. However, 10 hr later she reported slight dizziness and unspecific abdominal discomfort. During the following night she complained about abdominal pain. Lab tests showed a drop of her hemoglobin to 7.4 g/dl. Ultrasound examination was performed demonstrating pathological findings in the left upper abdomen (Figure 1 and 2). Abdominal ultrasound revealed an enlarged spleen with hypoechoic areas at the upper splenic pole consistent with intrasplenic bleeding (Figure 1). In addition, free fluid was detected in the perisplenic abdominal cavity (Figure 2). Diagnostic aspiration of this fluid confirmed Intra-abdominal bleeding due to splenic injury. The patient was immediately transferred to the operating room, received transfusion of two packed red blood cells, and explorative laparotomy and splenectomy have been performed. Intraoperatively pronounced adhesions of the greater omentum (mainly in the left lower abdomen) have been documented. The spleen was partially avulsed with sub capsular hematoma and secondary rupture. The postoperative course was uneventful and the patient was discharged after five days having received triple vaccination against postsplenectomy infections according to the current guidelines. Treatment of Crohn's disease was resumed. Discussion Splenic injury due to colonoscopy is a rare complication and most patients have delayed symptoms. Less than 80 cases have been reported so far. In systematic reviews [1,2] two hypothetic mechanism of trauma have been suggested. Direct trauma by the endoscope being positioned in the left flexure, yet this mechanism of injury appears to be less frequent than excessive traction on the splenocolic ligament when advan
我们在此报告一例常规结肠镜检查后脾脏破裂的病例。结肠镜检查后脾脏损伤极为罕见;然而，内科医生/胃肠病学家应该意识到这种可能的潜在致命并发症及其延迟和非特异性发病。Lorenz Theilmann, Ulrich Voehringer和Ahmed Abdel Samie*德国HELIOS医院消化内科病例报告一名44岁女性因克罗恩病累及上消化道和回肠末端入院。4个月前通过胃十二指肠镜和MRI肠造影进行组织学诊断，并开始使用皮质类固醇治疗。患者再次接受完整的分期，包括她之前拒绝的回肠结肠镜检查。在异丙酚清醒镇静下进行回肠结肠镜检查，发现回肠远端克罗恩氏病活动性，长度为10 cm。整个结肠外观正常。组织学证实了这些发现。内窥镜检查过程很顺利。手术进展顺利，无明显的回肠末端环，总手术时间为12分钟，撤下时间为8分钟。手术后患者无症状，可移动。然而，10小时后，她报告轻微头晕和不明确的腹部不适。第二天晚上，她抱怨腹痛。实验室检测显示她的血红蛋白下降到7.4克/分升。超声检查显示左上腹部病理发现(图1和2)。腹部超声显示脾肿大，脾上极低回声区符合脾内出血(图1)。此外，脾周腹腔内检出游离液体(图2)。诊断性抽吸该液体证实脾损伤引起的腹腔内出血。患者立即转至手术室，输2个填充红细胞，并行探查性剖腹手术和脾切除术。术中有明显的大网膜粘连(主要在左下腹)。脾脏部分撕脱，并发包膜下血肿和继发破裂。术后过程顺利，患者在五天后出院，根据现行指南接种了预防脾切除术后感染的三联疫苗。克罗恩病的治疗得以恢复。结肠镜检查引起的脾损伤是一种罕见的并发症，大多数患者有延迟症状。到目前为止，报告的病例不到80例。在系统综述中[1,2]提出了两种创伤的假设机制。内窥镜定位于左屈直接损伤，但这种损伤机制似乎比将内窥镜推进至横结肠时过度牵拉脾结肠韧带导致脾包膜撕脱更少见[1]。到目前为止，大多数病例的粘连是由以前的手术或炎症过程引起的。症状通常在结肠镜检查后24小时开始，此时大量血液积聚在荚膜下空间[3]，但可延迟数天。Ahmed Abdel Samie等，Clinics in Surgery Gastroenterological Surgery Remedy Publications LLC， | http://clinicsinsurgery.com/ 2018 | Volume 3 | Article 1989 2诊断出失血性休克。创伤超声聚焦评估(Focus Assessment with Sonography for Trauma)或增强CT扫描是首选的诊断工具[3]。尽管有血管内治疗脾出血的报道，但在血流动力学不稳定的情况下，FAST阳性应立即进行探查性剖腹手术。结肠镜检查后脾脏损伤极为罕见;然而，内窥镜医生应该意识到这种可能的潜在致命并发症及其延迟和非特异性发病。图1:腹部超声显示脾肿大伴低回声区。图2:脾周腹腔。
{"title":"A Patient with Abdominal Pain Following Routine Colonoscopy","authors":"L. Theilmann, Ulrich Voehringer, A. A. Samie","doi":"10.15761/RDI.1000135","DOIUrl":"https://doi.org/10.15761/RDI.1000135","url":null,"abstract":"Herein we report a case of splenic rupture following routine colonoscopy. Splenic injury after colonoscopy is extremely rare; however internists/gastroenterologists should be aware of this possible potentially fatal complication and its delayed and unspecific onset. Lorenz Theilmann, Ulrich Voehringer and Ahmed Abdel Samie* Department of Gastroenterology, HELIOS Hospital, Germany Case Presentation A 44 years old female was admitted to the hospital with Crohn’s disease involving the upper GI tract as well as the terminal ileum. Diagnosis had been attained 4 months before histologically by gastroduodenoscopy and MRI enterography and treatment with corticosteroids had been initiated. The patient was readmitted to complete staging including ileocolonoscopy which she previously had refused. Ileocolonoscopy was performed under conscious sedation using propofol and revealed active Crohn ́s disease of the distal ileum on a length of 10 cm. The entire colon showed normal appearance. These findings were confirmed by histology. The endoscopic procedure was uneventful. Progression of the scope up to the terminal ileum was achieved smoothly with no significant looping with a total procedure time of 12 min and withdrawal time of 8 min. The patient was asymptomatic and mobile following the procedure. However, 10 hr later she reported slight dizziness and unspecific abdominal discomfort. During the following night she complained about abdominal pain. Lab tests showed a drop of her hemoglobin to 7.4 g/dl. Ultrasound examination was performed demonstrating pathological findings in the left upper abdomen (Figure 1 and 2). Abdominal ultrasound revealed an enlarged spleen with hypoechoic areas at the upper splenic pole consistent with intrasplenic bleeding (Figure 1). In addition, free fluid was detected in the perisplenic abdominal cavity (Figure 2). Diagnostic aspiration of this fluid confirmed Intra-abdominal bleeding due to splenic injury. The patient was immediately transferred to the operating room, received transfusion of two packed red blood cells, and explorative laparotomy and splenectomy have been performed. Intraoperatively pronounced adhesions of the greater omentum (mainly in the left lower abdomen) have been documented. The spleen was partially avulsed with sub capsular hematoma and secondary rupture. The postoperative course was uneventful and the patient was discharged after five days having received triple vaccination against postsplenectomy infections according to the current guidelines. Treatment of Crohn's disease was resumed. Discussion Splenic injury due to colonoscopy is a rare complication and most patients have delayed symptoms. Less than 80 cases have been reported so far. In systematic reviews [1,2] two hypothetic mechanism of trauma have been suggested. Direct trauma by the endoscope being positioned in the left flexure, yet this mechanism of injury appears to be less frequent than excessive traction on the splenocolic ligament when advan","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74846057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the United Kingdom since the late 1990s there has been both a shortage of and falling level in recruitment of breast radiologists/radiographers. Specimen radiography is a widely used intra-operative adjunct to aid margin assessment in patients undergoing wide local excision for early stage breast cancer. Aim: This study looks to determine accuracy and congruence of radiological intra-operative margin assessment by surgeon and consultant radiographer against the gold standard of histological assessment.
{"title":"Breast conserving surgery and intra-operative specimen radiography: Margin assessment by the surgeon or the radiologist?","authors":"S. Mylvaganam, H. Tafazal, V. Caddick, P. Madahar","doi":"10.17352/IJRRO.000028","DOIUrl":"https://doi.org/10.17352/IJRRO.000028","url":null,"abstract":"In the United Kingdom since the late 1990s there has been both a shortage of and falling level in recruitment of breast radiologists/radiographers. Specimen radiography is a widely used intra-operative adjunct to aid margin assessment in patients undergoing wide local excision for early stage breast cancer. \u0000Aim: This study looks to determine accuracy and congruence of radiological intra-operative margin assessment by surgeon and consultant radiographer against the gold standard of histological assessment.","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"1 1","pages":"009-013"},"PeriodicalIF":0.0,"publicationDate":"2018-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86486044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bacterial meningitis is the most common cause of acquired sensorineural hearing loss in children, once it could quickly trigger ossification of cochlea, known as labyrinthitis ossificans. Medical team should be aware of such potential threaten and monitor hearing function of these patients. On suspicion of hearing loss, it is urgent to proceed audiological and radiological evaluation before complete cochlear ossification, since it evolves to profound hearing loss and reduces successful cochlear implant insertion. Although CT scan detect cochlear ossification, it sometimes too late. More recently, MRI could detect early intracochlear labyrinthitis ossificans stages, allowing cochlear implant surgery in the right moment. *Correspondence to: Miura MS, Department of Medical Surgery of Universidade Federal de Ciências da Saúde de Porto Alegre and Division of Pediatric Otorhinolaryngology at Hospital da Criança Santo Antônio, Programa de PósGraduação em Ciências Médicas-Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, E-mail: mmiura.voy@terra.com.br Received: June 29, 2018 Accepted: July 09, 2018; Published: July 12, 2018 Introduction Bacterial meningitis (BM) is the most common cause of acquired sensorineural hearing loss (SNHL) in children [1,2-9,10-12]. 5-7% of patients will develop hearing loss, since meningitis induces to labyrinthitis ossificans (LO) [7]. This process can be quick, and the medical team should monitor hearing function of these patients, as well as guide parents / caregivers for any disorders related to speech, language, responses to environmental sounds, or behavior changes. On suspicion of hearing loss, it is urgent to proceed audiological and radiological evaluation.
细菌性脑膜炎是儿童获得性感音神经性听力损失的最常见原因，一旦发生就会迅速引发耳蜗骨化，即骨化性迷路炎。医疗团队应该意识到这些潜在的威胁，并监测这些患者的听力功能。如果怀疑听力损失，在完全耳蜗骨化前进行听力学和放射学评估是迫切需要的，因为它会发展为深度听力损失，并降低人工耳蜗植入的成功率。虽然CT扫描能发现耳蜗骨化，但有时为时已晚。最近，MRI可以发现早期的耳蜗内迷路炎骨化阶段，允许在适当的时候进行人工耳蜗植入手术。*通信对象:Miura MS，巴西阿雷格里港联邦大学医学外科Ciências Saúde和圣克里安帕拉医院儿科耳鼻咽喉科Antônio, PósGraduação em Ciências巴西阿雷格里港联邦大学南里奥格兰德州大学医学院，E-mail: mmiura.voy@terra.com.br收稿日期:2018年6月29日接收日期:2018年7月9日;细菌性脑膜炎(BM)是儿童获得性感音神经性听力损失(SNHL)的最常见原因[1,2-9,10-12]。由于脑膜炎可诱发骨化性迷路炎(LO)， 5-7%的患者会出现听力损失[7]。这个过程可能很快，医疗团队应该监测这些患者的听力功能，并指导父母/照顾者注意任何与言语、语言、对环境声音的反应或行为变化有关的障碍。怀疑听力损失，迫切需要进行听力学和放射学评估。
{"title":"Post meningitis profound hearing loss: MRI as a predictor tool for urgent cochlear implant","authors":"Miura Ms, Mendonça Ajc, Soccol Ra, Mn Rios","doi":"10.15761/RDI.1000142","DOIUrl":"https://doi.org/10.15761/RDI.1000142","url":null,"abstract":"Bacterial meningitis is the most common cause of acquired sensorineural hearing loss in children, once it could quickly trigger ossification of cochlea, known as labyrinthitis ossificans. Medical team should be aware of such potential threaten and monitor hearing function of these patients. On suspicion of hearing loss, it is urgent to proceed audiological and radiological evaluation before complete cochlear ossification, since it evolves to profound hearing loss and reduces successful cochlear implant insertion. Although CT scan detect cochlear ossification, it sometimes too late. More recently, MRI could detect early intracochlear labyrinthitis ossificans stages, allowing cochlear implant surgery in the right moment. *Correspondence to: Miura MS, Department of Medical Surgery of Universidade Federal de Ciências da Saúde de Porto Alegre and Division of Pediatric Otorhinolaryngology at Hospital da Criança Santo Antônio, Programa de PósGraduação em Ciências Médicas-Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, E-mail: mmiura.voy@terra.com.br Received: June 29, 2018 Accepted: July 09, 2018; Published: July 12, 2018 Introduction Bacterial meningitis (BM) is the most common cause of acquired sensorineural hearing loss (SNHL) in children [1,2-9,10-12]. 5-7% of patients will develop hearing loss, since meningitis induces to labyrinthitis ossificans (LO) [7]. This process can be quick, and the medical team should monitor hearing function of these patients, as well as guide parents / caregivers for any disorders related to speech, language, responses to environmental sounds, or behavior changes. On suspicion of hearing loss, it is urgent to proceed audiological and radiological evaluation.","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87873186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liposarcoma is the second most common soft tissue sarcoma type in adults. These tumors take their origin from primitive mesenchymal cells. In abdomen they generally arise from the retroperitoneum. Here we report a case of Giant Liposarcoma of the abdomen arising from the mesentery. *Correspondence to: Manju Bala Popli, Department of Radiological Imaging, INMAS, Delhi, India, Tel: 011-2390528; Fax: 011-23930396; E-mail: manju_popli@rediffmail.com
{"title":"Giant abdominal liposarcoma","authors":"Popli Mb, Popli","doi":"10.15761/rdi.1000129","DOIUrl":"https://doi.org/10.15761/rdi.1000129","url":null,"abstract":"Liposarcoma is the second most common soft tissue sarcoma type in adults. These tumors take their origin from primitive mesenchymal cells. In abdomen they generally arise from the retroperitoneum. Here we report a case of Giant Liposarcoma of the abdomen arising from the mesentery. *Correspondence to: Manju Bala Popli, Department of Radiological Imaging, INMAS, Delhi, India, Tel: 011-2390528; Fax: 011-23930396; E-mail: manju_popli@rediffmail.com","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83934803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of traditional medicine astragalus membranaceus in the treatment of nephritis (10 cases)","authors":"G. Zhu","doi":"10.15761/rdi.1000132","DOIUrl":"https://doi.org/10.15761/rdi.1000132","url":null,"abstract":"","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81223014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kamaledeen, L. Vardon, S. Poulton, D. Flowers, C. Ihezue
Pyrexia of Unknown Origin is defined as a temperature of more than 38.3°c on more than one occasion for at least three weeks, with an unclear diagnosis after one week in hospital. We describe a case of an 82-year-old male with Pyrexia of Unknown Origin in which no diagnosis could be established despite multiple investigations. Positron emission tomography computerized tomography (PET-CT) scan, performed to exclude malignancy, revealed the unexpected finding of an infected thrombus as the source of the pyrexia. Our case demonstrates the pivotal role of PET-CT in diagnosing the cause of Pyrexia of unknown origin. PET-CT is now easily accessible to clinicians and should be considered in the search for an elusive diagnosis of Pyrexia of Unknown Origin. *Correspondence to: Salma Kamaledeen, Specialist Registrar, Clinical Radiology, Queen Alexandra Hospital, Portsmouth, UK, E-mail: salma.kamaledeen@doctors.org.uk
{"title":"Thrombophlebitis causing Pyrexia of unknown origin diagnosed by PET-CT","authors":"S. Kamaledeen, L. Vardon, S. Poulton, D. Flowers, C. Ihezue","doi":"10.15761/RDI.1000133","DOIUrl":"https://doi.org/10.15761/RDI.1000133","url":null,"abstract":"Pyrexia of Unknown Origin is defined as a temperature of more than 38.3°c on more than one occasion for at least three weeks, with an unclear diagnosis after one week in hospital. We describe a case of an 82-year-old male with Pyrexia of Unknown Origin in which no diagnosis could be established despite multiple investigations. Positron emission tomography computerized tomography (PET-CT) scan, performed to exclude malignancy, revealed the unexpected finding of an infected thrombus as the source of the pyrexia. Our case demonstrates the pivotal role of PET-CT in diagnosing the cause of Pyrexia of unknown origin. PET-CT is now easily accessible to clinicians and should be considered in the search for an elusive diagnosis of Pyrexia of Unknown Origin. *Correspondence to: Salma Kamaledeen, Specialist Registrar, Clinical Radiology, Queen Alexandra Hospital, Portsmouth, UK, E-mail: salma.kamaledeen@doctors.org.uk","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90793240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Cengiz, A. Altunkeser, Eryilmaz Ma, I. Tolu, I. Kucukosmanoglu
{"title":"Evaluation of response to chemotherapy in locally advanced breast cancer with mri, importance of lesion size and adc value, and association with ki-67 index","authors":"A. Cengiz, A. Altunkeser, Eryilmaz Ma, I. Tolu, I. Kucukosmanoglu","doi":"10.15761/RDI.1000137","DOIUrl":"https://doi.org/10.15761/RDI.1000137","url":null,"abstract":"","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77283198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. St, Arzoglou, D. Chourmouzi, G. Karkavelas, A. Drevelegkas
Intracranial neurenteric cysts are uncommon and occur usually in the posterior fossa. We report one case of a neurenteric cyst that was situated in the 4th ventricle. Total surgical removal was performed. One hundred cases having been published in the English language literature. We report on the imaging features of the tumor on several modalities as well as its histopathology. We further review the literature regarding this rare benign tumor entity. *Correspondence to: Potsi Stamatia, Asklipiou 10, Pilaia, Thessaloniki, Greece, Tel: +302310400000; Mob: +306977403145; Fax: +302310471056; E-mail: matinapotsi@hotmail.com
{"title":"Neurenteric cyst of the 4th ventricle. Case report and short review of the literature","authors":"P. St, Arzoglou, D. Chourmouzi, G. Karkavelas, A. Drevelegkas","doi":"10.15761/rdi.1000138","DOIUrl":"https://doi.org/10.15761/rdi.1000138","url":null,"abstract":"Intracranial neurenteric cysts are uncommon and occur usually in the posterior fossa. We report one case of a neurenteric cyst that was situated in the 4th ventricle. Total surgical removal was performed. One hundred cases having been published in the English language literature. We report on the imaging features of the tumor on several modalities as well as its histopathology. We further review the literature regarding this rare benign tumor entity. *Correspondence to: Potsi Stamatia, Asklipiou 10, Pilaia, Thessaloniki, Greece, Tel: +302310400000; Mob: +306977403145; Fax: +302310471056; E-mail: matinapotsi@hotmail.com","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87482703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The objective of the present study was to use ultrasound examination to determine the cross-sectional area (CSA) of the median nerve and quantify transverse sliding motion during finger movements in patients with carpal tunnel syndrome (CTS). Method: CSA and transverse sliding motion were compared between 15 cases with bilateral CTS (30 hands; 3 men, 12 women; average age: 65.7 years) and a control group (30 hands) of ageand sex-matched healthy individuals. Furthermore, 13 hands of 12 patients who underwent open carpal tunnel release (2 men, 10 women; average age: 62.3 years) were assessed and compared before and after surgery. Results: The mean CSA was larger in the CTS group (16.9 mm2) than in the controls (10.0mm2), whereas transverse sliding motion was significantly higher in controls (6.6 mm) than in the CTS group (4.9 mm). The 12 patients with CTS who underwent surgery showed a mean preoperative CSA of 19.1mm2 that declined significantly to 14.2 mm2 postoperatively, and the mean transverse sliding motion increased from 3.2 mm preoperatively to 5.0 mm postoperatively. Conclusion: Combining CSA and transverse sliding motion as observed in ultrasound examination can improve CTS diagnosis. Increased CSA and decreased transverse sliding motion noted at the median nerve in the wrists of patients with CTS are partially reversible by open carpal tunnel release. Correspondence to: Ryusuke Osada, Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Sugitani, Toyama-City, Japan; Tel: +81-76-434-7353; Fax: +81-76-434-5035; E-mail: osa97@med.u-toyama.ac.jp
{"title":"Ultasonographic indicators of carpal tunnel syndrome demonstrate reversibility following carpal tunnel release","authors":"Ryusuke Osada, Mineyuki Zukawa, Tomoatsu Kimura","doi":"10.15761/rdi.1000121","DOIUrl":"https://doi.org/10.15761/rdi.1000121","url":null,"abstract":"Background: The objective of the present study was to use ultrasound examination to determine the cross-sectional area (CSA) of the median nerve and quantify transverse sliding motion during finger movements in patients with carpal tunnel syndrome (CTS). Method: CSA and transverse sliding motion were compared between 15 cases with bilateral CTS (30 hands; 3 men, 12 women; average age: 65.7 years) and a control group (30 hands) of ageand sex-matched healthy individuals. Furthermore, 13 hands of 12 patients who underwent open carpal tunnel release (2 men, 10 women; average age: 62.3 years) were assessed and compared before and after surgery. Results: The mean CSA was larger in the CTS group (16.9 mm2) than in the controls (10.0mm2), whereas transverse sliding motion was significantly higher in controls (6.6 mm) than in the CTS group (4.9 mm). The 12 patients with CTS who underwent surgery showed a mean preoperative CSA of 19.1mm2 that declined significantly to 14.2 mm2 postoperatively, and the mean transverse sliding motion increased from 3.2 mm preoperatively to 5.0 mm postoperatively. Conclusion: Combining CSA and transverse sliding motion as observed in ultrasound examination can improve CTS diagnosis. Increased CSA and decreased transverse sliding motion noted at the median nerve in the wrists of patients with CTS are partially reversible by open carpal tunnel release. Correspondence to: Ryusuke Osada, Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Sugitani, Toyama-City, Japan; Tel: +81-76-434-7353; Fax: +81-76-434-5035; E-mail: osa97@med.u-toyama.ac.jp","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90961006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The purpose of this study was to quantify the dose reduction for each computed tomography (CT) reduction dose protocol. Subject and Method: One hundred and fifty repeat CT examinations with an implementation of a CT dose reduction technique per examination were included. Percent of dose reductions compared with their prior CT examinations with standard CT protocols in terms of dose length product were calculated. Result: There were 95 examinations using scanning parameter optimization technique, 47 examinations using reduction of multiphase scanning and 8 examinations using limited scan range. Percent of dose reductions for scanning parameter optimization, reduction of multiphase scanning and limitation of scan range were 43.3%, 52.5%, and 39.1% respectively. Among the scanning parameter optimization, percent of dose reductions by lowering tube voltage, and lowering tube current were 47.9%, and 38.6%, respectively. Conclusion: The presented dose lowering protocols are simple and available in most modern CT scanners. Reduction of multiphase scanning shows highest dose reduction. All of these techniques do not depend on CT scanners but requiring special CT protocol tailored for the individual patient for optimal diagnostic quality in the optimization of patient dose in CT. Correspondence to: Limchareon S, Division of Radiology and Nuclear Medicine, Faculty of Medicine, Burapha University, Thailand, Tel: +6638386554; Fax: +6638386557; E-mail: sornsupha@hotmail.com
{"title":"Management of radiation dose reduction in computed tomography: an experience at burapha university hospital, thailand","authors":"S. Limchareon, K. Kaowises, W. Saensawas","doi":"10.15761/RDI.1000123","DOIUrl":"https://doi.org/10.15761/RDI.1000123","url":null,"abstract":"Objective: The purpose of this study was to quantify the dose reduction for each computed tomography (CT) reduction dose protocol. Subject and Method: One hundred and fifty repeat CT examinations with an implementation of a CT dose reduction technique per examination were included. Percent of dose reductions compared with their prior CT examinations with standard CT protocols in terms of dose length product were calculated. Result: There were 95 examinations using scanning parameter optimization technique, 47 examinations using reduction of multiphase scanning and 8 examinations using limited scan range. Percent of dose reductions for scanning parameter optimization, reduction of multiphase scanning and limitation of scan range were 43.3%, 52.5%, and 39.1% respectively. Among the scanning parameter optimization, percent of dose reductions by lowering tube voltage, and lowering tube current were 47.9%, and 38.6%, respectively. Conclusion: The presented dose lowering protocols are simple and available in most modern CT scanners. Reduction of multiphase scanning shows highest dose reduction. All of these techniques do not depend on CT scanners but requiring special CT protocol tailored for the individual patient for optimal diagnostic quality in the optimization of patient dose in CT. Correspondence to: Limchareon S, Division of Radiology and Nuclear Medicine, Faculty of Medicine, Burapha University, Thailand, Tel: +6638386554; Fax: +6638386557; E-mail: sornsupha@hotmail.com","PeriodicalId":11275,"journal":{"name":"Diagnostic imaging","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79683440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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