Abstract Purpose This article prospectively assesses the feasibility of simple oral preparation contrast-enhanced computed tomography colonography (SOP-CE-CTC) using a large volume of oral 3% mannitol for good colonic distension along with mural and mucosal fold visualization. Methods A total of 100 patients in whom contrast CT abdomen was requested, recruited as per selection criteria, were advised to take mild oral bowel preparation for two nights, prior to the investigation. Then, after fasting overnight, they were asked to consume 1,500 to 2,000 mL of 3% mannitol solution in about an hour. Thirty minutes after completing the ingestion of oral mannitol, intravenous contrast was injected and SOP-CE-CTC was acquired at 55 seconds. Distension of six segments of the colon was evaluated by assigning scores 1 to 4 for qualitative assessment; and measuring the maximum luminal diameter of the colon, for quantitative assessment. Colonic mucosal and mural visualization were evaluated subjectively. All observations were recorded by two reviewers (with varying levels of experience) independently. Results On qualitative analysis, the colon showed optimal distension (score 4) in 58 to 89% cases on SOP-CE-CTC. There was agreement between both the reviewers in 89 to 99% cases (weighted kappa 0.820–0.979; p < 0.001). On quantitative analysis, the mean of the maximum colonic diameter ranged between 3.4 and 5.2 cm; and both the reviewers agreed in 89 to 97% cases (weighted kappa 0.777–0.967; p < 0.001). Mural and mucosal fold visualization in the proximal four segments of the colon was excellent (in 90–98%) but in the rectum and sigmoid it was 45 and 66%, respectively; both the reviewers agreed in 100% cases (weighted kappa 1.0 and p < 0.001). Conclusion Good colonic distension, mural, and mucosal fold visualization can be achieved on SOP-CE-CTC using 1,500 to 2,000 mL of 3% oral mannitol and mild oral bowel preparation agents.
{"title":"Feasibility of Simple Oral Preparation Contrast-Enhanced CT Colonography (SOP-CE-CTC) Using Mannitol as a Neutral Oral Contrast Agent","authors":"V. Rathi","doi":"10.1055/s-0042-1748522","DOIUrl":"https://doi.org/10.1055/s-0042-1748522","url":null,"abstract":"Abstract Purpose This article prospectively assesses the feasibility of simple oral preparation contrast-enhanced computed tomography colonography (SOP-CE-CTC) using a large volume of oral 3% mannitol for good colonic distension along with mural and mucosal fold visualization. Methods A total of 100 patients in whom contrast CT abdomen was requested, recruited as per selection criteria, were advised to take mild oral bowel preparation for two nights, prior to the investigation. Then, after fasting overnight, they were asked to consume 1,500 to 2,000 mL of 3% mannitol solution in about an hour. Thirty minutes after completing the ingestion of oral mannitol, intravenous contrast was injected and SOP-CE-CTC was acquired at 55 seconds. Distension of six segments of the colon was evaluated by assigning scores 1 to 4 for qualitative assessment; and measuring the maximum luminal diameter of the colon, for quantitative assessment. Colonic mucosal and mural visualization were evaluated subjectively. All observations were recorded by two reviewers (with varying levels of experience) independently. Results On qualitative analysis, the colon showed optimal distension (score 4) in 58 to 89% cases on SOP-CE-CTC. There was agreement between both the reviewers in 89 to 99% cases (weighted kappa 0.820–0.979; p < 0.001). On quantitative analysis, the mean of the maximum colonic diameter ranged between 3.4 and 5.2 cm; and both the reviewers agreed in 89 to 97% cases (weighted kappa 0.777–0.967; p < 0.001). Mural and mucosal fold visualization in the proximal four segments of the colon was excellent (in 90–98%) but in the rectum and sigmoid it was 45 and 66%, respectively; both the reviewers agreed in 100% cases (weighted kappa 1.0 and p < 0.001). Conclusion Good colonic distension, mural, and mucosal fold visualization can be achieved on SOP-CE-CTC using 1,500 to 2,000 mL of 3% oral mannitol and mild oral bowel preparation agents.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"28 1","pages":"148 - 156"},"PeriodicalIF":0.0,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90448767","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}
Ahmad L. F. Yasin, R. Kassamali, Mohammad Khader, Omran Almokdad, A. Barah, A. Omar
Abstract Colonic varices are an uncommon type of ectopic varices that can occur due to underlying liver cirrhosis and portal hypertension. They form a very rare cause of lower gastrointestinal bleeding that can result in massive hemorrhage. We present a 38-year-old woman with a background of ulcerative colitis complicated by primary sclerosing cholangitis-induced liver cirrhosis presenting with fresh rectal bleeding. The colonoscopy failed to identify the source of bleeding. Then, computed tomography scan showed multiple dilated tortuous venous collaterals around the descending colon that extended into the colonic submucosa and drained via the left ovarian vein representing colonic varices. She underwent balloon-occluded retrograde transvenous obliteration (BRTO), which successfully embolized these varices with no significant complications. Despite there being no established management guidelines for colonic variceal bleeding, BRTO is a minimally invasive procedure that can be considered as good option for the treatment of these varices, especially when other alternatives are not applicable.
{"title":"Acute Colonic Variceal Bleeding in a Cirrhotic Patient Treated by Modified Balloon-occluded Retrograde Transvenous Obliteration: A Case Report","authors":"Ahmad L. F. Yasin, R. Kassamali, Mohammad Khader, Omran Almokdad, A. Barah, A. Omar","doi":"10.1055/s-0042-1750137","DOIUrl":"https://doi.org/10.1055/s-0042-1750137","url":null,"abstract":"Abstract Colonic varices are an uncommon type of ectopic varices that can occur due to underlying liver cirrhosis and portal hypertension. They form a very rare cause of lower gastrointestinal bleeding that can result in massive hemorrhage. We present a 38-year-old woman with a background of ulcerative colitis complicated by primary sclerosing cholangitis-induced liver cirrhosis presenting with fresh rectal bleeding. The colonoscopy failed to identify the source of bleeding. Then, computed tomography scan showed multiple dilated tortuous venous collaterals around the descending colon that extended into the colonic submucosa and drained via the left ovarian vein representing colonic varices. She underwent balloon-occluded retrograde transvenous obliteration (BRTO), which successfully embolized these varices with no significant complications. Despite there being no established management guidelines for colonic variceal bleeding, BRTO is a minimally invasive procedure that can be considered as good option for the treatment of these varices, especially when other alternatives are not applicable.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"48 1","pages":"037 - 041"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73506991","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}
Abstract Midgut malrotation is usually present in the early neonatal period with intestinal obstruction and bilious vomiting. However, sometimes it may present later in childhood and adolescence with atypical features and then may remain undiagnosed for long, adversely affecting the growth and development of the child. Here we describe three cases of intestinal malrotation with various atypical presentation and imaging findings.
{"title":"Spectrum of Clinical and Radiological Presentation of Midgut Malrotation in Children and Adolescents: Case Series","authors":"Saurya Saurya, P. Sherwani, G. Sharma, S. Saxena","doi":"10.1055/s-0042-1749674","DOIUrl":"https://doi.org/10.1055/s-0042-1749674","url":null,"abstract":"Abstract Midgut malrotation is usually present in the early neonatal period with intestinal obstruction and bilious vomiting. However, sometimes it may present later in childhood and adolescence with atypical features and then may remain undiagnosed for long, adversely affecting the growth and development of the child. Here we describe three cases of intestinal malrotation with various atypical presentation and imaging findings.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"25 1","pages":"217 - 221"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72512627","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}
Abstract Wandering spleen is a rare entity, wherein the spleen is attached only by an elongated vascular pedicle, predisposing it to complications like hilar torsion, infarction, rupture, etc. Pancreatic volvulus is another very rare anomaly, with isolated case reports described in association with wandering spleen. The presentation varies from asymptomatic lump (stimulating a mass) to acute abdomen (due to torsion). We present a case of 26-year-old female patient who complained of pain in abdomen, and was radiologically diagnosed and surgically confirmed to have a torsion of wandering spleen with involvement of pancreatic tail and splenic flexure. Few cases with associated finding of gastric volvulus and sigmoid volvulus have been described previously. Involvement of descending colon in a 9-year-old child has been reported. However, to the authors' knowledge, this is the first case report describing the combination of wandering spleen with splenic flexure and pancreatic tail involvement in an adult.
{"title":"Torsion of a Wandering Spleen Involving the Pancreatic Tail and Splenic Flexure and Isolated Left-Sided Portal Hypertension due to Chronic Splenic Vein Thrombosis","authors":"M. Kachare, Pooja Jaisinghani","doi":"10.1055/s-0042-1749672","DOIUrl":"https://doi.org/10.1055/s-0042-1749672","url":null,"abstract":"Abstract Wandering spleen is a rare entity, wherein the spleen is attached only by an elongated vascular pedicle, predisposing it to complications like hilar torsion, infarction, rupture, etc. Pancreatic volvulus is another very rare anomaly, with isolated case reports described in association with wandering spleen. The presentation varies from asymptomatic lump (stimulating a mass) to acute abdomen (due to torsion). We present a case of 26-year-old female patient who complained of pain in abdomen, and was radiologically diagnosed and surgically confirmed to have a torsion of wandering spleen with involvement of pancreatic tail and splenic flexure. Few cases with associated finding of gastric volvulus and sigmoid volvulus have been described previously. Involvement of descending colon in a 9-year-old child has been reported. However, to the authors' knowledge, this is the first case report describing the combination of wandering spleen with splenic flexure and pancreatic tail involvement in an adult.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"3 1","pages":"202 - 208"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90468194","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. Natarajan, D. Phansalkar, G. Kurian, M. R., P. T., Jayaranjeetham Jayabalan
Abstract Objective Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging modality to study pancreaticobiliary tree. The primary aim of this study was to compare the image quality of MRCP obtained with the use of ferric ammonium chloride (negative oral contrast) with that of combined use of ferric ammonium chloride and ranitidine (administered orally). Secondary aim was to determine the interobserver agreement between the assessing radiologists. Materials and Methods The study was a single-center randomized-controlled trial. The patients were randomized into two groups. One group received ranitidine orally and ferric ammonium chloride (Dexorange) and the other group received only the ferric ammonium chloride. The images were qualitatively analyzed independently by the two blinded radiologists. Two scoring systems were used for grading the diagnostic quality of the images: the gastrointestinal tract signal intensity score (range: 1–4) and the structure visibility score (range: 0–3). The mean score of contrast effect and image effect of the two groups were compared by using Mann–Whitney U test. A p- value < 0.05 was considered statistically significant. Interobserver agreement was studied using Cohen kappa coefficient. Results A total of 93 patients were eligible for the study. Forty-one patients were randomly assigned to the group that received only negative oral contrast and 52 group that received both ranitidine and negative oral contrast. The mean score of the images obtained with using both ranitidine and negative oral contrast was significantly higher when compared with the other group (3.02 vs. 2.7) ( p -value = 0.018). However, there was no significant difference in mean structure visualization score of various parts of the pancreaticobiliary system. The interobserver agreement between the two readers in our study was acceptable. Conclusion Combined use of hematinic syrup and ranitidine increases the image quality by improving the suppression of gastrointestinal fluid signal as compared with the use of only hematinic syrup as negative oral contrast.
【摘要】目的磁共振胆管造影(MRCP)是一种研究胰胆树的无创成像方式。本研究的主要目的是比较使用氯化铁铵(口服阴性造影剂)和联合使用氯化铁铵和雷尼替丁(口服)获得的MRCP图像质量。次要目的是确定评估放射科医师之间的观察者之间的一致性。材料与方法本研究为单中心随机对照试验。患者随机分为两组。一组口服雷尼替丁和氯化铁铵(右橙)，另一组只口服氯化铁铵。图像由两位盲法放射科医生独立进行定性分析。采用两种评分系统对图像的诊断质量进行评分:胃肠道信号强度评分(范围:1-4)和结构可见性评分(范围:0-3)。采用Mann-Whitney U检验比较两组对比效果和图像效果的平均得分。p值< 0.05认为有统计学意义。采用Cohen kappa系数研究观察者间的一致性。结果共93例患者符合研究条件。41例患者被随机分配到只接受阴性口服造影剂的组和52例同时接受雷尼替丁和阴性口服造影剂的组。雷尼替丁联合口服阴性造影剂组的图像平均评分明显高于对照组(3.02 vs. 2.7) (p值= 0.018)。胰胆管系统各部位的平均结构可视化评分差异无统计学意义。在我们的研究中，两个读者之间的观察者之间的一致是可以接受的。结论联合使用血液学糖浆和雷尼替丁比单独使用血液学糖浆作为阴性口服造影剂，通过改善胃肠道液体信号的抑制，提高了图像质量。
{"title":"Combined Use of Negative Oral Contrast and Ranitidine for Magnetic Resonance Cholangiopancreatography: A Randomized Controlled Trial","authors":"A. Natarajan, D. Phansalkar, G. Kurian, M. R., P. T., Jayaranjeetham Jayabalan","doi":"10.1055/s-0042-1750138","DOIUrl":"https://doi.org/10.1055/s-0042-1750138","url":null,"abstract":"Abstract Objective Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging modality to study pancreaticobiliary tree. The primary aim of this study was to compare the image quality of MRCP obtained with the use of ferric ammonium chloride (negative oral contrast) with that of combined use of ferric ammonium chloride and ranitidine (administered orally). Secondary aim was to determine the interobserver agreement between the assessing radiologists. Materials and Methods The study was a single-center randomized-controlled trial. The patients were randomized into two groups. One group received ranitidine orally and ferric ammonium chloride (Dexorange) and the other group received only the ferric ammonium chloride. The images were qualitatively analyzed independently by the two blinded radiologists. Two scoring systems were used for grading the diagnostic quality of the images: the gastrointestinal tract signal intensity score (range: 1–4) and the structure visibility score (range: 0–3). The mean score of contrast effect and image effect of the two groups were compared by using Mann–Whitney U test. A p- value < 0.05 was considered statistically significant. Interobserver agreement was studied using Cohen kappa coefficient. Results A total of 93 patients were eligible for the study. Forty-one patients were randomly assigned to the group that received only negative oral contrast and 52 group that received both ranitidine and negative oral contrast. The mean score of the images obtained with using both ranitidine and negative oral contrast was significantly higher when compared with the other group (3.02 vs. 2.7) ( p -value = 0.018). However, there was no significant difference in mean structure visualization score of various parts of the pancreaticobiliary system. The interobserver agreement between the two readers in our study was acceptable. Conclusion Combined use of hematinic syrup and ranitidine increases the image quality by improving the suppression of gastrointestinal fluid signal as compared with the use of only hematinic syrup as negative oral contrast.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"46 1","pages":"008 - 014"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87564899","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}
Among the recent developments in computed tomography (CT), dual-energy CT (DECT) is one of the most important recent advances. The challenges with single-energy CT (SECT) acquisition are tissue characterization and lesion differentiation. In SECT, the two different elements with the same attenuation depict a similar Hounsfield’s unit. DECT can overcome this challenge. In DECT, tissues are imaged with two energy levels. The attenuation response to both energy levels is used to characterize the tissues further. This issue especially deals with the applications of DECT in abdominal imaging. In the first article, Alavandar et al1 have discussed the basic principles and available hardware in DECT. In the second article, Narappulan et al2 have analyzed the role of virtual monoenergetic imaging, one of the essential image sets generated from dual-energy source images. They discuss its role in evaluating hypervascular focal lesions in the liver. In the following article, Marri and Madhusudhan3 have explained the role of DECT in the evaluation of diffuse liver diseases like fat/iron deposition and fibrosis. In the subsequent article, Singh et al4 have discussed the use of DECT in evaluating gall bladder pathologies. Further in the issue, Mroueh et al5 have explained the role of DECT in pancreas imaging with applications in pathologies like pancreatitis, trauma, and pancreatic neoplasms. In the following article by Mehra,6 DECT role in urolithiasis has been discussed extensively. Lastly, in the article by Tripathy et al,7 DECT applications in abdominal interventions are discussed. The role of calcium and bone subtraction images in evaluating vessels in atherosclerotic diseases and virtual noncontrast images/iodine maps in evaluating residual tumors following locoregional treatment of HCC is explained very well in this article. This article also analyzes the evaluation of endoleaks in low monoenergetic images and metal artifacts reduction in high monoenergetic data sets. We wish our readers an enjoyable and highly informative reading.
{"title":"Dual-Energy Computed Tomography Applications in the Abdomen","authors":"R. Venkataramanan, V. Arunachalam","doi":"10.1055/s-0042-1750724","DOIUrl":"https://doi.org/10.1055/s-0042-1750724","url":null,"abstract":"Among the recent developments in computed tomography (CT), dual-energy CT (DECT) is one of the most important recent advances. The challenges with single-energy CT (SECT) acquisition are tissue characterization and lesion differentiation. In SECT, the two different elements with the same attenuation depict a similar Hounsfield’s unit. DECT can overcome this challenge. In DECT, tissues are imaged with two energy levels. The attenuation response to both energy levels is used to characterize the tissues further. This issue especially deals with the applications of DECT in abdominal imaging. In the first article, Alavandar et al1 have discussed the basic principles and available hardware in DECT. In the second article, Narappulan et al2 have analyzed the role of virtual monoenergetic imaging, one of the essential image sets generated from dual-energy source images. They discuss its role in evaluating hypervascular focal lesions in the liver. In the following article, Marri and Madhusudhan3 have explained the role of DECT in the evaluation of diffuse liver diseases like fat/iron deposition and fibrosis. In the subsequent article, Singh et al4 have discussed the use of DECT in evaluating gall bladder pathologies. Further in the issue, Mroueh et al5 have explained the role of DECT in pancreas imaging with applications in pathologies like pancreatitis, trauma, and pancreatic neoplasms. In the following article by Mehra,6 DECT role in urolithiasis has been discussed extensively. Lastly, in the article by Tripathy et al,7 DECT applications in abdominal interventions are discussed. The role of calcium and bone subtraction images in evaluating vessels in atherosclerotic diseases and virtual noncontrast images/iodine maps in evaluating residual tumors following locoregional treatment of HCC is explained very well in this article. This article also analyzes the evaluation of endoleaks in low monoenergetic images and metal artifacts reduction in high monoenergetic data sets. We wish our readers an enjoyable and highly informative reading.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82526224","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}
Objectives The objectives of this study are to describe the role of dual-energy computed tomography (DECT) in evaluation of renal stones in current practice and elaborate the imaging findings that need to be reported to help surgeons make an appropriate management strategy for renal stones. Background Nephrolithiasis is a global problem, affecting people across geographical, cultural, and economic boundaries. Renal stones can be accurately diagnosed on computed tomography. Discussion With the development of DECT, renal stones can now be better characterized in terms of stone burden, stone composition, and stone fragility. Conclusion These parameters are helpful to treating surgeons in not only planning an appropriate management for patient but also in predicting the success of the various procedures such as extracorporeal shock wave lithotripsy, flexible ureterorenoscopy, or percutaneous nephrolithotomy. Familiarity with recent developments will help radiologists give an apt description of renal stone to meet the requirements of treating surgeon.
{"title":"Role of Dual-Energy Computed Tomography in Urolithiasis","authors":"Shibani Mehra","doi":"10.1055/s-0042-1749108","DOIUrl":"https://doi.org/10.1055/s-0042-1749108","url":null,"abstract":"\u0000 Objectives The objectives of this study are to describe the role of dual-energy computed tomography (DECT) in evaluation of renal stones in current practice and elaborate the imaging findings that need to be reported to help surgeons make an appropriate management strategy for renal stones.\u0000 Background Nephrolithiasis is a global problem, affecting people across geographical, cultural, and economic boundaries. Renal stones can be accurately diagnosed on computed tomography.\u0000 Discussion With the development of DECT, renal stones can now be better characterized in terms of stone burden, stone composition, and stone fragility.\u0000 Conclusion These parameters are helpful to treating surgeons in not only planning an appropriate management for patient but also in predicting the success of the various procedures such as extracorporeal shock wave lithotripsy, flexible ureterorenoscopy, or percutaneous nephrolithotomy. Familiarity with recent developments will help radiologists give an apt description of renal stone to meet the requirements of treating surgeon.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72841371","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}
N. Kapur, R. Kapur, M. Varma, Chakshu Batra, B. Sharma
Abstract Perianal fistula (PF) is a common inflammatory condition affecting the perianal region including the sphincter muscles, ischioanal fossae, and the perianal skin. It is notorious to recur and, as a result, causes significant morbidity in both urban and rural population. Magnetic resonance imaging (MRI) has revolutionized imaging in PFs as it provides excellent anatomical visualization of the fistulous tracts, their origin, course, number, chronicity, opening in the external and internal anal sphincter, length of sphincter, evidence of active disease and abscess formation along the tract. It is also very useful in presurgical mapping and reduce the chances of recurrence. Most of the studies done on PFs are based on the urban population. Rural population have a completely different lifestyle which makes them susceptible to various diseases, less prevalent in the urban population. Hence, the purpose of this article is to find the prevalence of different grades in North Indian rural region close to the NCR (National Capital Region). In the study including 98 patients, the maximum number of patients were classified into grade 1 and grade 4 by MRI according to St. James' University Hospital MRI classification. This is the second reported study on prevalence of different grades of PFs in rural population in India. The higher prevalence of grade 4 PFs in our study might be secondary to illiteracy, social stigma, poor hygiene, or higher recurrence rate. Closely understanding the difference in dynamics of urban and rural population, our goal of the study is to determine the prevalence of different grades of PFs in the rural population. We also aim to familiarize physicians, radiologists, and surgeons with the MRI evaluation and grading of PF to help in presurgical mapping and thus, reducing the chances of recurrence. We also recommend further studies to evaluate psycho-social factors as a barrier in seeking early medical care in rural population.
{"title":"Fistula in Ano—A 2-Year Prevalence Study on North Indian Rural Population","authors":"N. Kapur, R. Kapur, M. Varma, Chakshu Batra, B. Sharma","doi":"10.1055/s-0042-1743174","DOIUrl":"https://doi.org/10.1055/s-0042-1743174","url":null,"abstract":"Abstract Perianal fistula (PF) is a common inflammatory condition affecting the perianal region including the sphincter muscles, ischioanal fossae, and the perianal skin. It is notorious to recur and, as a result, causes significant morbidity in both urban and rural population. Magnetic resonance imaging (MRI) has revolutionized imaging in PFs as it provides excellent anatomical visualization of the fistulous tracts, their origin, course, number, chronicity, opening in the external and internal anal sphincter, length of sphincter, evidence of active disease and abscess formation along the tract. It is also very useful in presurgical mapping and reduce the chances of recurrence. Most of the studies done on PFs are based on the urban population. Rural population have a completely different lifestyle which makes them susceptible to various diseases, less prevalent in the urban population. Hence, the purpose of this article is to find the prevalence of different grades in North Indian rural region close to the NCR (National Capital Region). In the study including 98 patients, the maximum number of patients were classified into grade 1 and grade 4 by MRI according to St. James' University Hospital MRI classification. This is the second reported study on prevalence of different grades of PFs in rural population in India. The higher prevalence of grade 4 PFs in our study might be secondary to illiteracy, social stigma, poor hygiene, or higher recurrence rate. Closely understanding the difference in dynamics of urban and rural population, our goal of the study is to determine the prevalence of different grades of PFs in the rural population. We also aim to familiarize physicians, radiologists, and surgeons with the MRI evaluation and grading of PF to help in presurgical mapping and thus, reducing the chances of recurrence. We also recommend further studies to evaluate psycho-social factors as a barrier in seeking early medical care in rural population.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"43 1","pages":"140 - 147"},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75273037","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}
Dual-energy computed tomography (DECT) is an evolving imaging technology that is gaining popularity, particularly in different abdominopelvic applications. Essentially, DECT uses two energy spectra simultaneously to acquire CT attenuation data which is used to distinguish among structures with different tissue composition. The wide variety of reconstructed image data sets makes DECT especially attractive in pancreatic imaging. This article reviews the current literature on DECT as it applies to imaging the pancreas, focusing on pancreatitis, trauma, pancreatic ductal adenocarcinoma, and other solid and cystic neoplasms. The advantages of DECT over conventional CT are highlighted, including improved lesion detection, radiation dose reduction, and enhanced image contrast. Additionally, data exploring the ideal protocol for pancreatic imaging using DECT is reviewed. Finally, limitations of DECT in pancreatic imaging as well as recommendations for future research are provided.
{"title":"Dual-Energy CT in the Pancreas","authors":"N. Mroueh, Jinjin Cao, A. Kambadakone","doi":"10.1055/s-0042-1744494","DOIUrl":"https://doi.org/10.1055/s-0042-1744494","url":null,"abstract":"Dual-energy computed tomography (DECT) is an evolving imaging technology that is gaining popularity, particularly in different abdominopelvic applications. Essentially, DECT uses two energy spectra simultaneously to acquire CT attenuation data which is used to distinguish among structures with different tissue composition. The wide variety of reconstructed image data sets makes DECT especially attractive in pancreatic imaging. This article reviews the current literature on DECT as it applies to imaging the pancreas, focusing on pancreatitis, trauma, pancreatic ductal adenocarcinoma, and other solid and cystic neoplasms. The advantages of DECT over conventional CT are highlighted, including improved lesion detection, radiation dose reduction, and enhanced image contrast. Additionally, data exploring the ideal protocol for pancreatic imaging using DECT is reviewed. Finally, limitations of DECT in pancreatic imaging as well as recommendations for future research are provided.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85399841","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}
Garima Jain, Nirmala Royal, Pramila Sharma, A. Bhandari, K. Mendiratta
Abstract Intussusception is one of the common causes of bowel obstruction in pediatric age group and is of idiopathic variety in most of the cases. Nonobstructing intussusception presenting with nonspecific symptoms (or chronic pain abdomen) is rare and usually clinically misdiagnosed/difficult to diagnose. The authors present a pictorial review of 10 cases of pediatric nonobstructing intussusception presenting with acute/chronic abdominal pain which were not suspected clinically but diagnosed with a pathologic lead point radiologically.
{"title":"Unsuspecting Lead Points Causing Nonobstructing Intussusceptions in Pediatric Patients Presenting with Chronic Pain Abdomen","authors":"Garima Jain, Nirmala Royal, Pramila Sharma, A. Bhandari, K. Mendiratta","doi":"10.1055/s-0042-1743511","DOIUrl":"https://doi.org/10.1055/s-0042-1743511","url":null,"abstract":"Abstract Intussusception is one of the common causes of bowel obstruction in pediatric age group and is of idiopathic variety in most of the cases. Nonobstructing intussusception presenting with nonspecific symptoms (or chronic pain abdomen) is rare and usually clinically misdiagnosed/difficult to diagnose. The authors present a pictorial review of 10 cases of pediatric nonobstructing intussusception presenting with acute/chronic abdominal pain which were not suspected clinically but diagnosed with a pathologic lead point radiologically.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"40 1","pages":"157 - 164"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75795834","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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