AJR. American journal of roentgenology
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AJR Am J Roentgenol · Feb 1990
Sonographic diagnosis of perforation in patients with acute appendicitis.
The sonographic diagnosis of appendicitis can be challenging in patients with perforation. In order to detect the accuracy of specific sonographic features of appendiceal perforation, graded compression sonograms in 100 patients with surgically confirmed acute appendicitis were reviewed retrospectively. Twenty-two of these patients had perforation. ⋯ By using a combination of one or more findings, the overall sensitivity of sonography for the diagnosis of perforation was 86%. The specificity, however, was only 60%. Our results suggest that in patients without a sonographically visible appendix, recognition of loculated pericecal fluid and prominent pericecal fat may be a useful indirect clue to the diagnosis of perforating appendicitis.
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AJR Am J Roentgenol · Feb 1990
Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.
A retrospective study was performed to determine the clinical and pathologic features, etiology, and outcome of children with the reversal sign. The reversal sign, a striking CT finding, probably represents a diffuse, anoxic/ischemic cerebral injury. CT features of the reversal sign are diffusely decreased density of cerebral cortical gray and white matter with a decreased or lost gray/white matter interface, or reversal of the gray/white matter densities and relatively increased density of the thalami, brainstem, and cerebellum. ⋯ In five of seven patients who died, autopsy findings were consistent with anoxic/ischemic encephalopathy. Surviving patients have profound neurologic deficits with severe developmental delay. The CT reversal sign carries a poor prognosis and indicates irreversible brain damage.
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AJR Am J Roentgenol · Jan 1990
Comparative StudyCT and chest radiography are equally sensitive in the detection of pneumothorax after CT-guided pulmonary interventional procedures.
Pneumothorax is the most common complication after CT-guided pulmonary interventional procedures and should be promptly diagnosed and treated. Because it is easier to obtain CT scans than chest radiographs after CT-guided interventional procedures, it is important to know the sensitivity of CT in detecting pneumothoraces. To determine the sensitivity of CT for detecting procedure-induced pneumothoraces, we retrospectively reviewed 70 pulmonary interventional procedures performed under CT guidance. ⋯ Twenty-nine (91%) of the pneumothoraces were detected on CT scans and 27 (84%) were detected on chest radiographs. The difference between these two detection rates was not statistically significant (p less than .90). We conclude that postprocedure CT scans can replace expiratory chest radiographs for the detection of pneumothoraces after CT-directed pulmonary procedures.
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AJR Am J Roentgenol · Jan 1990
Radiographic detection of esophageal malpositioning of endotracheal tubes.
Insertion of an endotracheal tube into the esophagus is an infrequent but life-threatening complication of endotracheal intubation. This complication is difficult to detect on standard, anteroposterior, portable chest radiographs because the incorrectly placed endotracheal tube is usually projected over the tracheal air column. To evaluate the use of chest radiographs to detect the malposition, we performed a two-part study. ⋯ The study of the portable chest radiographs showed that the endotracheal tube position could be identified correctly in 81 (92%) of 88 of the films made with the patient in a 25 degrees right posterior oblique position. The trachea and esophagus were superimposed in 25 (96%) of 26 of the radiographs made with the head turned to the left and with the patient in a 25 degrees left posterior oblique projection. Our results show that by positioning patients for chest radiographs in a 25 degrees right posterior oblique position, the location of endotracheal tubes can be identified accurately.