Clinical imaging
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Thirty-three patients were examined by color-coded Doppler ultrasound of the thoracoaxillary region or upper arm to review the utility of the method in this local area. The subclavian artery and vein were identified in all but one patient, in whom the subclavian vein was occluded and collateral vessels had developed. Masses and foreign bodies were easily distinguished from vascular abnormalities. ⋯ Carotid subclavian grafts were noted and evaluated appropriately in two patients. Color-coded sonography offered advantages in speed of localization of vessels and visual assessment of vessel location, direction of flow, turbulence, relationship to adjacent soft tissues, and detection of collateralization. Foreign body detection was not enhanced by color coding.
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Randomized Controlled Trial Comparative Study Clinical Trial
Dose optimization of nonionic contrast agent in dynamic computed tomography scanning of the abdomen and pelvis.
A prospective, randomized study was performed to examine the image quality of varying reduced doses of an intravenous (IV) nonionic contrast agent (ioversol, 320 mg/ml organically bound iodine) compared with the quality obtained using the maximum permissible dose (150 ml) of the same agent. Forty-five patients referred for abdominal-pelvic computed tomography (CT) scan were randomized into five groups to receive contrast doses equivalent to 100, 75, 65, 50, or 30% of 150 ml of contrast agent. ⋯ Patients receiving 65% and lower doses demonstrated a statistically significant decrease in enhancement, although all scans were diagnostically adequate. This study demonstrates that dynamic abdominal and pelvic CT scans obtained using a reduced dose of nonionic IV contrast agent are equivalent in diagnostic image quality compared with those scans obtained with the higher permissible dose of the same agent.
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Lymphangioleiomyomatosis (LAM) is a rare disease of women of child-bearing age characterized by the proliferation of smooth muscle throughout the lymph nodes and lymphatic channels of the retroperitoneum, mediastinum, and lungs. Most previous reports of LAM have concentrated on the pulmonary findings. ⋯ On computed tomography (CT) the lymphadenopathy was heterogeneous in nature but was predominantly of low attenuation. We believe that when CT demonstrates low-attenuation lymphadenopathy in the mediastinum or retroperitoneum of a woman of child-bearing age, LAM should be considered as a likely diagnosis.
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Two cases of posttraumatic pulmonary pseudocyst are reported. The characteristic thin-walled cystic lesions with air-fluid level were demonstrated in both cases by computed tomography but in only one case by conventional chest radiography. It is predicted that more such pseudocysts would be identified by using computed tomography with patients with blunt chest trauma.
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Traditional Chinese acupuncture involves placing needles into the subcutaneous tissues along predefined meridians, and later totally removing the needles. A peculiar form of acupuncture exists called "Hari", which involves the permanent placement of fine needles into the subcutaneous tissues. ⋯ Several reports have appeared describing their curious radiologic appearance. We present plain films, sonograms, and computed tomography findings of three patients who have undergone this form of acupuncture, and describe their implications in radiographic and clinical evaluation.