European radiology
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Comparative Study
The value of CT diagnosis of hernia recurrence after prosthetic repair of ventral incisional hernias.
Herein we present a prospective study made to compare the diagnostic value of a physical examination and a CT scan in the detection of a hernia relapse after carrying out of a intraperitoneal hernioplasty using a non-resorbable mesh. Fifty patients operated on for intraperitoneal hernioplasty with ePTFE mesh and postoperative symptomatology were assessed within a year of the operation via a physical exploration and CT. Each of the patients was subjected to an exploratory laparoscopy for the purpose of confirming the diagnosis. ⋯ The negative predictive values were 1 and 0.95, respectively. The differences between the values of both methods held a statistical meaning (chi-square test; p < 0.05). The postoperative assessment by CT of symptomatic patients who have been operated on for an intraperitoneal hernioplasty with unabsorbable mesh facilitates carrying out a correct diagnosis in the detection or exclusion of hernial relapse.
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Case Reports
Dynamic gadolinium-enhanced MR imaging of pancreatic VIPoma in a patient with Verner-Morrison syndrome.
We describe a rare case of a pancreatic VIPoma diagnosed in a patient presenting with watery diarrhea, hypokalemia, and achlorhydria, the so-called WDHA or Verner-Morrison syndrome. Emphasis is placed on the dynamic gadolinium-enhanced MR profile of the tumor, characteristics which have not been illustrated previously, to the best of our knowledge.
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The aim of this study was to compare 2D and 3D CT imaging in the pre- and postoperative evaluation of complex benign larynges-tracheal airway stenoses with rigid endoscopy, considered as the gold standard. Six patients (aged 5-72 years) with a total of nine complex laryngo-tracheal stenoses underwent non-contrast helical CT scans (slice thickness 3 mm, pitch 1.3, reconstruction interval 1.5 mm) before and after surgical resection. With prototype software, virtual endoscopy (VE) post-processing algorithms were applied to the imaging data sets. ⋯ Two-dimensional images and 3D VE of tracheal stenoses proved to be efficient and complementary to the rigid endoscopy, permitting a reliable endoluminal 3D view and evaluation of the surrounding anatomical structures. Limitations of this technique relate to the maximal spatial resolution of 1.5 mm, the lack of color, and the inability to assess the mucosa. Virtual endoscopy is for complex laryngo-tracheal stenoses an excellent complement for rigid endoscopy, remaining the method of reference, and may be indicated with complicated pathological structures.
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Assessment of vascular proliferation as an important grading criterion has been employed in both the histologic and the radiologic characterization of gliomas with encouraging results. Perfusion in gliomas can be measured by dynamic contrast-enhanced magnetic resonance imaging (dMRI). The goal of this study was to develop a model for simultaneously quantifying the fractional volumes of different tissue compartments of gliomas by dMRI. ⋯ Using cerebral blood volume (CBV), dMRI grading showed a correspondence with WHO grading in 83% of the cases (20/24 gliomas WHO grades II-IV). The use of interstitial volume maps can also be helpful, for instance, in differentiating gliomas from other brain tumors. As a supplement to conventional MRI, dynamic MR techniques thus provide a useful tool for improving in vivo glioma characterization.