Acquired malposition of the colon and gallbladder in patients with cirrhosis: CT findings and clinical implications
Article Abstract:
Cirrhosis of the liver is the result of various infections, inflammations, and insults to the liver that culminate in a chronic disease characterized by dense connective tissue and degeneration of liver function. The health of the liver affects other areas of the abdomen in close proximity to it. X-ray images have shown that diseased livers undergo radical changes in volume. Consequently, changes in liver volume may alter the position of such organs as the gallbladder, kidney, colon, stomach, and duodenum (first part of the small intestine). Research, using computed tomography (CT) scanning, demonstrated changes in the position of the gallbladder and colon following alteration in liver volume due to the cirrhotic disease process of alteration in liver volume. It is important to assess changes in the locations of these organs before performing a biopsy (removal of a small tissue sample from a living person); CT or ultrasound (US) can be used to guide the device which collects the tissue sample. It has been shown that patients with cirrhotic livers suffer a higher rate of complications during biopsy (12.8 percent) than do persons with noncirrhotic livers (normal in size, shape, and function; 3.8 percent). Complications resulting from biopsy range from bleeding to puncture of the peritoneum (the membrane that holds the organs of the gut). Inadvertent puncture of organs adjacent to the liver, such as the gallbladder, kidney, lung, and pancreas has also been reported. Therefore, if abnormalities in the position of the gallbladder and colon are encountered, a CT imaging examination should be done to determine the shape and size of the liver in persons suspected or known to have cirrhotic liver disease.
Publication Name: Radiology
Subject: Health
ISSN: 0033-8419
Year: 1989
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Comparison of scanning equalization and conventional chest radiography
Article Abstract:
Chest X-rays are the most commonly performed radiologic exam in the US. They are usually used to examine the chest for lung and cardiac diseases. Researchers compared a new chest radiographic scanning technique (SER, scanning equalization radiography) and two conventional methods of chest X-ray to evaluate the diagnostic accuracy and usefulness of the SER. The factor which distinguishes the SER from conventional X-ray is its use of a computer to optimally control x-ray distribution to all areas of the chest, permitting clearer imaging of the thicker parts of the chest: the mediastinum (contains the organs that pass between the lungs such as the heart, major blood vessels and esophagus), heart and diaphragm. Images of the chest were obtained on 253 volunteers with the conventional X-rays and an SER prototype system; all of the images were then evaluated by four radiologists. Results of these clinical trials reveal that there was an improvement in diagnostic accuracy by all the radiologists with the SER imaging technique which provided superior imaging of the structures in the chest. There was no disease category in which diagnostic accuracy decreased with the SER system. In addition, the greatest improvement occurred in diagnosing normal chest images; this effect can prevent false positive reports of disease (reporting disease when there is none) and save patients from having to undergo further testing while holding back medical costs.
Publication Name: Radiology
Subject: Health
ISSN: 0033-8419
Year: 1989
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Duplex Doppler US of renal allografts: causes of elevated resistive index
Article Abstract:
Doppler Ultrasound (doppler sound waves possess specific sound wave frequency changes) imaging was used to assess the causes of kidney transplant (allograft) failure among 162 patients. The period immediately following transplantation is helpful in predicting the type of rejection that will take place, according to the research. Less than 2 percent of the failures were hyperacute (within 24 hours after transplant surgery). Hyperacute pathology was characterized by blood vessel damage (generally poor blood flow due to occlusion of a vessel) and the infiltration of granulocytes (white blood cells that attack a foreign body) characteristic of the body's immune response to a foreign body. Acute rejection began early (24 hours after surgery) resulting in damage to the kidneys at the cellular level in conjunction with blood vessel damage. Chronic rejection was slow in developing and began six months after transplant surgery. Chronic kidney rejection demonstrates tissue damage, the presence of abnormally high numbers of leukocytes in the blood and infiltration of cells into the kidney. Although the study was able to formulate three basic categories of rejection 'type' it was not able to develop a predictive method to calculate the likelihood of rejection based on the results of a post-transplant Doppler US scan.
Publication Name: Radiology
Subject: Health
ISSN: 0033-8419
Year: 1989
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