Acute appendicitis: the radiologist's role

Article Abstract:

Appendicitis (acute inflammation of the appendix) is usually diagnosed from clinical findings, with surgery being performed immediately. Immediate surgery is necessary to remove the appendix before it bursts, but in many cases, the appendix is found to be normal at surgery. Surgery itself can lead to complications and unnecessary surgery should be avoided. Diagnostic imaging can be useful for diagnosing appendicitis. The most common technique is to perform an X-ray after a patient is given a barium enema. This technique is highly accurate and safe, although it can falsely identify a normal appendix as diseased. In recent years, ultrasound (US) has been investigated as a tool for diagnosing appendicitis. US uses high-frequency sound waves to produce images. In the July 1991 issue of Radiology, an article by Balthazar et al. examines the value of computed tomography (CT) in diagnosing appendicitis. This technique involves computer analysis of scanning X-rays of the body. Results from that study suggest that CT is very useful for diagnosing appendicitis. The question remaining is which imaging technique is best. Both US and CT appear to be better than the barium enema technique. US is very effective and cheaper than CT, but requires a highly experienced technician. CT may be more useful when it is thought that the appendix has already burst. Further research should help clarify the optimal use of current imaging techniques to help diagnose appendicitis and to prevent unnecessary surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, CT imaging, CAT scans, Appendicitis, Surgery, Unnecessary, Unnecessary surgery, editorial

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Lung abscesses: US examination and US-guided transthoracic aspiration

Article Abstract:

Lung abscesses are infected areas of the lung characterized by inflamed and pus-filled sacs of damaged tissue. Bacterial infections are a frequent cause of these abscesses. It is difficult to isolate the bacteria causing the infection because samples from the abscessed area are not easily obtained. Ultrasound (US) imaging is a technique that uses high frequency sound waves in order to produce images of tissues and organs. This study examined using US imaging to evaluate the abscessed areas and to guide a needle for taking samples from the abscessed areas. US and US-guided needle aspiration were performed on 35 patients with lung abscesses. Samples obtained were sent for microbial analysis. Lung abscesses as seen on US were oval with irregular outer margins, walls of irregular thickness, and an abscess cavity. US-guided needle aspiration was performed on 33 patients and was successful for 31. A total of 65 types of bacteria were isolated from the 33 patients. Other methods were only able to isolate seven of 65 types at most. These results indicate that US-guided needle aspiration of lung abscesses is both safe and effective for obtaining samples needed to isolate the underlying cause. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Lungs, Bacterial infections, Lung abscess

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