Peptic ulcer disease: CT evaluation (computed tomography)

Article Abstract:

Peptic ulcer disease (PUD) mainly involves the mucosa (tissue lining) of the stomach or intestines. It can lead to perforations or penetrations, known as peptic ulcers, into the tissues of these organs. Imaging of PUD in a noninvasive manner would be of great help in diagnosis and treatment. Computed tomography (CT) is an imaging technique in which computer-generated images are obtained from scanning X-rays. It is generally thought that CT cannot detect mucosal ulceration, but that it may be able to detect perforations caused by PUD. This study examined the value of CT in detecting PUD. Thirty-five patients with PUD were examined with CT. The clinical findings of PUD were correlated with the CT findings to see if CT could detect and evaluate PUD. Eight of the patients actually had gastritis or duodenitis (inflammation of the stomach or duodenum). CT of these eight showed bowel-wall thickening in three. The remaining 27 patients had PUD, with nine having perforations or penetrations as found clinically. CT was able to detect perforations or penetrations in six of the nine patients diagnosed with it clinically. CT also detected penetration in four patients not detected clinically. CT misdiagnosed three ulcers (found to be ulcers during surgery) as being tumors. These results indicate that CT has some, but limited, use in evaluating PUD. It is not useful in evaluating disease that does not involve any complications, and it can also misdiagnose ulcers as being other diseases. CT can be useful in patients with vague clinical signs suspicious of penetration. CT evidence of penetration would indicate the need for surgical exploration. (Consumer Summary produced by Reliance Medical Information, Inc.)

CT imaging, CAT scans, Gastrointestinal diseases, Gastrointestinal system, Peptic ulcer

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Biliary tract dilatation in chronic pancreatitis: CT and sonographic findings

Article Abstract:

Forty-four patients with a history of long-standing pancreatic inflammation (pancreatitis) were included in a retrospective study to determine which features obtained from various medical imaging techniques correlated with dilatations of the ducts common to both liver and pancreas. These results were also compared to anatomic findings obtained at time of surgery or by biopsy. Both sonography (also called ultrasound), a noninvasive technique which allows computer-generated images of the abdomen to be formed through the use of sound waves, and computed tomography, an X-ray system which provides high quality images of the abdominal structures, were used. Changes in the status of the ducts were also followed over a period of one to 48 months, as was the relationship of these findings to other laboratory data. Forty-one of the forty-four patients in this group had a history of alcohol abuse. Of this group of patients 24 were found to have dilatations of the bile duct system of which 88 percent had calcium deposition in the pancreas and 75 percent had a tumor of the head of the pancreas. Twenty patients did not show biliary duct dilatation by either sonography or CT. The reported rate of dilatation of the bile duct system shown in previous studies ranged from five to sixty-six percent. In this study the rate was found to be 55 percent. This finding may be perhaps distorted due to the inclusion of hospitalized patients who are in worse condition than the average pancreatitis patient.

Ultrasound imaging, PET imaging, Positron emission tomography, Pancreatic diseases, Cysts, Pancreatitis, Bile ducts, Diagnosis, Ultrasonic, Diagnostic ultrasonography, Pancreatic cysts, Pancreatic duct

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Lymphadenopathy in primary biliary cirrhosis: CT observations

Article Abstract:

Primary biliary cirrhosis is a rare disease of the small bile ducts within the liver. Computed tomography (CT) scanning was used to analyze lymphadenopathy (disease of the lymph nodes) in 21 patients. Research demonstrated that these findings may be misinterpreted as lymphoma (tissue growth in the lymphatic system) or metastatic disease (movement of diseased cells, especially cancer, from one part of the body to another). The results show that lymphadenopathy is a common CT finding in primary biliary cirrhosis. Two unexpected findings were reported: lymphadenopathy in the paracardiac (near the heart) region and mesenteric lymphadenopathy, which occurred in 19 percent of the patients studied (the mesentery is a peritoneal fold around the greater part of the small intestine, connecting the intestine to the rear abdominal wall). The CT finding of enlarged lymph nodes in the small bile ducts within the liver (hepatic portal) suggests a diagnosis of metastatic cancer or lymphoma, particularly in patients with elevated levels of liver enzymes.

Lymphomas, Liver cirrhosis, Medical imaging equipment, Lymphadenopathy

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