The purpose of this study was to describe CT findings of colonic involvement in acute nonnecrotizing pancreatitis and to analyze the correlation between colonic wall thickening at CT and the clinical course of these patients. The CT examinations of 19 consecutive patients with acute non-necrotizing pancreatitis who were not treated with antibiotics initially were analyzed retrospectively. The severity of acute pancreatitis was categorized according to the CT severity index (CTSI) and the presence of colonic wall thickening at the initial CT was compared with the clinical course of all patients. Seven of 11 patients with a CTSI of 4 showed a colonic wall thickening, whereas the remaining patients with a CTSI of 4 (n=4), CTSI of 3 (n=5), and CTSI of 2 (n=3) showed no colonic abnormalities at CT. Patients with colonic wall thickening presented more often with fever, showed higher levels of infectious parameters, needed more often antibiotic therapy, and had more requests for additional CT examinations and CT-guided fluid aspirations as well as a longer duration of hospital stay as compared with patients without colonic wall involvement, even if the latter presented with the same CTSI initially. It is well known that translocation of the colonic flora may significantly influence the clinical course of patients with acute pancreatitis, and our results indicate that patients with acute pancreatitis who present with colonic wall thickening at CT have an increased risk for a complicated clinical course regarding systemic infection.
Single CT criteria are not reliable enough to differentiate benign from malignant adrenal lesions: better results are achieved by using our scoring system.
The capabilities of a patient-oriented digital optical laser-card for the documentation of the image/report unit and for image transmission were assessed. 150 conventional X-rays covering the fields of urology (n = 50), traumatology (n = 50) and orthopaedics (n = 50) were digitised using a CCD scanner and subsequently transmitted to an Image-Transfer Medium (ITM) and to an optical laser-card. The image quality for the detection of relevant diagnostic parameters was evaluated by 4 radiologists and one clinician of the corresponding specialty. Based upon a total of 4740 decision readings for each method, it was found that the optical laser-card reduced the image quality significantly (p < 0.01) in comparison to the digitised ITM images in all fields. Thus, a primary diagnostic statement cannot be made based upon the images of the optical card. However, concomitant documentation of the image and opinion on the card may be used for the transmission of the radiological report, especially to external referring institutions.
Gastrointestinale Stromatumoren (GIST) sind die häufigsten mesenchymalen Tumoren des Gastrointestinaltraktes. Immunhistochemisch werden sie durch die positive Reaktivität für den c-kit Rezeptor (CD117) in nahezu allen Fällen charakterisiert. Sie treten im ganzen Gastrointestinaltrakt, Mesenterium und Omentum auf, werden jedoch vorwiegend im Magen angetroffen. Das klinische Verhalten bezüglich Dignität ist oft schwer vorherzusagen. 17–25% der GIST sind maligne. Von den histopathologischen Kriterien, die für Malignität sprechen, sind der Tumordurchmesser über 5 cm und die Tumornekrosen am besten in der Bildgebung fassbar. Ebenso gelten radiologisch nachweisbare Metastasen als sicheres Zeichen der biologischen Malignität. Die Bildgebung spielt nicht nur für Lokalisation, Ausdehnung des Primärtumors und das Staging eine wichtige Rolle, sondern auch für Nachsorge und simultanen oder im Verlauf späteren Ausschluss seltener assoziierter Tumorentitäten wie das pulmonale Chondrom und das extraadrenale Paraganglion (Carney-Syndrom).
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