The purpose of this study was to evaluate CT findings of phytobezoar associated with small bowel obstruction. We evaluated abdominal CT of 19 patients with phytobezoar. Abdominal CT of 6 patients with small bowel feces was included for the comparison. On CT we analyzed morphological features of phytobezoars such as location, number, size, shape, and the presence or absence of an encapsulating wall. The sites of the phytobezoar were in the jejunum in 12 patients (63%) and the ileum in 7 (37%). The phytobezoars were single in number in 13 patients (68%) and multiple in 6 (32%). The mean short- and long-axis diameters of the phytobezoars measured 3.2 cm (range 2.1-5.2 cm) and 5.2 cm (range 2.2-11.0 cm), respectively. The phytobezoars were ovoid in 9 patients, round in 6, and tubular in 4. On CT, phytobezoars appeared as gas-containing masses in 17 patients (89%) and as a solid mass without gas in the remaining 2 patients (11%). An encapsulating wall was noted in 6 patients (32%). Small bowel feces were much more tubular in shape but did not have encapsulating wall on CT. The CT imaging is useful in making the diagnosis of phytobezoar associated with small bowel obstruction.

Penile fracture is a rare but serious urologic condition that typically requires surgical repair. Because of its multiplanar capability and excellent tissue contrast, magnetic resonance (MR) imaging can be a useful diagnostic tool in the evaluation of patients with acute penile fracture. MR imaging can accurately depict the presence, location, and extent of tunical tear, which manifests as discontinuity of the tunica albuginea. Moreover, because the tunica albuginea is well demonstrated as a low-signal-intensity structure on both T1- and T2-weighted images, MR imaging is optimal for the evaluation of the integrity of this anatomic structure even in patients with severe pain and swelling of the penis. This capability makes MR imaging particularly helpful in determining the need for surgical intervention, which is largely based on the integrity of the tunica albuginea. Associated injuries to adjacent structures (eg, corpus spongiosum, urethra) can also be demonstrated. In patients with no penile fracture, MR imaging can demonstrate an intact tunica albuginea and the presence of intracavernosal or extratunical hematoma. It remains uncertain whether the routine use of contrast material-enhanced MR imaging is justified, and further study is needed to determine the role of this modality.

Conventional radiographic contrast material-enhanced studies (eg, retrograde urethrography [RUG], voiding cystourethrography [VCUG], double-balloon catheter urethrography) and ultrasonography are useful in evaluating the anatomy of the urethra but are limited in demonstrating anatomic derangement of adjacent structures. Since the anatomic details of both the urethra and periurethral tissues can be evaluated noninvasively with magnetic resonance (MR) imaging, this modality can be used as an adjunctive tool for evaluation of urethral abnormalities. In patients with congenital anomalies, MR imaging is reserved for cases of intersex anomalies or complex genitourinary anomalies, in which evaluation of internal organs is essential. MR imaging may demonstrate diverticula that are not seen on radiographic contrast-enhanced studies, including VCUG, RUG, or double-balloon catheter study. In cases of inflammation, MR imaging can demonstrate not only inflammatory infiltration around the urethra but also the presence of a periurethral abscess or sinus tract. In cases of trauma, MR imaging is helpful in assessing the presence and extent of anterior or posterior urethral injury and predicting the occurrence of complications. At MR imaging, a fistula can be seen as a direct communicating channel with an adjacent organ. In patients with urethral tumors, the major role of MR imaging is in local staging.

The purpose of this study was to evaluate the ability of pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent in depicting renal parenchymal changes in acute pyelonephritis. The study population included 30 patients with acute pyelonephritis and 10 healthy volunteers. Pulse inversion harmonic imaging with or without contrast agent was compared with conventional ultrasonography and tissue harmonic imaging in terms of detection and conspicuity of renal abnormalities. The detection and conspicuity of renal parenchymal abnormalities in acute pyelonephritis on tissue harmonic imaging, pulse inversion harmonic imaging, and contrast-enhanced pulse inversion harmonic imaging were significantly better than those on conventional ultrasonography. In 2 of 10 healthy volunteers all 4 techniques yielded false-positive diagnoses of parenchymal abnormalities. In conclusion, tissue harmonic imaging and pulse inversion harmonic imaging are sensitive techniques for depicting renal parenchymal lesions in acute pyelonephritis. Despite relatively lower specificities and negative predictive values, these techniques are thought to be useful for the depiction of subtle parenchymal changes in acute pyelonephritis.