SPIO-enhanced MR imaging was more sensitive than dual-phase CT in the depiction of colorectal metastases.

No abstract

Objective To determine the influence of pelvicalyceal with a pelvicalyceal angle <90°, in 12% of those with an angle >90°, in 70% of patients with an infundibuangle, size of the lower calyx infundibulum and lowerpole calyceal anatomy in predicting the clearance of lar diameter <4 mm, in 16% of those with a diameter >4 mm, in 78% with a complex calyceal pattern and fragments after extracorporeal shock wave lithotripsy (ESWL) for lower calyceal stones.12% with a simple calyceal pattern. Conclusions These three anatomical factors play a key Patients and methods The study comprised a retrospective analysis of 133 patients, divided into 92 who role in predicting the clearance of stone and they should be assessed during intravenous urography to were considered to be completely clear of fragments 6 months after ESWL and 41 who had residual stones.facilitate the planning of treatment for lower calyceal stones. The pelvicalyceal angle, diameter of the lower calyx infundibulum and lower-pole calyceal pattern were Keywords Extracorporeal shock wave lithotripsy, lower calyx, residual stone, renal calculus determined from intravenous urograms. Results There were residual stones in 64% of the patients Lithotripsy was carried out using a Technomed

The purpose of this study was to compare dynamic contrast enhanced MRI (DCEMR) with Doppler ultrasound (US) in the assessment of portal venous anatomy and to analyse the causes of discrepancy. Over a 1 year period, 97 patients undergoing assessment prior to hepatic surgery underwent imaging of the liver and portal venous system using US with colour and spectral Doppler and MRI with axial T2 weighted spin echo (SE) and coronal oblique T1 weighted rapid gradient echo (GRE) imaging before and immediately after bolus injection of Gd-DTPA (0.1 mmol kg-1). When the US and MRI findings were discrepant, the images were reviewed by two observers and compared with surgical findings. US and DCEMR were concordant in 90 patients (portal vein patent in 80, occluded in 10). In three patients with cirrhosis and gross ascites the portal vein was reported as occluded on US and patent on MRI; surgery confirmed the MRI findings. In one patient the portal vein was patient on US but not on MRI, but there was a 3 week interval between the examinations. In three patients the portal vein was patent on US, but MRI detected occlusion of intrahepatic portal vein branches in two, and encasement of an intrahepatic branch in the third case. Spontaneous splenorenal shunts were seen in 15 patients only on MRI; varices were seen in 39 patients on MRI and in 22 patients on US. Both US and DCEMR contribute to the pre-operative assessment of the portal venous system. MRI provides additional information over US in assessing intrahepatic portal branches and detecting varices and splenorenal shunts, and is recommended for all surgical candidates and in patients with abnormal portal venous anatomy and equivocal US findings.

Computed tomography (CT) delivers a substantial proportion of the medical radiation dose to the population. The National Radiological Protection Board (NRPB) recommends that "CT examinations should only be carried out after there has been proper clinical justification for the examination of each individual by an experienced radiologist". The aim of this study was to review the indications for body CT in a large acute hospital in order to identify groups of patients in whom CT might not be "clinically justified". We reviewed the age, sex and diagnosis of all patients undergoing CT of the abdomen and pelvis (including lumbar spine) in our department in 1992. All requests had been checked by a senior radiologist before booking. CT was performed in 1078 male patients and in 990 females. Patients examined for benign disease were younger (mean age 52 years) than patients with malignant disease (mean age 57 years). Of 915 examinations performed for benign disease, 293 (32%) were orthopaedic in nature and included 255 (87%) for back pain. CT was carried out for benign non-orthopaedic disease in 97 women under 50 years old, usually following other tests with inconclusive or normal results. 49 of these examinations were reported as normal. Of 191 patients who had more than one CT examination, 158 (83%) were undergoing follow-up for malignant disease. All 39 patients who underwent CT on three or more occasions had life-threatening conditions, either malignancy or complicated acute pancreatitis. We have been unable to find substantial numbers of patients in whom CT was performed inappropriately. Substitution of magnetic resonance imaging (MRI) for CT of the spine will help population dose reduction. The benign condition responsible for the largest radiation dose from CT is complicated acute pancreatitis, and it may be possible to substitute MRI for CT in these patients. Women under 50 years old with normal CT form an important group for clinical audit.

No abstract

No abstract

No abstract