Fistulas of the genitourinary tract have diverse anatomic locations, causes, and clinical features. They can involve the upper urinary tract (kidney, ureter), the lower urinary tract (bladder, urethra), or the female reproductive tract (vagina, uterus). Causes include infection, inflammatory disease, neoplasms, congenital conditions, trauma, and iatrogenic injury. Diagnosis of genitourinary tract fistulas usually requires radiologic studies performed with fluoroscopic or cross-sectional modalities. Fistulography is the most direct means of visualizing a fistula and should be considered when feasible (eg, cutaneous fistulas). Intravenous urography and pyelography or ureterography are mainstays of investigation of the upper tract. Likewise, voiding cystourethrography and urethrography are central to study of the lower tract. Cross-sectional techniques, in particular computed tomography, are increasingly useful for diagnosis and are considered the primary test in some cases. Radiologists should be familiar with the radiologic features of genitourinary tract fistulas for accurate diagnosis and treatment planning. Management approaches depend on the type of fistula, the degree of morbidity, and the overall functional status of the patient and vary from conservative observation to aggressive surgical repair.
Liver CT is useful for the detection and grading of esophageal varices. A diameter of 3 mm may be an appropriate screening threshold for large clinically significant varices.
This study shows the feasibility of using multiple microwave antennas simultaneously in the treatment of liver tumors intraoperatively. Additional percutaneous studies are currently under way to investigate the safety and efficacy in treating nonsurgical candidates.
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