Items in AFP with MESH term: Tomography, X-Ray Computed
Intestinal Obstruction in an Octogenarian - Photo Quiz
Computed Tomography After Minor Head Injury - Point-of-Care Guides
Soft Tissue Mass over Right Brow - Photo Quiz
Is There Benefit to Coronary Calcium Screening? - Editorials
New-Onset Seizures - Photo Quiz
ABSTRACT: The increasing use of cross-sectional imaging has led to an increase in the incidental discovery of adrenal masses (adrenal incidentalomas). Although most of these lesions are benign, they often present a diagnostic dilemma. Before creating a management plan, the physician should determine if the lesion is benign or malignant and if the lesion is functioning or nonfunctioning. Incidentally discovered adrenal masses usually are benign adenomas; however, myelolipomas, cysts, hemorrhage, pheochromocytomas, metastases, and adrenocortical carcinomas are also possible. Unenhanced computed tomography and chemical shift magnetic resonance imaging can characterize most adenomas because the lesions have high lipid content. Contrast-enhanced computed tomography can further characterize the adenomas because of the washout characteristics with iodinated intravenous contrast media. Fluorodeoxyglucose– positron emission tomography can be helpful in characterizing some lesions, and biopsy is rarely required. This article summarizes the American College of Radiology Appropriateness Criteria for the use of imaging modalities and biopsy to characterize incidentally discovered adrenal masses.
Chronic Productive Cough - Photo Quiz
ABSTRACT: The differential diagnosis of left lower-quadrant pain includes gastrointestinal, gynecologic, and renal/ureteric pathology. Imaging is helpful in evaluating left lower-quadrant pain, and is generally guided by the clinical presentation. Acute sigmoid diverticulitis should be suspected when the clinical triad of left lower-quadrant pain, fever, and leukocytosis is present. The severity of disease varies from mild pericolonic and peridiverticular inflammation to severe inflammatory changes with complications such as perforation, peritonitis, or abscess or fistula formation. Computed tomography is the preferred test in evaluating clinically suspected diverticulitis. It is used to evaluate the severity and extent of disease and to identify complications, but it also may diagnose other causes of left lower-quadrant pain that can mimic diverticulitis. Magnetic resonance imaging can be used to assess left lower-quadrant pain. It has superior resolution of soft tissues and does not expose the patient to ionizing radiation, but it is expensive and requires more time to perform. Transabdominal ultrasonography with graded compression is another effective technique but is limited by its high operator dependency and technical difficulties in scanning patients who are obese. Pelvic ultrasonography is the preferred imaging modality in women of childbearing age. Radiography with contrast enema is less sensitive than computed tomography in diagnosing diverticulitis and is seldom used.
ABSTRACT: For many years, there were no guidelines for evaluating patients with chronic neck pain. However, in the past 15 years, considerable research has led to recommendations regarding whiplash-associated disorders. This article summarizes the American College of Radiology Appropriateness Criteria for chronic neck pain. Imaging plays an important role in evaluating patients with chronic neck pain. Five radiographic views (anteroposterior, lateral, open-mouth, and both oblique views) are recommended for all patients with chronic neck pain with or without a history of trauma. Magnetic resonance imaging should be performed in patients with chronic neurologic signs or symptoms, regardless of radiographic findings. The role of magnetic resonance imaging in evaluating ligamentous and membranous abnormalities in persons with whiplash-associated disorders is controversial. If there is a contraindication to magnetic resonance imaging, computed tomography myelography is recommended. Patients with normal radiographic findings and no neurologic signs or symptoms, or patients with radiographic evidence of spondylosis and no neurologic findings, need no further imaging studies.