SA Journal of Radiology - Volume 11, Issue 1, 2007
Volume 11, Issue 1, 2007
Source: SA Journal of Radiology 11, pp 14 –18 (2007)More Less
Background. Current practice at our institution for routine abdominal CT includes coverage from the diaphragm to the symphysis pubis and therefore includes pelvic organs. Limited upper abdominal imaging exists in other modalities, and tailoring the examination to pathology will result in higher positive yield.
Objective. To determine if the pelvic component of a routine abdominal CT scan contributes to the final diagnosis in organ-specific upperabdominal pathology.
Methods. This was a retrospective study spanning a 14-month consecutive period; all abdominal CTs for organ-specific upper-abdominal pathology were included. There were no age or gender limitations. Patients with multi-organ involvement such as lymphoma and TB were excluded. The consultant radiologists' reports were evaluated for the indication, preceding investigations, presence of pelvic pathology and final CT diagnosis.
Results. Of 133 CT studies done, 116 did not show any abnormality in the pelvis. In 3 cases there were pelvic abnormalities that contributed to making the final diagnosis. Independent review of these cases by 4 consultant radiologists with masking of the pelvic cuts did not influence the final outcome. In 5 cases free fluid was noted and in 9 cases there were incidental findings with no impact on the final diagnosis.
Conclusions. It is not essential to include the pelvis in the field of radiation in scanning specific upper-abdominal pathology, with the exclusion of staging a known renal mass and imaging renal calculi.
Source: SA Journal of Radiology 11, pp 20 –22 (2007)More Less
Multicentric epitheloid haemangioendothelioma (EHE) of bone is a rare primary bone tumour which may present at any age. The diagnosis is suspected on radiographs and the differential diagnosis includes metastatic disease, epitheloid angiosarcoma and EHE. Confirmation is only by means of biopsy and histological examination.
Multiple lesions and metastases are confirmed or excluded by further imaging such as radiographs, whole-body nuclear bone scan and CT scan of the chest. When positive, these findings change the prognosis and approach to treatment.
In our case an elderly man presented with a pathological fracture of the right tibia as a complication of EHE. Diagnosis was suspected on radiographs and confirmed on histology. Whole-body bone scintigraphy and CT scan of the chest were performed, which confirmed multiple bone lesions and metastases to the lungs.
Source: SA Journal of Radiology 11, pp 25 –27 (2007)More Less
This report describes an intraventricular neurocysticercus cyst of the 4th ventricle with consequent hydrocephalus in an adult man. He was managed with anti-helminthic therapy and a 3rd ventriculostomy. Initial imaging showed the cyst within the 4th ventricle. At follow-up imaging a cyst was present in the 3rd ventricle and the 4th ventricle had returned to normal. It is postulated that the cyst 'migrated' from the 4th to the 3rd ventricle.