Normal splenic volume assessment on CT in 426 adults.

Objective: The purpose of this study was to determine the normal splenic volume on computed tomography in Thai adult patients at Siriraj Hospital. Methods: The width (W), length (L), thickness (T) and splenic volume were obtained from 426 patients who underwent CT for various indications. The relationship between splenic volume and age, gender and body habitus were also examined. Results: The average splenic volume (S Vol) was 124.1 ± 51.8 cm3, ranging from 27.60 to 430.85 cm3. Correlation between splenic volume and age, height, weight and BMI were significant (age: r = -0.151, p<0.001; height: r = 0.187, p <0.001; weight: r = 0.248, p< 0.001 and BMI: r = 0.159, p<0.05). Splenic volume correlated well with all the linear measurements, especially with the splenic length. The formulae S Vol (in cm3) = 19.6 + 0.5 (LxWxT) and S Vol (in cm3) = -40.3 + 21.4L were derived and can be used to estimate the splenic volume. Conclusion: Two formulae of splenic measurement indexes were derived with good correlation which can be satisfactorily used in order to estimate splenic volume in routine practice.

Ultrasound findings of benign intratesticular cystic lesions.

Ultrasonography (US) is usually the initial modality to evaluate pathological conditions of testes including benign intratesticular cysts. US allows characterization of intratesticular cysts and differentiation from a solid mass. A simple intratesticular cyst is usually not palpable in contrast to a peripherally located cyst of tunica albuginea. An epidermoid cyst has a classic onion-ring appearance. An intratesticular spermatocele communicates with the seminiferous tubules, whereas simple ectasia of the rete testis does not do so directly. Color doppler US is helpful to diagnose intratesticular varicocele and intratesticular abscesses.

CT features of adrenal pheochromocytoma: Evaluation with clinical and pathological correlation.

Objective: To evaluate CT features of adrenal pheochromocytoma with clinical and histopathological correlation. Methods: A retrospective study was approved by the ethics committee. Forty-four patients with proven adrenal pheochromocytoma from January 2002- December 2007 at our institution were included. Only 10 out of the 44 had available pre-operative computed tomography (CT). All 10 CT were interpreted independently by two abdominal radiologists, with correlation with clinical and histopathological analysis. Results: All 10 patients had unilateral adrenal pheochromocytoma. Three were men and 7 were women. The mean age of patients was 45.1 years old. Eight out of 10 patients presented with hypertension. Four patients presented with neuroendocrine symptoms such as palpitation and diaphoresis. Other symptoms were palpable abdominal mass, headache and gastrointestinal symptoms (nausea, vomiting or abdominal pain). Pre-operative biochemistry tests for pheochromocytoma were performed in 8 patients. The tumor size varied from 2-15 cm in diameter. CT features of pheochromocytoma of this study showed 1 tumor of pure solid mass (2 cm tumor size) and 9 tumors of complex cystic masses. The range of density values at the solid part of tumors was 25-53 HU on non-contrast phase CT and the mean was about 41.4 HU. All 10 tumors showed enhancement of the solid part. Intratumoral hemorrhage and calcifications were detected. No intratumoral fatty component was detected. Conclusion: CT findings of adrenal pheochromocytoma were typical heterogeneous soft tissue density mass and moderate enhancement. Tumors with cystic component and hemorrhage were common in our study. CT was useful for tumor characterization in patient with nonclassic clinical manifestation of pheochromocytoma and also for pre-operative management.

Multiplanar reconstruction computed tomography of lumbar spinal stenosis in correlation with surgical findings: Initial experience.

Lumbar spinal stenosis is a debilitating illness affecting middle-aged and elderly people. There are several imaging modalities available for use in affirming the diagnosis. The CT provides excellent osseous detail of osteophyte, fracture and location of bony abnormality and extension to adjacent soft tissue. New spiral CT technology allows multiplanar images to be obtained quickty and easily. Among these, multiplanar reconstruction computed tomography (MPR-CT) is the specific means to assess narrowed lumber spinal canal. This present work was done in order to evaluate the reliability of MPR-CT in diagnosing lumber spinal stenosis by correlation with operative finding. From July to December 2002, MPR-CT was done on 10 patients and evaluated by a well-known radiologist. Seven patients were approached surgically and the remaining three treated medically. Subsequently, the following variables were analyzed: central canal stenosis, lateral canal stenosis, fornminal stenosis, dise herniation, nerve root compression, ligamentum flavum hypertrophy and spondylolisthesis. The results of MPR-CT were in good correlation with finding from surgical exploration; the positive predictive values of central canal atenosis, lateral canal stenosis and foraminal stenosis were 77.7%, 75% and 50% respectively which were higher than those for disc herniation or nerve root compression. Typical claudication was found in 10% of the cases and the most common affected level was L4-L5. Therefore, MPR-CT which composed of axial, coronal and sagittal views was shown to be an application imaging modality because of its reliability.