ABSTRACT
Despite new nonsurgical treatment methods for gynecologic diseases (eg, endometrial radiofrequency ablation for dysfunctional uterine bleeding, uterine artery embolization for uterine fibroids), surgery continues to be the main treatment modality in this setting. New and improved surgical techniques include laparoscopic hysterectomy, which is performed much more frequently than abdominal hysterectomy because it offers the advantages of speedy postsurgical recovery and a short hospital stay. Nevertheless, a number of early and delayed complications continue to occur following gynecologic surgery. Radiologists with access to multiple imaging modalities play an important role in the diagnosis and management of these postsurgical complications and can assist the surgeon at this critical juncture. Improved computed tomographic and magnetic resonance imaging techniques have made imaging more reliable for early diagnosis. Familiarity with normal postsurgical anatomy, pitfalls in interpretation, and imaging-guided interventional procedures will facilitate the diagnosis and management of complications following gynecologic surgery.
Subject(s)
Diagnostic Imaging/methods , Gynecologic Surgical Procedures/adverse effects , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Wounds, Penetrating/diagnosis , Wounds, Penetrating/etiology , Female , HumansABSTRACT
OBJECTIVE: The objective of our study was to compare image quality and radiation dose associated with abdominopelvic CT using combined modulation, angular modulation, and constant tube current. CONCLUSION: Compared with using a constant tube current to scan the abdomen and pelvis, the use of a combined modulation technique results in a substantial reduction (42-44%) in radiation dose with acceptable image noise and diagnostic acceptability.
Subject(s)
Radiography, Abdominal/instrumentation , Tomography Scanners, X-Ray Computed , Adult , Aged , Aged, 80 and over , Contrast Media , Female , Humans , Male , Middle Aged , Radiation Dosage , Statistics, NonparametricABSTRACT
The institutional review board approved this Health Insurance Portability and Accountability Act-compliant study protocol, with waiver of informed consent. The purpose of the study was to retrospectively evaluate the combined automatic tube current modulation technique in patients with orthopedic metallic prostheses. Five hundred abdominal-pelvic computed tomographic (CT) studies performed with combined modulation technique were reviewed to identify nine patients with metallic prostheses (mean age, 66 years; range, 35-86 years; male-female ratio, 5:4). On the basis of age and transverse abdominal images, these patients were matched with nine others with no metallic prostheses (mean age, 56 years; range, 36-72 years; male-female ratio, 4:5) who were control patients. Images were graded for extent and severity of streak artifacts (grade 1, streak artifact present but not substantially compromising evaluation of adjacent structures; grade 2, streak artifact present and slightly compromising evaluation of adjacent structures; and grade 3, streak artifact present and severely compromising evaluation of adjacent structures). Student t test was performed for statistical analysis. There was no difference in mean effective tube current-time product between study and control patients (P > .49). With automatic tube current modulation, an increase in CT dose caused by metallic prostheses can be successfully avoided.
