ABSTRACT
AIM: To determine if visual assessment of the attenuation of morphologically normal appearing thyroid glands on unenhanced computed tomography (CT) of the chest is useful for identifying patients with decreased thyroid function. MATERIALS AND METHODS: This was a retrospective study of 765 patients who underwent both unenhanced CT of the chest and thyroid function tests performed within 1 year of the CT examination. Attenuation of the thyroid gland was visually assessed in each patient relative to the attenuation of the surrounding muscles to categorise the gland as "low attenuation" (attenuation similar to surrounding muscles) or "high attenuation" (attenuation greater than surrounding muscles). Thyroid attenuation was quantitatively measured in each case to determine the validity of the visual assessment. Results of thyroid function tests were used to classify thyroid function as hypothyroid, euthyroid, or hyperthyroid. Data were analysed to determine the relationship between visual assessment of thyroid attenuation and status of thyroid function. RESULTS: Thyroid glands of low attenuation were present in 4.2% (32/765) of the patients. Nearly half (47%) of the patients with low-attenuation thyroids had hypofunctioning thyroid glands. Compared to patients with high-attenuation thyroids, patients with low-attenuation thyroids were significantly more likely to have decreased thyroid function (clinical and subclinical hypothyroidism) and significantly less likely to be euthyroid (p<0.0001). Quantitative measurement of thyroid attenuation confirmed the validity of the visual assessment. CONCLUSION: Low attenuation of an otherwise normal-appearing thyroid gland on unenhanced CT of the chest is strongly associated with decreased thyroid function.
Subject(s)
Hypothyroidism/diagnostic imaging , Thyroid Gland/diagnostic imaging , Tomography, X-Ray Computed/methods , Visual Perception , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective StudiesSubject(s)
Clinical Competence , Internship and Residency , Radiology/education , Ultrasonography , Curriculum , HumansABSTRACT
Dilatation of the inferior vena cava is a frequent finding in patients with cirrhosis and portal hypertension, and may be produced by various mechanisms. In this article we illustrate the spectrum of causes and appearances of inferior vena caval dilatation in patients with cirrhosis and portal hypertension.
Subject(s)
Hypertension, Portal/complications , Liver Cirrhosis/complications , Tomography, X-Ray Computed , Ultrasonography, Doppler, Duplex , Vena Cava, Inferior , Blood Flow Velocity , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/etiology , Dilatation, Pathologic/physiopathology , Humans , Hypertension, Portal/diagnosis , Hypertension, Portal/physiopathology , Radiography, Thoracic , Vascular Resistance , Vena Cava, Inferior/diagnostic imagingABSTRACT
We present a case of AIDS-related intrathoracic lymphoma in which the pulmonary lesions were evaluated with Doppler sonography. The presence of internal vascularity within such lesions may help to differentiate this entity from tuberculosis.
Subject(s)
Lymphoma, AIDS-Related/diagnostic imaging , Lymphoma, Non-Hodgkin/diagnostic imaging , Thoracic Neoplasms/diagnostic imaging , Tuberculosis, Pulmonary/diagnosis , Ultrasonography, Doppler, Color , Adult , Blood Flow Velocity , Diagnosis, Differential , Female , Humans , Lymphoma, AIDS-Related/physiopathology , Lymphoma, Non-Hodgkin/physiopathology , Thoracic Neoplasms/blood supply , Tomography, X-Ray ComputedABSTRACT
We present a case of pneumoretroperitoneum detected on computed tomography that resulted from open reduction and internal fixation of a femoral fracture. Retroperitoneal air has many etiologies. These range from the clinically insignificant to the potentially catastrophic, if not recognized promptly. We present a case of retroperitoneal air secondary to open reduction and internal fixation of a femoral fracture. To our knowledge, this association has not previously been described.
Subject(s)
Femoral Fractures/surgery , Fracture Fixation, Internal , Postoperative Complications/etiology , Retropneumoperitoneum/etiology , Adult , Female , Femoral Fractures/diagnostic imaging , Humans , Retropneumoperitoneum/diagnostic imaging , Tomography, X-Ray ComputedSubject(s)
Abscess/complications , Escherichia coli Infections/complications , Fallopian Tube Diseases/complications , Ovarian Diseases/complications , Ovary/blood supply , Thrombosis/complications , Abscess/diagnostic imaging , Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use , Escherichia coli Infections/diagnostic imaging , Escherichia coli Infections/therapy , Fallopian Tube Diseases/diagnostic imaging , Fallopian Tube Diseases/therapy , Female , Heparin/therapeutic use , Humans , Leukocyte Count , Middle Aged , Ovarian Diseases/diagnostic imaging , Ovarian Diseases/therapy , Ovary/physiopathology , Ovary/surgery , Thrombosis/physiopathology , Thrombosis/surgery , Tomography, X-Ray Computed , VeinsABSTRACT
RATIONALE AND OBJECTIVES: We compared observer performance in the interpretation of radiographs using an automated film masking and illuminating system (AFIS) with performance using standard radiographic viewing equipment. METHODS: Observer performance was compared in three ways. In the first method, a radiographic pattern of vertical bars of varying conspicuity was shown to 11 subjects with use of the two different viewing systems. Subjects were not allowed to use a brightlight or handle the film. We then performed a receiver operating characteristic (ROC) study to compare observer accuracy in detection of low-contrast targets. ROC methodology was also used in the third portion of our study to compare the accuracy of interpretation of cervical spine radiographs by six radiologists. In both the second and third portions of our study, film handling and use of a bright-light was permitted to simulate clinical circumstances. RESULTS: As a group, observers performed significantly better using the AFIS in the first (P < .001) and second (P < .05) portions of our study. There was no significant difference in performance in interpretation of cervical spine radiographs between the two viewing systems. CONCLUSION: The AFIS enhanced low-contrast perception, but further research is needed to determine its ideal clinical applications.
Subject(s)
Radiographic Image Enhancement/instrumentation , Automation , Humans , Lighting , ROC CurveABSTRACT
PURPOSE: To determine the prevalence and appearance of cardiophrenic angle (CPA) varices at computed tomography (CT) in patients with portal hypertension (PHT). MATERIALS AND METHODS: A retrospective review was performed of 148 consecutive contrast material--enhanced abdominal CT scans of patients with PHT. The paracardiac region was assessed for tubular structures suggestive of varices. Variceal diameter and CT attenuation relative to adjacent liver were noted. RESULTS: Tubular structures consistent with CPA varices were noted in 29 cases and were more common on the right side than on the left. Mean CPA variceal diameter was 2.6 mm. In three cases, right CPA varices measured 10-13 mm in diameter, but no variceal enhancement was noted on initial dynamic CT images. Delayed CT demonstrated contrast enhancement that reflected delayed enhancement of the portal venous system. CONCLUSION: CPA varices, particularly on the right side, are not uncommon in patients with PHT. Varices should be considered and excluded as a cause of CPA masses, particularly before percutaneous biopsy. Delayed CT may be necessary to correctly delineate CPA varices.
Subject(s)
Diaphragm/blood supply , Hypertension, Portal/complications , Mediastinum/blood supply , Varicose Veins/diagnostic imaging , Varicose Veins/etiology , Female , Humans , Hypertension, Portal/diagnostic imaging , Male , Middle Aged , Prevalence , Retrospective Studies , Tomography, X-Ray Computed , Varicose Veins/epidemiologyABSTRACT
We describe a case in which a focus of intense contrast enhancement within the anterior aspect of the medial segment of the left lobe of the liver was detected on abdominal CT. This led to the diagnosis of clinically unsuspected superior vena cava obstruction.
