ABSTRACT
PURPOSE: To evaluate the quality assurance of image-processing techniques in plain radiographs of skeletal structures. MATERIAL AND METHODS: Twenty-two patients were studied, each with one osteolytic metastasis. Accuracy and precision of tube voltage and timer were confirmed. The mean value of grey-level histograms in plain radiographs (MVGLHs) was assessed. The deviation was monitored after five sets of sequential X-rays retaining the same settings for each radiograph. RESULTS: Deviation was significantly higher in anatomical areas of thorax (21.2%) and abdomen (42.4%), while the consistency of MVGLH for weight-bearing bones was satisfactory with a maximum deviation of 2.9% (P<0.001, Kruskal-Wallis test). CONCLUSION: Assessment of MVGLH in plain radiographs is a reliable method for the extremities and generally for regions without superimposed movable tissues.
Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Quality Assurance, Health Care , Radiographic Image Interpretation, Computer-Assisted/standards , Adult , Aged , Female , Humans , Male , Middle Aged , Statistics, NonparametricABSTRACT
BACKGROUND/AIMS: A prospective study was performed to compare the sensitivities of computed tomography, magnetic resonance imaging and CTAP (CT during arterial portography) in the detection of focal malignant hepatic lesions. METHODOLOGY: Twenty-eight (28) patients with primary and secondary hepatic malignant tumors were evaluated. All of these patients underwent hepatic resection and a lesion-to-lesion imaging-pathological analysis was performed. RESULTS: The overall sensitivities were 53% for CT, 66% for MRI sequences and 88% for CTAP. For lesions smaller than 1 cm the sensitivities were 6% for CT, 17% for MRI and 72% for CTAP. The combination of CTAP and MRI yielded an overall detection rate of 93%. The difference between the sensitivity of CTAP and that of the other two imaging techniques was statistically significant (P < 0.04) according to the McNemar test. CTAP demonstrated four false-positive lesions, two of which were correctly characterized by MRI and one by CT. In 6 patients (21.4%) the surgical plan was modified after CTAP. CONCLUSIONS: We conclude that, CTAP has the highest sensitivity and should be part of the preoperative examination. In some instances, the addition of MR imaging must be considered a helpful adjuvant. Both techniques should be considered complementary in the preoperative diagnostic algorithm.
Subject(s)
Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , Portography , Tomography, X-Ray Computed , Adult , Aged , Carcinoma/diagnosis , Carcinoma, Hepatocellular/diagnosis , Cholangiocarcinoma/diagnosis , Female , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Male , Middle Aged , Prospective Studies , Sensitivity and SpecificityABSTRACT
We present the findings and possible causes in three cases of postoperative adrenal hematomas. In 16 cases of 45 consecutive patients, following segmental right or left lobe hepatectomy, CT was performed in order to evaluate possible fluid collection or other complications. In all cases imaging findings and a correlation with preoperative CT scans were done. Follow up CT examinations were also reviewed. In three cases solid suprarenal masses with attenuation values consistent with adrenal hematomas were found. Preoperative scans at the same level indicated normal adrenal glands. Follow-up scans revealed the hematoma, stable in size, for up to 12 weeks, although lower attenuation values were evident. Right adrenal hematoma is a possible postoperative complication following hepatectomy; if it remains stable in size, it can be left alone.
