Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report.

BACKGROUND: Postpartum ovarian vein thrombophlebitis (POVT) is a rare but serious postpartum complication that affects mostly postpartum women. A high index of suspicion is required when faced with sudden postpartum abdominal pain. CASE SUMMARY: A 25-year-old healthy woman who accepted a vaginal delivery procedure suffered fever (temperature 39.6℃) one day after delivery, accompanied with left lower abdominal pain. Physical examination indicated mild tenderness in the left lower abdomen, accompanied with rebound pain. The patient was confirmed to have left ovarian venous thrombosis with inflammation after receiving a multi-detector row computed tomography scan. CONCLUSION: POVT is a rare and dangerous postpartum complication. A high index of suspicion is required for the occurrence of ovarian venous thrombosis when faced with postpartum abdominal pain and fever. Early application of Doppler ultrasound, computed tomography, magnetic resonance imaging and other auxiliary examinations is conducive to timely and accurate diagnosis of POVT, thus reducing maternal mortality.

Triphasic dynamic enhanced computed tomography for differentiating cholesterol and adenomatous gallbladder polyps.

BACKGROUND: Triphasic dynamic enhanced computed tomography (CT) scans were acquired to identify cholesterol and adenomatous gallbladder (GB) polyps that were inaccurately diagnosed before surgery. PURPOSE: To evaluate the CT findings of 1.0- to 2.0-cm GB polyps for differentiating between cholesterol and adenomatous polyps. METHODS: Fifty-two patients with GB polyps were treated surgically from December 2017 to July 2020 and were retrospectively divided into 2 groups according to the postoperative pathologic results: a cholesterol group with 30 patients and an adenomatous group with 22 patients. Unenhanced and triphasic dynamic enhanced CT scans were performed for all the patients within 2 weeks before surgery. The CT image parameters were measured and analyzed by 2 senior radiologists blinded to the pathological diagnoses. RESULTS: Of the 22 patients in the adenomatous group, 77.3% were female and 22.7% were male, with a mean age of 53.5 years; among the 30 patients in the cholesterol group, 66.7% were female and 33.3% were male, with a median age of 50.1 years. The CT image parameters of all 52 patients with GB polyps were analyzed. Significant differences were found in the arterial phase CT values, portal venous phase CT values, delayed phase CT values, ∆CT1 values (portal venous phase CT minus delayed phase CT values), and ∆CT2 values (arterial phase CT minus delayed phase CT values) between the cholesterol and adenomatous polyp groups (p < 0.05). In differentiating the two groups, the ∆CT1 and ∆CT2 values were superior to the arterial, portal venous and delayed phase CT values regarding both sensitivity and specificity. CONCLUSION: The arterial phase CT values, portal venous phase CT values, delayed phase CT values, and ∆CT values (including ∆CT1 and ∆CT2) from triphasic dynamic enhanced CT scans can differentiate the nature of gallbladder polypoid lesions, with the ∆CT values having the highest sensitivity and specificity.

Dual-energy CT to differentiate gallbladder polyps: cholesterol versus adenomatous.

BACKGROUND: Dual-energy computed tomography (DE-CT) scans were acquired to identify cholesterol and adenomatous gallbladder (GB) polyps, which have not been well evaluated before surgery. PURPOSE: To evaluate the DE-CT findings of GB polyps 1.0-2.0 cm in size and differentiate between cholesterol and adenomatous polyps. MATERIAL AND METHODS: Forty-six patients with GB polyps were surgically treated from December 2017 to December 2019 and divided into two groups according to their postoperative pathologic results: a cholesterol group with 26 patients and an adenomatous group with 20 patients. All of these patients underwent DE-CT imaging with tube voltages of 80 kVp and 140 kVp within two weeks before surgery. Mean attenuation values were measured for every GB polyp at 80/140 kVp and at 40/140 keV. The mean attenuation value changes between 140 kVp and 80 kVp (MAVC140-80 kVp) and mean attenuation value changes between 100 keV and 40 keV (MAVC100-40 keV) were calculated. RESULTS: The CT image parameters of all 46 patients with GB polyps were analyzed. There were significant differences in MAVC140-80 kVp and MAVC100-40 keV between cholesterol and adenomatous polyps (P <0.05); these values were positive for cholesterol polyps and negative for adenomatous polyps. CONCLUSION: The unique energy spectrum information provided by DE-CT scans is helpful in differentiating between cholesterol and adenomatous polyps 1.0-2.0 cm in size.