Metal artifact reduction in computed tomography: Is it of benefit in evaluating sacroiliac joint fusion?

PURPOSE: The aim of this study was to compare image quality of computed tomography (CT) images with and without orthopedic metal artifact reduction (O-MAR) in the follow-up of patients after sacroiliac (SI) joint fusion. METHODS: Thirty-six consecutive patients (31 females and 5 males) undergoing CT within 24 h after SI joint fusion were included. CT images were reconstructed with and without O-MAR and scored by two radiologists with over 20 years of experience using a six-point ordinal scale. Images were scored on overall image quality and five criteria that are important to the clinician for the follow-up of patients after SI joint fusion. In addition, images were scored on how well four bony structures could be delineated. Wilcoxon signed-ranks tests with Holm-Bonferroni correction were used to test for differences between the radiologists' scores on CT images with and without O-MAR. RESULTS: Both radiologists scored overall image quality significantly higher (p < 0.05) on the images without O-MAR than on the images with O-MAR. In addition, two of the follow-up criteria, delineation of the sacrum and delineation of the implanted ilium were scored significantly higher (p < 0.05) on the images without O-MAR. Neither radiologist scored the images with O-MAR significantly higher than the images without O-MAR for any of the criteria. CONCLUSION: CT imaging without O-MAR provided higher image quality and better assessment of SI joint fusion follow-up criteria compared to CT imaging with O-MAR in the follow-up of patients after SI joint fusion.

B-mode and colour-flow duplex ultrasonography: a useful adjunct in diagnosing scrotal diseases?

OBJECTIVE: To determine the value of ultrasonography (US) and colour-flow duplex ultrasonography (CFD) as routine investigations in the diagnosis of scrotal pathologies. PATIENTS AND METHODS: The imaging techniques were applied to 215 consecutive patients with scrotal complaints. The diagnosis of a urologist (D1, made from the patient's history, physical examination and laboratory results) and that of the radiologist (D2, using US and CFD) were compared with the "gold standard' (D3, the operative findings and course of the disease). The sensitivity and specificity of the diagnostic pathways (D1, D2) were determined statistically and compared with D3. RESULTS: The final diagnoses (D3) were testicular torsion (13 patients), torsion of the appendix testis (5), epididymitis (42), inguinal hernia (7), tumour (11), trauma (9), hydrocele (46), epididymal cyst (37), orchitis (10), varicocele (46) and other diagnoses (8). Using D1, the urologist missed seven diagnoses, of which one was a patient with a testicular torsion combined with an inguinal hernia, and one a patient with a tumour. Using US and CFD (D2), the radiologist missed five diagnoses, including one patient with combined testicular torsion and inguinal hernia. CONCLUSION: For the diagnosis of scrotal disorders, the basic clinical evaluation usually provides the correct diagnosis. However, US and CFD are useful adjuncts which cause a minimal burden to the patient and that in most cases will lead to the correct diagnosis, especially with important diagnoses like testicular torsion, when US and CFD should be performed immediately. If this does not provide a clear diagnosis, the patient should be explored surgically.

Baló concentric sclerosis: MR diagnosis.

An antemortem MR diagnosis of concentric sclerosis was made. After corticosteroid therapy the patient's symptoms diminished, and repeat MR revealed a decrease in the size of the lesion.

Preparation of the colon for single- and double-contrast barium enema examination: a simplified method.

A commercially available prepackaged liquid diet was prescribed to 112 patients to use in combination with laxatives in a 1-day preparation regimen before single- and double-contrast barium enema examination. Cleansing enemas were not performed before the examination. Colon radiographs were evaluated with regard to amount of residual stool, mucosal detail, coating, and overall quality. Results were excellent in 92% (103 of 112) of patients and fair in 5% (six of 112). Cleansing enemas can be avoided through use of this preparation protocol.

Dimensions of the spinal canal in individuals symptomatic and non-symptomatic for sciatica: a CT study.

Measurements obtained in 50 spinal CT studies of patients referred for suspected lumbo-sacral nerve root compression, were compared to those of a group of 30 individuals asymptomatic in this respect, who had been referred for abdominal pathology. Transverse ligamentous interfacet and transverse dural dimensions were significantly reduced in the sciatica group, with usually normal interpedicular and sagittal dimensions ruling out idiopathic developmental stenosis. The borderline value for ligamentous interfacet distance (ILD) at L4-5 appeared to be 11 mm.