Frank M. Corl

CT of nonneoplastic diseases of the small bowel : Spectrum of disease

This article reviews the CT imaging features of a variety of nonneoplastic conditions that affect the small bowel and stresses important distinctive patterns that may help distinguish specific entities. Various inflammatory conditions (Crohn disease, radiation enteritis, graft versus host disease, celiac disease, Whipple disease, eosinophilic gastroenteritis, Behçet disease) as well as infiltrative disorders (amyloidosis, lymphangiectasia) and infectious diseases (Mycobacterium avium intracellulare, cytomegalovirus, cryptosporidiosis) are reviewed, with key differential points emphasized. In addition, miscellaneous conditions such as ischemia, small bowel diverticulitis, and small bowel hemorrhage are discussed.

Pancreatic Surgery for the Radiologist, 2011: An Illustrated Review of Classic and Newer Surgical Techniques for Pancreatic Tumor Resection

OBJECTIVE Pancreatic surgery has evolved considerably since the earliest described pancreatectomies were performed in the late 1800s. Emerging surgical techniques for pancreatic cancer have modified what was traditionally deemed unresectable disease. This review summarizes the main type of pancreatic resections used for tumor removal on the basis of location and biologic behavior. CONCLUSION CT interpretation should incorporate an understanding of current surgical techniques to provide surgeons with the information necessary for patient selection and preoperative planning.

MDCT Arthrography of the Shoulder With Datasets of Isotropic Resolution: Indications, Technique, and Applications

OBJECTIVE The purposes of this review are to summarize the indications for MDCT arthrography of the shoulder, highlight the features of MDCT acquisition, and describe the normal and abnormal MDCT arthrographic appearances of the shoulder. CONCLUSION MDCT arthrography is a valid alternative for shoulder imaging of patients with contraindications to MRI or after failed MRI. MDCT arthrography is accurate for assessment of a variety of shoulder abnormalities and, with further validation, may become the imaging test of choice for evaluation of the postoperative shoulder.

Pediatric Skeletal Trauma: Use of Multiplanar Reformatted and Three-dimensional 64-Row Multidetector CT in the Emergency Department

Orthopedic injuries account for one-half of all emergency department visits by pediatric patients in the United States. Although radiography is the first-line method of diagnosis in the emergency department, multidetector computed tomography (CT) is playing an increasingly important role in definition of skeletal and soft-tissue injuries in the pediatric trauma patient. With the advent of 64-detector row CT, images can be produced with subsecond gantry rotation times and with submillimeter acquisition, which yield true isotropic high-resolution volume data sets. This technique is particularly advantageous in the evaluation of pediatric patients because it may eliminate the need for sedation and minimize dependence on patient cooperation. The role of three-dimensional volume imaging in the evaluation of fractures and soft-tissue injuries in pediatric patients continues to evolve as this technique increasingly enables detection and characterization of abnormalities and provides results that affect decisions about patient care.

Patterns of collateral pathways in extrahepatic portal hypertension as demonstrated by multidetector row computed tomography and advanced image processing

Pancreatic neoplasm can compromise the portal vein or its tributaries, resulting in extrahepatic portal hypertension. Collateral channels may develop, usually in a hepatopetal direction. These include gastroepiploic veins, short gastric veins, left gastric vein, left colic veins, and spontaneous splenorenal shunts. We present the spectrum of these collaterals as delineated by multidetector row computed tomography with advanced image processing. Delineation of these collaterals is important before surgery so as to avoid possible uncontrollable bleeding if they are inadvertently disrupted.

Acute non-traumatic maternal illnesses in pregnancy: imaging approaches

The imaging methods used to obtain diagnostic information for pregnant patients presenting with acute non-traumatic maternal illnesses have been reviewed. Conditions affecting the gastrointestinal tract, urinary tract, uterus, adnexae, central nervous system and chest have been investigated via a variety of imaging methods, which include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), intravenous pyelography (IVP), angiography and fluoroscopy. The method of choice, application, and safety to the mother and fetus are considered for investigation of each condition.

Imaging evaluation of posttraumatic renal injuries

Computed tomography plays an important role for the evaluation of most patients with suspected renal injury after trauma. Intravenous urography is used for gross assessment of renal function in hemodynamically unstable patients. Renal injuries can be classified into four large groups: (1) minor renal contusion, lacerations, subcapsular hematoma, and small cortical infarcts; (2) major renal lacerations extending to the medulla with or without involvement of the collecting system; (3) catastrophic renal injuries including fragmentation of the kidney and renal pedicle vascular injuries; and (4) ureteropelvic junction injuries. Integration of the imaging findings of renal injury with clinical information is important to developing a treatment plan.

Imaging of Limb Salvage Surgery

OBJECTIVE Limb salvage surgery comprises surgical techniques designed to resect musculoskeletal extremity tumors and subsequently reconstruct a limb with an acceptable oncologic, functional, and cosmetic result. Today, 70-90% of malignant extremity tumors are being treated with limb salvage surgery. CONCLUSION The purpose of this article is to describe the operative techniques, review the imaging techniques, and to illustrate imaging findings related to the surgeries in complicated and uncomplicated cases.

Visitors and content preferences on an educational Web site dedicated to clinical body computed tomography: Results of a 2001 audit and online survey

Scatarige JC, Garland MR, Corl FM, et al. Visitors and content preferences on an educational web site dedicated to clinical body computed tomography: results of a 2001 audit and online survey. Invest Radiol 2002;37:53–59. rationale and objectives. To ascertain demographic characteristics and content preferences of visitors to an educational Web site dedicated to clinical body computed tomography (CT). Such information could help determine whether the resource is attaining its educational goals. methods. During February 2001, a commercial Internet service measured the number and average length of visits to the site, the domain names of the visitors, and the content most frequently requested. During the same month, a nine-question self-administered user survey was posted on the site’s main page. results. The service reported 19,013 visits during which 98,685 pages of content were viewed. Of the total number of users to visit, 37.9% were from domains outside North America. Helical CT scanning protocols, teaching atlases, CT teaching files, and medical illustrations were the most frequently requested content. Of the 687 visitors responding to the survey, 51.5% were radiologists and 33.5% were radiological technologists. conclusions. Radiologists and radiological technologists are the principal visitors to the site. These users prefer to view helical CT scanning protocols and the Web site’s core educational material.

GPIIb-IIIa Receptor Inhibitors: What the Interventional Radiologist Needs to Know

AbstractThe glycoprotein IIb-IIIa (GPIIb-IIIa) receptor inhibitors have established themselves as first line therapy in the treatment of acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI). The benefit of these agents rests in their ability to attenuate the deleterious effects of platelet activation, both at the site of an inflamed vessel wall (due to a ruptured plaque or PCI) and in the microcirculation as a result of embolization. Based on these results, interventional radiologists are beginning to explore the potential of using GPIIb-IIIa inhibitors during interventions in the peripheral circulation. This paper reviews the molecular biology of the GPIIb-IIIa receptor, the pharmacology of the GPIIb-IIIa receptor inhibitors, the current coronary and peripheral vascular literature as it pertains to the GPIIb-IIIa receptor inhibitors, and potential future applications of the GPIIb-IIIa receptor inhibitors in the peripheral circulation.