Jorge A. Soto

Diagnostic performance of helical CT angiography in trauma to large arteries of the extremities.

PURPOSEnThe purpose of this work was to assess the performance of helical CT angiography (CTA) in the diagnosis of injuries to large arteries of the extremities.nnnMETHODnWe performed helical CTA on 45 consecutive patients referred for conventional angiography for evaluation of suspected arterial injuries after sustaining trauma to the extremities (13 upper, 32 lower). Two radiologists interpreted the helical CTA studies independently. Diagnostic performance parameters evaluated included sensitivity, specificity, receiver operating characteristic (ROC) curves, and interobserver agreement (kappa statistics). Conventional angiography was used as the standard of reference for determination of final diagnoses.nnnRESULTSnForty-three of 45 patients (96%) had diagnostic helical CTA examinations. Final diagnoses in these 43 patients were arterial occlusion (n = 7), partial obstruction (n = 3), pseudoaneurysm (n = 5), arteriovenous fistula (n = 1), pseudoaneurysm and arteriovenous fistula (n = 3), and normal findings (n = 24). Sensitivity and specificity were 90% [95% confidence interval (CI), 80-99] and 100% (95% CI, 99-100), respectively, for Reader 1 and 100% (95% CI, 99-100) and 100% (95% CI, 99-100), respectively, for Reader 2. ROC curve analysis revealed high diagnostic performance, with areas under the curve of >0.9 for both readers. Interobserver agreement was 0.9.nnnCONCLUSIONnThe diagnostic performance of helical CTA for detection of major injuries of large arteries of the extremities is high.

Bile duct stones: Diagnosis with MR cholangiography and helical CT

MR cholangiography (MRC) is a highly accurate, noninvasive method for diagnosing bile duct stones. Various breath-hold and non-breath-hold techniques for MRC have been used successfully to depict stones in the intrahepatic and extrahepatic biliary tree. Although detection of stones with MRC is usually straightforward, attention to technical details is important to avoid false-negative and false-positive interpretations. With the advent of helical CT, other options for noninvasive imaging of the bile ducts, such as CT cholangiography, are now available. CT techniques are especially useful when MRI is unavailable or contraindicated, or when the quality of MRC images is suboptimal.

CT findings of malignant change in recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis is a chronic disease of children and young adults associated with various complications, one of which is malignant change. We report CT findings of malignant change in a case of recurrent respiratory papillomatosis.