Sharon M. Stein

Color Doppler sonography of adnexal torsion.

The purpose of this study was to describe the color Doppler sonographic findings in adnexal torsion that distinguish viable from nonviable ovaries. We present the color Doppler sonographic features in 13 patients with surgically proved adnexal torsion that help determine whether or not the ovaries were viable or nonviable at the time of surgery. Eleven combined ovarian and tubal torsions and two isolated tubal torsions were studied. In 10 cases the ovaries were considered nonviable at the time of surgery and in three cases they were considered viable. Of the nonviable group, six showed absent arterial and venous flow centrally, but two had low velocity (< 5 cm/s) arterial flow peripherally in the region of the adnexal branch of the uterine artery or in the main ovarian artery, and two demonstrated absent or reversed diastolic arterial flow. None of the nonviable ovaries showed venous flow centrally. In contrast, all of the viable ovaries demonstrated venous flow centrally, and two had peripheral and central arterial flow. Although the CDS findings in adnexal torsion are variable, ovarian viability may be predicted if central venous flow is present.

Appendicitis and alternate diagnoses in children: findings on unenhanced limited helical CT.

Abstract The objective of this manuscript is to review and illustrate the findings of appendicitis, and of alternate diagnoses that may clinically or radiographically simulate appendicitis, on unenhanced limited CT in children. Potential pitfalls in unenhanced limited CT interpretation of pediatric patients will also be discussed.

Imaging of the Kidney and Urinary Tract

Imaging modalities available for the evaluation of the urinary tract in children have changed dramatically in the past several decades. Although the excretory urogram (EU) and voiding cystourethrogram (VCUG) are still important diagnostic tools, radionuclide imaging, ultrasonography US) and computed tomography (CT) have come to complement and even replace them in many clinical situations. Magnetic resonance imaging (MRI), an even newer technique, is still in the developmental stage but may also prove to be of value in urinary tract imaging.