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Ovarian torsion-diagnostic features on imaging
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Abstract / Clinical Radiology 70 (2015) S1eS9
Methods and materials: We will provide examples of a range of cases of abdominal and pelvic MRI from our institution which demonstrate uterine abnormalities both before and after delivery. Results: MRI images will demonstrate cases of: e Retained products of conception e Arteriovenous malformation e Uterine rupture e Caesarean section scar abnormalities e Uterine adhesions after caesarean section e Placenta praevia e Placenta increta/percreta Conclusion: MRI can act as a useful problem solving tool in the assessment of uterine antenatal and postnatal abnormalities. In addition, previous complications of delivery may be seen as findings on imaging performed for other clinical indications.
Diagnostic value of barium swallow following oesophagogastro duodenoscopy (OGD) for dysphagia or dysmotility Authors: Pavan Nandra, Shayan Ahmed, Rosemary Phillips, Sridhar Redla
Purpose: Barium swallow can be useful in the investigation of dysphagia and dysmotility. With advances in oesophagogastroduodenoscopy (OGD) and manometry, the use of barium swallow has become less relevant. We aimed to study the diagnostic benefit of barium swallow in patients being investigated for dysphagia/dysmotility, particularly in those who had recently undergone OGD. Methods and materials: Using the computerised radiology information system (CRIS), a search was conducted for ‘motility’ and/or ‘dysphagia’ within the request for barium swallows performed during March 2014eMarch 2015. Reports were analysed individually by one person. Using GI Reporting Tool software, OGD reports for these patients during January 2014eMarch 2015 were analysed by the same person. Results: In a one year period, there were 36 barium swallows performed (female ¼ 22, male ¼ 14; average age 64) for the investigation of dysphagia/dysmotility. Of these, 18 (50.0%) were performed after a successfully completed OGD. Of these studies, 18 (100.0%) of the barium swallow reports correlated with the OGD report. No new clinical information was added, including the three of the barium swallows (16.7%) that demonstrated dysmotility; all of these three cases already had previous endoscopic findings suggestive of dysmotility. Conclusion: These findings showed that barium swallow following a successfully performed OGD added no additional diagnostic benefit in the investigation of dysphagia or dysmotility.
Ovarian torsion-diagnostic features on imaging
Methods and materials: Six cases of ovarian torsion have been reviewed and their imaging features analysed with respect to clinical presentation. Results: Ovarian torsion can be diagnosed confidently on magnetic resonance imaging (MRI), however, torsionedetorsion needs to be kept in mind in patients with fluctuating symptoms and a predisposing pathology, for example, cyst/tumour if there is no associated peri-ovarian inflammation. Computed tomography (CT) diagnosis was possible in one of the three cases analysed for this study. CT diagnosis is dependent on the amount of intraperitoneal fat and scan quality. Ultrasound features are fairly typical in the younger age group but may be difficult to assess in the older age group or in the presence of an underlying tumour. Conclusion: A high clinical suspicion and appropriate history helps in targeted imaging and early diagnosis. MRI is a very sensitive modality in our experience for a definitive diagnosis. Early correct diagnosis helps appropriate surgical planning. CT protocol optimisation in post-oesophagogastrectomy imaging Authors: Tanzilah A. Barrow, Yee Mei Koay, Velauthan Rudralingam, Rachel F. Magennis, Sathi A. Sukumar
Purpose: Review imaging protocol and findings in postoperative oesophagogastrectomy patients with suspected complications. Methods and materials: We undertook a retrospective study of 86 consecutive oesophagogastrectomy cases in a tertiary referral centre, with particular focus on postoperative patients with suspected complications, computed tomography (CT) imaging protocol and potential pitfalls. Results: The study included 86 patients who underwent surgery: 40 gastrectomies and 46 oesophagectomies. Complications were suspected in 25 patients. Computed tomography pulmonary angiography (CTPA) was performed in two cases of suspected pulmonary emboli. The remaining 23 patients were imaged according to the departmental CT protocol for postoperative patients with suspected leak. Although fluoroscopy is used as firstline investigation in some centres, we routinely rely on CT imaging with non-contrast examination prior to oral contrast bolus on the CT table. With specific reconstruction and reformat protocols, we optimise delineation of leaks while excluding other postoperative complications. Recognition of common pitfalls is important in accurate image interpretation. Conclusion: The high morbidity and mortality associated with postoperative leak highlights the importance of early detection and prompt treatment. As radiologists, we therefore have the responsibility of maximising detection of leaks, avoiding common pitfalls and excluding other complications. We have demonstrated accurate detection of anastomotic leaks using CT with refined protocols.
Authors: Rachana Shukla, Zachary Nash, Owen J. Owens
Purpose: Ovarian torsion is a gynaecological emergency. The clinical features can, however, be obscured by multiple co-morbidities, especially in the older age group. The purpose of the article is to demonstrate the diagnostic features of ovarian torsion with a multimodality review of cases. The case review also attempts to distinguish torsion-detorsion as compared to complete irreversible torsion on the basis of clinical symptoms and ovarian morphology.
Loopography after ileal conduit urinary diversion e a useful investigation? Authors: Naveed Altaf, Ashok Sakthivel, Geoff Naisby
Purpose: A loopogram has historically been used to demonstrate the anatomy and patency of the ureteroileal anastomosis following ileal conduit urinary diversion. We review the place of routine
Abstract / Clinical Radiology 70 (2015) S1eS9
Methods and materials: We will provide examples of a range of cases of abdominal and pelvic MRI from our institution which demonstrate uterine abnormalities both before and after delivery. Results: MRI images will demonstrate cases of: e Retained products of conception e Arteriovenous malformation e Uterine rupture e Caesarean section scar abnormalities e Uterine adhesions after caesarean section e Placenta praevia e Placenta increta/percreta Conclusion: MRI can act as a useful problem solving tool in the assessment of uterine antenatal and postnatal abnormalities. In addition, previous complications of delivery may be seen as findings on imaging performed for other clinical indications.
Diagnostic value of barium swallow following oesophagogastro duodenoscopy (OGD) for dysphagia or dysmotility Authors: Pavan Nandra, Shayan Ahmed, Rosemary Phillips, Sridhar Redla
Purpose: Barium swallow can be useful in the investigation of dysphagia and dysmotility. With advances in oesophagogastroduodenoscopy (OGD) and manometry, the use of barium swallow has become less relevant. We aimed to study the diagnostic benefit of barium swallow in patients being investigated for dysphagia/dysmotility, particularly in those who had recently undergone OGD. Methods and materials: Using the computerised radiology information system (CRIS), a search was conducted for ‘motility’ and/or ‘dysphagia’ within the request for barium swallows performed during March 2014eMarch 2015. Reports were analysed individually by one person. Using GI Reporting Tool software, OGD reports for these patients during January 2014eMarch 2015 were analysed by the same person. Results: In a one year period, there were 36 barium swallows performed (female ¼ 22, male ¼ 14; average age 64) for the investigation of dysphagia/dysmotility. Of these, 18 (50.0%) were performed after a successfully completed OGD. Of these studies, 18 (100.0%) of the barium swallow reports correlated with the OGD report. No new clinical information was added, including the three of the barium swallows (16.7%) that demonstrated dysmotility; all of these three cases already had previous endoscopic findings suggestive of dysmotility. Conclusion: These findings showed that barium swallow following a successfully performed OGD added no additional diagnostic benefit in the investigation of dysphagia or dysmotility.
Ovarian torsion-diagnostic features on imaging
Methods and materials: Six cases of ovarian torsion have been reviewed and their imaging features analysed with respect to clinical presentation. Results: Ovarian torsion can be diagnosed confidently on magnetic resonance imaging (MRI), however, torsionedetorsion needs to be kept in mind in patients with fluctuating symptoms and a predisposing pathology, for example, cyst/tumour if there is no associated peri-ovarian inflammation. Computed tomography (CT) diagnosis was possible in one of the three cases analysed for this study. CT diagnosis is dependent on the amount of intraperitoneal fat and scan quality. Ultrasound features are fairly typical in the younger age group but may be difficult to assess in the older age group or in the presence of an underlying tumour. Conclusion: A high clinical suspicion and appropriate history helps in targeted imaging and early diagnosis. MRI is a very sensitive modality in our experience for a definitive diagnosis. Early correct diagnosis helps appropriate surgical planning. CT protocol optimisation in post-oesophagogastrectomy imaging Authors: Tanzilah A. Barrow, Yee Mei Koay, Velauthan Rudralingam, Rachel F. Magennis, Sathi A. Sukumar
Purpose: Review imaging protocol and findings in postoperative oesophagogastrectomy patients with suspected complications. Methods and materials: We undertook a retrospective study of 86 consecutive oesophagogastrectomy cases in a tertiary referral centre, with particular focus on postoperative patients with suspected complications, computed tomography (CT) imaging protocol and potential pitfalls. Results: The study included 86 patients who underwent surgery: 40 gastrectomies and 46 oesophagectomies. Complications were suspected in 25 patients. Computed tomography pulmonary angiography (CTPA) was performed in two cases of suspected pulmonary emboli. The remaining 23 patients were imaged according to the departmental CT protocol for postoperative patients with suspected leak. Although fluoroscopy is used as firstline investigation in some centres, we routinely rely on CT imaging with non-contrast examination prior to oral contrast bolus on the CT table. With specific reconstruction and reformat protocols, we optimise delineation of leaks while excluding other postoperative complications. Recognition of common pitfalls is important in accurate image interpretation. Conclusion: The high morbidity and mortality associated with postoperative leak highlights the importance of early detection and prompt treatment. As radiologists, we therefore have the responsibility of maximising detection of leaks, avoiding common pitfalls and excluding other complications. We have demonstrated accurate detection of anastomotic leaks using CT with refined protocols.
Authors: Rachana Shukla, Zachary Nash, Owen J. Owens
Purpose: Ovarian torsion is a gynaecological emergency. The clinical features can, however, be obscured by multiple co-morbidities, especially in the older age group. The purpose of the article is to demonstrate the diagnostic features of ovarian torsion with a multimodality review of cases. The case review also attempts to distinguish torsion-detorsion as compared to complete irreversible torsion on the basis of clinical symptoms and ovarian morphology.
Loopography after ileal conduit urinary diversion e a useful investigation? Authors: Naveed Altaf, Ashok Sakthivel, Geoff Naisby
Purpose: A loopogram has historically been used to demonstrate the anatomy and patency of the ureteroileal anastomosis following ileal conduit urinary diversion. We review the place of routine