Pott's puffy tumor in a 5-year-old boy: The role of ultrasound and contrast-enhanced CT imaging—Surgical case report

Point-of-care ultrasound has become of utmost importance in the management of critically ill patients, changing everyday clinical practice. With this case report, we highlight the role of abdominal ultrasound in the management of elderly patientswith gallstone ileus (a rare cause of intestinal obstructions caused by a cholecysto-duodenal fistula) and with contraindications for contrast-enhanced CT scan.

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Adrenal incidentalomas: imaging challenges—role of MDCT scan versus MRI in evaluating adrenal incidentalomas

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00437-w ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Monica Maher Amin Nawar ◽

Sameh Abdel Aziz Zaky Hanna ◽

Shereen Sadik El-Sawy ◽

Sally Yehia Shokralla

Keyword(s):

Significant Risk ◽

Adrenal Incidentaloma ◽

Adrenal Incidentalomas ◽

Specific Patient ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Significant Difference ◽

Adrenal Masses

Abstract Background The term adrenal incidentaloma (AI), by definition, is an adrenal mass that is unexpectedly detected through an imaging procedure performed for reasons unrelated to adrenal dysfunction or suspected dysfunction. Despite their frequent appearance, the challenge remains in recognizing and treating the small percentage of AI that poses a significant risk, either because of their hormonal activity or because of their malignant histology. The aim of this study is to study the role of MRI, specifically chemical shift imaging (CSI), against various MDCT scans (non-enhanced, enhanced, and delayed) in the characterization of incidentally discovered adrenal masses to offer a way for the patients to avoid unnecessary time and money-wasting imaging modalities used to reach a diagnosis of their incidentally discovered adrenal lesions. We examined a total number of 20 patients with total of 22 adrenal lesions. The mean age was 51.1 ± 15.27. Results In our study, we found that among CT parameters, APW and RPW showed the highest sensitivity and specificity for detection of lipid-rich adenomas. CSI has also proven to be the best MR technique. However, there is no statistically significant difference in the diagnostic capability of CSI versus the CT washout technique. Both modalities could be conducted, according to specific patient preferences and/or limitations, with comparable highly accurate outcomes. Conclusion This study demonstrates that a similar diagnostic outcome is obtained from contrast-enhanced CT (CECT) and MRI with CSI of adrenal lesions.

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Incremental Role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in detection of recurrence of carcinoma cervix

10.1055/s-0039-1685260 ◽

2016 ◽

Author(s):

S. Dash ◽

A. Goel ◽

S. Sogani

Keyword(s):

Fdg Pet ◽

Carcinoma Cervix ◽

Histopathological Correlation ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Radiologic Imaging ◽

18F Fdg

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.

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