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Papers by Randy Ernst

Research paper thumbnail of Paleoradiology: Advanced CT in the Evaluation of Nine Egyptian Mummies

RadioGraphics, 2002

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Research paper thumbnail of Paleoradiology: Advanced CT in the Evaluation of Nine Egyptian Mummies

RadioGraphics, 2002

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Research paper thumbnail of Alternative diagnoses to stone disease on unenhanced CT to investigate acute flank pain

Emergency Radiology, 2003

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Research paper thumbnail of Magnetic Resonance Imaging of Cystic Adnexal Lesions During Pregnancy

Current Problems in Diagnostic Radiology, 2008

Management of cystic adnexal lesions diagnosed during pregnancy is a challenging issue for obstet... more Management of cystic adnexal lesions diagnosed during pregnancy is a challenging issue for obstetricians. The range of treatment options changes from immediate surgery to close follow-up. This pictorial essay illustrates the magnetic resonance imaging findings of various cystic adnexal lesions in pregnant patients. Magnetic resonance imaging may help in better characterization of some of the cystic adnexal lesions diagnosed during pregnancy without exposing the fetus to ionizing radiation.

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Research paper thumbnail of Mimicks of Pancreatic Malignancy in Patients with Chronic Pancreatitis: Correlation of Computed Tomography Imaging Features with Histopathologic Findings

Current Problems in Diagnostic Radiology, 2006

Differentiation of chronic pancreatitis and pancreatic carcinoma can be a clinical and radiologic... more Differentiation of chronic pancreatitis and pancreatic carcinoma can be a clinical and radiologic dilemma. Several patients with chronic pancreatitis can undergo unnecessary major abdominal surgery for benign lesions. This pictorial review illustrates the computed tomographic findings and histopathologic features of lesions mimicking pancreatic neoplasm in patients with chronic pancreatitis. Several benign lesions can simulate pancreatic malignancy in patients with chronic pancreatitis. Knowledge of the computed tomographic appearance of these benign entities is important to prevent unnecessary surgeries.

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Research paper thumbnail of Rapid CT diagnosis of acute appendicitis with IV contrast material

Emergency Radiology, 2005

The purpose of this study was to determine the sensitivity and specificity of computed tomography... more The purpose of this study was to determine the sensitivity and specificity of computed tomography (CT) without administration of oral contrast in confirming suspected acute appendicitis. One hundred seventy-three patient studies were retrieved by a computer-generated search for the word "appendicitis" in radiology reports. Patients presenting to the emergency department over an 8-month period were examined for acute abdominal pain or suspected acute appendicitis. IV-contrast-enhanced CT scans of the abdomen and pelvis were obtained without oral or rectal contrast. Criteria for diagnosis of acute appendicitis included a dilated appendix (>6 mm), periappendiceal inflammation, or abscess. Final diagnoses were established with surgical/clinical follow-up, histopathological analysis or both. The standard time (1 h) for the administration of oral contrast prior to the CT scan was eliminated. Fifty-nine CT diagnoses were made of acute appendicitis, 56 of which were histologically verified and three of which resulted in another diagnosis. One hundred fourteen CT diagnoses were negative for appendicitis. This corresponds to a sensitivity of 100% and specificity of 97%, a positive predictive value of 95%, and a negative predictive value of 100%. CT with IV contrast is sensitive and specific for the confirmation or exclusion of acute appendicitis. By eliminating the time required to administer oral contrast, the diagnosis might be made more rapidly.

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Research paper thumbnail of Traumatic diaphragmatic rupture: can oral contrast increase CT detectability?

Emergency Radiology, 2003

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Research paper thumbnail of Emergent MRI utilizing a 5-inch surface coil to evaluate for acute penile fracture

Emergency Radiology, 2002

MR imaging is useful in rapidly detecting penile fractures and in guiding surgical planning.

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Research paper thumbnail of The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy

The American Journal of Surgery, 1999

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Research paper thumbnail of Accurate Determination of Chemical Composition of Urinary Calculi by Spiral Computerized Tomography

The Journal of Urology, 1998

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Research paper thumbnail of A picture archiving and communications system featuring multiple monitors using Windows98

Journal of Digital Imaging, 1999

We present an effective approach to manage, review, and distribute Digital Imaging and Communicat... more We present an effective approach to manage, review, and distribute Digital Imaging and Communications in Medicine (DICOM) images with multiple monitors using Windows98 (Microsoft Corp, Redmond, WA) that can be implemented in an office-based setting. Computed tomography (CT), magnetic resonance imaging (MRI), and angiographic DICOM images were collected, compressed, and stored using Medweb (Medweb, Inc, San Francisco, CA) software. The Medweb server used the Linux/UNIX operating system on a Pentium 333-MHz processor with 128 MB of RAM. Short-term storage capacity was about 2 weeks with routine usage of an 11-GB hard drive. Images were presented for reading on a dual-monitor Windows98 Pentium display station with 160 MB of RAM using a Medweb/Netscape (Netscape Communications Corp, Mountain View, CA) viewer. There was no significant discrepancy in diagnosis between electronic and conventional film images. Mean reading time for 32 cases was 118 seconds. The Medweb JAVA plug-in viewer loaded the first image within 30 seconds of selecting the case for review. Full uncompressed 16-bit images allowed different window settings to better assess for pathology. Multiple monitors allowed viewing various hanging protocols. Cine viewing was also possible. Key diagnostic images were electronically transmitted to referring physicians. On-call radiologists were able to access images through the Internet. By combining Medweb, DICOM, and web-browser software using desktop personal computers (PCs), an easily accessible picture archiving and communications system (PACS) is available to radiologists and referring physicians. Multiple monitors are easily configured and managed using Windows98. This system can sustain changes and can be extended to provide variable functions using inexpensive PCs.

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Research paper thumbnail of Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting1 1Vital Images Inc. has supported research at UCLA (to D. S. K. L., J. A. B., and E. G. M.). Monex provided support (to M. M.). GE Medical Systems provided software license and research support (t...

Gastroenterology, 2003

No multicenter study has been reported evaluating the performance and interobserver variability o... more No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study. A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.

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Research paper thumbnail of MR imaging in the triage of pregnant patients with acute abdominal and pelvic pain

Abdominal Imaging, 2009

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Research paper thumbnail of Localization of Appendix with MDCT and Influence of Findings on Choice of Appendectomy Incision

American Journal of Roentgenology, 2006

The purpose of this study was to show the relation between McBurney&a... more The purpose of this study was to show the relation between McBurney's point and the appendix in patients undergoing 3D MDCT and to investigate the effect of this information on a surgeon's choice of appendectomy incision. Among 142 adults undergoing consecutive MDCT studies, 100 patients (35 women, 65 men; mean age, 52.1 years) with an identifiable appendix on abdominopelvic MDCT examinations were selected for the study group. The presence of intraabdominal mass or a history of abdominal surgery were the exclusion criteria. Three-dimensional reconstruction of the CT data was performed with a surface shaded display algorithm. The locations of the base of the appendix and McBurney's point were marked on a single 3D image that allowed display of the skin surface markings for each patient. The superoinferior and mediolateral distances from the level of the appendix to the level of McBurney's point were measured, and the radial distance was calculated from these measurements. A surgeon experienced in emergency abdominal surgery reviewed 3D CT images and one axial image showing the appendix, and his choice of incision for each patient based on the CT information was recorded. The influence of the superoinferior and mediolateral distances of the appendix from McBurney's point on the surgeon's decision was analyzed with a multivariate logistic regression model. The appendix was exactly at McBurney's point in only 4% of the patients. In 36% of the cases, the appendix was within 3 cm, in 28% of cases it was 3-5 cm, and in 36% of the cases it was more than 5 cm away from McBurney's point. Mean +/- SD superoinferior, mediolateral, and radial distances between the appendix and McBurney's point were 33.0 +/- 24.1, 20.8 +/- 19.3, and 42.1 +/- 26.7 mm, respectively. After reviewing the images, the surgeon would have altered his incision site in 35% of the cases. The surgeon preferred a higher incision in 28% and a lower incision in 7% of the cases. Both positive and negative superoinferior displacement away from McBurney's point were significant factors regarding the surgeon's decision to alter the incision (p = 0.005), and the superoinferior distance was more than 3 cm in 94% of the cases in which the surgeon would have altered the incision. The location of the appendix varies widely among individuals, and McBurney's point has limitations as an anatomic landmark. Three-dimensional MDCT findings can be useful to surgeons customizing appendectomy incisions. Additional information about the location of the appendix in the CT report (if possible, together with a 3D image showing the location of the appendix) may be beneficial for surgeons performing appendectomy.

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Research paper thumbnail of Revisiting MRI for Appendix Location During Pregnancy

American Journal of Roentgenology, 2006

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Research paper thumbnail of Gadolinium-Based Contrast Exposure, Nephrogenic Systemic Fibrosis, and Gadolinium Detection in Tissue

American Journal of Roentgenology, 2008

The objective of our study was to retrospectively review one institution&... more The objective of our study was to retrospectively review one institution's cases of nephrogenic systemic fibrosis (NSF), evaluate possible associated factors, determine the prevalence of NSF, and search for gadolinium in skin samples obtained from patients with NSF. A retrospective review of our dermatopathology database from 1997 to 2007 was performed to search for patients with NSF. The records of patients with NSF were reviewed for factors suspected to be associated with NSF such as acidosis, low hemoglobin levels, low serum calcium levels, inflammatory conditions, serum antibodies, pharmaceutical erythropoietin, angiotensin-converting enzyme inhibitors, gadolinium-based contrast agents (GBCAs), renal failure, and dialysis. The biopsy samples from NSF patients and from control subjects were examined with energy-dispersive X-ray spectroscopy to detect gadolinium. Retrospective chart reviews of patients evaluated at our local dialysis center and our dermatology clinic were conducted to identify patients who underwent MRI, who had NSF managed exclusively by our tertiary referral centers, or both from 1997 to 2007. Seven cases of NSF were found in the dermatopathology database. Two of the seven patients were also followed up at our outpatient dialysis clinic. No other cases of NSF were discovered within the dialysis clinic's population exclusively followed within our institution. All seven dermatopathology database NSF patients developed symptoms of NSF after receiving GBCAs during renal failure and showed concomitant proinflammatory conditions. No other proposed risk factors were uniformly present in these NSF cases. All four NSF patients with chronic renal failure developed NSF after hemodialysis, with one patient dialyzed 12 hours after receiving a contrast dose. Gadodiamide was the only GBCA that all seven NSF patients received before symptom onset. Symptom onset was from 3 weeks to 18 months after GBCA exposure, with cumulative GBCA doses ranging from 0.16 to 0.43 mmol/kg. Gadolinium was detected in six of seven NSF patients' skin biopsies. Seven of eight random control specimens obtained from three healthy control subjects, three patients with renal insufficiency who had not been exposed to gadodiamide, and two patients without renal disease who had been exposed to gadodiamide were negative. Seventy-two dialysis clinic patients underwent 127 contrast-enhanced MR examinations from 1997 to 2007. Eighteen patients received gadopentetate, none of whom developed NSF. Sixty-three patients received gadodiamide, two of whom developed NSF (prevalence of NSF in patients exposed to GBCA, 2.8%; odds ratio, 0.82 [95% CI, 0.04-18.10]; likelihood ratio, 1.16 [95% CI, 1.06-1.26]). Nine patients received both contrast agents. An association with GBCAs in the development of NSF is suggested in the setting of renal insufficiency, but other factors seem to play a role. Dialysis did not prevent the development of NSF. Gadolinium was detected in skin samples from NSF patients.

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Research paper thumbnail of Magnetic Resonance Imaging of the Chest, Abdomen, and Pelvis in the Evaluation of Pregnant Patients with Neoplasms

American Journal of Perinatology, 2007

This article illustrates the magnetic resonance (MR) technique and MR imaging (MRI) findings of v... more This article illustrates the magnetic resonance (MR) technique and MR imaging (MRI) findings of various neoplasms in chest, abdomen, and pelvis in pregnant patients. MRI can provide useful information about characterization and staging of maternal neoplasms without exposing the fetus to ionizing radiation and can be considered as a first-line cross sectional imaging method as an adjunct to ultrasonography.

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Research paper thumbnail of CAD Performance Analysis for Pulmonary Nodule Detection: Comparison of Thick- and Thin-slice Helical CT Scans

PURPOSE To compare the performance of a computer-aided detection (CAD) system in detecting lung n... more PURPOSE To compare the performance of a computer-aided detection (CAD) system in detecting lung nodules from thick- and thin-slice helical CT scans, and to evaluate the potential benefit of CAD on radiologist sensitivity. METHOD AND MATERIALS Thoracic CT studies of 57 patients were used retrospectively to evaluate the potential contribution of a CAD system (QuickCue�, iCAD, Inc., Beavercreek, OH) in detecting lung nodules. All chest CT examinations were performed using a 4-detector LightSpeed QX/i scanner (GE Medical Systems, Milwaukee, WI). Images were obtained using the HQ setting with 5.0 mm collimation, helical pitch of 0.75/1.0, 120 kVp, and 160-270 mA. Images were then reconstructed with a slice thickness of 2.5 mm, providing thick-slice (5 mm) and thin-slice (2.5mm) scans for each patient. Two board-certified radiologists reviewed the thick-slice studies and all identified nodules were documented. The CAD system was then applied to both the thick-slice and thin-slice studies ...

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Research paper thumbnail of Paleoradiology: Advanced CT in the Evaluation of Nine Egyptian Mummies

RadioGraphics, 2002

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Research paper thumbnail of Paleoradiology: Advanced CT in the Evaluation of Nine Egyptian Mummies

RadioGraphics, 2002

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Alternative diagnoses to stone disease on unenhanced CT to investigate acute flank pain

Emergency Radiology, 2003

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Research paper thumbnail of Magnetic Resonance Imaging of Cystic Adnexal Lesions During Pregnancy

Current Problems in Diagnostic Radiology, 2008

Management of cystic adnexal lesions diagnosed during pregnancy is a challenging issue for obstet... more Management of cystic adnexal lesions diagnosed during pregnancy is a challenging issue for obstetricians. The range of treatment options changes from immediate surgery to close follow-up. This pictorial essay illustrates the magnetic resonance imaging findings of various cystic adnexal lesions in pregnant patients. Magnetic resonance imaging may help in better characterization of some of the cystic adnexal lesions diagnosed during pregnancy without exposing the fetus to ionizing radiation.

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Research paper thumbnail of Mimicks of Pancreatic Malignancy in Patients with Chronic Pancreatitis: Correlation of Computed Tomography Imaging Features with Histopathologic Findings

Current Problems in Diagnostic Radiology, 2006

Differentiation of chronic pancreatitis and pancreatic carcinoma can be a clinical and radiologic... more Differentiation of chronic pancreatitis and pancreatic carcinoma can be a clinical and radiologic dilemma. Several patients with chronic pancreatitis can undergo unnecessary major abdominal surgery for benign lesions. This pictorial review illustrates the computed tomographic findings and histopathologic features of lesions mimicking pancreatic neoplasm in patients with chronic pancreatitis. Several benign lesions can simulate pancreatic malignancy in patients with chronic pancreatitis. Knowledge of the computed tomographic appearance of these benign entities is important to prevent unnecessary surgeries.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Rapid CT diagnosis of acute appendicitis with IV contrast material

Emergency Radiology, 2005

The purpose of this study was to determine the sensitivity and specificity of computed tomography... more The purpose of this study was to determine the sensitivity and specificity of computed tomography (CT) without administration of oral contrast in confirming suspected acute appendicitis. One hundred seventy-three patient studies were retrieved by a computer-generated search for the word "appendicitis" in radiology reports. Patients presenting to the emergency department over an 8-month period were examined for acute abdominal pain or suspected acute appendicitis. IV-contrast-enhanced CT scans of the abdomen and pelvis were obtained without oral or rectal contrast. Criteria for diagnosis of acute appendicitis included a dilated appendix (>6 mm), periappendiceal inflammation, or abscess. Final diagnoses were established with surgical/clinical follow-up, histopathological analysis or both. The standard time (1 h) for the administration of oral contrast prior to the CT scan was eliminated. Fifty-nine CT diagnoses were made of acute appendicitis, 56 of which were histologically verified and three of which resulted in another diagnosis. One hundred fourteen CT diagnoses were negative for appendicitis. This corresponds to a sensitivity of 100% and specificity of 97%, a positive predictive value of 95%, and a negative predictive value of 100%. CT with IV contrast is sensitive and specific for the confirmation or exclusion of acute appendicitis. By eliminating the time required to administer oral contrast, the diagnosis might be made more rapidly.

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Research paper thumbnail of Traumatic diaphragmatic rupture: can oral contrast increase CT detectability?

Emergency Radiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Emergent MRI utilizing a 5-inch surface coil to evaluate for acute penile fracture

Emergency Radiology, 2002

MR imaging is useful in rapidly detecting penile fractures and in guiding surgical planning.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy

The American Journal of Surgery, 1999

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Research paper thumbnail of Accurate Determination of Chemical Composition of Urinary Calculi by Spiral Computerized Tomography

The Journal of Urology, 1998

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Research paper thumbnail of A picture archiving and communications system featuring multiple monitors using Windows98

Journal of Digital Imaging, 1999

We present an effective approach to manage, review, and distribute Digital Imaging and Communicat... more We present an effective approach to manage, review, and distribute Digital Imaging and Communications in Medicine (DICOM) images with multiple monitors using Windows98 (Microsoft Corp, Redmond, WA) that can be implemented in an office-based setting. Computed tomography (CT), magnetic resonance imaging (MRI), and angiographic DICOM images were collected, compressed, and stored using Medweb (Medweb, Inc, San Francisco, CA) software. The Medweb server used the Linux/UNIX operating system on a Pentium 333-MHz processor with 128 MB of RAM. Short-term storage capacity was about 2 weeks with routine usage of an 11-GB hard drive. Images were presented for reading on a dual-monitor Windows98 Pentium display station with 160 MB of RAM using a Medweb/Netscape (Netscape Communications Corp, Mountain View, CA) viewer. There was no significant discrepancy in diagnosis between electronic and conventional film images. Mean reading time for 32 cases was 118 seconds. The Medweb JAVA plug-in viewer loaded the first image within 30 seconds of selecting the case for review. Full uncompressed 16-bit images allowed different window settings to better assess for pathology. Multiple monitors allowed viewing various hanging protocols. Cine viewing was also possible. Key diagnostic images were electronically transmitted to referring physicians. On-call radiologists were able to access images through the Internet. By combining Medweb, DICOM, and web-browser software using desktop personal computers (PCs), an easily accessible picture archiving and communications system (PACS) is available to radiologists and referring physicians. Multiple monitors are easily configured and managed using Windows98. This system can sustain changes and can be extended to provide variable functions using inexpensive PCs.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting1 1Vital Images Inc. has supported research at UCLA (to D. S. K. L., J. A. B., and E. G. M.). Monex provided support (to M. M.). GE Medical Systems provided software license and research support (t...

Gastroenterology, 2003

No multicenter study has been reported evaluating the performance and interobserver variability o... more No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study. A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of MR imaging in the triage of pregnant patients with acute abdominal and pelvic pain

Abdominal Imaging, 2009

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Research paper thumbnail of Localization of Appendix with MDCT and Influence of Findings on Choice of Appendectomy Incision

American Journal of Roentgenology, 2006

The purpose of this study was to show the relation between McBurney&a... more The purpose of this study was to show the relation between McBurney's point and the appendix in patients undergoing 3D MDCT and to investigate the effect of this information on a surgeon's choice of appendectomy incision. Among 142 adults undergoing consecutive MDCT studies, 100 patients (35 women, 65 men; mean age, 52.1 years) with an identifiable appendix on abdominopelvic MDCT examinations were selected for the study group. The presence of intraabdominal mass or a history of abdominal surgery were the exclusion criteria. Three-dimensional reconstruction of the CT data was performed with a surface shaded display algorithm. The locations of the base of the appendix and McBurney's point were marked on a single 3D image that allowed display of the skin surface markings for each patient. The superoinferior and mediolateral distances from the level of the appendix to the level of McBurney's point were measured, and the radial distance was calculated from these measurements. A surgeon experienced in emergency abdominal surgery reviewed 3D CT images and one axial image showing the appendix, and his choice of incision for each patient based on the CT information was recorded. The influence of the superoinferior and mediolateral distances of the appendix from McBurney's point on the surgeon's decision was analyzed with a multivariate logistic regression model. The appendix was exactly at McBurney's point in only 4% of the patients. In 36% of the cases, the appendix was within 3 cm, in 28% of cases it was 3-5 cm, and in 36% of the cases it was more than 5 cm away from McBurney's point. Mean +/- SD superoinferior, mediolateral, and radial distances between the appendix and McBurney's point were 33.0 +/- 24.1, 20.8 +/- 19.3, and 42.1 +/- 26.7 mm, respectively. After reviewing the images, the surgeon would have altered his incision site in 35% of the cases. The surgeon preferred a higher incision in 28% and a lower incision in 7% of the cases. Both positive and negative superoinferior displacement away from McBurney's point were significant factors regarding the surgeon's decision to alter the incision (p = 0.005), and the superoinferior distance was more than 3 cm in 94% of the cases in which the surgeon would have altered the incision. The location of the appendix varies widely among individuals, and McBurney's point has limitations as an anatomic landmark. Three-dimensional MDCT findings can be useful to surgeons customizing appendectomy incisions. Additional information about the location of the appendix in the CT report (if possible, together with a 3D image showing the location of the appendix) may be beneficial for surgeons performing appendectomy.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Revisiting MRI for Appendix Location During Pregnancy

American Journal of Roentgenology, 2006

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Gadolinium-Based Contrast Exposure, Nephrogenic Systemic Fibrosis, and Gadolinium Detection in Tissue

American Journal of Roentgenology, 2008

The objective of our study was to retrospectively review one institution&... more The objective of our study was to retrospectively review one institution's cases of nephrogenic systemic fibrosis (NSF), evaluate possible associated factors, determine the prevalence of NSF, and search for gadolinium in skin samples obtained from patients with NSF. A retrospective review of our dermatopathology database from 1997 to 2007 was performed to search for patients with NSF. The records of patients with NSF were reviewed for factors suspected to be associated with NSF such as acidosis, low hemoglobin levels, low serum calcium levels, inflammatory conditions, serum antibodies, pharmaceutical erythropoietin, angiotensin-converting enzyme inhibitors, gadolinium-based contrast agents (GBCAs), renal failure, and dialysis. The biopsy samples from NSF patients and from control subjects were examined with energy-dispersive X-ray spectroscopy to detect gadolinium. Retrospective chart reviews of patients evaluated at our local dialysis center and our dermatology clinic were conducted to identify patients who underwent MRI, who had NSF managed exclusively by our tertiary referral centers, or both from 1997 to 2007. Seven cases of NSF were found in the dermatopathology database. Two of the seven patients were also followed up at our outpatient dialysis clinic. No other cases of NSF were discovered within the dialysis clinic's population exclusively followed within our institution. All seven dermatopathology database NSF patients developed symptoms of NSF after receiving GBCAs during renal failure and showed concomitant proinflammatory conditions. No other proposed risk factors were uniformly present in these NSF cases. All four NSF patients with chronic renal failure developed NSF after hemodialysis, with one patient dialyzed 12 hours after receiving a contrast dose. Gadodiamide was the only GBCA that all seven NSF patients received before symptom onset. Symptom onset was from 3 weeks to 18 months after GBCA exposure, with cumulative GBCA doses ranging from 0.16 to 0.43 mmol/kg. Gadolinium was detected in six of seven NSF patients' skin biopsies. Seven of eight random control specimens obtained from three healthy control subjects, three patients with renal insufficiency who had not been exposed to gadodiamide, and two patients without renal disease who had been exposed to gadodiamide were negative. Seventy-two dialysis clinic patients underwent 127 contrast-enhanced MR examinations from 1997 to 2007. Eighteen patients received gadopentetate, none of whom developed NSF. Sixty-three patients received gadodiamide, two of whom developed NSF (prevalence of NSF in patients exposed to GBCA, 2.8%; odds ratio, 0.82 [95% CI, 0.04-18.10]; likelihood ratio, 1.16 [95% CI, 1.06-1.26]). Nine patients received both contrast agents. An association with GBCAs in the development of NSF is suggested in the setting of renal insufficiency, but other factors seem to play a role. Dialysis did not prevent the development of NSF. Gadolinium was detected in skin samples from NSF patients.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Magnetic Resonance Imaging of the Chest, Abdomen, and Pelvis in the Evaluation of Pregnant Patients with Neoplasms

American Journal of Perinatology, 2007

This article illustrates the magnetic resonance (MR) technique and MR imaging (MRI) findings of v... more This article illustrates the magnetic resonance (MR) technique and MR imaging (MRI) findings of various neoplasms in chest, abdomen, and pelvis in pregnant patients. MRI can provide useful information about characterization and staging of maternal neoplasms without exposing the fetus to ionizing radiation and can be considered as a first-line cross sectional imaging method as an adjunct to ultrasonography.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of CAD Performance Analysis for Pulmonary Nodule Detection: Comparison of Thick- and Thin-slice Helical CT Scans

PURPOSE To compare the performance of a computer-aided detection (CAD) system in detecting lung n... more PURPOSE To compare the performance of a computer-aided detection (CAD) system in detecting lung nodules from thick- and thin-slice helical CT scans, and to evaluate the potential benefit of CAD on radiologist sensitivity. METHOD AND MATERIALS Thoracic CT studies of 57 patients were used retrospectively to evaluate the potential contribution of a CAD system (QuickCue�, iCAD, Inc., Beavercreek, OH) in detecting lung nodules. All chest CT examinations were performed using a 4-detector LightSpeed QX/i scanner (GE Medical Systems, Milwaukee, WI). Images were obtained using the HQ setting with 5.0 mm collimation, helical pitch of 0.75/1.0, 120 kVp, and 160-270 mA. Images were then reconstructed with a slice thickness of 2.5 mm, providing thick-slice (5 mm) and thin-slice (2.5mm) scans for each patient. Two board-certified radiologists reviewed the thick-slice studies and all identified nodules were documented. The CAD system was then applied to both the thick-slice and thin-slice studies ...

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