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Biomedical subjects

B Raval

Publications and source records attributed to B Raval.

At least 19 recordsLinked to original sources
PubMed2000

Advances in the imaging of common duct stones using magnetic resonance cholangiography, endoscopic ultrasonography, and laparoscopic ultrasonography.

Advances in magnetic resonance cholangiography (MRC) have resulted in consistently high sensitivity and specificity for the detection of common duct stones by MRC. There are multiple advantages to using MRC over endoscopic retrograde cholangiography (ERC) in the diagnosis of common duct stones, thereby reserving the use of ERC mainly as a therapeutic tool. Endoscopic ultrasonography has emerged as a modality capable of common duct stone detection and, when available, will compete with MRC and ERC for the diagnosis of common duct stones. However, its ability to image intrahepatic or proximal common duct stones would seem to be limited. Laparoscopic ultrasonography helps shorten operative time and costs less compared with intraoperative cholangiography. As more surgeons gather experience with laparoscopic ultrasonography and it becomes widely available, it has the promise to substitute for intraoperative cholangiography.

Cholangiography↗
PubMed1999

Evaluating the impact of workstation usage on radiology report times in the initial 6 months following installation.

Picture archiving and communications systems (PACS) workstations are reported to improve workflow by making studies immediately available for review upon their completion. This study tested the hypothesis that a workstation would decrease the time from completion of a study to dictation of results (report time). A four-monitor, 2K x 2K workstation (Imation Cemax-Icon, Fremont, CA), was installed in a body imaging computed tomography (CT) reading room. Use of the workstation by the staff radiologists was voluntary. Images were also printed on film and films continued to be hung at the routine hanging times. To evaluate the workstation's maximum impact, data were collected for report times for studies completed during the routine day shift of the staff radiologist (Monday to Friday, 8 AM to 5 PM). Data were collected before workstation installation (August 1997 to November 1997) and for the subsequent 6 months. Histograms of the number of studies (743 v 103) versus report time (mean, 11.7 v 7.4 hours) showed a bimodal distribution, with peaks at approximately 6 and 24 hours, both before (8/97-11/97) and after (6/98) the workstation's installation. However, the number of studies dictated greater than 60 hours (25.2% v 20.4%) and the percentage of studies in the second peak (16 to 48 hours; 4.4% v 0%) both decreased. In conclusion, the workstation decreased the mean (11.7 v 7.4 hours) and standard deviation (19.8 v 9.1 hours) for report times. This was due to a decrease in both the number of cases dictated the day following their completion and the number of outliers (markedly delayed dictations). The decrease in outliers is probably due to a decrease in the number of "lost" film-based studies.

Computer Systems↗
PubMed1997

Renal inflammatory disease: the current role of CT.

Computed tomography (CT) plays a significant role in establishing the diagnosis in clinically equivocal cases of renal infection, determining the extent of the disease process, and assessing its complications. Gas, calculi, renal parenchymal calcifications, hemorrhage, and masses can be revealed with unenhanced CT. A subsequent study with contrast enhancement is crucial for the complete evaluation of patients with renal infection in order to demonstrate the areas of altered nephrogram that occur as a result of the inflammatory process and to identify complications. In this article we review a spectrum of renal inflammatory disease, with illustrations of the CT findings in representative cases. We also review the role and potential pitfalls of fast scanning techniques that can image a particular phase of the nephrogram in a renal infection. In acute pyelonephritis, enhanced CT scans obtained during the cortical nephrographic phase typically demonstrate solitary or multifocal hypodense areas with obliteration of the corticomedullary differentiation. Delayed images obtained during the excretory phase are frequently more helpful in defining the extent of the disease process, identifying the complications such as renal abscess, and confirming the presence of urinary obstruction than are early images.

Acute Disease↗
PubMed1994

Portal vein thrombosis: imaging findings.

Portal vein thrombosis (PVT) is usually a complication of pre-existing cirrhosis, abdominal malignancy (e.g., pancreatic or hepatocellular carcinoma), or abdominal inflammation (e.g., appendicitis, diverticulitis, pancreatitis). Less frequently, PVT can be associated with myeloproliferative or connective tissue disorders or inflammatory bowel disease [1]. PVT can cause or exacerbate portal hypertension; variceal bleeding or hypersplenism may then develop acutely or several years later. PVT also complicates portosystemic shunt surgery or hepatic transplantation. Unfortunately, the signs and symptoms of PVT can be subtle or nonspecific and can be overshadowed by the underlying illness. The radiologist may be the only physician to suggest the preoperative or premortem diagnosis of PVT. Familiarity with the imaging findings of PVT, therefore, is imperative.

Adult↗
PubMed1990

Perforation of the colon due to endometriosis.

Endometriosis is a common disease which affects the bowel in 12 to 35% of cases. Despite extensive serosal and intramural involvement, the intestinal mucosa usually remains intact and bowel perforation rarely occurs. We describe a patient with perforation of the sigmoid colon due to endometriosis. To our knowledge, this is the first such case to be reported in the radiologic literature.

Endometriosis↗
PubMed1990

CT diagnosis of acquired small bowel volvulus.

Small-bowel volvulus is an uncommon but important cause of small-bowel obstruction and often results in ischemia or infarction. Clinical examination and plain film radiography may be nondiagnostic, leading to delay in surgical intervention with subsequent increase in morbidity and mortality. We present two patients in whom the diagnosis of strangulating small-bowel volvulus was made by computed tomography (CT), allowing rapid surgical correction of this potentially life-threatening condition.

Aged↗
PubMed1989

CT diagnosis of perforated duodenal diverticulum.

We present a case of perforated duodenal diverticulum diagnosed preoperatively on computed tomography. This rare but potentially fatal condition has been difficult to detect with more conventional radiographic techniques.

Diverticulum↗
PubMed1989

Omental cakes in American Burkitt lymphoma. Computed tomography demonstration.

Diffuse tumor infiltration of the omentum or so-called omental "cakes" is well recognized on computed tomography (CT) and is usually associated with pelvic or gastrointestinal carcinoma. However, this has not been described in American Burkitt lymphoma despite frequent intraabdominal involvement in this disease. We report two cases of American Burkitt lymphoma in which omental cakes were demonstrated by CT.

Abdominal Neoplasms↗
PubMed1987

Role of computed tomography in diverticulitis.

Fourteen patients with diverticulitis who were clinically believed to require radiologic investigation form the basis of this report. An inflammatory mass (n = 10) or abscess (n = 2) were reliable findings on computed tomography. Other signs encountered were abnormal density of pericolic fat, thickening of colonic wall, and narrowing of the lumen of the colonic wall. Colovesical fistulas, all of which were suspected clinically, occurred in three patients. Computed tomography should be performed with administration of rectal contrast medium to demonstrate the origin of inflammation from the colon, assess pericolic extent, and confirm colovesical fistula.

Adult↗
PubMed1987

Use of computed tomography in appendicitis: technique, findings, and pitfalls.

Twelve patients with acute appendicitis were studied by computed tomography. Our technique of conducting the examination, the computed tomography signs, and the pitfalls encountered in studying these patients are presented. Use of computed tomography should be considered whenever the clinical presentation is atypical or confirmation of the clinical diagnosis is necessary.

Acute Disease↗
PubMed1987

CT demonstration of preferential routes of the spread of pelvic disease.

Specific anatomical pathways, both extraperitoneal and intraperitoneal, exist which result in the spread of disease into or out of the pelvis. Often, the full extent of the disease is not appreciated clinically and may be uncovered first by computed tomography (CT). This review discusses the pertinent normal anatomy as shown by CT and magnetic resonance (MR) and then illustrates each route with examples. An awareness of these preferential routes of disease spread permits the radiologist monitoring the examination to decide when areas adjacent to the pelvis should be included in the study. This will provide a complete assessment of the extent of disease and guide appropriate therapy.

Abdominal Muscles↗
PubMed1986

Retroaortic left renal vein: an interpretive pitfall on computed tomography.

In a patient with retroaortic left renal vein, the anomalous vessel is demonstrated by computed tomography to take a caudal course of several centimeters before crossing in a retroaortic fashion to join with the inferior vena cava. This case differs from previously published reports. Computed tomography provided excellent anatomic details of the vascular anomaly and highlighted the value of postcontrast dynamic computed tomography scanning.

Female↗
PubMed1986

Computed tomography of complicated cholecystitis.

Reported are 10 patients with surgically verified acute cholecystitis and its complications. Of these 10 patients, 6 (60%) had atypical clinical presentation so that cholecystitis was not the primary diagnosis being considered before computed tomography. Common computed tomography findings included gallbladder wall thickening (100%), pericholecystic fluid (80%), gallstones (50%), and air in the gallbladder lumen and wall (20%). An awareness of the computed tomography appearances can be helpful in the diagnosis of complicated cholecystitis even when the clinical presentation is atypical.

Acute Disease↗