Abdominal-gastrointestinal radiology.
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Gastrointestinal Diseases↗
Biomedical subjects
D J Dovgan
Publications and source records attributed to D J Dovgan.
CT of the iliopsoas compartment: value in differentiating tumor, abscess, and hematoma.
OBJECTIVE: The iliopsoas compartment is an extraperitoneal space defined by the iliopsoas fascia; its major components include the iliacus, psoas major, and psoas minor muscles. Distinction of neoplastic, inflammatory, and hemorrhagic conditions of the iliopsoas compartment is often difficult, whether based on clinical evaluation or CT findings. The purpose of this study was to determine specific CT features that might help differentiate these three abnormalities. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 44 patients who had abnormalities of the iliopsoas compartment (15 neoplasms, 21 abscesses, and eight hematomas). Final diagnoses were established by surgical biopsy (n = 14), percutaneous biopsy (n = 18), or clinical evidence (n = 12). Diagnoses were correlated with 11 CT features to determine findings that could be used to differentiate the three abnormalities. These included enlargement of the iliopsoas muscles; extent, margination, and attenuation of the lesion; presence of gas, calcification, bone destruction, fat infiltration, and fascial disruption; and associated fluid or adenopathy. The radiologist who interpreted the scans had no knowledge of the clinical findings. RESULTS: The most reliable CT features for each condition were as follows: irregular margins, 67% sensitive, 52% specific, and 57% accurate for neoplasms; low attenuation, 100% sensitive, 43% specific, and 70% accurate for abscesses; and diffuse involvement of the entire muscle, 88% sensitive, 78% specific, and 80% accurate for hematomas. Combinations of individual CT features did not improve the ability to differentiate the three conditions. CONCLUSION: Our results show that the efficacy of CT, when scans are interpreted without knowledge of the clinical history, is poor for differentiating iliopsoas neoplasms, abscesses, and hematomas.
Adolescent↗
Computed tomographic evaluation of maximal diaphragmatic crural thickness.
The purpose of this study is to determine the range of maximal diaphragmatic crural thickness during different phases of respiration and to correlate crural thickness with age and gender. Prospective evaluation of computed tomographic (CT) scans of 200 patients without juxtacrural abnormalities was performed. Maximal short-axis crural thickness measurements were determined in all patients. Measurements were obtained at full inspiration during chest CT (n = 60), full expiration during abdominal CT (n = 89), and unknown phase of respiration during dynamic CT scans (n = 51). Maximal crural thickness measurements were analyzed by side, age, and gender. The right crus was thicker than the left crus in 91% of patients. The range of maximal crural thickness remained fairly constant from the second to the eighth decades of life. The range of maximal crural thickness was 1.8-18.8 mm in men and 1.8-21.1 mm in women. Maximal crural thickness does not significantly vary with age and gender for specific phase of respiration.
Adult↗
Mapping diabetic sensory neuropathy by current perception threshold testing.
Detailed clinical neurological examinations were conducted on 44 nondiabetic volunteers and 59 diabetic subjects. The examinations focused particularly on sensory symptomatic and physical evaluation. Standardized assessment of symptoms and physical testing of light touch, pain, vibratory, and thermal sensation was performed at the hand, wrist, elbow, foot, ankle, and knee. A total symptom score and physical score were defined by summing test scores at each site. Current perception threshold (CPT) testing that used constant sine-wave-alternating current was conducted at the same anatomic sites. CPT correlations with the physical score gave r values of .55 for 5 Hz, .60 for 250 Hz, and .62 for 2000 Hz (n = 618). Correlations with the symptom score were not as strong: r = .45 for 5 Hz, .46 for 250 Hz, and .51 for 2000 Hz. The correlation with symptom score was due primarily to a strong relationship for the symptom of numbness (r = .53 for all 3 frequencies). Correlations with pain and paresthesia were much lower. CPTs for diabetic subjects at the three frequencies were higher at most locations than for the nondiabetic volunteers. However, CPTs were no different from normal values in diabetic subjects without evidence of neuropathy. CPT testing appears to be a useful technique for assessment of diabetic sensory neuropathy.
Adult↗