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At least 19 recordsLinked to original sources

Sensitivity of CT scout radiography and abdominal radiography for revealing ureteral calculi on helical CT: implications for radiologic follow-up.

OBJECTIVE: We compared the sensitivity of CT scout radiography with that of abdominal radiography in revealing ureteral calculi on unenhanced helical CT. MATERIALS AND METHODS: Over a 6-month period, patients presenting to the emergency department with acute flank pain were examined with standard abdominal radiography and unenhanced helical CT, which included CT scout radiography. In 60 patients in whom a diagnosis of ureteral calculus was made, CT scout radiographs and abdominal radiographs were examined by two interpreters who assessed whether stones could be visualized. All CT scout radiographs were viewed on a workstation using optimized window settings. RESULTS: CT scout radiography and abdominal radiography revealed 28 (47%) and 36 (60%) of 60 ureteral calculi, respectively. All ureteral calculi that appeared on CT scout radiography also appeared on abdominal radiography. However, eight calculi that were visible on abdominal radiography were not visible on CT scout radiography. CT scout radiography and abdominal radiography revealed 28% and 46% of 39 calculi less than or equal to 3 mm in diameter, respectively. For 21 calculi larger than 3 mm, the sensitivity of CT scout radiography and abdominal radiography was 81% and 86%, respectively. CONCLUSION: Abdominal radiography is more sensitive than CT scout radiography in revealing ureteral calculi; however, some calculi revealed on unenhanced helical CT cannot be seen on either abdominal radiography or CT scout radiography. Ureteral calculi not visible on either study can only be followed, when necessary, with unenhanced helical CT.

Adult↗

Abdominal radiography after CT reveals urinary calculi: a method to predict usefulness of abdominal radiography on the basis of size and CT attenuation of calculi.

OBJECTIVE: The purpose of this study was to determine if the radiographic visibility of urinary tract calculi could be predicted on the basis of CT features. MATERIALS AND METHODS: The images of 26 patients whose urinary tract calculi were revealed on unenhanced helical CT and who also underwent digital abdominal radiography were retrospectively reviewed. CT features studied included size and CT attenuation of the calculi. These CT findings were correlated with the ability to detect the same calculi with radiography. RESULTS: Forty-nine urinary tract calculi were detected with unenhanced helical CT in 26 patients. Twenty-six (53%) calculi were visible on radiography. Most (79%) calculi larger than 5 mm were detectable with radiography (p < 0.01). One (8%) of 13 calculi with CT attenuation below 200 H was detectable on radiographs. Ninety-five percent (21/22) of calculi with CT attenuation exceeding 300 H were visible on radiographs (p < 0.0001). The one remaining calculus was obscured by overlying anatomy. CONCLUSION: Radiographic surveillance of urinary tract calculi detected with CT may not be useful if the calculi have a CT attenuation below 200 H. Most calculi larger than 5 mm and nearly all calculi with a CT attenuation exceeding 300 H can be seen on abdominal radiographs.

Adult↗

Diabetes mellitus. I: Routine plain abdominal radiography.

The plain abdominal radiographs of 43 consecutive diabetic patients were studied. Disordered bowel motility which was unrelated to the severity of the diabetes mellitus occurred in 76.7% while artheriosclerosis occurred in 65%. Only 7% (3 patients) had pancreatic calcification; of these, one was a complication of urinary schistosomiasis (Schistosoma haematobium). All the patients with pancreatic calcification were above 45 years of age and had had diabetes mellitus for more than 7 years. This study shows that pancreatic calcification is uncommon among Nigerian diabetics, so plain abdominal radiography should be limited to patients who are above 45 years and who have had the illness for more than 7 years.

Adolescent↗

Emergency abdominal radiography.

Plain abdominal radiographs are rarely diagnostic when the patient presents with acute abdominal pain. Emergency physicians, therefore, should be aware of the appropriate indications and limitations of abdominal films in this setting and should be skilled in their interpretation to exclude the rare cases of pneumoperitoneum, pneumobilia, hepatic-portovenous gas, small and large bowel obstruction, toxic megacolon, volvulus and intramural gas.

Abdomen, Acute↗

Acute nontraumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation.

PURPOSE: To compare the diagnostic yield of abdominal radiography with that of computed tomography (CT) in adult patients presenting to the emergency department with nontraumatic abdominal pain. MATERIALS AND METHODS: Records of 1,000 consecutive patients presenting to the emergency department with acute abdominal pain from April to June 1998 were retrospectively reviewed. A total of 871 patients underwent abdominal radiography, and 188 underwent abdominal CT. The report interpretations of the abdominal radiographs and CT scans were divided into normal, nonspecific, and abnormal categories. Final discharge diagnoses were compared with the interpretations of the imaging examination results, and sensitivities and specificities of each modality were calculated and compared. RESULTS: Interpretation of abdominal radiographs was nonspecific in 588 (68%) of 871 patients, normal in 200 (23%), and abnormal in 83 (10%). The highest sensitivity of abdominal radiography was 90% for intraabdominal foreign body and 49% for bowel obstruction. Abdominal radiography had 0% sensitivity for appendicitis, pyelonephritis, pancreatitis, and diverticulitis. Sensitivities of abdominal CT were highest for bowel obstruction and urolithiasis at 75% and 68%, respectively. CONCLUSION: Abdominal radiographs are not sensitive in the evaluation of adult patients presenting to the emergency department with nontraumatic abdominal pain.

Abdomen, Acute↗

[Radiologic diagnosis of abdominal aortic aneurysm. Value of abdominal radiography, ultrasonic tomography and abdominal aortography].

Radiological diagnosis of arteriosclerotic abdominal aortic aneurysm is discussed. This review is based on the evaluation of 70 abdominal plain films and 58 aortograms. In addition, 11 aneurysms have been examined by ultrasound tomography (grey-scale technique). In 15% of patients referred with suspicion of aneurysm, the diagnosis could not be confirmed radiologically or operatively. The diagnosis of abdominal aortic aneurysm can be established in 80% of patients on the basis of the abdominal plain films. Ultrasonography gives better results as a screening method, since it renders a definite diagnosis possible in about 98% of cases and unnecessary arteriography can thus be avoided. However, preoperative abdominal aortography remains indispensable for demonstration of the exact anatomic details and pathologic changes in the large abdominal and pelvic arteries. The risk involved in this examination are minimal. Suprarenal or combined supra- and infrarenal aneurysm were found in 9% (5 patients), and renal artery stenosis or obstruction in 12% (7 cases). Obstruction or stenosis of the celiac artery and the superior mesenteric artery were present in only 2 patients with suprarenal expansion of the aneurysm. The angiographic-anatomic correlation is excellent, and only very infrequently is it impossible to determine exactly the distal extent of the aneurysm (2 patients).

Aged↗

Graft versus host disease: findings on plain abdominal radiography.

The plain abdominal radiographs of 31 patients who had undergone bone marrow transplantation were reviewed retrospectively to determine the radiological abnormalities caused by intestinal graft versus host disease. Abnormal radiological signs were observed in 95% of patients with acute graft versus host disease but none were sufficiently characteristic to differentiate between patients with and without acute intestinal graft versus host disease.

Adolescent↗

Efficacy of plain abdominal radiography in patients with gastrointestinal bleeding.

To assess the value of plain abdominal radiography in cases of gastrointestinal hemorrhage, the records of 100 such consecutive patients were reviewed. Seventy-eight of the patients had presented to the emergency department, and 22 were inpatients. The radiologic and clinical records were scrutinized to determine the actual effect of the radiologic examination on management of the patient. Three patients had pneumoperitoneum attributed to bowel perforation, and two had confirmed bowel obstruction. In each, the clinical findings suggested the diagnosis. We found no instance of silent gastrointestinal bleeding in which plain radiography contributed important diagnostic information. We conclude that gastrointestinal bleeding is not, in itself, a valid indication for abdominal radiography.

Evaluation Studies as Topic↗

Ineffectiveness of routine abdominal radiography in patients with gastrointestinal hemorrhage admitted to an intensive care unit.

GOALS: To determine the utility of plain abdominal radiography in the initial evaluation of acute gastrointestinal (GI) hemorrhage in a medical intensive care unit. BACKGROUND: Plain abdominal radiographs are frequently used in the routine evaluation of patients with GI bleeding. The utility of these studies in the intensive care unit setting is unclear. STUDY: The study was a retrospective chart review of 71 adult subjects admitted to a medical intensive care unit with the diagnosis of GI bleeding. Subjects were excluded if they presented with peritoneal signs, received an abdominal CT scan in the 24 hours prior to admission, or were chronically treated with immunosuppressive medication. Subjects were divided into two cohorts based on whether or not they underwent plain abdominal radiography during the first hospital day. The primary study endpoints were hospital mortality, intensive care unit length of stay, and whether or not radiographic findings altered clinical management. RESULTS: Of the 71 patients admitted with a diagnosis of GI bleeding (mean age 65.8 +/- 14.5 years, 73.2% male), 56 (79%) had a plain abdominal radiograph performed. Subjects who had a plain film did not differ significantly from those who did not in age, gender, degree of anemia, degree of coagulopathy, or in severity of illness as measured by Acute Physiology and Chronic Health Evaluation (APACHE II) score. There was no statistically significant difference in hospital mortality or intensive care unit length of stay between patients who received plain films and those who did not. In no subject (0%; 95% confidence interval, 0%-5.4%) did abdominal radiography reveal an abnormality that altered clinical management. CONCLUSIONS: Based on our observations, plain films of the abdomen do not appear to alter clinical outcomes or management decisions for patients with GI bleeding and normal abdominal examinations who are admitted to the intensive care unit.

Aged↗

Ultrasonography and abdominal radiography versus intravenous urography in investigation of urinary tract infection in men: prospective incident cohort study.

OBJECTIVES: To compare ultrasonography and abdominal radiography with intravenous urography in the investigation of urinary tract infection in men. DESIGN: Prospective study in two hospital departments. Radiological procedures and urological assessments performed on different days by different clinicians SETTING: District general hospital. PARTICIPANTS: Consecutive series of men (n=114) referred to the department of urology for investigation of proved urinary tract infection. INTERVENTIONS: Ultrasonography and intravenous urography of renal tract and assessment of urinary flow rate. Clinical assessment, cystoscopy, urodynamic studies, and transrectal ultrasonography with biopsy. MAIN OUTCOME MEASURES: Sensitivity and specificity of ultrasonography and abdominal radiography compared with intravenous urography. RESULTS: Important abnormalities were seen in 53 of 100 fully evaluated patients, the most common being a poorly emptying bladder (34). The combination of plain radiographs of kidneys, ureter, and bladder and ultrasonography detected more abnormalities than intravenous urography alone. No important abnormality was missed by this combination (sensitivity 100% and specificity 93%). CONCLUSIONS: Ultrasonography with abdominal radiography is as accurate as intravenous urography in detecting important urological abnormalities in men presenting with urinary tract infection. This combination is safer than intravenous urography and should be the initial investigation for such patients. Additional determination of urinary flow rate is useful for the assessment of an incompletely emptying bladder.

Adolescent↗

[Evaluation of plain abdominal radiography prescriptions in a university hospital center].

OBJECTIVES: The aim of this study was to evaluate the prescription, impact and diagnostic utility of plain abdominal radiography in a University Hospital. METHODS: Plain abdominal radiography series performed over 15 consecutive days were evaluated for quality and agreement with the patient's clinical status. Agreement between the final diagnosis and the radiographic findings were also compared. Contribution of plain abdominal radiography to final diagnosis was assessed on the basis of the conclusions on the hospital discharge report or from those drawn from a telephone survey. The same relationship was also assessed in terms of clinician status (medical student, resident physician, senior physician). RESULTS: The series included 175 radiography series (11.6 per day). In 86% of the cases, the choice of views was adapted to the clinical context. In 14% it was not. The quality of the x-rays was found to be unsatisfactory in 17%, good in 63% and excellent in 20%. The radiography was considered to be contributive to the final diagnosis in 13% of the cases and non-contributive in 87%. Clinician status was not correlated with the degree of usefulness for final diagnosis. Finally, the prescription was in agreement with standard guidelines in 28% of the cases and not in agreement in 72%. CONCLUSION: Plain abdominal radiographs are neither sensitive nor specific, frequently misleading, and costly per specific and correct diagnosis. Better physician awareness is required to limit the number of unnecessary examinations.

Abdomen↗

Abdominal radiography in monitoring the resolution of sand accumulations from the large colon of horses treated medically.

This retrospective study consisted of 14 horses (age 6 weeks-12 years) with radiographically evident sand accumulations cranioventrally in the abdomen and clinical signs suggestive of sand enteropathy. The horses were treated medically and resolution of sand was monitored radiographically. Routine treatment consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral oilif needed. Initially, the number, size and shape of the sand accumulations showed large variation and the response to therapy was not predictable based on the initial appearance of the accumulation. In 2 foals, some of the sand was passed and the rest was mixed with other intestinal contents within 2-4 days. Even large accumulations disappeared in 2-4 days with psyllium alone or combined with mineral oil in 4 horses. In another 4 horses, the size of the accumulations decreased but varying amounts remained approximately at the same site, despite treatment for 1-4 weeks, and all these horses also had either gastric or large colon impaction. Three horses had a limited response to psyllium treatment, but the accumulation resolved with repeated doses of magnesium sulphate, with or without mineral oil. One horse did not respond to prolonged laxative treatment but the accumulation resolved on pasture. Clinical improvement was not necessarily related to the resolution of sand. Radiography of the cranioventral abdomen was found to be a useful means for monitoring the resolution of sand and confirming the effect of medical treatment in removing sand from the large colon in the horse.

Animals↗