OBJECTIVE: To compare the apparent diffusion coefficient (ADC) values of upper abdominal organs with 2 different 3.0 tesla MR systems and to investigate the usefulness of normalization using the spleen. MATERIALS AND METHODS: Forty-one patients were enrolled in this prospective study, of which, 35 patients (M:F, 27:8; mean age ± standard deviation, 62.3 ± 12.3 years) were finally analyzed. In addition to the routine liver MR protocol, single-shot spin-echo echo-planar diffusion-weighted imaging using b values of 0, 50, 400, and 800 s/mm2 in 2 different MR systems was performed. ADC values of the liver, spleen, pancreas, kidney and liver lesion (if present) were measured and analyzed. ADC values of the spleen were used for normalization. The Pearson correlation, Spearman correlation, paired sample t test, Wilcoxon signed rank test and Bland-Altman method were used for statistical analysis. RESULTS: For all anatomical regions and liver lesions, both non-normalized and normalized ADC values from 2 different MR systems showed significant correlations (r = 0.5196-0.8488). Non-normalized ADC values of both MR systems differed significantly in all anatomical regions and liver lesions (p < 0.001). However, the normalized ADC of all anatomical regions and liver lesions did not differ significantly (p = 0.065-0.661), with significantly lower coefficient of variance than that of non-normalized ADC (p < 0.009). CONCLUSION: Normalization of the abdominal ADC values using the spleen as a reference organ reduces differences between different MR systems, and could facilitate consistent use of ADC as an imaging biomarker for multi-center or longitudinal studies.
Aged ; *Diffusion Magnetic Resonance Imaging ; Echo-Planar Imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Kidney/*radiography ; Liver/*radiography ; Male ; Middle Aged ; Pancreas/*radiography ; Prospective Studies ; Spleen/*radiography

OBJECTIVEDetection of abdominal injury is a very important component in trauma management, so a precise assessment of liver and spleen injuries including their severity degree is necessary. There is a good case to believe that in emergency situations the radiologists' performance may profit from a systematic approach using established scoring systems. Score systems as the organ injury scale (OIS) drawn up by the American Association for the Surgery of Trauma are a valuable guidance for objective trauma assessment. Aim of this study was to evaluate retrospectively whether a structured approach using the OIS may help improve trauma assessment.

METHODSFifty-three patients, 38 male and 15 female who underwent CT and laparotomy after abdominal trauma were included in this study. The laparotomy was performed by experienced surgeons with a minimum experience of 6 years. While the original CT reports were written by different radiologists with a minimum experience of 3 years, and then a radiologist with experience of 4 years reviewed the same original CT pictures, resulting in the structured report. Both the original and structured CT results on liver and spleen injuries were transferred into OIS grades. Finally, the initial and structured CT results were compared with the intraoperative findings gathered from the surgery report.

RESULTSRegarding the original CT report we found a mean divergence of 0.68 ± 0.8 (r=0.45) to the OIS finding in the surgery report for liver injuries (0.69 ± 1.17 for spleen injuries; r=0.69). In comparison with the structured approach, where we detected a divergence of 0.8 ± 0.68; r=0.63 (0.47 ± 0.77 for spleen injuries; r=0.91), there was no significant difference. However we detected a lower rate of over-diagnosis in structured approaches.

CONCLUSIONOur study shows that a structured approach to triage abdominal trauma using an imaging checklist does not lead to a significantly higher detection rate, but a nonsignificant trend to reduce the rate of over-diagnoses, thus being more precise in grading the severity grade. Concerning the bias by retrospective study design, further prospective investigations are needed to evaluate the impact of trauma scores on the workflow in emergency department procedure as structured reporting systems are a valuable guidance in other radiological disciplines.

Adult ; Female ; Humans ; Liver ; diagnostic imaging ; injuries ; Male ; Radiography ; Retrospective Studies ; Spleen ; diagnostic imaging ; injuries ; Trauma Severity Indices

Normal values and upper limits (95th percentile and 95% confidence interval of liver, spleen and portal vein size, as well as liver extensions below the costal margin were determined prospectively with ultrasound in 224 healthy subjects (renal donors). Correlation with sex, age, weight, height, and body surface area were assessed. Some correlation values were significant (r ? 0.30). The highest correlation (r=0.65 was liver AP diameter with weight. A formula to predict normal liver AP diameter was derived. Another set of subjects with established liver disease was compared with the normal means. All abnormal diameter means were at or above the 95th percentile, and the difference between the means of the normal and abnormal diameters were significant.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Liver ; Spleen ; Portal Vein ; Adult ; Veins ; Palpation ; Percussion ; Radiography

BACKGROUND/AIMS: The aim of this study was to identify the parameters that could noninvasively predict the presence of esophageal/gastric varices and portal hypertensive gastropathy (PHG) in patients with chronic liver disease (CLD), and to determine the accuracy of those parameters. METHODS: We retrospectively analyzed 232 patients with CLD who underwent both upper endoscopy and liver CT within an interval of 3 months. The multidimensional index (M-Index) for spleen volume was obtained from the multiplication of splenic length, width, and thickness, as measured by computer tomography. RESULTS: The multivariate analysis revealed that platelet, albumin, and M-Index were independently associated with the presence of varices and PHG. We combined three independent parameters, and developed a varices and portal hypertensive gastropathy (VAP) scoring system (=[platelet count (/mm3)xalbumin (g/dL)]/[M-Index (cm3)]). The area under the receiver operating characteristic curve of the VAP score was 0.850 (95% confidence interval, 0.801-0.899). The VAP cut-off value of 861 had a sensitivity of 85.3%, a positive likelihood ratio of 3.17, and a negative predictive value of 86.4%. For predicting high-risk lesions for bleeding, with a cut-off value of 861 the sensitivity was 92.0%, the positive likelihood ratio was 2.20, and the negative predictive value was 96.4%. CONCLUSIONS: The VAP score can predict the presence of varices and PHG in patients with CLD and may increase the cost-benefit of screening endoscopy in the clinical practice setting. A prospective validation study is necessary in the future.
Adult ; Aged ; Chronic Disease ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices/complications/*diagnosis ; Female ; Humans ; Hypertension, Portal/complications/*diagnosis ; Liver Diseases/complications/*diagnosis ; Male ; Middle Aged ; Platelet Count ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis ; Severity of Illness Index ; Spleen/physiology/radiography ; Tomography, X-Ray Computed

The principal objective of this study was to determine whether visceral fat or liver fat is a more relevant risk factor for metabolic syndrome. A total of 98 subjects aged 18-65 yr, who visited a health promotion center in a university hospital, were enrolled in this study. Metabolic syndrome was diagnosed based on the modified National Cholesterol Education Program's Adult Treatment Panel III report (NCEP-ATPIII) criteria. We defined the visceral obesity as a visceral fat area of > or = 100 cm2 which was acquired by CT at the L4-5 level. To evaluate fatty liver, we applied a liver-to-spleen attenuation ratio < or = 1.1 as measured by CT at the T12 level. We employed binary logistic regression models that used the presence or absence of metabolic syndrome as a dependent variable and age, sex, and the presence or absence of visceral obesity and fatty liver as independent variables. Visceral obesity was not found to be an independent variable as a risk factor of metabolic syndrome (odds ratio 2.7; 95% confidence interval 0.55-13.30), but fatty liver was found to be significant in this model (odds ratio 71.3; 95% CI 13.04-389.53). Our study suggests that liver fat may be a more important risk factor than visceral fat in terms of its association with metabolic syndrome.
Adolescent ; Adult ; Aged ; Blood Pressure ; Body Composition ; Demography ; Fatty Liver/*complications ; Female ; Humans ; Intra-Abdominal Fat/*anatomy & histology/radiography ; Liver/anatomy & histology/radiography ; Logistic Models ; Male ; Metabolic Syndrome X/diagnosis/epidemiology/*etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Sex Factors ; Spleen/anatomy & histology/radiography ; Tomography, X-Ray Computed ; Young Adult

A fourteen-year female Jindo dog showing signs of hemoperitoneum was diagnosed with hemangiosarcoma through abdominal radiography and histopathological examination. In the abdominal radiographs, a circular mass was observed on the posterior of the spleen. When the splenic mass was removed via laparotomy, it was spherical, poorly circumscribed, and showed signs of necrosis, with white spots present on the outer side of the mass. Microscopically, the mass showed that hemorrhage was widespread and extensive infiltration of neoplastic cells was found throughout. There was hypercellularity, including occasional pleomorphic cells and mitotic figures. Inflammation at the edge of the mass, along with necrosis, was also found. In this report, we describe the gross and histopathological findings of a case of canine hemangiosarcoma.
Animals ; Dental Caries ; Dogs ; Female ; Hemangiosarcoma ; Hemoperitoneum ; Hemorrhage ; Humans ; Inflammation ; Laparotomy ; Necrosis ; Radiography, Abdominal ; Spleen

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.
Abdominal Injuries/complications ; Adult ; Diagnosis, Differential ; Humans ; Male ; Medical Records ; Spleen/injuries/surgery ; Splenectomy ; Splenosis/*diagnosis/etiology/radiography ; Thoracic Diseases/*diagnosis/etiology/radiography ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

Antineoplastic Agents ; therapeutic use ; Diagnosis, Differential ; Female ; Histiocytosis, Langerhans-Cell ; metabolism ; pathology ; Humans ; Interferons ; therapeutic use ; Leukemia, Mast-Cell ; metabolism ; pathology ; Mastocytosis, Cutaneous ; metabolism ; pathology ; Mastocytosis, Systemic ; diagnostic imaging ; drug therapy ; metabolism ; pathology ; Middle Aged ; Proto-Oncogene Proteins c-kit ; metabolism ; Radiography ; Radionuclide Imaging ; Spleen ; pathology ; surgery ; Splenectomy ; Tryptases ; metabolism

A two-year-old male Pointer had been presented with anorexia, cachexia, and weight loss of 10-day duration. Upon physical examination, fever, lethargy, superficial lymph node enlargement, and tick infestation were noted. The only abnormality in CBC and serum chemistry analyses was mild hyperglobulinemia. Spleen was enlarged by radiography, and the lymph nodes showed neutrophilic lymphadenitis by cytological examination. A polymerase chain reaction test for babesiosis and commercial ELISA tests for Ehrlichia canis, heartworm, and Lyme disease was negative except for Lyme disease, which was verified by both an IFA-IgG test and a quantitative C6 assay. Doxycycline was administered for 2 weeks and the recovery was uneventful. Post-treatment C6 titer decreased to within normal limits.
Animals ; Anti-Bacterial Agents/therapeutic use ; Dog Diseases/*diagnosis/drug therapy/epidemiology/pathology ; Dogs ; Doxycycline/therapeutic use ; Enzyme-Linked Immunosorbent Assay/veterinary ; Korea/epidemiology ; Lyme Disease/drug therapy/epidemiology/pathology/*veterinary ; Lymph Nodes/pathology ; Male ; Spleen/radiography

Hydatid disease (HD) is an endemic illness in many countries, and it poses an important public health problem that's influenced by peoples' socioeconomic status and migration that spreads this disease. Although rare, it may occur in any organ or tissue. The most common site is the liver (59-75%), followed in frequency by lung (27%), kidney (3%), bone (1-4%) and brain (1-2%). Other sites such as the heart, spleen, pancreas and muscles are very rarely affected. Unusual sites for this disease can cause diagnostic problems. This pictorial essay illustrates various radiological findings of HD in the liver, spleen, kidney, pancreas, peritoneal cavity, omentum, adrenal, ovary, lung, mediastinum and retroperitoneum. Familiarity with the imaging findings of HD may be helpful in making an accurate diagnosis and preventing potential complications.
Abdominal Cavity/parasitology/radiography ; Adolescent ; Adult ; Child ; Child, Preschool ; Contrast Media/administration & dosage ; Digestive System/pathology/radiography/ultrasonography ; Digestive System Diseases/diagnosis/parasitology ; Echinococcosis/*diagnosis/parasitology/*radiography ; Endocrine Glands/parasitology/radiography ; Female ; Humans ; Kidney/parasitology/pathology ; Liver/parasitology/radiography ; Lung/parasitology/radiography ; Magnetic Resonance Imaging/methods ; Male ; Mediastinum/parasitology/radiography ; Middle Aged ; Pancreas/parasitology/radiography ; Radiographic Image Enhancement/methods ; Spleen/parasitology/radiography ; Tomography, X-Ray Computed/methods