Errors in Abdominal Radiology
There are many diagnostic imaging techniques for the radiological exarmna tion of the abdomen. Noninvasive methods include supine and upright views of the abdomen (sometimes fluoroscopy and decubitus films); posteroanterior (PA) views of the chest; contrast studies of the alimentary tract; ultrasonogra phy (US), scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI). Biopsy under fluoroscopic control and angiography are inva sive techniques. Most of the errors described in this book are related to faulty interpretation; others are due to improper technique. For example, a patient with acute abdominal pain secondary to a perforated hollow viscus may be studied only by supine and upright views of the abdomen that do not include the subdi aphragmatic regions. A complementary PA view of the chest or a left lateral decubitus film would, however, detect free air in the pentoneal cavity that the incomplete two-film study might have missed. Errors of techmque are due to under- or overexposure, long exammation times or an uncooperative patient (both of which can induce motion artIfacts), improper processing, and failure to perform the proper standard noninvasive or mvaSlVe modalitIes for examining the hollow viscus and the solid organs of the alimentary tract. In order to visualize the diaphragm and the supra- and mfradiaphragmatIc spaces, frontal and lateral chest roentgenograms complement the standard views of the abdomen. Fluoroscopy IS of great value m assessing diaphrag matic motion as well as being essential when contrast media are utilized.
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Benign Liver Tumor Simulating Metastasis
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abdominal pain abnormal adrenal gland alimentary tract aneurysm aorta arrow arteriogram ascending colon barium enema barium enema showed biopsy calcifications cause cavernous hemangiomas celiac arteriogram celiac artery chest chronic clinical contrast CT examination diagnosis diaphragm diffuse displacement dorsal duodenum film flank focal gallbladder hepatic artery hepatic veins hepatoma hepatomegaly hypervascular imaging inferior vena cava intestinal intravenous urogram ischemic colitis large bowel Late phase left adrenal gland left kidney left lobe left renal left upper quadrant lesion liver malignancy Margulis and Burhenne medial mesenteric panniculitis neovascularity normal Note obstruction opacification pancreas paravertebral patient presented portal vein proximal jejunal Radiological Examination region retractile mesenteritis revealed right atrium right kidney right lobe right upper quadrant Selective celiac simulating small bowel small bowel loops spleen splenic artery splenic vein splenomegaly stomach subdiaphragmatic superior mesenteric arteriogram superior mesenteric artery surgery syndrome tail topography ulcerative colitis upper GI series upper pole venous phase