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Thứ Tư, 26 tháng 6, 2013

AJR 7-2013

Bowel Obstructions in Older Children
Anastasia Hryhorczuk1, Edward Y. Lee1,2 and Ronald L. Eisenberg3
Citation: American Journal of Roentgenology. 2013;201:W1-W8

Residents' Section
Structured Review
Primary Malignant Diseases of the Small Intestine
Patrick D. McLaughlin1,2 and Michael M. Maher1,2
Citation: American Journal of Roentgenology. 2013;201:W9-W14

FOCUS ON: Gastrointestinal Imaging
Reducing Body CT Radiation Dose: Beyond Just Changing the Numbers
Amy K. Hara1, Clinton V. Wellnitz1, Robert G. Paden1, William Pavlicek1 and Dushyant V. Sahani2
Citation: American Journal of Roentgenology. 2013;201:33-40

OBJECTIVE. CT dose reduction has become a top priority for many radiology practices as a result of federal and state initiatives and public concern. Implementing this in practice, however, is difficult because of the variability between practices, CT scanners, radiologist preferences, and institutional capacity.
CONCLUSION. This article will discuss strategies for successful CT dose reduction instituted in multivendor practices.
Keywords: CT, radiation dose

FOCUS ON: Gastrointestinal Imaging
Imaging-Based Diagnostic Systems for Hepatocellular Carcinoma
Irene Cruite1, An Tang2 and Claude B. Sirlin3

Citation: American Journal of Roentgenology. 2013;201:41-55

OBJECTIVE. Noninvasive imaging plays critical roles in the treatment of patients with cirrhosis or other risk factors for the development of hepatocellular carcinoma. In recognition of the critical roles played by imaging, numerous international scientific organizations and societies have, in the past 12 years, proposed diagnostic systems for the interpretation of liver imaging examinations performed of at-risk patients.
CONCLUSION. Although these imaging-based diagnostic systems represent important advances, they have limitations and they are not perfectly consistent with each other. The limitations and inconsistencies potentially cause confusion and may impair the integration of the systems into clinical practice as well as their utilization in research studies. The purpose of this article is to synthesize and critically appraise the current published imaging-based diagnostic systems endorsed by major societies for the noninvasive diagnosis and staging of hepatocellular carcinoma and to propose future directions that we hope may be helpful in further advancing the field.

Neuroradiology/Head and Neck Imaging
Original Research
How Reliable Is Sonography in the Assessment of Sialolithiasis?
Sylvain Terraz1, Pierre Alexandre Poletti1, Pavel Dulguerov2, Natalia Dfouni3, Christoph D. Becker1, Francis Marchal2 and Minerva Becker1
Citation: American Journal of Roentgenology. 2013;201:W104-W109

OBJECTIVE. The purpose of this study was to determine the value of sonography for the diagnosis of salivary gland calculi.
SUBJECTS AND METHODS. In this study, 82 salivary glands in 79 consecutively registered patients with acute or recurrent parotid or submandibular gland swelling were examined with 7.5-12 MHz linear probes. All sonographic examinations were performed by two experienced radiologists without knowledge of the final diagnosis. The reference standard was digital sialography and sialendoscopy with or without surgery for 54 salivary glands and digital sialography alone for 28 glands.
RESULTS. Sialolithiasis was present in 44 glands and was absent in 38 glands as confirmed by the final diagnosis. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of sonography in the detection of calculi were 77%, 95%, 85%, 94%, and 78%, respectively. False-negative sonographic findings were associated with calculi with a diameter less than 3 mm in nondilated or dilated salivary ducts; most calculi with a diameter of 3 mm or greater were correctly identified. False-positive findings were caused by ductal stenosis with wall fibrosis, which was erroneously interpreted as lithiasis.
CONCLUSION. Because of its limited sensitivity and limited negative predictive value, sonography does not allow reliable exclusion of small salivary gland calculi. Therefore, further diagnostic investigations are recommended to detect calculi in patients with normal sono-graphic findings and suspected lithiasis.

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