Multislice-CT of the Abdomen

368 Pages·2012·21.25 MB·English

by  Thomas Flohr (auth.)

Medical Radiology
Diagnostic Imaging
Series Editors
Maximilian F. Reiser
Hedvig Hricak
Michael Knauth
Editorial Board
Andy Adam, London
Fred Avni, Brussels
Richard L. Baron, Chicago
Carlo Bartolozzi, Pisa
George S. Bisset, Durham
A. Mark Davies, Birmingham
William P. Dillon, San Francisco
D. David Dershaw, New York
Sam Sanjiv Gambhir, Stanford
Nicolas Grenier, Bordeaux
Gertraud Heinz-Peer, Vienna
Robert Hermans, Leuven
Hans-Ulrich Kauczor, Heidelberg
Theresa McLoud, Boston
Konstantin Nikolaou, Munich
Caroline Reinhold, Montreal
Donald Resnick, San Diego
Rüdiger Schulz-Wendtland, Erlangen
Stephen Solomon, New York
Richard D. White, Columbus
For furthervolumes:
http://www.springer.com/series/4354
Christoph Johannes Zech
Carlo Bartolozzi Richard Baron
•
Maximilian F. Reiser
Editors
Multislice-CT of the
Abdomen
Foreword by
Maximilian F. Reiser
123
Christoph Johannes Zech CarloBartolozzi
Department of ClinicalRadiology Department ofOncology
UniversityHospitals Munich, Großhadern Department ofTransplants
Marchioninistraße 15 andAdvanced Technology
81377Munich UniversityofPisa,Via Paradisa 2
Germany 56127Pisa
Italy
Richard Baron
Department of Radiology MaximilianF. Reiser
The Universityof Chicago Department ofClinical Radiology
5841S. MarylandAve MC,2026 UniversityHospitals Munich,Großhadern
Chicago, IL 60611 Marchioninistraße15
USA 81377Munich
Germany
ISSN 0942-5373
ISBN 978-3-642-17862-7 ISBN 978-3-642-17863-4(eBook)
DOI 10.1007/978-3-642-17863-4
SpringerHeidelbergNewYorkDordrechtLondon
LibraryofCongressControlNumber:2012936367
(cid:2)Springer-VerlagBerlinHeidelberg2012
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Foreword
ComputedTomography,incontrasttootherimagingmodalities,haslongbeen
regarded as a not very attractive working horse in diagnostic imaging. This
notion greatly changed when Spiral-CT and Multislice-CT (MSCT) came up.
A large number of acquisition parameters, reconstruction modes and contrast
media protocols are available and have to be scientifically explored. Since
MSCT proved so effective and versatile, there was a steep increase in the uti-
lization of this modality. The consequence was a considerable increase of
radiation exposure of the population which in turn provoked criticism that
resulted in reconsidering the use of MSCT by the radiological community.
InthiseditionofMedicalRadiology/DiagnosticImagingrecognizedexperts
in the field will elucidate the technique and physical background, future tech-
nologicaldevelopments,radiationdoseaswellascontrastmediaapplicationin
protocols in MSCT of the abdomen.
Iwouldliketoexpressmysinceregratitudetotheeditorsofthisvolumefor
gatheringsuchauniquegroupofauthorscoveringthefieldsoftechnique,liver
andbiliarysystem,pancreasandspleen,kidneyandurogenitalsystemaswellas
bowel and peritoneal cavity. The different sections are organized according to
pathologic mechanisms, such as inflammatory lesions, tumors, traumatic and
post-surgical findings. In this way, an excellent overview on aspects important
for the daily clinical practice could be achieved.
I am confident, that this monograph will become indispensable for all those
whoareinvolvedinabdominalimagingandwill provide anexcellentguideline
for performing state-of-the-art MSCT examinations of the abdomen with
adequate technique following diligent selection of the patients and for inter-
pretation of MSCT scans.
This volume of Medical Radiology/Diagnostic Imaging also is in line with
themissionandvisionoftheseries—tobringtogetherwellknownexpertsinthe
field, in order to offer our readers an up-to-date and scientifically based over-
view.IwouldalsoliketothankSpringerPublishersfortheirgreatsupportand
continuous enthusiasm in promoting this important endeavour.
Prof. Dr. med. Dr. h.c. Maximilian F. Reiser FACR, FRCR
Professor and Chairman
Institute of Clinical Radiology
Ludwig-Maximilians-University Hospital Munich
v
Preface
Diagnostic imaging ofabdominal pathologies represents a large amountofthe
daily workload in radiology facilities worldwide. The impact of Radiology in
the management of such patients is clearly evidenced by the fact that most
clinical decisions in abdominal disease depend on the outcome of imaging
procedures in ambulatory and hospital settings. Computed tomography (CT)
has evolved over the past 40 years and become the widely acknowledged key
componentinthediagnosticwork-upofpatientswithabdominaldiseases.The
development of multislice CT (MSCT) has been a major contributing factor
adding to the breadth and depth of abdominal evaluation possible with imag-
ing. It is therefore natural and timely to develop a book solely dedicated to
current techniques and applications of MSCT in the abdomen.
While other modalities such as ultrasound or magnetic resonance imaging
have proved to be superior in certain specific situations, MSCT remains the
most used and relied upon technique as a general abdominal imaging tool,
offeringrobustversatilitywithdetailedanatomicandphysiologicinformation,
equally applicable in unstable patients. Due to developments in scanner tech-
nology and reconstruction algorithms, the radiation dose is continuing to
decrease. All these unique properties make MSCT the backbone of abdominal
evaluation for most institutions.
The concept for this book is to provide a broad overview of relevant
abdominalpathologiesand associated CTfindings.In ordertokeepthelength
of the book within reasonable limits we focused on frequent and relevant
findingsto provide a practical educational and clinical tool. Our aim isto help
radiologists in daily practice meet their practical clinical needs in determining
the examination strategy, optimizing the examination protocol and interpre-
tation of the images rather than being another encyclopaedia of abdominal
pathologies.
vii
viii Preface
Wewanttothankallcontributingauthors,internationallyknownexpertsin
their field, for their outstanding contributions. Our publisher Springer-Verlag
has supported us from the draft of this book to the final editing process with
theirinvaluableprofessionalandkindassistance.Finallywewanttothankour
readers for the trust in our book and we hope that in using it we have helped
you to advance your practices and aid in the care of patients.
Munich Christoph J. Zech
Chicago Richard Baron
Pisa Carlo Bartolozzi
Munich Maximilan F. Reiser
Contents
Physical Background of Multi Detector
Row Computed Tomography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Thomas Flohr
Future Developments for MSCT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Patrik Rogalla
Radiation Exposure and Risk Associated with CT Examinations. . . . . . 25
Gunnar Brix and Elke A. Nekolla
Contrast Agent Application and Protocols . . . . . . . . . . . . . . . . . . . . . . 37
Markus S. Juchems
Imaging Findings of Cirrhotic Liver . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Jeong Min Lee, Dong Ho Lee, and Jeong-Hee Yoon
Imaging Findings in Non-Cirrhotic Liver. . . . . . . . . . . . . . . . . . . . . . . 85
Daniele Marin and Giuseppe Brancatelli
Liver and Biliary System: Postoperative Findings. . . . . . . . . . . . . . . . . 101
Magaly Zappa, Annie Sibert, and Valérie Vilgrain
Inflammatory Processes in the Liver and Biliary Tract. . . . . . . . . . . . . 115
Wesley C. Chan and Benjamin M. Yeh
Neoplastic Processes in Biliary System. . . . . . . . . . . . . . . . . . . . . . . . . 129
Tae Kyoung Kim, Korosh Khalili, and Hyun-Jung Jang
Assessment of the Hepatic Vessels with MDCT. . . . . . . . . . . . . . . . . . . 145
Rocio Perez-Johnston, Dipti K. Lenhart, Daniella F. Pinho,
and Dushyant V. Sahani
MSCT Imaging of Acute and Chronic Pancreatitis. . . . . . . . . . . . . . . . 161
Shelby Fishback, David H. Kim, and Perry J. Pickhardt
Solid Pancreatic Masses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Alec J. Megibow
ix
x Contents
Cystic Pancreatic Masses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
A. Oto
Imaging CT of the Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Giovanni Morana and Christian Cugini
Imaging of Post Pancreatic Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . 223
R. Graziani, S. Mautone, M. C. Ambrosetti, M. Barillari, R. Manfredi,
and R. Pozzi Mucelli
Renal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Anno Graser and Ullrich G. Mueller-Lisse
Adrenal Masses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Julie H. Song and William W. Mayo-Smith
Inflammatory and Infectious Disease of the Kidney
and Urinary Collecting System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Ullrich G. Mueller-Lisse, Ulrike L. Mueller-Lisse, Eva M. Coppenrath,
and Anno Graser
MSCT of the Stomach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Sameer Ahmed, Karen M. Horton, Elliot K. Fishman,
and Pamela T. Johnson
Small Bowel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Franco Iafrate, Marco Rengo, Paola Lucchesi, Maria Ciolina,
Paolo Baldassari, and Andrea Laghi
MSCT of the Abdomen: Colon, Rectum and CT Colonography . . . . . . 301
Emanuele Neri, Annalisa Mantarro, Rossella Scandiffio, Pietro Bemi,
Lorenzo Faggioni, and Carlo Bartolozzi
Mesenteric and Retroperitoneal Diseases . . . . . . . . . . . . . . . . . . . . . . . 321
Antonella Filippone, Roberta Cianci, and Antonio Raffaele Cotroneo
Imaging Findings in Acute Abdomen. . . . . . . . . . . . . . . . . . . . . . . . . . 337
Borut Marincek
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Contributors
S. Ahmed Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
M.C.AmbrosettiDepartmentofRadiology,PoliclinicoG.B.Rossi,University
of Verona, P.le Scuro 10, 37134 Verona, Italy
P. Baldassari Department of Radiological Sciences, Oncology and Pathology,
Sapienza-University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
M. Barillari Department of Radiology, Policlinico G.B. Rossi, University of
Verona, P.le Scuro 10, 37134 Verona, Italy
C.BartolozziDiagnosticandInterventionalRadiology,UniversityofPisa,Via
Roma 67, 56100 Pisa, Italy
P. Bemi Diagnostic and Interventional Radiology, University of Pisa, Via
Roma 67, 56100 Pisa, Italy
G. Brancatelli Department of Radiology, University of Palermo, 90127
Palermo,Italy; RadiologyUnit, LaMaddalena Hospital,90146Palermo,Italy
G. Brix Department of Medical and Occupational Radiation Protection,
Federal Office for Radiation Protection, Ingolsta¨dter Landstrasse 1, 85764
Neuherberg, Germany, e-mail: [email protected]
W. C. Chan Department of Radiology and Biomedical Imaging, University of
California San Francisco, San Francisco, CA 94143-0628, USA
R. Cianci Department of Neurosciences and Imaging, Section of Imaging, G.
d’Annunzio University, Chieti-Pescara.SS. Annunziata Hospital, via dei
Vestini, 66100 Chieti, Italy
M. Ciolina Department of Radiological Sciences, Oncology and Pathology,
Sapienza-University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
Eva M. Coppenrath Departments of Radiology, University of Munich
Hospitals, Marchioninistrasse 15, 81377 Munich, Germany
A.R.CotroneoDepartmentofNeurosciencesandImaging,SectionofImaging,
G. d’Annunzio University, Chieti-Pescara.SS. Annunziata Hospital, via dei
Vestini, 66100 Chieti, Italy
C. Cugini Radiological Department, General Hospital Ca’ Foncello, Piazza
Ospedale 1, 31100 Treviso, Italy
xi