Abdominal Parenchymal Organs Research Articles

Management of Injuries to the Parenchymal Abdominal Organs

The most common organs affected by abdominal trauma are the spleen and the liver, often in combination. Pancreatic injuries are rare. In the case of blunt abdominal trauma, which is much more common, a clinical and laboratory examination as well as sonography should be performed. In the initial assessment, the circulatory situation must be screened. If there is haemodynamic instability and presentation of free fluid, an emergency laparotomy is indicated. If the situation is stable or stabilised and a pathological sonography is present, it is essential to perform triphasic contrast enhanced computed tomography, which is also mandatory in polytraumatised patients. If a renal injury is suspected, a late venous phase should be attached. In addition to the classification of the injury, attention should be paid to possible vascular injury or active bleeding. In this case, angiography with the possibility of intervention should be performed. Endoscopic treatment is possible for injuries of the pancreatic duct. If the imaging does not reveal any intervention target and a circulation is stable, a conservative approach is possible with continuous monitoring using clinical, laboratory and sonographic controls. Most injuries can be successfully treated by non-operative management (NOM).There are various surgical options for treating the injury, such as local and resecting procedures. There is also the option of "damage control surgery" with acute bleeding control and second look. Complex surgical procedures should be performed at centres. Postoperative complications arise out of elective surgery.In the less common case of penetrating abdominal trauma, the actual extent of the injury cannot be estimated from the visible wound. Here again, the circulatory situation determines the next steps. An emergency laparotomy should be carried out in case of instability. If the condition is stable, further diagnostics should be performed using contrast enhanced computed tomography. If penetration through the peritoneum cannot be clearly excluded, diagnostic laparoscopy should be performed.

Endovascular technologies in the treatment of patients with blunt abdominal trauma

Trauma is one of the leading causes of disability and mortality in working-age population. Abdominal injuries comprise 20-30% of traumas. Uncontrolled bleeding is the main cause of death in 30-40% of patients. Among abdominal organs, spleen is most often damaged due to fragile structure and subcostal localization. In the last two decades, therapeutic management has become preferable in patients with abdominal trauma and stable hemodynamic parameters. In addition to clinical examination, standard laboratory tests and ultrasound, as well as contrast-enhanced CT of the abdomen should be included in diagnostic algorithm to identify all traumatic injuries and assess severity of abdominal damage. Development of interventional radiological technologies improved preservation of damaged organs. Endovascular embolization can be performed selectively according to indications (leakage, false aneurysm, arteriovenous anastomosis) and considered for severe damage to the liver and spleen, hemoperitoneum or severe polytrauma. Embolization is essential in complex treatment of traumatic vascular injuries of parenchymal abdominal organs. We reviewed modern principles and methods of intra-arterial embolization for the treatment of patients with traumatic injuries of the liver and spleen.

The absolute mass of the internal organs of the Landras pigs grown in Western Siberia

Several factors determine the development of internal organs. They characterise the intensity of animals’ growth, physique, constitutional strength, resistance to diseases of various genesis and, in general, the adaptive ability of animals. The authors assessed the absolute mass of such parenchymal abdominal organs as the liver, kidneys, and spleen of Landrace pigs. A group of representatively selected pigs, taking into account their origin, sex, age, and live weight, was formed at the early stages of the technological cycle. The total number of animal units was 12. The fattening of the animals took place on a large pig farm in the Altai Territory. The conditions of keeping the animals corresponded to the regular feeding for meat fattening. In addition, a preventive plan for vaccinated animals and systematic veterinary control was provided. Based on the current technical instructions and other regulatory documents, Slaughter was carried out at the end of the technological cycle when the live weight reached 100 kg. The absolute mass of organs without surrounding structures was determined by weighing on a balance with a high accuracy class. The obtained data were evaluated using Microsoft Office Excel and the R programming language in the data analysis environment RStudio version 2022.07.2+576 (RStudio, PBC). The visual assessment showed the absence of pathological and anatomical changes in organs. Based on the ShapiroWilk test, a normal distribution was established in all cases. For the liver, the W-criterion is 0.93, the kidneys - 0.90 and the spleen - 0.98; the significance level is more significant than 0.05. In pigs, the median absolute weight of the liver was 1542.0 g; for the kidneys - 303.0, and the spleen - 164.0 g; The 95% confidence interval for kidneys is 133.0–195.0 g; for the spleen - 120.0–197.0; for the liver - 1310.0–1792.0 g. The article presents the indicators of the variability of the trait under consideration. The authors established interbreed differentiation of pigs by the mass of parenchymal organs.

Low kV Computed Tomography of Parenchymal Abdominal Organs-A Systematic Animal Study of Different Contrast Media Injection Protocols.

Objectives: To evaluate multiphase low kV computed tomography (CT) imaging of the abdomen with reduced contrast media (CM) dose using different injection protocols. Methods: Two injection protocols were evaluated for use with low kV (80 kV) multiphase abdominal imaging in comparison to the standard procedure acquired at 120 kV (500 mgI/kg; 5 mL/s). This evaluation was conducted in a highly standardized animal study (5 Goettingen minipigs). The low kV protocols consisted of (a) a single-flow (SF) injection with 40% reduced CM dose and injection rate (300 mgI/kg; 3 mL/s) and (b) a DualFlow (DF) injection protocol consisting of 60%/40% contrast to saline ratio administered at 5 mL/s. Dynamic CT was first performed within representative liver regions to determine optimal contrast phases, followed by evaluation of the three protocols in multiphase abdominal CT imaging. The evaluation criteria included contrast enhancement (CE) of abdominal organs and vasculature. Results: The 80 kV DF injection protocol showed similar CE of the abdominal parenchymatous organs and vessels to the 120 kV reference and the 80 kV SF protocol. Hepatic parenchyma showed comparable CT values for all contrast phases. In particular, in the portal venous parenchymal phase, the 80 kV DF protocol demonstrated higher hepatic parenchymal enhancement; however, results were statistically non-significant. Similarly, CE of the kidney, pancreas, and abdominal arterial/venous vessels showed no significant differences between injection protocols. Conclusions: Adapted SF and DF injection protocols with reduced IDR/iodine load offer the potential to calibrate optimal CM doses to the tube voltage in abdominal multiphase low kV CT imaging. The data suggest that the DF approach allows the use of predefined injection protocols and adaption of the contrast to saline ratio to an individualized kV setting and yields the potential for patient-individualized CM adaption.

Prevalence of Cystic Lesions in Parenchymal Abdominal Organs

Abstract Introduction: Abdominal cystic lesions can be localized either in parenchymal or non-parenchymal organs and can be acquired or congenital. Knowing the characteristic imaging features as well as demographic data and the prevalence of cystic lesions can help radiologists in establishing the correct diagnosis. In this article, we conducted a statistical study of congenital and acquired cystic lesions of the abdomen, diagnosed by CT scan in patients hospitalized in Emergency Clinical County Hospital of Constanţa in years 2019 - 2020. Material and methods: The retrospective study included 285 patients admitted to the hospital. In the case of each patient, we recorded the following variables: Age, Sex, Localization of the lesion, Types of cysts for each localization. Results: The average age of the patients is 61.53 years. Most of the cystic lesions were localized in the liver (182 cases) and they were represented by: hydatid cysts, simple hepatic cysts, hepatic abscess, hepato-renal polycystic disease and hepatic adenocarcinoma. Cystic lesions of the kidney (56 cases) were represented by: autosomal dominant polycystic kidney disease, renal carcinoma, simple renal cysts, acquired polycystic renal disease, tuberous sclerosis, clear cell renal carcinoma and von Hippel Lindau syndrome. Cystic lesions of pancreas (47 cases) were represented by: pancreatic cysts, pancreatic pseudocysts and pancreatic adenocarcinoma. Conclusions: CT examination is extremely useful in establishing the location, type, imaging characteristics of cystic lesions, echo over surrounding organs, possibility of malignant transformation. The prevalence of certain types of localizations and morphologies depending on the age and organ involved always helps to obtain a correct and rapid diagnosis.

Reproducibility Analysis of Iodine Concentrations of Abdominal Parenchymal Organs Based on Spectral CT

Objective To investigate the intra-and inter-observer reproducibility of iodine concentrations of abdominal parenchymal organs based on spectral CT.Methods The water-free iodine images of the venous phase were retrospectively obtained from 50 patients with abdominal dynamic spectral CT scans.The iodine concentrations were measured in the left,right and caudate lobes of liver,spleen,pancreas and bilateral kidneys.Intraclass correlation coefficient(ICC)and Bland-Altman plot were employed to analyze the intra-and inter-observer reproducibility.Results The intra-observer ICCs of the left,right and caudate lobes of liver,spleen,pancreas,and left and right kidneys were 0.938(0.894,0.965),0.932(0.884,0.961),0.939(0.895,0.965),0.947(0.909,0.970),0.912(0.851,0.949),0.946(0.906,0.969)and 0.907(0.842,0.946),which indicated good intra-observer reproducibility.The inter-observer ICCs of the left,right and caudate lobes of liver,spleen,pancreas,and left and right kidneys were 0.947(0.909,0.970),0.927(0.875,0.958),0.943(0.902,0.968),0.956(0.924,0.975),0.934(0.887,0.962),0.927(0.875,0.958)and 0.892(0.818,0.937),which indicated good inter-observer reproducibility.Bland-Altman plots presented that more than 95% points of the intra-observer differences located within 95% CI of limits of agreement for the caudate lobe of liver,spleen,pancreas and bilateral kidneys,which was same as inter-observer differences of the caudate lobe of liver,spleen and right kidney.Conclusion The iodine concentration measurement based on the spectral CT presented good intra-and inter-observer reproducibility for the caudate lobe of liver and spleen.

Advanced diffusion imaging of abdominal organs in different hydration states of the human body: stability of biomarkers

BackgroundMR diffusion weighted imaging (DWI) may provide important information regarding the pathophysiology of parenchymal abdominal organs. The purpose of our study was to investigate the stability of imaging biomarkers of diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in abdominal parenchymal organs regarding two body hydration states. MethodsTen healthy volunteers twice underwent DWI of abdominal organs using a double-refocused spin-echo echo-planar imaging sequences with 11 different b-values (ranging from 0 to 1,500 s/mm2): after 4 h of fluid deprivation; 45 min following 1000 ml of water intake. Four different diffusion models were evaluated and compared: standard DWI, DKI with mono-exponential fitting, multistep algorithm with variable b-value threshold for IVIM, combined IVIM-Kurtosis; in four abdominal organs: kidneys, liver, spleen and psoas muscle. ResultsDiffusion parameters from all four models remained similar for the renal parenchyma before and after the water challenge. Significant differences were found for the liver, spleen, and psoas muscle. The largest effects were seen for: the liver parenchyma after the water challenge by means of IVIM model's true diffusion (p < 0.02); the spleen, for IVIM's perfusion fraction (p < 0.03), the psoas muscle for the ADC value (p < 0.02). ConclusionsHerein, we showed that diffusion parameters of the kidney remain remarkably stable regarding the hydration status. This may be attributed to the kidney-specific compensatory mechanisms. For the liver, spleen and psoas muscle the diffusion parameters were sensitive to changes of the hydration. This phenomenon needs to be considered when evaluating diffusion data of these organs.

Urgentna ultrasonografska dijagnostika akutnih traumatskih abdominalnih stanja - urgentni ultrazvuk u abdominalnoj traumi

Clearly defined protocols and multidisciplinary approach present a milestone for patients' condition evaluation. Ultrasound is a fast, accessible, non-invasive and repeatable radiological examination and has an important place in the trauma algorithms. It detects trauma of parenchymal and hollow abdominal organs, hematoperitoneum, and helps in the assessment of volume status. Ultrasound in trauma is performed according to the Focused Assessment with Sonography for the Trauma (FAST) protocol or as a standard ultrasonographic examination of the abdomen and can be repeated to monitor morphological changes due to indications for emergency surgical treatment.

The Effectiveness of Rinsing Organs With Selected Preservation Solutions Based on the Analysis of Their Physicochemical Parameters

BackgroundOne of the key elements of successful transplantation is effectively rinsing off the blood and preserving organs under controlled hypothermia. The aim of the study was to analyze the physicochemical parameters of Biolasol (Biochefa, Sosnowiec, Poland) and histidine-tryptophan-ketoglutarate (HTK) (Custodiol) solutions, which are recommended for perfusion and preservation of abdominal parenchymal organs. MethodsBiolasol and HTK solution were used for the study. The solutions were subjected to physicochemical analysis involving pH, density, osmolarity, viscosity, refractive index, zeta potential, hydrodynamic diameter, and rheological properties. Rheological parameters were associated with morphologic features of fluids. ResultsHTK and Biolasol are non-Newtonian systems with pseudoplastic properties and yield stress. The solutions begin to flow under shear stress greater than the ultimate stress. In addition, a nonlinear relationship of their viscosity as a function of velocity gradient (shear rate) was observed. ConclusionsThe solutions reproduce blood properties, which leads to the conclusion about their effective filling of the vascular bed and high efficiency in organ rinsing.

Evaluation of usefulness of post-mortem computed tomography in the diagnosis of abdominal parenchymal organ injuries compared to medicolegal autopsy findings

Post-mortem computed tomography (PMCT) is an examination technique which provides particular benefits in forensic medical practice in the evaluation of traumatic injuries. However, the usefulness of PMCT in the diagnosis of parenchymal structures in the human body is not obvious. To evaluate the usefulness of PMCT in the diagnosis of parenchymal organ injuries (liver, pancreas, spleen and kidneys) and the presence of blood in the abdominal cavity. The study was conducted on apopulation of deceased persons who underwent medicolegal autopsy in the Chair and Department of Forensic Medicine, Jagiellonian University Medical College in Krakow. The study included cases of violent death with the presence of blunt-force trauma. In all cases studied, the autopsy examination was preceded by PMCT. Both methods were employed to identify signs of injury to parenchymal organs and the presence of blood in the abdominal cavity. Observations made during the autopsies were considered in this study as the gold standard to which the PMCT findings were compared. The data obtained in the study was analyzed statistically to determine arange of parameters including sensitivity, specificity, positive and negative predictive values, and reliability. The values were presented in atabulated form. The evaluation of usefulness of PMCT in the detection of abdominal parenchymal organ injuries and the presence of blood in the abdominal cavity failed to yield satisfactory results that would justify the application of PMCT in medicolegal practice as adiagnostic tool comparable to autopsy. However, promising results were obtained with respect to the suitability of PMCT as ascreening test to exclude the presence of such injuries.

Abdominal bleeding in victims with abdominal-vertebral injury as a result of road accidents

One of the main factors for increasing mortality from injuries and injuries is road traffic injuries. With a combined and isolated abdominal trauma, the operational activity reaches 88%, significantly exceeding that in injuries of the limbs, pelvis, chest and head injuries. The purpose of our work was to reduce the lethality of internal bleeding in victims of abdominal-vertebral trauma as a result of an accident by improving medical diagnostic tactics and provision of emergency surgical care. We analyzed the treatment of 122 victims with abdominal-vertebral trauma as a result of an accident, were hospitalized in the Kiev City Clinical Emergency Hospital for the period from 2013–2017. Abdominal bleeding of different volume in case of concomitant abdominal-vertebral injury as a result of an accident occurs in 37.4% of cases and is shocking in 57.4% of cases. The main source of hemoperitoneum is damage to the parenchymal abdominal organs. A feature of spleen and liver injury is the weak correlation between the mechanism of combined trauma and the degree of damage to the parenchymal abdominal organs.

Intravoxel Incoherent Motion Analysis of Abdominal Organs: Application of Simultaneous Multislice Acquisition.

The aim of this study was to systematically evaluate the accuracy of quantitative intravoxel incoherent motion (IVIM) analysis of the upper abdomen applying simultaneous multislice (SMS) diffusion-weighted imaging (DWI) to reduce acquisition time. Diffusion-weighted imaging of parenchymal abdominal organs was performed in 8 healthy volunteers at 3 T using a standard DWI sequence (acceleration factor 1 [AF1]) and an SMS-accelerated echo planar imaging sequence with acceleration factors 2 and 3 (AF2/AF3). Intravoxel incoherent motion analysis was performed with a multistep algorithm for true diffusion coefficient (Dt), pseudodiffusion coefficient (D*), and fraction of perfusion (Fp) measured for the liver, kidney cortex and medulla, pancreas, spleen, and erector spinae muscle. Qualitative and quantitative parameters were compared using a repeated measurement 1-way analysis of variance test and the Bonferroni post hoc method. Simultaneous multislice DWI provided diagnostic image quality in all volunteers with a reduction of scan time of 50% for AF2 (67% for AF3) compared with the standard sequence. Decent IVIM analysis for Dt, D*, and Fp can be calculated on the images of both the SMS sequences AF2 and AF3 with typical organ characteristics of IVIM; however, systematical deviations from AF1 were observed: Dt values increased and Fp decreased significantly with higher acceleration factor for liver, kidney, pancreas, and muscle (P < 0.05). Fitting curves of higher acceleration factors tend to be more monoexponentially shaped. Simultaneous multislice acceleration provides considerable scan time reduction for upper abdomen DWI with equivalent quality of IVIM analysis compared with the standard nonaccelerated technique. Systematic discrepancies of the true Dt, D*, and Fp for SMS acquisitions need to be considered when comparing to standard DWI sequences.

Incidental findings of the kidneys, adrenal glands, adnexa uteri, gastrointestinal tract, mesentery and lymph nodes : Assessment and management recommendations

Besides the upper abdominal parenchymal organs, the increasing application of cross-sectional imaging has also led to arising number of incidental findings in the kidneys, adrenal glands, adnexa uteri, the gastrointestinal tract, mesentery and abdominal lymph nodes. Abdominal computed tomography investigations often show unexpected findings without any correlating symptoms. The growing clinical relevance is due to the large number of incidental findings as well as an increasing awareness of ethical and socioeconomic factors. When interpreting radiological findings not only morphological criteria but also individual risk factors of the patient and the clinical context are of great importance. The aims of this article are the description and evaluation of frequent incidental findings detected by computed tomography and to provide information about management recommendations.

The Value of Injury Severity Score and Abbreviated Injury Scale in the Management of Traumatic Injuries of Parenchymal Abdominal Organs

The aim of this study was to investigate the influence of etiology, types of injury, levels of consciousness and the Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) values on the selection of treatment modality and survival in patients with injuries of parenchymal abdominal organs. Case records of 224 patients treated for traumatic injury of parenchymal abdominal organs from January 2003 until December 2015 were reviewed. Th e values of ISS and AIS of injury severity were calculated and compared to the values obtained according to the etiology, state of consciousness and survival. Of the 224 patients, 172 (76.8%) were treated by surgical approach and 52 (23.2%) were treated conservatively. Th e mean patient age was 40.1}18.3 years. Th ere were 97 (43.3%) polytrauma cases. Of the 224 injured patients, 143 (63.8%) were treated with transfusions of blood products. Two hundred and six (92%) patients survived. Th e mean AIS and ISS values were significantly lower in patients that survived (AIS=3; ISS=28) than in those that died (AIS=5; ISS=34) (p< 0.001). There was a statistically significant difference in AIS and ISS values between conscious (AIS=2.7; ISS=25.9) and unconscious (AIS=3.2; ISS=33) patients (p< 0.001). Of the 224 patients that did not survive, 18 (8%) were hemodynamically unstable. Survival depended on hemodynamic stability at admission; the ISS and AIS values were associated with the injuries and state of consciousness at admission. Hemodynamic stability, state of consciousness, and ISS and AIS values were the quality predictors of survival after abdominal traumatic injury.

Evaluation of Free Breathing Versus Breath Hold Diffusion Weighted Imaging in Terms Apparent Diffusion Coefficient (ADC) and Signal-to-Noise Ratio (SNR) Values for Solid Abdominal Organs.

SummaryBackgroundOur aim was to compare the apparent diffusion coefficient (ADC) values of normal abdominal parenchymal organs and signal-to-noise ratio (SNR) measurements in the same patients with breath hold (BH) and free breathing (FB) diffusion weighted imaging (DWI).Material/MethodsForty-eight patients underwent both BH and FB DWI. Spherical region of interest (ROI) was placed on the right hepatic lobe, spleen, pancreas, and renal cortices. ADC values were calculated for each organ on each sequence using an automated software. Image noise, defined as the standard deviation (SD) of the signal intensities in the most artifact-free area of the image background was measured by placing the largest possible ROI on either the left or the right side of the body outside the object in the recorded field of view. SNR was calculated using the formula: SNR=signal intensity (SI)(organ)/standard deviation (SD)(noise).ResultsThere were no statistically significant differences in ADC values of the abdominal organs between BH and FB DWI sequences (p>0.05). There were statistically significant differences between SNR values of organs on BH and FB DWIs. SNRs were found to be better on FB DWI than BH DWI (p<0.001).ConclusionsFree breathing DWI technique reduces image noise and increases SNR for abdominal examinations. Free breathing technique is therefore preferable to BH DWI in the evaluation of abdominal organs by DWI.

Did low tube voltage CT combined with low contrast media burden protocols accomplish the goal of "double low" for patients? An overview of applications in vessels and abdominal parenchymal organs over the past 5years.

Imaging communities have already reached a consensus that the radiation dose of computed tomography (CT) should be reduced as much as reasonably achievable to lower population risks. Increasing attention is being paid to iodinated contrast media (CM) induced nephrotoxicity (CIN); a decrease in the intake of iodinated CM is required by increasingly more radiologists. Theoretically, the radiation dose varies with the tube current time and square of the tube voltage, with higher iodine contrast at low photon energies (Huda etal. [2000] Radiology, 21 7, 430-435).The use of low tube voltage is a promising strategy to reduce both the radiation dose and CM burden. The term 'double low' has been coined to describe scanning protocols that reduce radiation dose and iodine intake synchronously. These protocols are becoming increasingly popular in the clinical setting. The aim of this review was to describe all original studies using the 'double low' strategy in the last 5years. We searched an online electronic database (PubMed) from January 2011 to December 2015 for original studies published on the relationship of low tube voltage with low radiation dose and low iodine contrast media burden in patients undergoing CT scans. Studies that failed to reduce radiation dose or iodine CM burden were excluded in this study. Thirty-seven studies aimed at reducing radiation dose using low tube voltage combined with iodine CM reduced protocols were included in this study. Most studies evaluated conditions associated with arteries. Four were cerebral and neck computed tomography angiography (CTA) studies, 15 were pulmonary CTA (pCTA) and coronary CTA (cCTA) studies, one concerned myocardial perfusion, five studies focused on the thoracic and abdominal aorta, and one investigated renal arteries. Three studies consisted of CT venography (CTV) of the pelvis and lower extremities. Six publications examined the liver, and two focused on the kidney. Overall, this review demonstrates that the low tube voltage CT protocol is a powerful tool to reduce the radiation dose in CTA, especially with pCTA and cCTA.

Fast Abdominal Magnetic Resonance Imaging.

Abdominal imaging is the driving force that necessitates the development of numerous techniques for accelerated image acquisition in magnetic resonance imaging (MRI). Today, numerous techniques are available that enablerapid, high spatial resolution acquisition forboth T1 and T2 weighted images. Thesetechniques open new opportunities in the detection and classification of numerous pathologies in the abdomen. However, there is still ongoing progress in the development of fast and ultrafast sequences and promising techniques are currently close to clinical application. With these 4D-technologies, MRI is becoming the central imaging modality for dynamic, motion-compensated imaging of the parenchymal abdominal organs such as liver, pancreas and kidney. • Fast imaging techniques are especially valuable in the upper abdomen, as this region is particularly affected by respiratory motion.• Parallel imaging and k-space-based acceleration techniques are the basic components of fast 3 D sequences.• By further accelerating 3 D imaging with high spatial resolution, 4 D techniques become available. Citation Format: • Budjan J., Schoenberg S. O., Riffel P. Fast Abdominal Magnetic Resonance Imaging. Fortschr Röntgenstr 2016; 188: 551 - 558.

Current Practice vs. Guideline Based Imaging in Abdominal Radiology in the German Speaking Area: Results of an Online Survey.

The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80% of the questions, were included in the statistical evaluation. 27% of all participants were registered radiologists while 73% represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging. • In German speaking countries indications for abdominal radiological examinations are performed with a high compliance to published guidelines. • There is a significant heterogeneity regarding the acquisition of different contrast phases for parenchymal abdominal organs. • There is an urgent need to publish radiological recommendations and guidelines based on current radiological literature for radiological abdominal imaging.

Комплексная лучевая диагностика абдоминальных проявлений туберкулезной инфекции у детей

The results of the X-Ray & ultrasound examinations of the abdominal parenchymal organs in 207 children aged from 3 to 18 years with various forms of TB infection are reported in the article. Аbdominal tuberculosis can occur as an independent disease or as a manifestation of TB infection in combination with other symptoms. The ultrasound reveals the signs of tuberculous infectious process in the absence of other pathological changes according to X-Ray examination. The ultrasonic symptoms of TB lesions of abdominal parenchymal organs include the enlarged liver or spleen, increased echogenicity of the parenchyma of organs, dilation and induration of the intrahepatic vessels or splenic vein walls and calcifications in liver or spleen parenchyma.

Defining the Modalities of Intravenous Contrast Application During the Diagnostics of Hepatic Metastases with Computerized Tomography.

Introduction:The liver is the biggest human abdominal parenchymal organ; it weights approximately 1500 grams and is located in the right hypochondrium, under the diaphragm. Liver is able to perform multiple functions also by means of the rich dual vascularization: hepatic arterial system and the portal vein system, between which exists a short circuit (shunt) and free mixture inside the sinusoid, whilst the two flows drain in the same vein system. The discovery of CT and its application in practice fundamentally changes the importance of diagnostic methods for hepatobiliary lesions.Patients and methods:During a 4-year period, 984 patients suspected with liver or biliary tract disease were explored with CT. 117 of these patients were analyzed with liver metastases. Examinations of the liver was performed in dorsal decubitus and in absolute apnea with spiral movement of the table and in denominations of 1and 5 mm. Siemens MSCT 64 and 6 tier apparatuses enable short scanning time with almost immediate reconstruction, which offers all the necessary elements required for carrying out certain protocols.Results:The average density of metastatic lesions is about 20 HU smaller than normal liver parenchyma. Metastasis with necrosis are more hypodense (30-50 HU smaller than normal liver parenchyma), whilst necrotic metastases with smaller dimensions are almost isodense with normal parenchyma. However, metastases with diameter between 4 to 6 cm are completely isodense and will remain so even after the application of I.V. contrast. The average more frequent size according to most authors, as well as according to our material (148 patients or 90%) was 2-3 cm in transversal diameter.