Fixed Rate vs Fixed Injection Duration In Single-Pass Contrast-Enhanced Abdominal Multi-Detector CT: Effects On Vascular Enhancement.

OBJECTIVES: To evaluate the effects on vascular enhancement of either a fixed rate (FR) or a fixed injection duration (FID) in single-pass (SP) contrast-enhanced abdominal multi-detector CT (CE-MDCT). MATERIALS & METHODS: Ninety-nine (54M; 45F; aged 18-86 yrs) patients with nontraumatic acute abdomen underwent a SP CE-MDCT after i.v. injection of 1.7 cc/Kg of a nonionic iodinated contrast-media (370 mgI/ml) performed with either a FR (2 cc/sec; Group A) or a FID (55 sec; Group B). In both groups, patients were further stratified according to total body weight (Kg) as follows: 40-60 (L); 61-80 (M); 81-100 (H). Signal- (SNR) and contrast-to-noise ratios (CNR) were calculated for the liver and for both abdominal aorta (AA) and main portal vein (MPV). Statistical analysis was performed by Student's T or Chi-square test for continuous and categorical data, respectively, whereas post-hoc analysis was performed by the Mann-Whitney test (p < 0.05). RESULTS: There were no significant differences in demographic and physical characteristics between Group A (n = 50; 53 ± 20 yrs; BMI = 23.4 ± 4.4) and B (n = 50; 51 ± 17 yrs; BMI 22.7 ± 4.2). Whereas overlapping findings were observed in the M sub-groups (n = 40), SNR and CNR were significantly higher (p < 0.01) in Group B for both AA and MPV in the high (H) weight sub-groups (n = 20) while not significant differences were observed in the low (L) weight sub-groups (n = 40) despite a significantly lower injection rate (1.6 ± 0.2 cc/sec, p < 0.01) in Group B. CONCLUSION: A FID results in an overall better vascular enhancement than a FR in SP CE-MDCT.

Para-oesophageal hernia in 4-month-old girl: possible role of ultrasound-case report and literature review.

Hiatal hernia is the passage of digestive tract portions into the posterior mediastinum through a defect in the esophageal diaphragmatic hiatus. By guidelines, the diagnosis uses first-level radiographic investigations such as chest X-ray and contrastographic methods. As of today, use of ultrasonography in the suspicion/diagnosis of hiatal hernia is not standardized although it shows advantages such as not using ionizing radiation, which is essential in the small pediatric patient. We report the case of a little 4-month-old patient who came to our attention for dysphagia, vomiting and borborygmus to whom Type II hiatal hernia was suspected by ultrasound investigation, later confirmed by guidelines approved methods.