Thoracic causes of acute abdominal pain.

The origin of abdominal pain may be extra-abdominal, caused by a thoracic illness. This article illustrates the various thoracic disorders that may present with acute abdominal pain. An erroneous focus on the abdomen alone can easily lead to misdiagnosis and incorrect treatment. In cases of unexplained acute abdominal pain, radiologists should be aware of also viewing beyond the borders of the abdomen. The key to most of these thoracic diagnoses is detection of pulmonary consolidation, pleural fluid or pericardial fluid.

Diffuse gallbladder wall thickening: differential diagnosis.

OBJECTIVE: The objective of our study was to review and illustrate the various clinical entities that may cause diffuse thickening of the gallbladder wall on diagnostic imaging studies. CONCLUSION: Diffuse gallbladder wall thickening may be caused by a wide range of gallbladder diseases and extracholecystic pathologic conditions. In most cases its cause can be determined by correlation of the clinical presentation and associated imaging findings.

[Breast-specific gamma imaging in breast cancer]. / 'Breast-specific gamma imaging' bij borstkanker.

Breast-specific gamma imaging (BSGI) is a new technique in nuclear medicine for the diagnosis of breast cancer. After intravenous injection of the radioactive substance 99mTc-sestamibi the breasts are imaged with a gamma camera. The radionuclide assimilates into intracellular mitochondria, which are present in greater numbers in breast cancer cells than in normal cells. This causes a relatively high uptake of the radionuclide in tumours. Along with mammography and ultrasound, MRI is the current gold standard in breast imaging diagnostics. However, MRI is a complex and expensive procedure and has low specificity leading to high false-positive rates. BSGI has equally high sensitivity but is more specific, cheaper and much simpler to interpret. BSGI could replace MRI as a complementary technique to show, exclude or indicate the extent of breast cancer.

Mimics of appendicitis: alternative nonsurgical diagnoses with sonography and CT.

OBJECTIVE: Our objective was to illustrate the imaging features of alternative nonsurgical disorders in patients presenting with clinical signs of appendicitis. CONCLUSION: This article illustrates the sonographic and CT features of various appendicitis-mimicking conditions that are self-limiting or that can be treated conservatively. A correct imaging diagnosis of these disorders may prevent a nontherapeutic appendectomy and unnecessary hospitalization.

Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography.

OBJECTIVE: The purpose of our study was to evaluate clinical findings and sonographic features of abdominal wall endometriosis and also to report its CT and MR appearance. MATERIALS AND METHODS: A computerized search of our institution's database over a 5-year period was performed, yielding 12 surgically proven cases of abdominal wall endometriosis that were retrospectively studied. All patients had undergone sonography including power Doppler examination. Additional CT was performed in one patient and MRI in four. Pathologic material was preoperatively obtained by sonographically guided puncture in six patients. The clinical data were analyzed, and the imaging studies were reviewed by two radiologists working in consensus. RESULTS: All patients had a history of at least one prior cesarean section. All presented with focal pain near the surgical scar, which was cyclic in three patients. Nine patients presented with a palpable mass near the scar. Sonography detected 11 lesions within the abdominal wall, with a mean diameter of 25 mm. All lesions were hypoechoic, vascular, and solid, with some cystic changes in one. The calculated frequency of abdominal wall endometriosis is approximately 0.8% of all women who had a cesarean delivery. CONCLUSION: Abdominal wall endometriosis frequently presents with noncyclic symptoms. Imaging findings of a solid mass near a cesarean section scar strongly suggest its diagnosis.