Recognizing the Ultrasound Patterns of Mesenteric Panniculitis.

ABSTRACT: Mesenteric panniculitis (MP) is a rare, benign, and nonspecific chronic fibrosing inflammation of the mesenteric adipose tissue. Abdominal pain is the most frequent presentation.The objective was to recognize ultrasound (US) features in MP. A retrospective 9-year review of computed tomography- (CT) or US-diagnosed cases of MP recorded in the radiology department was performed. The inclusion criteria included an US recorded in PACS imaging data base within 10 days before CT, to compare and evaluate the correlation of MP diagnosis.The prevalence of MP on CT was 2.8%. The 120 selected patients had an abdominal US 10 days before CT. Male-to-female ratio was 4:1. Fifty-three percent of MP was suggested by US. The US finding was increased volume with fatty mass in the mesentery root (98%). The fatty mesenteric mass had oval shape or convex anterior border in 94%, central abdominal location in 91%, and focal mesenteric increased echogenicity in 95%. Lateral bowel loop displacement was observed in 59%. Detection of lymph nodes was less frequent (55%).In conclusion, MP is an entity to be considered in the differential diagnosis of abdominal pain. Knowledge and recognition of the US findings of MP and central abdominal compression may improve detection during the abdominal US examination.

[Gastric intramural pseudocyst in a heterotopic pancreas causing gastric outlet obstruction. Report of one case]. / Pseudoquiste pancreático intramural gástrico en páncreas heterotópico, una causa infrecuente de retención gástrica. Caso clínico.

Heterotopic pancreas is a silent gastrointestinal malformation that may become clinically evident when complicated by inflammation and pseudocyst formation. We report a 26 year-old male presenting with vomiting, pain and abdominal distention. An abdominal CT scan showed an important gastric distention secondary to a 4-cm cystic lesion located in the antrum wall. An endosonography showed that the lesion obstructed the gastric outlet and was compatible with a pseudocyst. A cysto-gastrostomy was performed draining the cyst. Its high lipase and amylase content confirmed that it was a pancreatic pseudocyst. Six months later, the lesion appeared again and a subtotal gastrectomy was performed Histopathology confirmed ectopic pancreatic tissue.

[Correlation in radiological bone age determination using the Greulich and Pyle method versus automated evaluation using BoneXpert software]. / Correlación en la determinación de la edad ósea radiológica mediante el método de Greulich y Pyle versus la evaluación automatizada utilizando el software BoneXpert.

OBJECTIVE: To determine the degree of correlation in the radiological bone age assessment using the Greulich and Pyle method versus automated assessment through BoneXpert® software between 2013 and 2016. MATERIAL AND METHOD: Correlation study of diagnostic techniques of 1500 carpal X-rays to assess bone age in patients under 16 years of age from Clínica Alemana de Santiago. X-rays with bone age assessment using the Atlas of Greulich and Pyle (GP) by 1 out of 7 pediatric radiologists, were analyzed using the BoneXpert (BE) software for automated bone age assessment. 100 cases were taken at random for analysis/re-analysis using the BoneXpert method to determine its accuracy. The level of correlation of the measurements was analyzed using the correlation coefficient (Pearson's r) and the variability of the measurements using the Bland-Altman analysis. RESULTS: 1493 cases were assessed, seven were excluded due to failure in the X-ray technique, 922 females (61.8%), with a median chronological age of 9.96 years and 11.12 years for males (p 0.001). The correlation between manual bone age (GP) and automated bone age using BoneXpert method among radiologists ran ged from 0.91 to 0.93. The Bland-Altman analysis indicated an average difference between manual bone age and bone age using the BoneXpert method of 0.19 years (CI 0.13 to 0.25). In the analysis/ re-analysis of 100 random cases using the BoneXpert software, the correlation was 1.00 (100% accu racy). CONCLUSION: The automated analysis using BoneXpert allows for standardized, low-variability, and high-concordance assessment.

Correlación en la determinación de la edad ósea radiológica mediante el método de Greulich y Pyle versus la evaluación automatizada utilizando el software BoneXpert / Correlation in radiological bone age determination using the Greulich and Pyle method versus automated evaluation using BoneXpert software

Resumen: Objetivo: Determinar el grado de correlación en la valoración de la edad ósea radiológica mediante el método de Greulich y Pyle versus la evaluación automatizada por el programa computacional BoneXpert® entre los años 2013-2016. Material y Método: Estudio de correlación de técnicas diag nósticas de 1500 radiografías de carpo para evaluar la edad ósea, en pacientes menores de 16 años pertenecientes a Clínica Alemana de Santiago. Las radiografías con evaluación de la edad ósea por el Atlas de Greulich y Pyle (GP) por 1 de 7 radiólogos pediatras fueron sometidas al programa BoneX pert (BE) para la evaluación automatizada de la edad ósea. Se tomó 100 casos al azar para un análisis/ re-análisis del método BE, para conocer su precisión. Se analizó el nivel de correlación de las medicio nes por coeficiente de correlación (r de Pearson) y la variabilidad de las mediciones mediante análisis de Bland-Altman. Resultados: Se incluyeron 1.493 casos, se excluyeron 7 por falla en técnica de la radiografía, 922 de sexo femenino (61.8%), mediana de edad cronológica 9.96 años y 11.12 años para los varones (p 0,001). La correlación entre la edad ósea manual GP y la edad ósea automatizada BE entre los lectores varió entre 0,91 y 0,93. El análisis de Bland-Altman indicó una diferencia promedio entre la edad ósea manual y la edad ósea BE de 0,19 años (IC 0,13 a 0,25). En el análisis/re-análisis de 100 casos al azar mediante BoneXpert, la correlación fue de 1,0. Conclusión: El análisis automatizado mediante BoneXpert permite una evaluación estandarizada, de baja variabilidad, y alta concordancia.

Abstract: Objective: To determine the degree of correlation in the radiological bone age assessment using the Greulich and Pyle method versus automated assessment through BoneXpert® software between 2013 and 2016. Material and Method: Correlation study of diagnostic techniques of 1500 carpal X-rays to assess bone age in patients under 16 years of age from Clínica Alemana de Santiago. X-rays with bone age assessment using the Atlas of Greulich and Pyle (GP) by 1 out of 7 pediatric radiologists, were analyzed using the BoneXpert (BE) software for automated bone age assessment. 100 cases were taken at random for analysis/re-analysis using the BoneXpert method to determine its accuracy. The level of correlation of the measurements was analyzed using the correlation coefficient (Pearson's r) and the variability of the measurements using the Bland-Altman analysis. Results: 1493 cases were assessed, seven were excluded due to failure in the X-ray technique, 922 females (61.8%), with a median chronological age of 9.96 years and 11.12 years for males (p 0.001). The correlation between manual bone age (GP) and automated bone age using BoneXpert method among radiologists ran ged from 0.91 to 0.93. The Bland-Altman analysis indicated an average difference between manual bone age and bone age using the BoneXpert method of 0.19 years (CI 0.13 to 0.25). In the analysis/ re-analysis of 100 random cases using the BoneXpert software, the correlation was 1.00 (100% accu racy). Conclusion: The automated analysis using BoneXpert allows for standardized, low-variability, and high-concordance assessment.

Pseudoquiste pancreático intramural gástrico en páncreas heterotópico, una causa infrecuente de retención gástrica: caso clínico / Gastric intramural pseudocyst in a heterotopic pancreas causing gastric outlet obstruction: report of one case

Heterotopic pancreas is a silent gastrointestinal malformation that may become clinically evident when complicated by inflammation and pseudocyst formation. We report a 26 year-old male presenting with vomiting, pain and abdominal distention. An abdominal CT scan showed an important gastric distention secondary to a 4-cm cystic lesion located in the antrum wall. An endosonography showed that the lesion obstructed the gastric outlet and was compatible with a pseudocyst. A cysto-gastrostomy was performed draining the cyst. Its high lipase and amylase content confirmed that it was a pancreatic pseudocyst. Six months later, the lesion appeared again and a subtotal gastrectomy was performed Histopathology confirmed ectopic pancreatic tissue.

Computed tomography imaging of complications of acute cholecystitis.

Acute cholecystitis (AC) is a frequent complication of biliary cholelithiasis. Although ultrasound is the first diagnostic imaging procedure, frequently the initial imaging modality is computed tomography (CT). Therefore, familiarization of CT findings in AC and potential related complications are extremely important. This pictorial essay reviews a broad spectrum of complications related to AC and its key findings in CT.