Liver Abscess Due to Dropped Appendicolith after Laparoscopic Appendectomy

The lifetime risk of appendicitis is 6 to 7 % [1]. When appendicitis is clinically suspected, an appendicolith can be found in 30% of the patients [2]. An appendicolith may be retained post-operatively (‘dropped appendicolith’) due to previous perforation, non-recognition during surgery or the impossibility to remove it. Abscesses that result from ectopic appendicoliths tend to occur paraceacally in the vicinity of Morrison’s pouch and should be removed to prevent abscess development and possible overt sepsis [3]. As far as we know, we describe the first documented case of an intrahepatic localization of a dropped appendicolith causing a liver abscess

Gastrointestinal amyloidosis presenting as enterocolitis on abdominal CT scan

The imaging findings of amyloidosis are nonspecific and diverse due to its association with various chronic diseases such as multiple myeloma. We report a case of gastrointestinal amyloidosis presenting as enterocolitis on a contrast enhanced CT scan of the abdomen

The normal appendix on CT: does size matter?

PURPOSE: (1) To evaluate the frequency of visualisation and measurements of the normal appendix. (2) To correlate Body Mass Index (BMI) and gender with visualisation of the normal appendix. (3) To correlate age, gender and body length with appendiceal length. MATERIALS AND METHODS: A retrospective review of 186 patients undergoing abdominal CT without suspicion of acute appendicitis was done. Frequency of visualisation and measurements (including maximal outer diameter, wall thickness, length, content, location of base and tip) of normal appendices were recorded. RESULTS: Prevalence of appendectomy was 34.4%. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of visualisation of the normal appendix were 76%, 94%, 96%, 67%, and 82% respectively. The mean maximal diameter of the appendix was 8.19 mm±1.6 (SD) (range, 4.2-12.8 mm). The mean length of the appendix was 81.11 mm±28.44 (SD) (range, 7.2-158.8 mm). The mean wall thickness of the appendix was 2.22 mm±0.56 (SD) (range, 1.15-3.85 mm). The most common location of the appendiceal tip was pelvic in 66% appendices. The most common location of the appendiceal base was inferior, medial, and posterior in 37%. The normal appendix contained high-density material in 2.2%. There was a significant correlation between gender and appendiceal length, with men having longer appendices than women. CONCLUSION: Most normal appendices are seen at multislice CT using i.v. contrast. The maximal outer diameter of the normal appendix overlaps with values currently used to diagnose appendicitis on CT

Use of eXIA 160 XL for Contrast Studies in Micro–Computed Tomography: Experimental Observations

The purpose of this study was to evaluate the time course of contrast enhancement of spleen, liver, and blood using eXIA 160 XL in healthy mice. eXIA 160 XL was intravenously injected in C57bl/6 mice ( n = 12) at a dose of 0.1 mL/20 g (16 mg iodine [I]/20 g) ( n = 6) or 0.2 mL/20 g (32 mg I/20 g) ( n = 6). The distribution was analyzed by repeated micro–computed tomographic scans up to 48 hours after contrast administration. Images were analyzed using Amide software. Regions of interest were drawn in the spleen, liver, and left ventricle. Contrast enhancement was measured and expressed as a function of time. Peak contrast enhancement of the spleen was reached at 30 minutes, and peak contrast enhancement of the liver occurred 45 minutes after 16 mg I/20 g. Given that this contrast was found to be rather low in the spleen in comparison with former eXIA 160 products, experiments were done at a higher dose. However, the 32 mg I/20 g dose was lethal for mice. Enhancement inside the heart lasts for 1 hour. Administration of eXIA 160 XL results in long-lasting blood pool contrast with higher contrast enhancement in heart and liver in comparison with eXIA 160; however, the administered dose should be limited to 16 mg I/20 g

Ileocolic invagination as a complication of a cecal adenocarcinoma

Ileocolic invagination in the adult may be caused by adenocarcinoma and lead to intestinal obstruction. We report a case of a cecal adenocarcinoma that was complicated by an ileocolic invagination in a 38 year old female, diagnosed on a contrast enhanced CT scan of the abdomen and highlights the importance of contrast enhanced CT for diagnosis of ileocolic invagination

Quality control of micro-computed tomography systems

The rapid proliferation of micro-computed tomography (micro-CT) scanners in preclinical small animal studies has created a need for a method on scanner performance evaluation and scan parameter optimisation. The purpose of this study was to investigate the performance of the scanner with a dedicated micro-CT phantom. The phantom was developed with different independent sections that allow for measurement of major scanner characteristics such as uniformity, linearity, contrast response, dosimetry and resolution. The results of a thorough investigation are discussed

Combined hepatocellular and cholangiocellular carcinoma presenting with radiological characteristics of focal nodular hyperplasia

Combined hepatocellular and cholangiocellular carcinoma (cHCC-CC) is a rare tumor type containing unequivocal elements of both hepatocellular carcinoma and cholangiocarcinoma that are intimately mixed. Although these tumors are usually considered to be more related to hepatocellular carcinoma than to cholangiocarcinoma, they sometimes, in contrast to hepatocellular carcinoma, contain a significant amount of fibrous stroma. This might in some cases explain atypical radiological features. We report a case of a cHCC-CC in a 47-year-old female that resembled focal nodular hyperplasia on Magnetic Resonance Imaging. Correlation of imaging and serum levels of α-fetoprotein and CA19.9 can help to make the correct diagnosis preoperatively

Time-course of contrast enhancement in spleen and liver with Exia 160, Fenestra LC, and VC

Objective: The purpose of this study was to compare the time-course of contrast-enhancement in spleen and liver using Exia 160 in comparison with Fenestra LC and VC in healthy mice. Procedures: Healthy C57bl/6 mice were used in this study. Fenestra LC and VC was administered intravenously at a dose of 0.1 ml/20 g or 0.2 ml/20 g. Exia 160 at a dose of 0.05 ml/20 g or 0.1 ml/20 g. Each animal underwent a micro-CT scan before contrast injection (baseline) and immediately after contrast injection. Additional scans were performed at 1, 2, 3, 4, 24, and 48 h after contrast administration. The mice who received Exia 160 were also scanned after 15, 30, and 45 min. Results: The peak enhancement of Exia 160 occurred after 15 min for the spleen and after 30 min for the liver. Conclusions: Exia 160 allows rapid spleen and liver enhancement. The high iodine content results in small injection volumes