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    October 2015
    David Orion MD, Yarden Yavne, Shlomi Peretz MD and Gili Givati MD
    656-658 Abstract Full article
    January 2015
    Yael Adler-Levy MD, Simcha Yagel MD, Michael Nadjari MD, Yaakov Bar-ziv MD, Natalia Simanovsky MD and Nurith Hiller MD
    42-46 Abstract Full article
    Background: Sonographic evaluation of congenital skeletal dysplasias is often challenging. Ultrasound may be limited in demonstrating the skeleton and may overlook specific signs of skeletal abnormality. Computed tomography (CT) with 3D reconstruction was proposed as an aid in the diagnosis of skeletal dysplasias.

    Objectives: To describe our experience with 3D-CT imaging for the evaluation of suspected skeletal dysplasias.

    Methods: The study group comprised 20 pregnant women carrying 22 fetuses, referred for further evaluation by CT following sonographic suspicion of fetal skeletal dysplasia at 17–39 weeks of gestation. Examinations were performed using various CT protocols. Radiation exposure was decreased during the study period, with eventual lowering of the dose to 1–3 mSv. Meticulous review of the skeleton and long bone measurements were performed on 3D reconstructions. For cases of pregnancy termination, the postmortem diagnosis was compared retrospectively with the CT findings.

    Results: Very low dose CT protocols provided excellent diagnostic images. Of 22 fetuses suspected of having skeletal dysplasia on ultrasound, 8 were found by CT to be dysplastic and in 7 the pregnancy was terminated. Postmortem findings, when available, concurred with the CT diagnosis. The remaining 14 fetuses within this cohort were found to be normal according to CT and were carried to term.

    Conclusions: 3D-CT may be a valuable complimentary imaging tool to ultrasound for the diagnosis of skeletal dysplasias. Using low dose protocols makes this examination relatively safe, and in the appropriate clinical context may assist in making difficult decisions prenatally.
    June 2014
    Itay Zoarets MD, Natan Poluksht MD and Ariel Halevy MD
    335-337 Abstract Full article

    Background: Appendectomies are the most common operations performed on an emergency basis. The accepted rate of "white" appendectomies is around 20%. In recent years, computed tomography (CT) scanning has been recognized as a valuable tool with high sensitivity and specificity in the diagnosis of acute appendicitis. The use of CT scans in the management of patients with suspected acute appendicitis is increasing worldwide.

    Objectives: To assess whether introducing more liberal use of CT in the management of patients presenting to the emergency room with right lower quadrant pain or suspected acute appendicitis would reduce the rate of “white” appendectomies.

    Methods: We conducted a retrospective study of the pathology reports and CT scans of all patients who underwent appendectomy during a 3 year period. We examined the correlation between the rate of CT scans performed and the rate of "white" appendectomies.

    Results: Overall, we performed 797 appendectomies during the study period. In 2004, we performed 272 appendectomies and CT in 34 patients (12.5%). In 2005, we performed 275 appendectomies and CT in 83 patients (30.2%). In 2006, we performed 250 appendectomies and CT in 88 patients (35.2%). The percentage of "white" appendectomies decreased from 29% in 2004 to 21.1% in 2005 and to 18.8% in 2006.

    Conclusions: It appears that a more selective use of CT scans in the management of suspected appendicitis could reduce the rate of "white" appendectomies.

    July 2013
    G. Yaniv, G. Twig, O. Mozes, G. Greenberg, C. Hoffmann and Y. Shoenfeld
    450-454 Abstract Full article
     Systemic lupus erythematosus (SLE) is a complex autoimmune disorder involving multiple organs. One of the main sites of SLE morbidity is the central nervous system (CNS), specifically the brain. In this article we review several imaging modalities used for CNS examination in SLE patients. These modalities are categorized as morphological and functional. Special attention is given to magnetic resonance imaging (MRI) and its specific sequences such as diffusion-weighted imaging (DWI), diffuse tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). These modalities allow us to better understand CNS involvement in SLE patients, its pathophysiology and consequences.

     

    March 2012
    U. Dior, I. Shelef, B. Joshua, O. Gluck and M. Puterman
    198-199 Abstract Full article
    November 2008
    I. Greenberg-Wolff et al
    806-808 Abstract Full article

    Background: Cardiac computed tomography scans influde several extra-cardiac structures such as mediastinum, lung parenchyma and upper abdominal organs. A variety of abnormalities in those structures might be clinically important and in some cases might explain the patient's complaints.

    Objectives: To analyze consecutive cardiac computed tomography examinations for the prevalence and clinical significance of extra-cardiac findings.

    Methods: Cardiac CT scans of 134 sequential patients (104 males, 30 females) aged 20–77 years (mean 54 years) with suspected coronary artery disease were prospectively and independently reviewed by a consensus of two radiologists for the presence of lung, mediastinal, pleural, upper abdominal and skeletal abnormalities. CT scans with extra-cardiac abnormalities were divided into two groups: group A – defined as "clinically significant" or "potentially significant findings" – consisted of patients requiring further evaluation or follow-up, and group B – "clinically non-significant findings."

    Results: Extra-cardiac abnormalities were found in 103 of the 134 patients (76.8%). Group A abnormalities were found in 52/134 patients (39%), while group B abnormalities were seen in 85/134 (63%). The most common abnormalities in group A were non-calcified lung nodules (> 4 mm) noted in 17/134 patients (13%), followed by enlarged mediastinal lymph nodes (> 10 mm) in 14/134 (10%), diaphragmatic hernia (2 cm) in 12/134 (9%), moderate or severe degenerative spine disease in 12/134 (9%), and emphysema and aortic aneurysm in 6 patients each (4.5%). A malignant lung tumor was noted in one patient.

    Conclusions: There is a high prevalence of non-cardiac abnormalities in patients undergoing CCT[1]. Clinically significant or potentially significant findings can be expected in 40% of patients who undergo CCT, and these will require further evaluation and follow-up. The reporting radiologist should be experienced in chest imaging and aware of the large variety of non-cardiac findings in CCT that might explain the patient's complaints. 





    [1] CCT = coronary computed tomography


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