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Purpose: To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT)., Materials and Methods: A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann-Whitney U-test., Results: Duodenal, jejunal and ileal distention (p<0.05, <0.001, <0.001, respectively) and wall visualization (p<0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (p<0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (kappa-range: 0.41-0.74) and wall visualization (kappa-range: 0.48-0.71)., Conclusion: MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.

Tuberculosis (TB) is still a major cause of significant morbidity and mortality despite universal availability of effective chemotherapy. The emergence of multidrug-resistant mycobacteria along with a worldwide increase in HIV infection has led to a recent surge in the number of patients with TB. TB involves both pulmonary and extrapulmonary sites. Tuberculous spondylitis is the most common form of musculoskeletal TB and accounts for approximately 50% of cases. Extraspinal musculoskeletal TB is among the least common manifestations of TB. It shows a predilection for joints and para-articular areas while isolated soft tissue TB occurs extremely rare. A non-specific, often indolent clinical presentation in conjunction with its low prevalence constitutes obstacles for diagnosis. The differential diagnosis of extraspinal musculoskeletal TB consists of degenerative processes, inflammatory and infectious conditions, primary neoplasms, and metastatic lesions. Early diagnosis and treatment is of utmost importance to prevent serious joint and bone destruction. Radiological assessment of patients with musculoskeletal TB is often the key to adequate diagnosis and early treatment. The purpose of this manuscript is to review the imaging features of extraspinal musculoskeletal TB and to focus on the magnetic resonance imaging (MRI) characteristics of this pathology.

Objective: To determine the prevalence and morphologic helical computed tomography (CT) features of peripancreatic vascular abnormalities in patients with acute pancreatic inflammatory disease in correlation with the severity of the pancreatitis., Materials and Methods: One hundred and fifty-nine contrast-enhanced helical CT scans of 100 consecutive patients with acute pancreatitis were retrospectively and independently reviewed by three observers. CT scans were scored using the CT severity index (CTSI): pancreatitis was graded as mild (0-2 points), moderate (3-6 points), and severe (7-10 points). Interobserver agreement for both the CT severity index and the presence of peripancreatic vascular abnormalities was calculated (K-statistic). Correlation between the prevalence of complications and the degree of pancreatitis was estimated using Fisher's exact test., Results: The severity of pancreatitis was graded as mild (n = 59 scans), moderate (n = 82 scans), and severe (n = 18 scans). Venous abnormalities detected included splenic vein (SV) thrombosis (31 scans, 19 patients), superior mesenteric vein (SMV) thrombosis (20 scans, 14 patients), and portal vein (PV) thrombosis (17 scans, 13 patients). Arterial hemorrhage occurred in five patients (6 scans). In our series, no cases of arterial pseudoaneurysm formation were detected. The interobserver agreement range for scoring the degree of pancreatitis and the overall presence of major vascular abnormalities was 75.5-79.2 and 86.2-98.8%, respectively. The presence of the vascular abnormalities in correlation with the severity of pancreatitis was variable., Conclusion: Vascular abnormalities are relatively common CT findings in association with acute pancreatitis. The CT severity index is insufficiently accurate in predicting some of these complications since no statistically significant correlation between their prevalence and the severity of pancreatitis could be established.