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Background Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey’s preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. Methods All patients who presented with perforated diverticulitis between 1999 and 2009 in two teaching hospitals of Rotterdam, the Netherlands, and in addition had a preoperative CT scan within 24 h before emergency surgery were included. Two radiologists reviewed all CT scans and were asked to classify the severity of the disease according to the Hinchey classification. The CT classification was compared to Hinchey’s classification at surgery. Results Seventy-five patients were included, 48 of whom (64 %) were classified Hinchey 3 or 4 perforated diverticulitis during surgery. The positive predictive value of preoperative CT scanning for different stages of perforated diverticulitis ranged from 45 to 89 %, and accuracy was between 71 and 92 %. The combination of a large amount of free intra-abdominal air and fluid was strongly associated with Hinchey 3 or 4 and therefore represented a reliable indicator for required surgical treatment. Conclusions The accuracy of predicting Hinchey’s classification by preoperative CT scanning is not very high. Nonetheless, free intra-abdominal air in combination with diffuse fluid is a reliable indication for surgery as it is strongly associated with perforated diverticulitis with generalized peritonitis. In 42 % of cases, Hinchey 3 perforated diverticulitis is falsely classified as Hinchey 1 or 2 by CT scanning.

The use of fractal dimension as a discriminator in SAR images for analyzing surface roughness has been proved to be effective. Fractal dimension has also been used as an indicator for terrain surface roughness in DEM. However, a single fractal dimension is not a very useful measure. In this paper, we have proposed a surface roughness index for estimation of image surface roughness. Promising results are shown for applications in DEM of different altitude ranges and SAR image of different landuse classes.

Sixty-three patients with the clinical diagnosis of acute pancreatitis were submitted to contrast enhanced CT examination. As compared to Ranson's objective clinical parameters, CT grading according to Hill et al. as modified by Balthazar et al. was found to reflect accurately the severity of acute pancreatitis. Evaluation of serial CT examination did not reveal any significant progression in classification during the course of acute pancreatitis. The presence of hypodense areas in the pancreas as a single parameter seems to have a distinct prognostic value. In only one out of five pancreatic abscesses was the presence of gas bubbles observed on CT. It is concluded that contrast enhanced CT has a definite place in the management of acute pancreatitis.