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Pulmonary embolism is a leading cause of morbidity and mortality that can occur in many clinical situations. For several years, spiral CT has represented a relatively non invasive modality for diagnosing this common disease. The present article is reviewing the CT features of acute and chronic pulmonary embolism, the technical aspects of spiral CT acquisition, the diagnostic accuracy and major limitations and pitfalls of the technique.

The authors report a case of liver trauma with hematoma complicated with a pseudoaneurysm. The latter was suspected on day 7, with a monophasic helical CT and was demonstrated with helical CT angiography. Arteriography confirmed the lesion and showed an associated arteriovenous fistula, unsuspected on helical CT. The pseudoaneurysm was managed with transcatheter embolization, completed with percutaneous embolization because of vascular spasm.

The X-ray and CT follow-up features of unilateral peripheral pulmonary masses spontaneously varying in size and amount in a patient with limited Wegener disease are reported. Diagnosis was established by nasal biopsy and dosage of the neutrophils anti-cytoplasmic autoantibodies. The current literature over the condition is reviewed.

The multiplanar capability of spiral CT improves the evaluation of bile duct lesions. In particular, spiral CT after intravenous administration of a cholangiographic agent (spiral CT cholangiography) provides adequate 2D and 3D images of the bile ducts in patients with normal bilirubin levels. Spiral CT cholangiography may be particularly useful as a noninvasive imaging method to detect biliary anatomic variations and bile duct stones before or after laparoscopic cholecystectomy. This technique does not replace retrograde cholangiography which has therapeutic applications, but might help to select patients who need to undergo invasive procedures such as retrograde cholangiography.

It is generally admitted, that after cholecystectomy, the cystic duct and the gallbladder remnant may cause symptoms, by being the site of inflammation. Recurrence of stones in a reformed gallbladder is avoided when cholecystectomy is complete. We report the case of a 43-year-old woman, presenting 19 years after cholecystectomy with a reformed gallbladder containing stones demonstrated by US, CT and cholangiography.

The sensitivity of ultrasonography (US) as the initial imaging procedure in acute diverticulitis of the left colon was retrospectively compared with that of computed tomography (CT) in 34 patients. Final diagnosis was based on clinical findings and follow-up in a first group of 20 patients with mild diverticulitis, and was proved by surgery in a second group of 14 patients with severe diverticulitis. In the first group, US showed findings consistent with diverticulitis in 19 patients, as did CT. The image of an inflamed diverticulum was shown by US in 10 patients. In the surgical group, findings consistent with diverticulitis were shown by US in 11 cases, and by CT in 13 cases. An inflamed diverticulum was not detected at US in this group of patients, presumably because the diverticulum was incorporated in the inflammatory process. These results suggest that US is a valuable technique in the initial evaluation of patients suspected of having acute diverticulitis, especially when the disease is not severe. The image of an inflamed diverticulum shown at US strongly suggests the diagnosis of mild diverticular disease. When diverticulitis is severe, CT should be performed in addition to US.

Computed tomography (CT) of the esophagus, the stomach and the duodenum allows characterization of some lesions: lipomas, cysts and duplications, recent haematomas, vascular anomalies. CT is particularly used for the extramural staging of neoplasms: despite important limitations, CT may be useful as staging test to identify a subgroup of patients with definitive metastases or local invasion who therefore have unresectable tumors. CT is helpful for the staging of lymphomas. The importance of this staging classification is reflected in differences in treatment and prognosis. CT is also useful for the follow-up after treatment, the diagnosis of recurrence and postoperative complications.