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Purpose: To propose an optimization method of contrast medium injection for the split-bolus protocol based on the contrast medium pharmacokinetics and investigate the utility of the optimized split-bolus protocol in 3D CT angio-venography for laparoscopic gastrectomy. Materials and methods: A pharmacokinetic relationship between injection duration and time to the peak enhancement was taken into account in the protocol design. The first 20 consecutive patients underwent a multi-phase scan with a single-bolus injection (single-bolus protocol), and the next 20 underwent the proposed split-bolus protocol. CT attenuations of the arteries and veins and dose-length products (DLPs) were compared between the two protocols. Two radiologists visually assessed arterial and venous depictions and the misregistrations. Results: Mean arterial CT attenuations were not significantly different between the two protocols. Though mean venous CT attenuations for the split-bolus protocol were 7–11% lower than those of the single-bolus protocol, they were visually evaluated as similar. The mean DLP of the split-bolus protocol was 46% lower than that of the single-bolus protocol. Misregistration between the arteries and veins occurred 35–80% during the single-bolus protocol, but was not indicated in the split-bolus protocol. Conclusion: The split-bolus protocol with optimized timing was more effective for providing improved image quality with reduced radiation dose compared with the single-bolus protocol in 3D CT angio-venography for laparoscopic gastrectomy. [ABSTRACT FROM AUTHOR]

We report the case of a 65-year-old man with blunt abdominal trauma following a fall from a three-meter-high roof. Contrast-enhanced abdominal computed tomography (CT) obtained in early phase showed intense contrast enhancement in the urinary tract as dense as artery. This finding was considered characteristic of traumatic communication between artery and collecting system. In cases of blunt abdominal trauma, contrast-enhanced CT should be obtained in the early phase to diagnose this disorder. When the diagnosis is made, prompt treatment should be initiated.

Background and Purpose: Three-dimensional time-of-flight MR angiography (3D TOF MRA) often discloses prominent posterior cerebral artery (PCA) laterality in the setting of M1-segment middle cerebral artery (MCA) occlusion. We sought to analyze the implications of prominent PCA laterality at 3D TOF MRA., Methods: We retrospectively reviewed 3D TOF MRA and digital subtraction angiography (DSA) findings in 25 patients (12 male, 13 female; mean age, 68.8 years [age range, 29-94 years]) with M1-segment occlusion. The observable laterality of the PCA, determined on the basis of 3D TOF MRA findings, was scored according to distal signal extent and compared with findings of collateral flow from the ipsilateral PCA via the leptomeningeal anastomosis (LMA) at DSA. Frequency of PCA laterality at 3D TOF MRA in patients and that in 56 healthy control subjects was also compared., Results: The positive predictive value of PCA laterality for the existence of collateral flow was 99.9% and the negative predictive value 30.7%. The distal extent of ipsilateral PCA signal at 3D TOF MRA positively correlated with the grade of collateral flow from the PCA via the LMA (r = 0.802; P <.01). PCA laterality was significantly less common in control subjects (P <.01)., Conclusion: Prominent PCA laterality at 3D TOF MRA in patients with M1-segment occlusion represents the existence of collateral flow from the PCA via the LMA.

Imaging findings of hepatic lesions of visceral larva migrans are reported. A 44-year-old man presented with chills, eruptions, marked leukocytosis (31,400/microlitter), and eosinophilia (eosinophil, 72%). Multiple liver nodules were detected as low-density lesions on computed tomography (CT). They were visualized as high signal intensity lesions on T2-weighted, and as low signal intensity lesions on T1-weighted magnetic resonance imaging (MRI). The patient was diagnosed as having visceral larva migrans due to Toxocara canis, by Toxocara immnoserological test. After antihelmintic therapy, multiple liver nodules disappeared on CT. We consider that the differential diagnosis of multiple liver nodules should include visceral larva migrans.