Genevieve L. Bennett, M.D.

ACR Appropriateness Criteria(R) Acute Pelvic Pain in the Reproductive Age Group
Andreotti RF; Lee SI; Dejesus Allison SO; Bennett GL; Brown DL; Dubinsky T; Glanc P; Javitt MC; Mitchell DG; Podrasky AE; Shipp TD; Siegel CL; Wong-You-Cheong JJ; Zelop CM
2011 Sep;27(3):205-210, Ultrasound quarterly
Premenopausal women who present with acute pelvic pain frequently pose a diagnostic dilemma, exhibiting nonspecific signs and symptoms, the most common being nausea, vomiting, and leukocytosis. Diagnostic considerations encompass multiple organ systems, including obstetric, gynecologic, urologic, gastrointestinal, and vascular etiologies. The selection of imaging modality is determined by the clinically suspected differential diagnosis. Thus, a careful evaluation of such a patient should be performed and diagnostic considerations narrowed before a modality is chosen. Transvaginal and transabdominal pelvic sonography is the modality of choice when an obstetric or gynecologic abnormality is suspected, and computed tomography is more useful when gastrointestinal or genitourinary pathology is more likely. Magnetic resonance imaging, when available in the acute setting, is favored over computed tomography for assessing pregnant patients for nongynecologic etiologies because of the lack of ionizing radiation. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment
— id: 137966, year: 2011, vol: 27, page: 205, stat: Journal Article,

ACR Appropriateness Criteria((R)) on Abnormal Vaginal Bleeding
Bennett, Genevieve L; Andreotti, Rochelle F; Lee, Susanna I; Dejesus Allison, Sandra O; Brown, Douglas L; Dubinsky, Theodore; Glanc, Phyllis; Mitchell, Donald G; Podrasky, Ann E; Shipp, Thomas D; Siegel, Cary Lynn; Wong-You-Cheong, Jade J; Zelop, Carolyn M
2011 Jul;8(7):460-468, Journal of the American College of Radiology : JACR
In evaluating a woman with abnormal vaginal bleeding, imaging cannot replace definitive histologic diagnosis but often plays an important role in screening, characterization of structural abnormalities, and directing appropriate patient care. Transvaginal ultrasound (TVUS) is generally the initial imaging modality of choice, with endometrial thickness a well-established predictor of endometrial disease in postmenopausal women. Endometrial thickness measurements of </=5 mm and </=4 mm have been advocated as appropriate upper threshold values to reasonably exclude endometrial carcinoma in postmenopausal women with vaginal bleeding; however, the best upper threshold endometrial thickness in the asymptomatic postmenopausal patient remains a subject of debate. Endometrial thickness in a premenopausal patient is a less reliable indicator of endometrial pathology since this may vary widely depending on the phase of menstrual cycle, and an upper threshold value for normal has not been well-established. Transabdominal ultrasound is generally an adjunct to TVUS and is most helpful when TVUS is not feasible or there is poor visualization of the endometrium. Hysterosonography may also allow for better delineation of both the endometrium and focal abnormalities in the endometrial cavity, leading to hysteroscopically directed biopsy or resection. Color and pulsed Doppler may provide additional characterization of a focal endometrial abnormality by demonstrating vascularity. MRI may also serve as an important problem-solving tool if the endometrium cannot be visualized on TVUS and hysterosonography is not possible, as well as for pretreatment planning of patients with suspected endometrial carcinoma. CT is generally not warranted for the evaluation of patients with abnormal bleeding, and an abnormal endometrium incidentally detected on CT should be further evaluated with TVUS
— id: 134926, year: 2011, vol: 8, page: 460, stat: Journal Article,

ACR Appropriateness Criteria(R) Assessment of Gravid Cervix
Glanc P; Andreotti RF; Lee SI; Dejesus Allison SO; Bennett GL; Brown DL; Dubinsky T; Javitt MC; Mitchell DG; Podrasky AE; Shipp TD; Siegel CL; Wong-You-Cheong JJ; Zelop CM
2011 Dec;27(4):275-280, Ultrasound quarterly
ABSTRACT: It is well recognized that preterm birth is the leading cause of perinatal mortality and morbidity. There is a significant association between cervix length and preterm birth risk. Most authorities consider a cervical length <3 cm as the lower limit of normal. A cervical length >3 cm has a high negative predictive value for delivery less than 34 weeks. A cervical length of <15 mm is moderately predictive ( approximately 70%) of preterm birth within 48 hours. Cervical length is normally distributed and should remain relatively constant until the third trimester. Transabdominal US is the least reliable method of cervical length assessment. The most reliable method of documenting cervical length is transvaginal ultrasound (TVUS). Transperineal US is an alternative for imaging if TVUS is contraindicated, such as with premature rupture of membranes. However, the resolution is decreased compared to TVUS. Short cervix length is the single most important predictive finding for premature delivery. This observation should prompt consultation for high risk obstetrical care and consideration of other management options such as cerclage or activity restriction.The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed biennially by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging
— id: 146237, year: 2011, vol: 27, page: 275, stat: Journal Article,

Diffusion-weighted imaging for prediction of volumetric response of leiomyomas following uterine artery embolization: a preliminary study
Hecht, Elizabeth M; Do, Richard K G; Kang, Stella K; Bennett, Genevieve L; Babb, James S; Clark, Timothy W I
2011 Mar;33(3):641-646, Journal of magnetic resonance imaging
PURPOSE: To determine if pretreatment apparent diffusion coefficient (ADC) of leiomyomas could predict volumetric response (VR) following uterine artery embolization (UAE). MATERIALS AND METHODS: We retrospectively studied 11 women who underwent pelvic MRI before and >120 days following UAE. MRI included conventional and diffusion weighted imaging sequences. Percentage change in leiomyoma volume was determined by multiplanar T2-weighted imaging. A Pearson correlation coefficient was calculated between leiomyoma VR following UAE and the following pre-embolization parameters: initial volume, relative enhancement, relative T2 signal intensity (SI) and ADC. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of ADC for predicting volumetric response. RESULTS: Twenty-eight leiomyomas were included with a mean interval from UAE to follow-up MRI of 207 days. The preprocedural volume of the leiomyomas ranged from 18 to 182 cm(3) (median 47 cm(3)). and ADC ranged from 0.37 to 1.71 mm(2)/s (mean 0.80 mm(2)/s). All leiomyomas were 100% necrotic following UAE. Leiomyoma VR following UAE was 48% +/- 3.5%. with significant correlation between VR and ADC (r = 0.41; P = 0.017) but no correlation with initial leiomyoma volume, relative T2 SI, or relative enhancement. Using a threshold of 0.875 x 10(-3) mm(2)/s, ADC could predict > 50% VR with sensitivity and specificity of 70% and 83%, respectively. CONCLUSION: Pre-UAE ADC of leiomyomas correlated significantly with percent VR following UAE. In contrast, no correlation was seen between VR post-UAE and conventional imaging findings. This suggests that VR following UAE depends on leiomyoma histology reflected in DWI rather than features revealed by conventional MRI
— id: 132319, year: 2011, vol: 33, page: 641, stat: Journal Article,

Preliminary Clinical Experience at 3 T With a 3D T2-Weighted Sequence Compared With Multiplanar 2D for Evaluation of the Female Pelvis
Hecht, Elizabeth M; Yitta, Silaja; Lim, Ruth P; Fitzgerald, Erin F; Storey, Pippa; Babb, James S; Bani-Baker, Kamil O; Bennett, Genevieve L
2011 Aug;197(2):W346-W352, American journal of roentgenology
OBJECTIVE: The purpose of this article is to compare 3D T2-weighted sampling perfection with application-optimized contrast with different flip-angle evolutions (SPACE) with three-plane 2D turbo-spin echo (TSE) sequences for female pelvic imaging at 3 T. MATERIALS AND METHODS: Twenty women were imaged with 2D TSE and 3D SPACE sequences. Three radiologists independently assessed image quality, diagnostic quality, and artifacts; measured normal anatomic structures; evaluated pathologic abnormalities; and recorded interpretation time. Readers subsequently performed a side-by-side comparison, and their preferences were graded according to overall interpretation, sharpness of lesion edges, motion and other artifacts, uterine and cervical zonal anatomy distinction, identification of adnexal pathologic abnormalities, and distinction between fat and fluid. Quantitative comparison of relative signal intensity and relative tissue contrast was performed. RESULTS: The mean acquisition time of 3D SPACE was significantly shorter than that of 2D TSE (6 minutes 35 seconds vs 8 minutes 50 seconds; p < 0.005). Intrareader agreement between interpretations of 2D and 3D sequences was excellent. There were no significant differences among readers in detecting artifacts, normal structures, and pathologic abnormalities or in determining endometrial thickness, image quality, or interpretation time (p > 0.05). Except for distinctions between fat and fluid, the average reader score indicated a slight preference for the 3D sequence. Three-dimensional multiplanar reconstructions were helpful but not considered essential. Relative agreement between readers was moderate (r >/= 0.4) to strong (r >/= 0.7). The relative signal intensity was higher for fat and bladder fluid on the 3D sequence than on the 2D sequence (p = 0.014 and p = 0.018, respectively). Relative tissue contrast was higher for the 3D sequence (p < 0.05), with no significant difference in bladder or fat contrast (p = 0.31) but a trend toward more superior contrast on the 2D sequence. CONCLUSION: At 3 T, 3D SPACE has similar image quality and diagnostic quality with shorter scan time when compared with 2D TSE but with reduced contrast between fat and fluid
— id: 135580, year: 2011, vol: 197, page: W346, stat: Journal Article,

Commonly Encountered Foreign Bodies and Devices in the Female Pelvis: MDCT Appearances
Mausner, Elizabeth V; Yitta, Silaja; Slywotzky, Chrystia M; Bennett, Genevieve L
2011 Apr;196(4):W461-W470, American journal of roentgenology
OBJECTIVE: The objective of this article is to illustrate the MDCT appearances of several commonly encountered foreign bodies and devices in the female pelvis. CONCLUSION: The presence of a foreign body or device in the female pelvis can be a potential source of confusion to radiologists, particularly to the inexperienced reader. Familiarity with the normal appearances and locations of these devices on MDCT allows their accurate identification and detection of associated complications
— id: 128807, year: 2011, vol: 196, page: W461, stat: Journal Article,

Normal or Abnormal? Demystifying Uterine and Cervical Contrast Enhancement at Multidetector CT
Yitta, Silaja; Hecht, Elizabeth M; Mausner, Elizabeth V; Bennett, Genevieve L
2011 May-Jun;31(3):647-661, Radiographics
Computed tomography (CT) is not generally advocated as the first-line imaging examination for disorders of the female pelvis. However, multidetector CT is often the modality of choice for evaluating nongynecologic pelvic abnormalities, particularly in emergent settings, in which all the pelvic organs are invariably assessed. Incidental findings of uterine and cervical contrast enhancement in such settings may easily be mistaken for abnormalities, given the broad spectrum of anatomic variants and enhancement patterns that may be seen in the normal uterus and cervix. The authors' review of CT and magnetic resonance (MR) imaging enhancement patterns, augmented by case examples from their clinical radiology practice, provides a solid foundation for understanding the spectrum of normal uterine and cervical appearances and avoiding potential pitfalls in the diagnosis of benign cervical lesions, adenomyosis, infection, malignancy, and postpartum effects. This information should help radiologists more confidently differentiate between normal and abnormal CT findings and, when CT findings are not definitive, offer appropriate recommendations for follow-up ultrasonography or MR imaging. (c) RSNA, 2011
— id: 132590, year: 2011, vol: 31, page: 647, stat: Journal Article,

Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary?
Yitta, Silaja; Mausner, Elizabeth V; Kim, Alice; Kim, Danny; Babb, James S; Hecht, Elizabeth M; Bennett, Genevieve L
2011 Oct;18(5):371-380, Emergency radiology
To determine the added value of reimaging the female pelvis with ultrasound (US) immediately following multidetector CT (MDCT) in the emergent setting. CT and US exams of 70 patients who underwent MDCT for evaluation of abdominal/pelvic pain followed by pelvic ultrasound within 48 h were retrospectively reviewed by three readers. Initially, only the CT images were reviewed followed by evaluation of CT images in conjunction with US images. Diagnostic confidence was recorded for each reading and an exact Wilcoxon signed rank test was performed to compare the two. Changes in diagnosis based on combined CT and US readings versus CT readings alone were identified. Confidence intervals (95%) were derived for the percentage of times US reimaging can be expected to lead to a change in diagnosis relative to the diagnosis based on CT interpretation alone. Ultrasound changed the diagnosis for the ovaries/adnexa 8.1% of the time (three reader average); the majority being cases of a suspected CT abnormality found to be normal on US. Ultrasound changed the diagnosis for the uterus 11.9% of the time (three reader average); the majority related to the endometrial canal. The 95% confidence intervals for the ovaries/adnexa and uterus were 5-12.5% and 8-17%, respectively. Ten cases of a normal CT were followed by a normal US with 100% agreement across all three readers. Experienced readers correctly diagnosed ruptured ovarian cysts and tubo-ovarian abscesses (TOA) based on CT alone with 100% agreement. US reimaging after MDCT of the abdomen and pelvis is not helpful: (1) following a normal CT of the pelvic organs or (2) when CT findings are diagnostic and/or characteristic of certain entities such as ruptured cysts and TOA. Reimaging with ultrasound is warranted for (1) less-experienced readers to improve diagnostic confidence or when CT findings are not definitive, (2) further evaluation of suspected endometrial abnormalities. A distinction should be made between the need for immediate vs. follow-up imaging with US after CT
— id: 137438, year: 2011, vol: 18, page: 371, stat: Journal Article,

Imaging: MRI of the urethra in women with lower urinary tract symptoms: Spectrum of findings at static and dynamic imaging
Bennett G.L.; Hecht E.M.; Tanpitukpongse T.P.; Babb J.S.; Taouli B.; Wong S.; Rosenblum N.; Kanofsky J.A.; Lee V.S.; Siegel C.
2010 ;184(3):1052-1053, Journal of urology
— id: 112062, year: 2010, vol: 184, page: 1052, stat: Journal Article,

Unusual manifestations and complications of endometriosis--spectrum of imaging findings: pictorial review
Bennett, Genevieve L; Slywotzky, Chrystia M; Cantera, Mariela; Hecht, Elizabeth M
2010 Jun;194(6 Suppl):WS34-WS46, American journal of roentgenology
— id: 109800, year: 2010, vol: 194, page: WS34, stat: Journal Article,

Unusual manifestations and complications of endometriosis--spectrum of imaging findings: self-assessment module
Bennett, Genevieve L; Slywotzky, Chrystia M; Cantera, Mariela; Hecht, Elizabeth M
2010 Jun;194(6 Suppl):S84-S88, American journal of roentgenology
The educational objectives for this self-assessment module are for the participant to exercise, self-assess, and improve his or her understanding of the imaging spectrum of endometriosis
— id: 109799, year: 2010, vol: 194, page: S84, stat: Journal Article,

ACR appropriateness criteria(c) ovarian cancer screening
Brown, Douglas L; Andreotti, Rochelle F; Lee, Susanna I; Dejesus Allison, Sandra O; Bennett, Genevieve L; Dubinsky, Theodore; Glanc, Phyllis; Horrow, Mindy M; Lev-Toaff, Anna S; Horowitz, Neil S; Podrasky, Ann E; Scoutt, Leslie M; Zelop, Carolyn M
2010 Dec;26(4):219-223, Ultrasound quarterly
The majority of women with ovarian cancer have advanced stage disease at the time of diagnosis and a poor 5 year survival rate. Hence, screening has been investigated in the hopes of improving survival by diagnosing ovarian cancer at an earlier stage. Most screening methods thus far have included ultrasound and/or serum tumor markers. However, low prevalence of the disease, high false positive rate of current screening methods, and the probable rapid growth of most ovarian carcinomas from no defined precursor lesion, all contribute to difficulty in screening for ovarian cancer. While screening may be able to detect ovarian cancer at an earlier stage, adequate data is presently lacking on whether screening improves survival. The results of ongoing large clinical trials will be available in a few years and should provide critical information regarding the usefulness of screening. Pending results of those large clinical trials, screening is not currently recommended for women at average risk for ovarian cancer. Screening is most likely to be performed in women with an increased familial risk of ovarian cancer, but patients should be aware that even with this risk factor, there is currently insufficient evidence to know if screening is effective. New screening methods, including new or multiple serum markers and proteomics, are also being investigated
— id: 133446, year: 2010, vol: 26, page: 219, stat: Journal Article,

Laparoscopic and open partial nephrectomy: frequency and long-term follow-up of postoperative collections
Hecht, Elizabeth M; Bennett, Genevieve L; Brown, Kevin W; Robbins, David; Hyams, Elias S; Taneja, Samir S; Stifelman, Michael A
2010 May;255(2):476-484, Radiology
PURPOSE: To compare imaging findings between laproscopic and open partial nephrectomy at 6 months after surgery and to follow the evolution of the findings over time. MATERIALS AND METHODS: This HIPAA-compliant retrospective study had institutional review board approval and consent was waived. A surgical database was cross-referenced with an imaging database to identify patients who underwent partial nephrectomy and computed tomographic and/or magnetic resonance imaging within 6 months of surgery. Fifty-eight patients (mean age, 61 years; range, 34-78 years; 21 women, 37 men) underwent 62 partial nephrectomies (laparoscopic, 31; open, 31) to remove 68 masses. Two radiologists in consensus reviewed images obtained between 10 days and 72 months (mean, 28 months) after surgery. Preoperative mass size and location and postoperative kidney orientation, fat stranding, parenchymal defect, collection (including size, location, and appearance), and other complications were recorded. Relative incidence of postoperative imaging findings, demographics, and initial imaging findings of both groups were statistically assessed by using Student t and chi(2) tests corrected for multiple comparisons. RESULTS: Common imaging findings following surgery included kidney displacement (48% [30 of 62]), perinephric fat stranding (93% [63 of 68]), parenchymal defect (74% [50 of 68]), and a non-fat-containing postoperative collection 75%, with significantly more posterior renal displacement (P < .01) and a trend toward more persistent fat stranding in the open surgery group. Fifty-one collections were identified in 74% (43 of 58) of patients, with significantly more collections in the laparoscopic (90% [27 of 30] vs 55% [16 of 29]; P < .05). The proportion of resolved collections increased over time, with significantly more resolving in the open group within 24 months of surgery (P < .05). Development or resolution of a collection was not dependent on age, sex, preoperative lesion size, or location (P > .05). CONCLUSION: Prevalence of findings 2-3 years after partial nephrectomy depends on the surgical approach. After laparoscopic partial nephrectomy, collections are more frequently detected on images and may take longer to resolve than following an open approach
— id: 109518, year: 2010, vol: 255, page: 476, stat: Journal Article,

ACR Appropriateness Criteria on acute pelvic pain in the reproductive age group
Andreotti, Rochelle F; Lee, Susanna I; Choy, Garry; DeJesus Allison, Sandra O; Bennett, Genevieve L; Brown, Douglas L; Glanc, Phyllis; Horrow, Mindy M; Javitt, Marcia C; Lev-Toaff, Anna S; Podrasky, Ann E; Scoutt, Leslie M; Zelop, Carolyn
2009 Apr;6(4):235-241, Journal of the American College of Radiology : JACR
Premenopausal women who present with acute pelvic pain frequently pose a diagnostic dilemma, exhibiting nonspecific signs and symptoms, the most common being nausea, vomiting, and leukocytosis. Diagnostic considerations encompass multiple organ systems, including obstetric, gynecologic, urologic, gastrointestinal, and vascular etiologies. The selection of imaging modality is determined by the clinically suspected differential diagnosis. Thus, a careful evaluation of such a patient should be performed and diagnostic considerations narrowed before a modality is chosen. Transvaginal and transabdominal pelvic sonography is the modality of choice when an obstetric or gynecologic abnormality is suspected, and computed tomography is more useful when gastrointestinal or genitourinary pathology is more likely. Magnetic resonance imaging, when available in the acute setting, is favored over computed tomography for assessing pregnant patients for nongynecologic etiologies because of the lack of ionizing radiation
— id: 112019, year: 2009, vol: 6, page: 235, stat: Journal Article,

MRI of the urethra in women with lower urinary tract symptoms: spectrum of findings at static and dynamic imaging
Bennett, Genevieve L; Hecht, Elizabeth M; Tanpitukpongse, Teerath Peter; Babb, James S; Taouli, Bachir; Wong, Samson; Rosenblum, Nirit; Kanofsky, Jamie A; Lee, Vivian S
2009 Dec;193(6):1708-1715, American journal of roentgenology
OBJECTIVE: The purpose of our study was to determine the findings at both static and dynamic MRI in women with a clinically suspected urethral abnormality. MATERIALS AND METHODS: MRI of the urethra was performed in 84 women with lower urinary tract symptoms using multiplanar T2-weighted turbo spin-echo and unenhanced and contrast-enhanced gradient-echo sequences. A dynamic true fast imaging with steady-state free precession sequence was performed during straining in the sagittal plane. Images were evaluated by two radiologists for urethral pathology and pelvic organ prolapse. MRI findings were correlated with clinical symptoms using the Fisher's exact and Mann-Whitney tests. RESULTS: Urethral abnormalities were found in 10 of 84 patients (11.9%), including two urethral diverticula, five Skene's gland cysts or abscesses, and three periurethral cysts. Thirty-three patients (39.3%) were diagnosed with pelvic organ prolapse, of whom 29 (87.9%) were diagnosed exclusively on dynamic imaging. In 29 of 33 patients with prolapse (87.9%), the urethra was structurally normal. MRI showed 13 cystoceles and 17 cases of urethral hypermobility not detected on physical examination. Patients with a greater number of vaginal deliveries, stress urinary incontinence, frequency of voiding, and voiding difficulty were statistically more likely to have anterior compartment prolapse (p < 0.05). CONCLUSION: Including a dynamic sequence permits both structural and functional evaluation of the urethra, which may be of added value in women with lower urinary tract symptoms. Dynamic MRI allows detection of pelvic organ prolapse that may not be evident on conventional static sequences
— id: 105514, year: 2009, vol: 193, page: 1708, stat: Journal Article,

CT diagnosis of mucocele of the appendix in patients with acute appendicitis
Bennett, Genevieve L; Tanpitukpongse, Teerath P; Macari, Michael; Cho, Kyunghee C; Babb, James S
2009 Mar;192(3):W103-W110, American journal of roentgenology
OBJECTIVE: The purpose of this study was to identify the CT features of mucocele of the appendix coexisting with acute appendicitis and to determine whether this entity can be differentiated from acute appendicitis without mucocele. MATERIALS AND METHODS: CT scans of 70 patients (12 with acute appendicitis with mucocele, 29 with acute appendicitis without mucocele, 29 with a normal appendix) were retrospectively interpreted by two readers. The appendix was evaluated for maximal luminal diameter, cystic dilatation, luminal attenuation, appendicolith, mural calcification and enhancement, periappendiceal fat stranding, fluid, and lymphadenopathy. CT findings were compared by use of Mann-Whitney U and Fisher's exact tests. Receiver operating characteristics analysis was performed to assess the diagnostic utility of appendiceal luminal diameter in differentiating acute appendicitis with from that without coexisting mucocele. RESULTS: Cystic dilatation of the appendix and maximal luminal diameter achieved statistical significance (p < 0.05) for the diagnosis of acute appendicitis with mucocele. Mural calcification achieved statistical significance for one reader (p = 0.0049) and a statistical trend for the other (p < 0.1). A maximal luminal diameter greater than 1.3 cm had a sensitivity of 71.4%, specificity of 94.6%, and overall diagnostic accuracy of 88.2% for the diagnosis of acute appendicitis with mucocele. CONCLUSION: Although there is overlap with acute appendicitis without mucocele, CT features suggestive of coexisting mucocele in patients with acute appendicitis include cystic dilatation of the appendix, mural calcification, and a luminal diameter greater than 1.3 cm
— id: 95059, year: 2009, vol: 192, page: W103, stat: Journal Article,

Pattern recognition of benign nodules at ultrasound of the thyroid: which nodules can be left alone?
Bonavita, John A; Mayo, Jason; Babb, James; Bennett, Genevieve; Oweity, Thaira; Macari, Michael; Yee, Joseph
2009 Jul;193(1):207-213, American journal of roentgenology
OBJECTIVE: The purpose of this study was to evaluate morphologic features predictive of benign thyroid nodules. MATERIALS AND METHODS: From a registry of the records of 1,232 fine-needle aspiration biopsies performed jointly by the cytology and radiology departments at a single institution between 2005 and 2007, the cases of 650 patients were identified for whom both a pathology report and ultrasound images were available. From the alphabetized list generated, the first 500 nodules were reviewed. We analyzed the accuracy of individual sonographic features and of 10 discrete recognizable morphologic patterns in the prediction of benign histologic findings. RESULTS: We found that grouping of thyroid nodules into reproducible patterns of morphology, or pattern recognition, rather than analysis of individual sonographic features, was extremely accurate in the identification of benign nodules. Four specific patterns were identified: spongiform configuration, cyst with colloid clot, giraffe pattern, and diffuse hyperechogenicity, which had a 100% specificity for benignity. In our series, identification of nodules with one of these four patterns could have obviated more than 60% of thyroid biopsies. CONCLUSION: Recognition of specific morphologic patterns is an accurate method of identifying benign thyroid nodules that do not require cytologic evaluation. Use of this approach may substantially decrease the number of unnecessary biopsy procedures
— id: 100484, year: 2009, vol: 193, page: 207, stat: Journal Article,

Challenges and Pitfalls in the Diagnosis of Ectopic Pregnancy: Multimodality Imaging Evaluation (CME Credit Available)
Chaudhri, Y; Mauch, E; Oto, A; Slywotzky, C; Timor-Tritsch, I; Bennett, G
2009 MAY ;192(5):646-651, American journal of roentgenology
— id: 99183, year: 2009, vol: 192, page: 646, stat: Journal Article,

Differentiating pancreatic cystic neoplasms from pancreatic pseudocysts at MR imaging: value of perceived internal debris
Macari, Michael; Finn, Myra E; Bennett, Genevieve L; Cho, Kyunghee C; Newman, Elliot; Hajdu, Cristina H; Babb, James S
2009 Apr;251(1):77-84, Radiology
PURPOSE: To retrospectively evaluate the sensitivity and specificity of several morphologic findings that may be seen with cystic pancreatic lesions, in the diagnosis of pseudocyst at magnetic resonance (MR) imaging. MATERIALS AND METHODS: This study was institutional review board approved and HIPAA compliant. From January 1, 2005, to December 31, 2007, electronic radiology and pathology databases were searched to identify patients with pancreatic cystic neoplasms or pseudocysts who underwent pancreatic MR imaging. Twenty-two patients with cystic pancreatic neoplasms that were confirmed at surgical resection (n = 12) or endoscopic ultrasonography (US) with cystic fluid analysis (n = 10) were identified. Of 20 patients with pancreatic pseudocysts, seven had pseudocysts that were identified at pathologic resection and 13 had a clinical history of pancreatitis, with initial computed tomography (CT) revealing no pancreatic cyst and subsequent follow-up MR imaging depicting cystic lesions. Two abdominal radiologists independently and randomly evaluated each case for presence or absence of septa and internal dependent debris and for external cyst morphology on axial and coronal T2-weighted images and three-dimensional gradient-echo T1-weighted images obtained before and after intravenous contrast agent administration. Logistic regression for correlated data was used to assess the usefulness of internal debris, external morphology, and septa for differentiating cystic neoplasms from pseudocysts. RESULTS: The readers' assessments of the presence or absence of cystic debris were concordant for 40 (95%) of the 42 patients, with a kappa coefficient of 0.889, which indicated nearly perfect agreement. Thirteen (93%) of 14 lesions found to have debris by either or both readers were pseudocysts, and only one (4%) of the 22 cystic neoplasms had debris. Both readers were more likely to identify septa within cystic neoplasms than within pseudocysts; however, the difference was not significant for either reader. The readers were more likely to observe microlobulated morphology in cystic neoplasms than in pseudocysts, with the difference between these lesion types, in terms of prevalence of microlobulated morphology, exhibiting a trend toward-but not reaching-statistical significance (P = .0627). CONCLUSION: Presence of internal dependent debris appears to be a highly specific MR finding for the diagnosis of pancreatic pseudocyst
— id: 97865, year: 2009, vol: 251, page: 77, stat: Journal Article,

Magnetic resonance imaging appearance of ovarian stromal hyperplasia and ovarian hyperthecosis
Rosenkrantz, Andrew B; Popiolek, Dorota; Bennett, Genevieve L; Hecht, Elizabeth M
2009 Nov-Dec;33(6):912-916, Journal of computer assisted tomography
Ovarian stromal hyperplasia and ovarian hyperthecosis are non-neoplastic conditions of the ovary associated with clinical manifestations of hyperandrogenism from ovarian production of male hormones. In this article, we present the first published cases of the magnetic resonance imaging appearance of these conditions, which may mimic that of ovarian neoplasm. In contrast to bilateral ovarian vein sampling, magnetic resonance imaging may provide a noninvasive means of suggesting a diagnosis of ovarian stromal hyperplasia/ovarian hyperthecosis when a hormone-secreting ovarian neoplasm is suspected clinically and thereby may assist in identifying patients who may be effectively treated nonsurgically with gonadotrophin-releasing hormone therapy
— id: 105520, year: 2009, vol: 33, page: 912, stat: Journal Article,

Added value of multiplanar reformation in the multidetector CT evaluation of the female pelvis: a pictorial review
Yitta, Silaja; Hecht, Elizabeth M; Slywotzky, Chrystia M; Bennett, Genevieve L
2009 Nov-Dec;29(7):1987-2003, Radiographics
Although computed tomography (CT) is generally not the first-line imaging test of choice for the evaluation of female pelvic disorders, it is often the initial diagnostic examination performed in the emergency setting in patients who present with abdominal pain and nonspecific clinical symptoms. Multidetector CT coupled with reconstruction software permits isotropic voxel acquisition that can be used to generate two-dimensional multiplanar reformatted (MPR) images for evaluation of the female pelvis with no additional radiation exposure. Multidetector CT with MPR allows improved visualization of the normal anatomy and anatomic variants as well as greater diagnostic accuracy in the evaluation of the female pelvis. Although ultrasonography and magnetic resonance imaging remain the primary imaging modalities for the assessment of most female pelvic disorders, more accurate diagnosis of these disorders at multidetector CT may obviate additional imaging tests and allow more appropriate management
— id: 105367, year: 2009, vol: 29, page: 1987, stat: Journal Article,

MRI of pelvic floor dysfunction: dynamic true fast imaging with steady-state precession versus HASTE
Hecht, Elizabeth M; Lee, Vivian S; Tanpitukpongse, Teerath Peter; Babb, James S; Taouli, Bachir; Wong, Samson; Rosenblum, Nirit; Kanofsky, Jamie A; Bennett, Genevieve L
2008 Aug;191(2):352-358, American journal of roentgenology
OBJECTIVE: The objective of our study was to retrospectively compare the degree of pelvic organ prolapse shown on dynamic true fast imaging with steady-state precession (FISP) versus HASTE sequences in symptomatic patients. MATERIALS AND METHODS: Fifty-nine women (mean age, 57 years) with suspected pelvic floor dysfunction underwent MRI using both a sagittal true FISP sequence, acquired continuously during rest alternating with the Valsalva maneuver, and a sagittal HASTE sequence, acquired sequentially at rest and at maximal strain. Data sets were evaluated in random order by two radiologists in consensus using the pubococcygeal line (PCL) as a reference. Measurement of prolapse was based on a numeric grading system indicating severity as follows: no prolapse, 0; mild, 1; moderate, 2; or severe, 3. A comparison between sequences on a per-patient basis was performed using a Wilcoxon's analysis with p < 0.05 considered significant. RESULTS: Overall, 66.1% (39/59) of patients had more severe prolapse (>or= 1 degrees ) based on dynamic true FISP images, with 28.8% (17/59) of the cases of prolapse seen exclusively on true FISP images. Only 20.3% (12/59) of patients had greater degrees of prolapse on HASTE images than on true FISP images, with 10.2% (6/59) of the cases seen exclusively on HASTE images. A statistically significant increase in the severity of cystoceles (p < 0.01) and urethral hypermobility (p < 0.01)-with a trend toward more severe urethroceles (p < 0.07), vaginal prolapse (p < 0.09), and rectal descent (p < 0.06)-was shown on true FISP images. CONCLUSION: Overall, greater degrees of organ prolapse in all three compartments were found with a dynamic true FISP sequence compared with a sequential HASTE sequence. Near real-time continuous imaging with a dynamic true FISP sequence should be included in MR protocols to evaluate pelvic floor dysfunction in addition to dynamic multiplanar HASTE sequences
— id: 81578, year: 2008, vol: 191, page: 352, stat: Journal Article,

Schizencephaly in a dysgenetic fetal brain: prenatal sonographic, magnetic resonance imaging, and postmortem correlation
Huang, William M; Monteagudo, Ana; Bennett, Genevieve L; Fowkes, Mary E; Timor-Tritsch, Ilan E
2006 Apr;25(4):551-554, Journal of ultrasound in medicine
— id: 66250, year: 2006, vol: 25, page: 551, stat: Journal Article,

Imaging the female pelvis at 3.0 T
Lim, Ruth P; Lee, Vivian S; Bennett, Genevieve L; Chen, Qun; McGorty, KellyAnne; Taouli, Bachir; Hecht, Elizabeth M
2006 Dec;17(6):427-443, Topics in magnetic resonance imaging
Three-Tesla whole body imaging is rapidly becoming part of routine clinical practice. Although it is generally thought that pelvic imaging at 3.0 T will be beneficial because of increased signal to noise and greater spectral separation, adjustments in protocol and sequence parameters are necessary to optimize image quality. The question remains as to whether 3.0-T imaging will offer further benefits beyond 1.5 T in terms of lesion characterization and functional imaging. This article aims to address safety concerns and to illustrate the potential benefits and technical challenges of imaging the female pelvis at 3.0 T. Imaging protocols and sequence parameters for routine gynecologic indications are suggested, and potential clinical applications at 3.0 T are discussed such as magnetic resonance spectroscopy, perfusion, diffusion weighted imaging, and the use of alternate contrast agents
— id: 72501, year: 2006, vol: 17, page: 427, stat: Journal Article,

CT of Meckel's diverticulitis in 11 patients
Bennett, Genevieve L; Birnbaum, Bernard A; Balthazar, Emil J
2004 Mar;182(3):625-629, American journal of roentgenology
OBJECTIVE: This study reviews the CT findings of Meckel's diverticulitis in 11 patients and, to our knowledge, represents the largest series of such cases reported to date. CONCLUSION: The inflamed Meckel's diverticulum may be visualized on CT in most patients, appearing as a blind-ending pouch of variable size and mural thickness and containing fluid, air, or particulate material with surrounding mesenteric inflammation. The location of the diverticulum may vary from the right lower quadrant to the mid abdomen, with most cases in this series located near midline. Optimal luminal opacification of the ileocecal bowel with oral contrast material facilitated detection of the diverticulum and also proved invaluable in enabling identification of the normal appendix. The diagnosis is most difficult in the setting of secondary intestinal obstruction
— id: 42587, year: 2004, vol: 182, page: 625, stat: Journal Article,

Frequency and relevance of the "small-bowel feces" sign on CT in patients with small-bowel obstruction
Lazarus, Dawn E; Slywotsky, Chrystia; Bennett, Genevieve L; Megibow, Alec J; Macari, Michael
2004 Nov;183(5):1361-1366, American journal of roentgenology
OBJECTIVE: We sought to determine the incidence of the 'small-bowel feces' sign (SBFS) in patients with small-bowel obstruction (SBO) and whether it can be used to accurately locate the point of obstruction. SUBJECTS AND METHODS: From November 2002 until March 2003, 34 consecutive adult patients with CT findings of small-bowel obstruction were prospectively evaluated. The CT findings used to diagnose small-bowel obstruction were a dilated proximal small bowel and a collapsed distal small bowel and colon. CT scans were evaluated to determine the degree of obstruction (mild, moderate, or high-grade), the presence or absence of the SBFS (defined as particulate-type material in the dilated small bowel), the location of the SBFS in relation to the transition zone, and the cause of the obstruction. Mild obstruction was defined as a slight discrepancy between the caliber of the proximal and that of the distal small bowel; moderate SBO was defined as a discrepancy of 50% or more between the calibers of the proximal and the distal small bowel; and high-grade SBO was considered to be present if the distal small bowel and the colon had collapsed. The cause of the obstruction was determined from surgical findings or a combination of CT findings, follow-up barium studies, and clinical assessment. RESULTS: The SBFS was present in 19 (55.9%) of 34 patients with SBO. The degree of SBO was mild in six, moderate in 11, and high-grade in 17 of the patients. The SBFS was present in one of the six patients (16.6%) with mild, eight (72.7%) of the 11 with moderate, and 10 (58.8%) of the 17 with high-grade SBO. In all patients in whom the SBFS was present, the particulate material could be traced to the point of transition and was most conspicuous in the transition zone. The length of fecallike material ranged from 2 to 25 cm and was longer in moderate and high-grade SBO than in mild SBO. The cause of the SBO was an adhesion in 20 patients, a hernia in four patients, Crohn's disease in four patients, a tumor in three patients, and other miscellaneous causes in three patients. CONCLUSION: When present on CT, the SBFS can be used to help locate the transition zone in patients with SBO. The sign is present more frequently in patients with moderate and high degrees of SBO
— id: 47832, year: 2004, vol: 183, page: 1361, stat: Journal Article,

CT of the acute abdomen: gynecologic etiologies
Bennett, G L; Harvey, W B; Slywotzky, C M; Birnbaum, B A
2003 May;28(3):416-432, Abdominal imaging
— id: 34855, year: 2003, vol: 28, page: 416, stat: Journal Article,

Ultrasound and CT evaluation of emergent gallbladder pathology
Bennett, Genevieve L; Balthazar, Emil J
2003 Nov;41(6):1203-1216, Radiologic clinics of North America
Ultrasound is the initial imaging modality of choice for the evaluation of suspected acute gallbladder disorders, and is often sufficient for correct diagnosis. CT also plays a vital role, however, in the evaluation of acute gallbladder pathology. CT is particularly useful in situations where ultrasound findings are equivocal. CT is also extremely valuable in the assessment of suspected complications of acute cholecystitis, particularly emphysematous cholecystitis, hemorrhagic cholecystitis, and gallbladder perforation, which are often very difficult diagnoses to establish at sonography. If CT is the initial imaging test performed in a patient with abdominal pain of uncertain etiology, recognition of the various disorders described in this article may eliminate the need for further imaging and facilitate appropriate management
— id: 43877, year: 2003, vol: 41, page: 1203, stat: Journal Article,

Hot topics in women's radiology
Bennett, GL
2003 MAY ;12(4):414-414, Journal of women's health & gender-based medicine
— id: 36584, year: 2003, vol: 12, page: 414, stat: Journal Article,

Benign intratesticular dermoid cyst: sonographic findings
Bennett, Genevieve L; Garcia, Roberto A
2002 Nov;179(5):1315-1317, American journal of roentgenology
— id: 66251, year: 2002, vol: 179, page: 1315, stat: Journal Article,

Sonographic detection of hepatocellular carcinoma and dysplastic nodules in cirrhosis: correlation of pretransplantation sonography and liver explant pathology in 200 patients
Bennett, Genevieve L; Krinsky, Glenn A; Abitbol, Roxanne J; Kim, Sue Y; Theise, Neil D; Teperman, Lewis W
2002 Jul;179(1):75-80, American journal of roentgenology
OBJECTIVE: The objective of this study was to determine the sensitivity and specificity of sonography as an aid in detecting hepatocellular carcinomas and dysplastic nodules using explantation correlation in patients with cirrhosis and no known hepatocellular carcinomas. MATERIALS AND METHODS: The sonography reports of 200 patients with cirrhosis who underwent sonography and then underwent liver transplantation within 90 days were retrospectively reviewed for focal solid liver lesions. All focal solid masses detected on sonography were considered possible hepatocellular carcinomas. The sonographic findings were compared with thin-section explanted liver pathologic results. RESULTS: Twenty-seven patients (13.5%) had hepatocellular carcinoma at explantation, including four patients with diffuse, multifocal tumors. Eight of the 39 lesions were detected on sonography for a patient sensitivity of 29.6% and a lesion sensitivity of 20.5%. Sonography revealed three (75%) of four hepatocellular carcinomas larger than 5 cm in diameter, one (50%) of two hepatocellular carcinomas with diameters of 3.1-5.0 cm, one (20%) of five hepatocellular carcinomas with diameters of 2.1-3.0 cm, three (13.6%) of 22 hepatocellular carcinomas with diameters of 1-2 cm, and no lesions with diameters smaller than 1 cm. Forty-two patients (21%) had a total of 126 dysplastic nodules including two patients with innumerable lesions. Sonography depicted only two dysplastic nodules, for a patient sensitivity of 4.8% and a lesion sensitivity of 1.6%. The overall specificity of sonography for either hepatocellular carcinomas or dysplastic nodules was 96%. CONCLUSION: Sonography has low sensitivity but high specificity in revealing hepatocellular carcinomas and dysplastic nodules in patients with a cirrhotic liver requiring liver transplantation. In these patients, sonography should not be the sole imaging modality used for lesion detection before transplantation
— id: 35148, year: 2002, vol: 179, page: 75, stat: Journal Article,

CT findings in acute gangrenous cholecystitis
Bennett, Genevieve L; Rusinek, Henry; Lisi, Virna; Israel, Gary M; Krinsky, Glenn A; Slywotzky, Chrystia M; Megibow, Alec
2002 Feb;178(2):275-281, American journal of roentgenology
OBJECTIVE: The purpose of this study was to determine the CT findings in acute gangrenous cholecystitis. MATERIALS AND METHODS: Four observers retrospectively reviewed CT scans in 75 patients (23 with acute gangrenous cholecystitis, 25 with acute non-gangrenous cholecystitis, and 27 without cholecystitis). The following findings were evaluated: distention, mural thickening, wall enhancement, irregular wall, wall striation, intraluminal membranes, pericholecystic inflammation, gallstones, pericholecystic fluid, enhancement of liver parenchyma, pericholecystic abscess, and gas in the wall or lumen. Sensitivity and specificity of CT for gangrenous cholecystitis and for each finding were calculated. Two reviewers in consensus measured gallbladder dimension and wall thickness. Logistic regression models were used to predict gangrenous versus non-gangrenous cholecystitis. RESULTS: Sensitivity, specificity, and accuracy of CT for acute cholecystitis were 91.7%, 99.1%, and 94.3%, respectively, and for acute gangrenous cholecystitis were 29.3%, 96.0%, and 64.1%, respectively. Findings with the highest specificity for gangrenous cholecystitis were gas in the wall or lumen (100%), intraluminal membranes (99.5%), irregular or absent wall (97.6%), and abscess (96.6%). The difference between the mean gallbladder wall thickness and the short-axis dimension for the two groups with cholecystitis was statistically significant. In three patients with gangrenous cholecystitis, no mural enhancement was seen. Pericholecystic fluid also achieved statistical significance for the diagnosis of gangrene. Multivariate logistic regression analysis showed that the overall accuracy of CT for gangrenous cholecystitis was 86.7%. CONCLUSION: CT findings most specific for acute gangrenous cholecystitis are gas in the wall or lumen, intraluminal membranes, irregular wall, and pericholecystic abscess. Gangrenous cholecystitis is associated with a lack of mural enhancement, pericholecystic fluid, and a greater degree of gallbladder distention and wall thickening
— id: 26484, year: 2002, vol: 178, page: 275, stat: Journal Article,

Gynecologic causes of acute pelvic pain: spectrum of CT findings
Bennett, Genevieve L; Slywotzky, Chrystia M; Giovanniello, Giovanna
2002 Jul-Aug;22(4):785-801, Radiographics
Although ultrasound (US) is the primary imaging modality of choice in the radiologic evaluation of the female patient with acute pelvic pain, the role of computed tomography (CT) in the evaluation of abdominal and pelvic pain continues to expand. CT may be performed if a gynecologic disorder is not initially suspected, if US findings are equivocal, or if the abnormality extends beyond the field of view achievable with the endovaginal probe and further characterization of pelvic disease is required. Many gynecologic disorders that cause acute pelvic pain (eg, uterine disorders, ovarian disorders, endometriosis, pelvic inflammatory disease, postoperative or postpartum complications) demonstrate characteristic CT findings. Familiarity with these CT appearances is important: It will allow the radiologist to guide appropriate treatment of affected patients and may eliminate the need for further imaging evaluation
— id: 34858, year: 2002, vol: 22, page: 785, stat: Journal Article,

Computed tomography diagnosis utilizing compressed image data: an ROC analysis using acute appendicitis as a model
Megibow, Alec J; Rusinek, Henry; Lisi, Virna; Bennett, Genevieve L; Macari, Michael; Israel, Gary M; Krinsky, Glenn A
2002 Jun;15(2):84-90, Journal of digital imaging
Using receiver-operating characteristic (ROC) methodology, the ability to diagnose acute appendicitis with computed tomography (CT) images displayed at varying levels of lossy compression was evaluated. Nine sequential images over the ileocecal region were obtained from 53 consecutive patients with right lower quadrant pain who were clinically suspected to have acute appendicitis. Thirty were proven surgically to have acute appendicitis, alternative diagnoses confirmed in 23. The image sets were subjected to a lossy wavelet-based compression algorithm 'Embedded Predictive Wavelet Image Coder' (EPWIC). Compression levels were: none, 8:1, 16:1, and 24:1, resulting in 4 sets of images per patient. Image sets were randomized and evaluated separately by 4 body radiologists on a 1,024 x 768-pixel SVGA color PC monitor in 512 x 512 format. The readers were aware of the clinical suspicion of appendicitis but were unaware of the positive fraction of cases. Individual and combined reader ROC and c2 analyses of sensitivity, specificity, and accuracy were determined. For all readers, sensitivity decreases at 16:1 and 24:1 levels (P <0.01, P <0.001, respectively). Accuracy decreased at 24:1 levels (P <0.01). Specificity was unaffected. By ROC analysis there was statistically significantly decreased area under the curve at 24:1 levels (P <0.02) as compared with uncompressed images. Finite levels of lossy wavelet compression may be applied to CT images without compromising diagnostic performance
— id: 43659, year: 2002, vol: 15, page: 84, stat: Journal Article,

Pancreatic ultrasonography
Bennett GL; Hann LE
2001 Apr;81(2):259-281, Surgical clinics of North America
Pancreatic abnormalities usually are detected on US when it is used for screening patients with abdominal pain and for assessment of the gallbladder and bile ducts. Pancreatic visualization is limited by bowel gas, but with experienced sonographers and newer techniques, including harmonic imaging and oral contrast US, diagnosis of pancreatic abnormalities has significantly improved compared with earlier reports. Appropriate initial diagnosis by US can tailor further investigation, and US-guided biopsy may establish definitive diagnosis
— id: 20624, year: 2001, vol: 81, page: 259, stat: Journal Article,

CT interpretation utilizing compressed image data: Acute appendicitis as a model for assessing diagnostic quality
Megibow, AJ; Rusinek, H; Lisi, V; Macari, MJ; Bennett, GL; Israel, GM
2001 NOV ;221(2):377-377, Radiology
— id: 73268, year: 2001, vol: 221, page: 377, stat: Journal Article,

Addition of gadolinium chelates to heavily T2-weighted MR imaging: limited role in differentiating hepatic hemangiomas from metastases
Bennett GL; Petersein A; Mayo-Smith WW; Hahn PF; Schima W; Saini S
2000 Feb;174(2):477-485, American journal of roentgenology
OBJECTIVE: The purpose of this study was to determine whether the addition of gadolinium-enhanced imaging to heavily T2-weighted MR imaging of the liver is valuable in differentiating hemangiomas from metastases. The T2 relaxation time was also included in our analysis. SUBJECTS AND METHODS: Fifty-one patients with 52 proven liver lesions (24 hemangiomas and 28 metastases) larger than 1 cm underwent MR imaging at 1.5 T with T2-weighted spin-echo (TR/TE, 3000/80, 160) and gadolinium chelate-enhanced dynamic T1-weighted gradient-recalled echo (80/2.6, 80) pulse sequences. Images were reviewed by observers who were unaware of the patients' clinical history; first, only T2-weighted images were reviewed and then T2-weighted plus dynamic images were reviewed together. The T2 relaxation times were calculated for each lesion. Diagnostic accuracy by each method was compared using receiver operating characteristic analysis. RESULTS: Mean T2 relaxation times were 76 +/- 26 msec for metastases and 133 +/- 25 msec for hemangiomas. The addition of dynamic scanning to the T2-weighted sequence made a statistically significant difference for only one observer (p = 0.03). However, it did not make a statistically significant contribution for either observer when compared with the T2 relaxation time. Although addition of the dynamic images resulted in correct diagnosis of six lesions, three lesions were misdiagnosed after having been correctly characterized on the T2-weighted images alone. CONCLUSION: When optimized T2-weighted images are obtained and the T2 relaxation time is calculated, routine use of gadolinium enhancement for differentiation of hemangiomas from metastases is unnecessary although dynamic scanning is valuable in selected cases
— id: 8569, year: 2000, vol: 174, page: 477, stat: Journal Article,

Small-bowel obstruction associated with sigmoid diverticulitis: CT evaluation in 16 patients
Kim AY; Bennett GL; Bashist B; Perlman B; Megibow AJ
1998 May;170(5):1311-1313, American journal of roentgenology
OBJECTIVE: The purpose of this study was to identify acute sigmoid diverticulitis as a cause of small-bowel obstruction and to describe the CT findings. CONCLUSION: CT scanning enabled accurate preoperative diagnosis of colonic diverticulitis as the cause of the small-bowel obstruction, thereby allowing proper management and surgical planning
— id: 7627, year: 1998, vol: 170, page: 1311, stat: Journal Article,