2 articles
The unintentional leaving of gauze sponges in the abdomen after laparotomy is a rare but serious medical error. The diagnosis of a textile foreign body can be challenging due to its rarity, potential long-term asymptomatic evolution, and nonspecific imaging findings that may be unfamiliar to radiologists.
The data of 13 radiologically identified and surgically confirmed cases of abdominal textilomas treated over a 15-year period were assessed retrospectively. There were 10 women (76.9%) and 3 men (23.1%); the average age was 38.5±4.7 years. The average interval between the previous procedure and the diagnosis of textiloma was 25.3±15.2 months, ranging from 1 day to 16 years.
The most common imaging patterns seen on CT included masses with a typical spongiform structure with numerous small air bubbles and surrounded by a thin capsule, as well as a high-density, well-circumscribed lesion, sometimes with mottled calcification, and a dense capsule with intense contrast accumulation. Based on surgical history, physical examination, and CT scan findings, a likely diagnosis of textiloma was made before surgery in 11 (84.6%). In all patients, a repeated open surgery was necessary to remove textile foreign bodies.
The possibility of an abdominal textiloma should be considered in the differential diagnosis of any postoperative patient who presents with pain, infection, or a palpable mass. CT scanning is a practical and highly sensitive diagnostic tool for detecting textilomas with characteristic imaging features in both chronic encapsulated and acute inflammatory manifestations.
Digital tomosynthesis is a relatively new imaging modality that is already used in the diagnosis of breast cancer and has shown promising results in evaluating patients with pulmonary, osteoarticular, and other pathologies. However, up to date, there are no published studies related to the usefulness of digital tomosynthesis in the evaluation of patients with laryngeal cancer. The purpose of this study was to evaluate the clinical role of digital tomosynthesis in the diagnosis of laryngeal cancer and compare the imaging results with those obtained by digital radiography and computed tomography.
The study was carried out between 2015 and 2019 at the Institute of Oncology in the Republic of Moldova and included 253 consecutive patients with laryngeal cancer referred to the Institute of Oncology during this period. All patients underwent digital radiography and digital tomosynthesis investigations. In 41 patients who provided written informed consent, computed tomography was performed. The results of all imaging investigations were compared.
The statistical analysis revealed a high degree of agreement and a strong linear correlation between the data obtained with digital tomosynthesis and computed tomography, as well as concordance correlation coefficients for different parameters between 0.63 and 1.0 (mean value = 0.82±0.11). For comparison, the concordance correlation coefficients for the same parameters obtained for digital radiography versus computed tomography ranged between 0.08 and 0.93 (mean value = 0.43±0.25). An updated imaging algorithm that includes digital tomosynthesis has also been proposed for investigating patients with suspected laryngeal cancer.
The study demonstrated the usefulness of digital tomosynthesis for the evaluation of patients with laryngeal cancer. When compared to computed tomography, which is considered the gold standard, digital tomosynthesis revealed a much higher performance compared to digital radiography. Considering the availability of low-dose protocols for digital tomosynthesis, the modality might also be helpful for laryngeal cancer screening in a high-risk population. However, new studies are also required to confirm our findings and define the place of digital tomosynthesis in the imaging algorithm for patients with laryngeal cancer.