Interactive Multimedia Reporting Technical Considerations: HIMSS-SIIM Collaborative White Paper.

Despite technological advances in the analysis of digital images for medical consultations, many health information systems lack the ability to correlate textual descriptions of image findings linked to the actual images. Images and reports often reside in separate silos in the medical record throughout the process of image viewing, report authoring, and report consumption. Forward-thinking centers and early adopters have created interactive reports with multimedia elements and embedded hyperlinks in reports that connect the narrative text with the related source images and measurements.

Comparison of Dynamic Phase Enhancement of Hepatocellular Carcinoma Using Gadoxetate Disodium vs Gadobenate Dimeglumine.

Objective: To determine the differences in enhancement of hepatocellular carcinoma during the first 5 minutes of postcontrast phases with gadoxetic acid (Gd-EOB-DTPA) vs gadobenate dimeglumine.

Methods: Ninety-five cirrhotic patients with hepatocellular carcinoma were examined on a 1.5-T scanner: 74 patients with Gd-BOPTA and 21 patients with Gd-EOB-DTPA.

Administration of secretin (RG1068) increases the sensitivity of detection of duct abnormalities by magnetic resonance cholangiopancreatography in patients with pancreatitis.

Background & Aims: Administration of secretin improves noninvasive imaging of the pancreatic duct with magnetic resonance cholangiopancreatography (MRCP). We performed a large prospective study to investigate whether synthetic human secretin (RG1068)-stimulated MRCP detects pancreatic duct abnormalities with higher levels of sensitivity than MRCP.

Methods: We performed a phase 3, multicenter, baseline-controlled study of patients with acute or acute recurrent pancreatitis who were scheduled to undergo endoscopic retrograde cholangiopancreatography (ERCP) between March 26, 2008, and October 28, 2009.

Cystic neoplasms of the pancreas; findings on magnetic resonance imaging with pathological, surgical, and clinical correlation.

Pancreatic cysts are increasingly being identified by cross-sectional imaging studies. Pancreatic cystic lesions comprise a spectrum of underlying pathologies ranging from benign and pre-malignant lesions to frank malignancies. Magnetic resonance imaging with cholangiopancreatography is a non-invasive imaging modality used for the characterization of cystic pancreatic lesions.

MRCP in patient care: a prospective survey of gastroenterologists.

Objective: MRCP is increasingly used to evaluate pancreaticobiliary disease, yet its effect on patient care is unknown. The purpose of this study was to measure the effect of MRCP on referring physicians' initial diagnoses, the physicians' confidence in their diagnoses, and the influence of MRCP results on clinical management.

Subjects And Methods: We prospectively surveyed gastroenterologists who referred patients for nonurgent MRCP for pancreaticobiliary evaluation.

Usefulness of diffusion-weighted imaging in the evaluation of renal masses.

Objective: The objective of our study was to assess the value of diffusion-weighted imaging in differentiating among the various subgroups of renal masses.

Materials And Methods: This retrospective study measured the apparent diffusion coefficients (ADCs) of renal masses. Malignant lesions were confirmed with surgical pathology results.

Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis.

Objective: The objective of our study was to determine the usefulness of the apparent diffusion coefficient (ADC) of liver parenchyma for determining the severity of liver fibrosis.

Materials And Methods: This study investigated 78 patients who underwent diffusion-weighted imaging (DWI) with 1.5-T MRI and pathologic staging of liver fibrosis based on biopsy.

The value of diffusion-weighted imaging in characterizing focal liver masses.

Rationale And Objectives: To determine if focal liver masses could be differentiated as benign or malignant on the basis of diffusion-weighted imaging (DWI).

Methods And Materials: A total of 104 patients with focal liver masses were scanned using 1.5 T magnetic resonance imaging (MRI).

Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation.

Purpose: To prospectively measure pancreatic apparent diffusion coefficient (ADC) before and after secretin administration in subjects with and without chronic pancreatitis (CP) who underwent magnetic resonance (MR) cholangiopancreatography with diffusion-weighted (DW) imaging at 3.0 T.

Materials And Methods: Institutional review board approval of this HIPAA-compliant study was obtained.

Assessment of chronic pancreatitis: utility of diffusion-weighted MR imaging with secretin enhancement.

Purpose: To retrospectively measure and compare changes in pancreatic apparent diffusion coefficient (ADC) following secretin administration in patients with and those without chronic pancreatitis (CP) who underwent magnetic resonance (MR) cholangiopancreatography with diffusion-weighted (DW) imaging.

Materials And Methods: This retrospective HIPAA-compliant study was approved by the authors' institutional review board, with waiver of informed consent. Eighty-nine patients were categorized by the referring gastroenterologist as having no CP (n = 37), mild CP (n = 33), or severe CP (n = 19) on the basis of Cambridge criteria and/or clinical course.

Comparison of secretin-stimulated magnetic resonance pancreatography and manometry results in patients with suspected sphincter of oddi dysfunction.

Rationale And Objectives: To measure main pancreatic duct diameter (PDD) with magnetic resonance pancreatography (MRP) before and after secretin injection in patients with suspected sphincter of Oddi dysfunction (SOD) and to determine if the diameter change is predictive of sphincter of Oddi manometry (SOM) results.

Materials And Methods: We identified all patients during the study period referred for SOM for clinically suspected SOD; patients with an intact sphincter and without contraindication to MRP examination were considered for study entry. Consenting patients underwent MRP, including dynamic imaging of the pancreatic duct after intravenous administration of porcine secretin followed by SOM during endoscopic retrograde cholangiopancreatography.

Nonalcoholic fatty liver disease.

Objective: The inflammatory subtype of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, is becoming one of the most important causes of chronic liver disease. In this article, we discuss the epidemiology, pathogenesis, and clinical and radiologic diagnosis of the subtypes of nonalcoholic fatty liver disease.

Conclusion: We discuss the current and evolving imaging tests in the evaluation of hepatic fatty content, inflammation, and fibrosis.

New concepts in staging and treatment of locally advanced pancreatic head cancer.

Objective: The objective of this article is to discuss the CT findings that guide surgeons in deciding the feasibility of tumor excision in patients with locally advanced pancreatic head cancers.

Conclusion: Vascular resection as an adjunct to pancreaticoduodenectomy is increasingly used in pancreatic head cancer. As a result, the imaging criteria to determine which patients are candidates for potentially curative resection are evolving.

Abdominal MR imaging at 3.0 T.

Magnetic resonance (MR) imaging at 3.0 T offers an improved signal-to-noise ratio compared with that at 1.5 T.

Fetal magnetic resonance imaging.

Purpose Of Review: Fetal magnetic resonance imaging is becoming more used in the evaluation of complex fetal abnormalities. Rapid advances in the technology and application of fetal magnetic resonance imaging necessitate a review of this subject.

Recent Findings: Diffusion-weighted imaging, magnetic resonance spectroscopy and functional magnetic resonance imaging may allow assessment of fetal brain even before anatomical abnormalities are demonstrated.

Dynamic secretin-enhanced MR cholangiopancreatography.

Secretin causes temporary dilatation of pancreatic ducts, principally by increasing pancreatic exocrine secretions, and thus allows better visualization of the ducts at magnetic resonance (MR) cholangiopancreatography. Secretin-enhanced MR cholangiopancreatography is useful for detection and diagnosis of a variety of congenital, inflammatory, and neoplastic conditions of the pancreas. Although MR cholangiopancreatography without secretin is a reliable method for evaluating the pancreatobiliary ductal system, the authors believe that secretin-enhanced MR cholangiopancreatography gives additional valuable functional and anatomic information about the pancreatic duct and pancreatic excretory capacity.

Fast fetal magnetic resonance imaging.

Fetal magnetic resonance imaging (MRI) can be used as a problem-solving tool when ultrasonic findings are equivocal. The role of fetal MRI has increased as obstetricians become aware of its potential and in utero therapy for anomalies becomes increasingly sophisticated. In this pictorial essay, we present a wide range of anomalies diagnosed or confirmed using MRI and discuss findings that help in the differential diagnosis.

Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer.

Background: Accurate preoperative detection and staging of pancreatic cancer may identify patients with locoregional disease that is amenable to surgical resection.

Objective: To compare endoscopic ultrasonography and multidetector computed tomography (CT) for the detection, staging, and resectability of known or suspected locoregional pancreatic cancer.

Design: Prospective, observational, cohort study.

Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction.

Replacement of myocardium by fat, particularly of the right ventricle, is often diagnosed as arrhythmogenic right ventricular dysplasia. At autopsy, however, 68% of scars associated with chronic ischemic heart disease have shown fatty metaplasia in the scar. Four patients with a past history of previous myocardial infarctions and computed tomography demonstration of fatty change in left ventricular regions of hypokinesis and infarction are presented.

Fatty metastatic lesions in 2 patients with renal clear-cell carcinoma.

This is a case report of 2 patients with previously resected renal cell carcinoma who present with unusual fatty lesions that proved to be metastases.