Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE.

Main Recommendations: 1. Primary investigation of polypoid lesions of the gallbladder should be with abdominal ultrasound. Routine use of other imaging modalities is not recommended presently, but further research is needed.

Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

Objectives: The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

An appraisal of the computed axial tomographic appearance of the human mesentery based on mesenteric contiguity from the duodenojejunal flexure to the mesorectal level.

Objective: The human mesentery is now regarded as contiguous from the duodenojejunal (DJ) to anorectal level. This interpretation prompts re-appraisal of computed tomography (CT) images of the mesentery.

Methods: A digital model and reference atlas of the mesentery were generated using the full-colour data set of the Visible Human Project (VHP).

MRI evaluation of acute appendicitis in pregnancy.

In recent years, magnetic resonance imaging (MRI) has become a valuable diagnostic tool for evaluation of acute abdominal pain in pregnancy. MRI offers an opportunity to identify the normal or inflamed appendix as well as a variety of other pathologic conditions that can masquerade clinically as acute appendicitis in pregnant women. Visualization of the normal appendix by MRI virtually excludes the diagnosis of acute appendicitis and may help reduce the negative laparotomy rate in this patient population.

Magnetic resonance imaging of rectal cancer.

This article aims to discuss the anatomy of the anorectum, the MRI protocol parameters required to optimize diagnosis of rectal cancer, and the diagnostic MRI criteria essential to stage rectal cancer accurately, using the TNM staging classification. A brief review of more emerging important aspects of rectal cancer staging, such as the circumferential resection margin, extramural vascular invasion, and the staging of low rectal cancers, will also be provided. Finally, the authors will touch upon the evaluation of tumor response to neoadjuvant chemoradiation therapy in the setting of locally advanced rectal cancer.

Complication rate of ultrasound-guided percutaneous cholecystostomy in patients with coagulopathy.

Objective: The purpose of this article is to compare the complication rate for ultrasound-guided percutaneous cholecystostomy in patients with coagulopathy to the rate in patients with normal coagulation.

Materials And Methods: We performed a database search for patients who underwent ultrasound-guided percutaneous cholecystostomy from January 2000 through December 2010. Patients were divided into those with normal coagulation and those with coagulopathy, as documented by abnormal laboratory values (international normalized ratio ≥ 1.

ACR Appropriateness Criteria pretreatment staging of colorectal cancer.

Because virtually all patients with colonic cancer will undergo some form of surgical therapy, the role of preoperative imaging is directed at determining the presence or absence of synchronous carcinomas or adenomas and local or distant metastases. In contrast, preoperative staging for rectal carcinoma has significant therapeutic implications and will direct the use of radiation therapy, surgical excision, or chemotherapy. CT of the chest, abdomen, and pelvis is recommended for the initial evaluation for the preoperative assessment of patients with colorectal carcinoma.

Cystic tumors of the pancreas: imaging and management.

Cystic tumors of the pancreas are a subset of rare pancreatic tumors that vary from benign to malignant. Many have specific imaging findings that allow them to be differentiated from each other. This article (1) reviews the imaging features of the common cystic pancreatic lesions, including serous microcystic adenoma, mucinous cystic tumor, intraductal papillary mucinous tumor, and solid pseudopapillary tumor, and including the less common lesions such as cystic endocrine tumors, cystic metastases, cystic teratomas, and lymphangiomas; and (2) provides comprehensive algorithms on how to manage the individual lesions, with recommendations on when to reimage patients.

Demonstration of the course of the posterior intercostal artery on CT angiography: relevance to interventional radiology procedures in the chest.

Purpose: To document the course of the posterior intercostal artery (PIA) within the intercostal space (IS) in vivo using computed tomography angiography (CTA).

Materials And Methods: A review of 428 IS from CTA of the chest was performed. Using multiplanar reconstruction (MPR) algorithms, the course of the PIA within the IS and the maximum distance of the PIA from the undersurface of the rib were determined in the 4th to 8th IS at three clinically relevant points: the posterior paravertebral area (PPV), angle of the rib (AR), and 25 mm lateral to the angle of the rib (LAR).