Pancreatic endometrioma : a rare differential diagnosis for a pseudocyst.

Pancreatic endometriosis is extremely rare with only 14 cases reported in the medical literature and its diagnosis on radiological imaging poses a great challenge. We report a case of a 31-year-old female patient with recurrent admissions for pancreatitis of unknown aetiology and no relevant previous medical history. Sectional imaging showed a cystic lesion in the tail of the pancreas and the diagnosis of a post-pancreatitis pseudocyst or a less likely pre-malignant mucinous cystadenoma was considered.

Discordance between invasive coronary flow reserve (CFR) and non-invasive myocardial flow reserve (MFR) in diffuse coronary ectasia (DCE).

Clinical use with evidence base for diagnostic and prognostic value of quantitative positron emission tomography(PET) myocardial perfusion imaging (MPI) in patients with known or suspected coronary artery disease has exponentially increased over the last decade. This case illustrates the very first time that stress myocardial blood flow(MBF) in absolute terms (ml/min/gram) and myocardial flow reserve(MFR) are augmented in three vessel diffuse coronary ectasia by N13-Ammonia PET MPI. Moreover, relative qualitative MPI demonstrated moderate-sized ischemia in right coronary artery territory with chronic total occlusion in middle segment; despite regional myocardial flow reserve remains above ischemic thresholds while regional stress myocardial blood flow is mildly reduced.

The Role of 18F-FDG PET/MRI in the Assessment of Primary Intrahepatic Neoplasms.

Rationale And Objectives: To evaluate the results of 18F-FDG PET/MRI in relation to the histopathologic subtypes and histologic grades of mass-forming primary intrahepatic neoplasms.

Materials And Methods: We retrospectively evaluated 18F-FDG positron emission tomography/magnetic resonance imaging (PET/MRI) results for 39 patients with histopathologically confirmed primary hepatic neoplasms, 15 with mass-forming intrahepatic cholangiocarcinoma (ICC) and 24 with hepatocellular carcinoma (HCC). The apparent diffusion coefficient (ADC) and standardized uptake value (SUV) were analyzed in relation to the histopathologic diagnosis and histologic grade, including calculating the sensitivity and specificity of the imaging findings.

Added Value of Contrast Medium in Whole-Body Hybrid Positron Emission Tomography/Magnetic Resonance Imaging: Comparison between Contrast-Enhanced and Non-Contrast-Enhanced Protocols.

Objective: To compare the diagnostic ability and time efficiency of contrast-enhanced (CE) whole body fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) protocol and non-CE (NCE) protocol.

Subjects And Methods: Ninety-three patients with known primary tumors underwent whole-body hybrid FDG PET/MRI during the follow-up of their malignancies with the use of NCE and CE protocols. The NCE PET/MRI protocol consisted of diffusion-weighted (b = 0 and 800 s/mm2) and T1-weighted Turbo Flash in the axial plane and T2-weighted HASTE sequence in the coronal planes (Σ = 25 min).

Outcomes of first-line long-acting octreotide treatment in non-functional, advanced gastroenteropancreatic neuroendocrine tumors.

Purpose: Benefits of somatostatin analogues have been mostly studied in mixed samples of patients including both functional and non-functional neuroendocrine tumors. This study aimed to examine the response of patients with non-functional metastatic or inoperable gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that received first-line treatment with the somatostatin analogue octreotide LAR.

Methods: The medical records of 23 patients with locally inoperable or metastatic non-functional neuroendocrine tumors who received octreotide LAR (long acting release) treatment were retrospectively reviewed for clinical data and disease course.

CT and MRI findings of sarcomatoid cholangiocarcinoma.

Computed tomography (CT) and magnetic resonance imaging (MRI) findings for a case of intrahepatic sarcomatoid cholangiocarcinoma is presented. A 48-year-old man with upper abdominal pain underwent contrast-enhanced CT and MRI. A 13 × 10 × 7 cm mass was seen in the left liver lobe, which had hypodense internal architecture on CT and mixed signal intensities on both T1- and T2-weighted images with an overwhelmingly hypointense signal on T1-weighted images and a hyperintense signal on T2-weighted images.

A new technique for the reconstruction of complex portal vein anomalies in right lobe living liver donors.

Living donor liver right lobe transplantation using donors with variation of the right sectorial portal vein is considered a challenging procedure in terms of the donor's safety and the complexity of reconstruction in the recipient. We describe an innovative technique to reconstruct double portal vein orifices via a deceased donor iliac vein graft. The postoperative course of the recipient was uneventful.

Locally metastatic mucinous rectal adenocarcinoma: Imaging diagnosis with DW-MRI in comparison with PET-CT.

A 56-year-old male patient with locally advanced mucinous rectal cancer underwent neoadjuvant chemoradiotherapy. Follow-up imaging with positron emission tomography-computed tomography (PET-CT) revealed a local response to chemoradiotherapy, whereas diffusion-weighted magnetic resonance imaging (DW-MRI) showed newly presented sacral bone metastasis. Histopathologically confirmed bone metastasis and the local tumor were surgically removed.

Fulminant abdominal gas gangrene in metastatic colon cancer.

We report a case of fulminant abdominal gas gangrene in a patient with metastatic colon cancer. A 39-year-old patient with descending colon, high-grade adenocarcinoma and coexisting liver and lymph node metastases received two courses of chemotherapy. The patient developed sudden acute abdominal symptoms accompanied by septic shock parameters.

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in the evaluation of the biliary obstruction.

Purpose: In this study, our purpose was to investigate the diagnostic efficacy of the dynamic contrast-enhanced magnetic resonance imaging (MRI) method in the patients with bile duct obstruction.

Materials And Methods: 108 consecutive patients (53 men, 55 women, mean age; 55.77 ± 14.

MRI assessment of chronic pancreatitis.

Magnetic resonance imaging (MRI) plays an important role in the assessment of chronic pancreatitis. By standard MRI techniques, decreased parenchymal signal on T1-weighted fat-suppressed images and delayed gradual enhancement on serial contrast enhanced images represent fibrotic changes caused by chronic inflammation. Magnetic resonance cholangiopancreaticography (MRCP) can reveal ductal changes, including side branch ectasias, that are related to tissue fibrosis and destruction.

MRI and S-MRCP findings in patients with suspected chronic pancreatitis: correlation with endoscopic pancreatic function testing (ePFT).

Purpose: To review magnetic resonance imaging (MRI) and secretin stimulated magnetic resonance cholangiopancreatography (S-MRCP) findings of patients with suspected chronic pancreatitis and compare them with endoscopic pancreatic function testing (ePFT).

Materials And Methods: MRI and S-MRCP findings of 36 patients with clinically suspected chronic pancreatitis were reviewed. Baseline ductal changes, duodenal filling grades, and pancreatic duct caliber change (PDC) on S-MRCP, mean values of pancreatic anteroposterior (AP) diameter, signal intensity ratio (SIR) between pancreas and the spleen on T1-weighted fat saturated images, and arterial to venous (A/V) enhancement ratios were compared between groups of normal and abnormal pancreatic exocrine function determined by ePFT.

The effect of prior sphincterotomy on the secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP).

Rationale And Objectives: A lack of pancreatic duct compliance and decreased duodenal filling on secretin-stimulated magnetic resonance cholangiopancreatography (s-MRCP) has been noted in patients with chronic pancreatitis. Whether endoscopic sphincterotomy can affect pancreatic duct compliance and duodenal filling on diagnostic s-MRCP is unknown.

Materials And Methods: A retrospective review of patients referred to the authors' clinic from December 2006 to December 2007 was performed.

Fat containing HCC: findings on CT and MRI including serial contrast-enhanced imaging.

Rationale And Objectives: The purpose of this article is to review the spectrum of computed tomography (CT) and magnetic resonance imaging (MRI) findings of fat containing hepatocellular carcinoma (HCC), including serial contrast-enhanced imaging.

Materials And Methods: Imaging findings of 10 fat-containing HCCs on CT (n = 2) or MRI (n = 3) or on both CT and MRI (n = 5) were retrospectively reviewed in 9 patients. Both techniques included serial contrast enhanced imaging in arterial, portal venous, and late venous phases.

Acute pancreatic graft fistula and peripancreatic fluid collection: demonstration by secretin-stimulated MRI.

Peripancreatic fluid collections are among the common post pancreas transplant complications, which are mainly due to leakage from the anastomosis site to bowel and graft pancreatitis. Differentiation between these two entities is important because they are treated differently. In this case, secretin stimulated magnetic resonance cholangiopancreatography revealed gradual intraperitoneal fluid collection and accumulation of fluid in small bowel excluded leakage from the anastomosis of the pancreas to bowel and changed the management from surgery to medical treatment.

Pancreatic diffusion-weighted imaging (DWI): comparison between mass-forming focal pancreatitis (FP), pancreatic cancer (PC), and normal pancreas.

Purpose: To compare diffusion-weighted imaging (DWI) findings and the apparent diffusion coefficient (ADC) values of pancreatic cancer (PC), mass-forming focal pancreatitis (FP), and the normal pancreas.

Materials And Methods: DWI (b = 0 and 600 seconds/mm(2)) findings of 14 patients with mass-forming FP proven by histopathology and or clinical follow-up, 10 patients with histopathologically-proven PC, and 14 subjects with normal pancreatic exocrine function and normal imaging findings were retrospectively evaluated. ADC values of the masses, the remaining pancreas, and the normal pancreas were measured.

Diffusion-weighted MRI of the pancreas: correlation with secretin endoscopic pancreatic function test (ePFT).

Rationale And Objectives: To evaluate the correlation between apparent diffusion coefficient (ADC) values of the pancreas on diffusion-weighted imaging (DWI) and pancreatic exocrine function determined by HCO(3) concentration in the secretin endoscopic pancreatic function test (ePFT).

Materials And Methods: Mean ADC values derived from 10 different points of the pancreatic gland on DWI were reviewed in 14 patients with normal (peak HCO(3) > or = 80 mEq/L) and 14 patients with abnormal (peak HCO(3) < 80 mEq/L) ePFT results. Magnetic resonance cholangiopancreatography (MRCP) images of the same patients were evaluated for the diagnosis of chronic pancreatitis.

Imaging of liver disease: comparison between quadruple-phase multidetector computed tomography and magnetic resonance imaging.

Background And Aim: To compare quadruple-phase multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of focal and diffuse liver disease.

Methods: Quadruple-phase contrast-enhanced MDCT and MRI of 37 consecutive patients were retrospectively reviewed by two readers (R1 and R2). In patients with focal liver lesions, the gold standard was histopathology (n = 17) and/or long-term (>6 months) follow-up imaging (n = 27) or transarterial chemoembolization (n = 1).

Primary peritoneal carcinoma: computed tomography and magnetic resonance findings.

Objective: To present computed tomography (CT) and magnetic resonance imaging (MRI) findings of primary peritoneal carcinoma (PPC) at initial presentation (IP) and recurrent disease (RD).

Methods: We studied 15 consecutive female patients (age range, 47-83 years; mean, 66.2 years) with pathologically proven PPC who underwent CT and/or MRI between July 2000 and December 2005.

Normal pancreatic exocrine function does not exclude MRI/MRCP chronic pancreatitis findings.

Objective: Abnormal pancreatic function tests have been reported to precede the imaging findings of chronic pancreatitis. Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) is increasingly accepted as the primary imaging modality for the detection of structural changes of early mild chronic pancreatitis. The aim of this study was to evaluate MRI/MRCP findings in patients with symptoms consistent with chronic pancreatitis who have normal Secretin Endoscopic Pancreatic Function test.

Hepatobiliary and pancreatic MRI and MRCP findings in patients with HIV infection.

Objective: The purpose of this article is to describe the spectrum of MRI and MR cholangiopancreatography (MRCP) findings of hepatic, pancreatic, and biliary manifestations in patients with HIV infection.

Conclusion: The spectrum of MRI and MRCP findings in HIV-infected patients includes acute or chronic hepatitis (or both), pancreatitis, cholangitis, acalculous cholecystitis, and biliary strictures that may resemble primary sclerosing cholangitis. The presence of segmental extrahepatic biliary strictures is characteristic of AIDS cholangiopathy.

Comparison between malignant and benign abdominal lymph nodes on diffusion-weighted imaging.

Rationale And Objectives: The purpose of this study is to review the apparent diffusion coefficient (ADC) values of benign and metastatic abdominal lymph nodes on diffusion-weighted imaging (DWI).

Materials And Methods: Twenty-eight patients with a total of 40 benign (20 patients) and 16 malignant (8 patients) lymph nodes who underwent DWI MRI of the abdomen (b = 0.600) were enrolled in the study.

Magnetic resonance imaging and magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis.

Objectives: To correlate magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance imaging (MRI) findings of the pancreas with the pancreatic exocrine function determined by fecal elastase 1 concentration.

Methods: Magnetic resonance imaging and MRCP findings of 81 consecutive patients with clinically suspected chronic pancreatitis and 21 healthy volunteers were evaluated. All subjects underwent MRI/MRCP and fecal elastase 1 testing within 1 to 4 weeks' interval.