Postoperative doppler evaluation of liver transplants.

Doppler ultrasound plays an important role in the postoperative management of hepatic transplantation, by enabling early detection and treatment of various vascular complications. This article describes the normal Doppler findings following liver transplantation and reviews the imaging appearances of various vascular complications associated with it. The article also discusses transient waveform abnormalities, often seen on a post-transplant Doppler examination, and the importance of differentiating them from findings suggestive of ominous vascular complications.

The utility of secretin-enhanced MRCP in diagnosing congenital anomalies.

Purpose: To assess the additional value of secretin-enhanced MRCP (SMRCP) over conventional MRCP in diagnosing divisum.

Methods: Retrospective HIPAA-compliant and IRB-approved review found 140 patients with SMRCP and ERCP correlation within 6 months of each other. All studies were anonymized and the SMRCP images (SMRCP image set) were separated from 2D and 3D MRCP and axial and coronal T2-weighted images (conventional MRI image set).

Multidetector CT of vascular compression syndromes in the abdomen and pelvis.

Certain abdominopelvic vascular structures may be compressed by adjacent anatomic structures or may cause compression of adjacent hollow viscera. Such compressions may be asymptomatic; when symptomatic, however, they can lead to a variety of uncommon syndromes in the abdomen and pelvis, including median arcuate ligament syndrome, May-Thurner syndrome, nutcracker syndrome, superior mesenteric artery syndrome, ureteropelvic junction obstruction, ovarian vein syndrome, and other forms of ureteral compression. These syndromes, the pathogenesis of some of which remains controversial, can result in nonspecific symptoms of epigastric or flank pain, weight loss, nausea and vomiting, hematuria, or urinary tract infection.

Abdominal manifestations of neurologic disorders.

A variety of disorders-including infectious, inflammatory, hereditary, and metabolic diseases-may affect both the brain and abdominal cavity, and the findings in one region may help establish the diagnosis or limit the differential diagnosis. Establishing an accurate early diagnosis enables clinicians to adequately manage these unusual diseases and potentially avert life-threatening complications. For example, an early diagnosis of Gardner syndrome enables annual sigmoid- or colonoscopy and ultrasonography.

Urinary bladder cancer: role of MR imaging.

Urinary bladder cancer is a heterogeneous disease with a variety of pathologic features, cytogenetic characteristics, and natural histories. It is the fourth most common cancer in males and the tenth most common cancer in females. Urinary bladder cancer has a high recurrence rate, necessitating long-term surveillance after initial therapy.

Orthotopic liver transplantation: reversible Doppler US findings in the immediate postoperative period.

Orthotopic liver transplantation (OLT) is the only definitive treatment for irreversible acute liver failure and chronic liver disease. In the immediate postoperative period after OLT, patients are closely monitored with Doppler ultrasonography (US) to detect treatable vascular complications and ensure graft survival. The first postoperative Doppler US examination is performed fairly early on the first postoperative day, before surgical wound closure has been performed.

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 compartment syndrome.

Objective: The purpose of this article is to discuss the pathogenesis, clinical features, radiologic findings, and treatment of abdominal compartment syndrome, which is defined as an acute elevation of the intraabdominal pressure with organ dysfunction.

Conclusion: Abdominal compartment syndrome is not well reported in the radiology literature. In this review, we discuss a range of CT signs such as elevated diaphragm, collapsed inferior vena cava, bowel wall thickening, bowel mucosal hyperenhancement, hemoperitoneum, and increasing abdominal girth, which, in combination, may allow the radiologist to raise the possibility of abdominal compartment syndrome.

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.

Bowel complications seen on CT after pancreas transplantation with enteric drainage.

Objective: Bowel-related complications from pancreas transplantation account for much of the postsurgical morbidity. In a review of 98 pancreas transplant recipients, we found 19 (19.4%) with such complications.