Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Séquard syndrome: a case report.

Introduction: Intramedullary spinal cord metastasis is very rare. The majority are discovered incidentally during autopsy. Most symptomatic patients present with rapidly progressive neurological deficits and require immediate examination.

Imaging findings after radiofrequency ablation of adrenal tumors.

Objective: The purpose of this study was to describe the imaging findings after radiofrequency ablation of adrenal tumors.

Materials And Methods: We retrospectively reviewed the imaging findings of all patients with adrenal tumors treated with radiofrequency ablation in our department from January 2001 through August 2009. The studies were reviewed in consensus by two attending abdominal imaging radiologists and an abdominal imaging fellow.

Intraoperative ultrasonography of the pancreas.

Intraoperative ultrasonography (US) of the pancreas is a versatile technique that provides excellent spatial and contrast resolution and real-time imaging capabilities, making it useful for diagnostic imaging as well as for guidance of laparoscopic and open operative procedures. Intraoperative US may be used for applications such as staging and localizing tumors; performing regional metastatic surveys; documenting arterial and venous patency; identifying endocrine tumors; distinguishing pancreatitis from a neoplasm; and guiding biopsy, duct cannulation, and drainage of abscesses or cysts. The scanning approach and technique vary according to the application, with many different equipment and transducer options and sterilization methods available.

Efficacy of radiofrequency ablation in the treatment of small functional adrenal neoplasms.

Purpose: To evaluate the use of radiofrequency (RF) ablation as a primary treatment for symptomatic primary functional adrenal neoplasms and determine the efficacy of treatment with use of clinical and biochemical follow-up.

Materials And Methods: After obtaining institutional review board approval, the authors retrospectively evaluated images and medical records from 13 consecutive patients with symptomatic functional adrenal neoplasms (<3.2 cm in diameter) who underwent RF ablation during a 7-year period.

Quality initiatives: strategies for anticipating and reducing complications and treatment failures in hepatic radiofrequency ablation.

Radiofrequency (RF) ablation is one of several local treatment strategies that can be used for the destruction of a variety of primary and secondary liver tumors. As experience with RF ablation grows, it becomes increasingly evident that successful ablation requires meticulous technique. In addition, knowledge of potential complications is critical for both the interventionalist and the radiologist, whose postablation interpretation can facilitate identification of complications and treatment failures.

Stereotactic body radiotherapy and gemcitabine for locally advanced pancreatic cancer.

Purpose: Patients with nonmetastatic locally advanced unresectable pancreatic cancer have a dismal prognosis. Conventional concurrent chemoradiotherapy requires 6 weeks of daily treatment and can be arduous. We explored the safety and effectiveness of a 3-day course of hypofractionated stereotactic body radiotherapy (SBRT) followed by gemcitabine in this population.

Transanorectal interventions.

Over the past few decades, advances in modern imaging technology have enabled less invasive approaches to diagnose and treat disease. In the field of image-guided techniques, this has seen the common adaptation of needle biopsy and catheter drainage into clinical practice. In this article we review the most common applications of transanorectal techniques.

Practical performance of defecography for the evaluation of constipation and incontinence.

By opacifying the sigmoid, rectum, and vagina with different barium consistencies and using fluoroscopy to evaluate the mechanics of defecation in a physiologic setting, a wide range of pathologies associated with constipation and incontinence can be diagnosed. This review article discusses the primary indications for fluoroscopic defecography, techniques, common diagnoses, and challenges faced in clinical practice.

Immediate renal tumor involution after radiofrequency thermal ablation.

Purpose: To retrospectively evaluate solid renal tumor sizes before and after treatment with radiofrequency (RF) thermal ablation to assess for immediate changes on cross-sectional imaging.

Materials And Methods: Medical records were retrospectively reviewed in consecutive patients who underwent percutaneous image-guided RF thermal ablation for solid renal tumors between December 12, 2000, and December 13, 2006. All patients underwent noncontrast computed tomography (CT) immediately before and after RF ablation.

Thinking outside the abdominal box: safe use of the epipericardial fat pad window for percutaneous radiofrequency ablation of hepatic dome tumors.

Percutaneous imaging-guided tumor ablation is being increasingly performed for local disease control in a variety of primary and secondary neoplasms. Herein, the authors detail their experience with four patients in whom the epipericardial fat pad was traversed to access tumors within the hepatic dome for radiofrequency ablation. The procedure was technically successful in all patients, and the use of this novel window helped avoid crossing the pleura.

Plantar vein thrombosis: a rare cause of plantar foot pain.

Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound.

Comprehensive preoperative assessment of pancreatic adenocarcinoma with 64-section volumetric CT.

Pancreatic adenocarcinoma is a common gastrointestinal malignancy that has a poor prognosis and for which successful surgical resection is the only method of cure. Preoperative staging and assessment can be performed with a number of modalities. Multidetector (64-section) volumetric computed tomography (CT) allows rapid anatomic coverage coupled with excellent spatial resolution.

Virtual Whipple: preoperative surgical planning with volume-rendered MDCT images to identify arterial variants relevant to the Whipple procedure.

Objective: The purposes of this study were to combine a thorough understanding of the technical aspects of the Whipple procedure with advanced rendering techniques by introducing a virtual Whipple procedure and to evaluate the utility of this new rendering technique in prediction of the arterial variants that cross the anticipated surgical resection plane.

Conclusion: The virtual Whipple is a novel technique that follows the complex surgical steps in a Whipple procedure. Three-dimensional reconstructed angiographic images are used to identify arterial variants for the surgeon as part of the preoperative radiologic assessment of pancreatic and ampullary tumors.

Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI.

Objective: The objectives of our study were, first, to use MRI to determine the prevalence of osteitis pubis and of adductor dysfunction at the symphysis pubis in soccer players presenting with pubalgia and, second, to determine whether the two entities are mechanically related and whether one of the entities precedes or predisposes the development of the other.

Materials And Methods: One hundred consecutive soccer players with debilitating groin pain were referred for MRI. One hundred asymptomatic age- and sex-matched elite athletes were included as control subjects.

Intraoperative laparoscopic ultrasound.

In parallel with the increasing move from open surgical procedures to laparoscopic approaches, laparoscopic ultrasound (LUS) is being used with increasing frequency to image normal structures and intra-abdominal pathology. Special transducers and scanning techniques are required to perform LUS with a different set of considerations. Within the spectrum of LUS applications, LUS is used to complement laparoscopy for oncology staging, to facilitate an array of surgical procedures, and to guide laparoscopic biopsies.

Contrast-enhanced bolus-chased whole-body MR angiography using a moving tabletop and quadrature body coil acquisition.

Objective: MR angiography is now an established technique for the evaluation of various arterial structures. With recent developments in hardware, whole-body imaging has become technically feasible. The aim of this study is to describe a technique for whole-body MR angiography using a quadrature body coil and a moving tabletop.

Rapid automated measurement of body fat distribution from whole-body MRI.

Objective: The purpose of this article is to determine the feasibility of using computer-assisted diagnosis (CAD) techniques to automatically identify, localize, and measure body fat tissue from a rapid whole-body MRI examination.

Conclusion: Whole-body MRI in conjunction with CAD allows a fast, automatic, and accurate approach to body fat measurement and localization and can be a useful alternative to body mass index. Whole-body fat analysis can be achieved in less than 5 min.

Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation.

Purpose: To determine whether the secondary cleft sign demonstrated in the symphysis pubis at magnetic resonance (MR) imaging is a marker of injury in athletes presenting with groin pain.

Materials And Methods: Ethics review board approval was not required for studies involving retrospective image or case record review; informed consent for review was not required. Eighteen male athletes (mean age, 24 years; age range, 19-32 years) were included for study.

Colonic surveillance by CT colonography using axial images only.

Patients at increased risk of colon cancer require strict colon surveillance. Our objective was to establish the efficacy of 2D axial CT colonography as a surveillance test when performed in routine clinical practice. Eighty-two patients at increased risk of colon cancer underwent CT colonography followed by conventional colonoscopy on the same morning.

Efficacy of IV Buscopan as a muscle relaxant in CT colonography.

The aim of this study was to examine the efficacy of IV Buscopan as a muscle relaxant in CT colonography in terms of colonic distension and polyp detection, and to determine its particular efficacy in patients with diverticular disease. Seventy-three consecutive patients were randomised to receive IV Buscopan or no muscle relaxant prior to CT colonography. CT colonography was performed using a Siemens Somatom 4-detector multislice CT scanner.

Whole-body MR imaging in the diagnosis of polymyositis.

Objective: Our purpose was to evaluate the use of whole-body MR imaging in the assessment of the extent and distribution of muscle inflammation in patients with polymyositis.

Conclusion: Whole-body turbo short tau inversion recovery imaging is a convenient complete method of evaluating patients with muscle inflammation caused by polymyositis. This imaging technique allows us to evaluate the total inflammatory burden by revealing multiple muscle groups not seen with standard protocols.