Lymphoepithelial cyst of the pancreas: case report with special reference to imaging--pathologic correlation.

We report a case of resected lymphoepithelial cyst of the pancreas with special reference to the imaging-pathologic correlation. Visualization of a multilocular cystic nature with internal heterogeneous hyperechogenicity on ultrasound, hyperdensity on precontrast computed tomography, and granular hypointensity on T2-weighted image due to abundant internal keratin substances were considered to be keys to the differential diagnosis from other cystic lesions of the pancreas.

Intraluminal duodenal diverticulum: MR findings.

We report a case of intraluminal duodenal diverticulum with special reference to its magnetic resonance imaging findings. An intraluminal duodenal fluid collection surrounded by a hypointense rim on T2-weighted or magnetic resonance cholangiopancreatographic images, the shape of which is changed by peristalsis, is considered to be almost diagnostic for intraluminal duodenal diverticulum.

Cirrhotic nodules: association between MR imaging signal intensity and intranodular blood supply.

Purpose: To retrospectively determine whether there is a relationship between the intranodular blood supply evaluated at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) and the magnetic resonance (MR) imaging signal intensity of nodules associated with cirrhosis.

Materials And Methods: Neither institutional review board approval nor informed consent was required for retrospective reviews of medical records and images. One hundred fourteen hepatocellular nodules 10 mm or greater in largest diameter in 58 patients (39 men, 19 women; mean age, 61 years) with cirrhosis were evaluated at CTAP, CTHA, and MR imaging.

Phlebosclerotic colitis: imaging-pathologic correlation.

Objective: The objective of this study was to analyze the imaging findings of phlebosclerotic colitis in comparison with histologic findings.

Conclusion: Calcifications and/or obstructions of the veins of the colonic wall and adjacent mesentery and collateral formation, edematous thickening of the colonic wall, and increased density in the fatty tissue of the surrounding mesentery were features of this rare entity. However, in the early stage of the disease, no definite calcification of the affected veins was observed.

[Effect of saline flush using dual injector on abdominal dynamic contrast enhanced computed tomography].

Purpose: To evaluate the efficacy of the saline flush technique for abdominal multidetector-row computed tomography (CT).

Methods: As a clinical study, 147 patients with chronic hepatic disease were divided into two groups: group A, given 100 cc of contrast material flushed with 50 cc of saline; and group B, given 100 cc of contrast material only. The difference in attenuation values between groups A and B, and cirrhotic liver and non-cirrhotic liver were evaluated.

Solid serous cystadenoma of the pancreas: MR imaging with pathologic correlation.

We report a case of solid type serous cystadenoma of the pancreas. Computed tomographic and magnetic resonance (MR) images showed a hypervascular solid tumor that was difficult to differentiate from endocrine tumor of the pancreas. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on MR cholangiopancreatography, indicating not a solid but rather a cystic nature.

Prevention of hepatic infarction as acute-phase complication of TIPS by temporary balloon occlusion in a patient with primary myelofibrosis.

Severe acute liver dysfunction occurred following transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with massive ascites due to portal hypertension associated with primary myelofibrosis. On US and TIPS venography, we considered that the acute liver ischemia was induced by TIPS. To avoid diffuse hepatic infarction and irreversible liver damage, a balloon catheter was inserted transjugularly into the TIPS tract and occluded it to increase portal venous flow toward the peripheral liver parenchyma.

MRI findings of primary biliary cirrhosis: correlation with Scheuer histologic staging.

Magnetic resonance imaging (MRI) findings of primary biliary cirrhosis (PBC; currently regarded as a vanishing bile duct syndrome) are not established. In this report, we describe our preliminary analysis of the relation between MRI findings and histopathologic staging of PBC and review clinical, morphologic, and MRI findings of PBC especially focusing on the staging of PBC.

Focal sparing of fatty liver in segment II associated with aberrant left gastric vein.

We present a patient with aberrant left gastric vein (LGV) that directly enters the posterior edge of segment II in the liver. The corresponding area was focally spared of fatty liver. We consider that this aberrant LGV contributed to the cause of focal sparing.

Vertebral body osteonecrosis without vertebral collapse.

Study Design: A case of idiopathic focal vertebral body osteonecrosis without vertebral collapse is reported.

Objectives: To report a rare case of focal vertebral osteonecrosis and to clarify the features of imaging studies.

Summary Of Background Data: There are no previous reports describing focal vertebral body necrosis without collapse in the literature.

Groove pancreatic carcinomas: radiological and pathological findings.

The aim of this study was to clarify the characteristics of pancreatic head carcinomas mainly invading the groove between the duodenum and the pancreatic head. Nine patients with pathologically proven pancreatic head carcinomas underwent thin-slice dynamic CT, MR imaging, duodenal endoscopy, and angiography (seven patients). Plate-like masses within the groove region were seen in all cases, which showed hypointensity on T1-weighted images and slight hyperintensity on T2-weighted MR images.

Tumor-associated focal chronic pancreatitis from invasion of the pancreatic duct by common bile duct carcinoma: radiologic-pathologic correlation.

We report a case of tumor-associated focal chronic pancreatitis of the uncinate process of the pancreas. The chronic pancreatitis was secondary to stenosis of the main pancreatic duct from invasion by a common bile duct carcinoma. A feature distinguishing the chronic pancreatitis from pancreatic carcinoma was the localized dilatation of pancreatic duct branches evident in the focal lesion of the uncinate process.

Peritumoral rim enhancement of liver metastasis: hemodynamics observed on single-level dynamic CT during hepatic arteriography and histopathologic correlation.

Purpose: The purpose of this work was to clarify the mechanism of peritumoral rim enhancement of metastatic liver cancer.

Method: Twenty-nine liver metastases of colon cancer were examined by single-level dynamic CT during hepatic arteriography, which was performed without table feed. We analyzed these findings and correlated them with the histopathologic findings.

Cystic duct remnant carcinoma with widespread invasion along the extrahepatic bile duct wall: dynamic CT findings.

We report a case of remnant cystic duct carcinoma with widespread invasion along the common bile duct wall. Thin-slice dynamic computed tomography showed circumferential wall thickening of the extrahepatic bile duct (from the common hepatic duct to the intrapancreatic common bile duct) and the remnant cystic duct. Pathologically, the extrahepatic bile duct wall was thickened due to submucosal tumor infiltration by cystic duct papillary adenocarcinoma.

Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material.

Purpose: To analyze the correlation between intranodular blood supply of borderline lesions (ie, dysplastic nodules or hypovascular well-differentiated hepatocellular carcinoma [HCC] nodules) and their progression to hypervascular classic HCC in cirrhotic livers.

Materials And Methods: One hundred seventy-six borderline lesions seen at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were evaluated in 49 patients with cirrhosis who underwent repeated CTAP and/or CTHA but no therapy. On the basis of CTAP findings, nodules were categorized as group A (showing almost the same portal venous supply as the surrounding liver), group B (showing decreased portal venous supply) or group C (showing partially absent portal venous supply); on the basis of CTHA findings, nodules were categorized as group I (showing almost the same arterial supply as the liver), group II (showing decreased arterial supply), or group III (showing partially increased arterial supply).

Accumulation of iodized oil within the nonneoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization.

Purpose: After transcatheter arterial embolization (TAE) with iodized oil (Lipiodol), a relatively dense accumulation of Lipiodol is often seen in the nontumorous liver adjacent to a hypervascular hepatocellular carcinoma (HCC) nodule. We compared this phenomenon with the findings obtained with single-level dynamic CT during hepatic arteriography (SLDCTHA) and presumed its possible mechanism.

Methods: Fifty-six patients with HCC underwent hepatic angiography including SLDCTHA followed by segmental or subsegmental TAE with a mixture of an anticancer drug and Lipiodol.

Peritumoral spared area in fatty liver: correlation between opposed-phase gradient-echo MR imaging and CT arteriography.

Background: The purpose of the present study was to evaluate the magnetic resonance findings of a spared area of fatty liver caused by hepatic tumors and clarify the etiology of this phenomenon by computed tomographic (CT) arteriography.

Methods: Six patients with hepatic tumors (metastases from colon cancer, n = 3; breast cancer, n = 2; hepatocellular carcinoma, n = 1) were examined. In-phase (IP) and opposed-phase (OP) T1-weighted spoiled gradient-echo images were obtained.

Pseudolesion in segment IV of the liver adjacent to the falciform ligament caused by drainage of the paraumbilical vein: demonstration by power Doppler ultrasound.

A case of a pseudolesion in segment IV of the liver, adjacent to the falciform ligament, was observed on conventional CT and CT during arterial portography. The pseudolesion was caused by drainage of the paraumbilical vein. Power Doppler ultrasound was helpful in recognizing this pseudolesion by depicting that the paraumbilical vein was connected to vessels in this area.

CT arteriographic confirmation of focal hepatic fatty infiltration adjacent to the falciform ligament associated with drainage of inferior vein of Sappey: a case report.

We experienced a case of focal fatty infiltration in the anteromedial edge of the medial segment of the liver adjacent to the falciform ligament associated with advanced esophageal cancer. By using CT during selective right internal thoracic arteriography, we confirmed that the inferior vein of Sappey drained into the area of focal fatty infiltration. This is the first case to directly establish the relationship between drainage of the inferior vein of Sappey and occurrence of focal fatty infiltration of the liver.

Dynamic CT of hepatic abscesses: significance of transient segmental enhancement.

Objective: The purpose of this study was to evaluate dynamic CT findings of hepatic abscesses, especially segmental hepatic enhancement, and to clarify the cause.

Materials And Methods: Twenty-four abscesses in eight patients were examined by early (30 sec) and late phase (90 sec) dynamic CT. Patients underwent abscess drainage (n = 1), hepatic resection (n = 2), or antibiotic therapy (n = 5).

MR imaging of focal splenic extramedullary hematopoiesis in polycythemia vera: case report.

We report a case with focal mass-like lesion of the spleen in polycythemia vera. Magnetic resonance imaging of the lesion showed homogeneous hyperintensity on T2-weighted images, with progressive enhancement on dynamic magnetic resonance images after bolus injection of gadolinium. The magnetic resonance features of focal splenic extramedullary hematopoiesis have not been previously reported.

Intrahepatic biliary calculi: correlation of unusual MR findings with pathologic findings.

We report a case of intrahepatic biliary calculi. A localized dilated intrahepatic duct of the left lateral segment of the liver was filled with material that showed marked hyperintensity on T1- and T2-weighted magnetic resonance (MR) images. These MR findings are unusual for intrahepatic stones.

Enlargement of hilar periportal space: a sign of early cirrhosis at MR imaging.

The purpose of this study was to determine whether the finding of an enlarged hilar periportal space is a sign for early cirrhosis at magnetic resonance (MR) imaging. Forty-one pathologically proved cirrhotic patients in the early stage of disease who did not show conventional imaging findings of cirrhosis (early cirrhosis group) and 47 patients without history of chronic liver diseases (control group) were included in this study. MR images were qualitatively and quantitatively evaluated for the presence of enlargement of the periportal space.