Preoperative Identification and Outcomes of Vascular Variants on Surgery for Chronic Pancreatitis.

Introduction: Surgeries for chronic pancreatitis are tailored based on disease process and either include parenchymal-preserving surgeries or total pancreatectomy with or without islet cell autotransplantation. It is critical to account for vascular variants as injuries to these are associated with short- and long-term morbidity and mortality. There is a lack of contemporary data on the true incidence of aberrant arterial anatomy, and it is likely to be underreported by nonhepatobiliary radiologists.

Selection of parenchymal preserving or total pancreatectomy with/without islet cell autotransplantation surgery for patients with chronic pancreatitis.

Background: The selection of surgery between parenchymal preserving (PPS) and total pancreatectomy (TP) with/without islet cell autotransplantation (IAT) for chronic pancreatitis (CP) patients varies based on multiple factors with a scarcity in literature addressing both at the same time. The aim of this manuscript is to present an algorithm for the surgery selection based on dominant area of disease, ductal dilatation, and glycemic control and compare outcomes.

Methods: From 2017 to 2021, CP patients offered surgery at a single institution were retrospectively evaluated.

Portal flow dynamics after total pancreatectomy and autologous islet cell transplantation.

Background: Portal vein thrombosis (PVT) is a serious complication of total pancreatectomy and autologous islet cell transplant (TPAIT); therefore, portal flow dynamics are monitored by Doppler ultrasound postoperatively. The practical value of scheduled Doppler ultrasound examinations and the relationship between portal vein velocity, liver function, and complications have not been clearly studied.

Methods: A retrospective review of 16 TPAIT was performed.

MRI in pregnancy: Indications and practical considerations.

There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed.

Effects of raltegravir combined with tenofovir/emtricitabine on body shape, bone density, and lipids in African-Americans initiating HIV therapy.

Background: Raltegravir (RAL) plus tenofovir/emtricitabine (TDF/FTC) is a recommended initial antiretroviral regimen. A substantial proportion of persons diagnosed with HIV infection and starting antiretrovirals in the U.S.

Cardiovascular MRI in Detection and Measurement of Aortic Atheroma in Stroke/TIA patients.

Background: Aortic Atheroma (AoA) is an independent risk factor for new and recurrent stroke. AoA ulceration and mobility are associated with an increased risk for brain embolism. Transesophageal echocardiography (TEE) is the gold standard for detection and measurement of AoA in stroke/TIA patients.

Spontaneous portoazygos shunt in a patient with portal hypertension.

We present a case of spontaneous portoazygos shunt in a patient with liver cirrhosis and portal hypertension. The shunt was incidentally detected by abdominal magnetic resonance imaging for routine evaluation of liver cirrhosis. Multiplanar reconstruction images demonstrated the portal vein communicating with the azygos vein that was dilated and tortuous along its course to the mediastinum.

Image-guided optimization of the ECG trace in cardiac MRI.

Improper electrocardiogram (ECG) lead placement resulting in suboptimal gating may lead to reduced image quality in cardiac magnetic resonance imaging (CMR). A patientspecific systematic technique for rapid optimization of lead placement may improve CMR image quality. A rapid 3 dimensional image of the thorax was used to guide the realignment of ECG leads relative to the cardiac axis of the patient in forty consecutive adult patients.

Overlap syndrome of autoimmune chronic liver diseases: MRI findings.

Purpose: To describe the MR findings of overlap syndromes of autoimmune chronic liver diseases.

Methods: Review of clinical and radiological databases between March 2001 and July 2008 for patients with a clinical diagnosis and liver biopsy features compatible with overlap syndrome who had also undergone an abdominal MRI yielded 15 adult patients. MR features of overlap syndrome were reviewed by two radiologists by consensus.

Helical computed tomography inaccuracy in the detection of pulmonary metastases: can it be improved?

Background: In thoracic surgery, manual lung palpation for detection of pulmonary metastases during resection is the standard of care, despite improvements in computed tomography (CT) imaging. In our previous study based on chart review alone, the accuracy of helical CT in the detection of pulmonary metastases was surprisingly low, with a sensitivity of 78%. We hypothesized that this may be improved by scan interpretation with adequate clinical history and focused documentation of all pulmonary lesions, and may be influenced by the training of the reader.

Focal liver lesions evaluated by MR imaging.

Magnetic resonance signal intensity of focal liver lesions is the result of their histological and cytological features. Therefore, analysis of lesion signal intensity and enhancement patterns obtained with magnetic resonance imaging is essential for the differential diagnosis of focal liver lesions. In this article, we review the magnetic resonance imaging features of the most common focal liver lesions.

Aneurysm of the inferior vena cava: case report.

Venous aneurysms are uncommon. Despite their infrequency, venous aneurysms can present with significant clinical complications such as thrombosis, pulmonary embolism, and death. In this report, we present the case of a thrombosed inferior vena cava aneurysm discovered in a 16-year-old male who had deep vein thrombosis of the right lower extremity.

Future directions in body magnetic resonance imaging.

Technologic innovations in instrumentation and contrast agents naturally lead to new clinical and research applications in body MRI. Although long-range predictions of innovation are an uncertain process, short-term trends in development are more readily discernable. This review will provide examples of recent developments in magnetic resonance spectroscopic imaging, contrast agent development and molecular imaging, instrumentation, post-processing, and screening in an attempt to describe areas of active research.

Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI.

Objective: The objective of our study was to determine the sensitivity and specificity of gadolinium-enhanced 3D gradient-echo (GRE) MR images in the detection of pancreatic cancer.

Conclusion: Dynamic gadolinium-enhanced 3D GRE images are both sensitive and specific in the detection of pancreatic cancer. Our study shows that the identification of pancreatic cancer using these images can be performed with a high degree of confidence and accuracy, making them very useful in the detection of pancreatic cancer.

MR imaging findings in autoimmune hepatitis: correlation with clinical staging.

Purpose: To retrospectively evaluate the morphologic and enhancement features of the liver on magnetic resonance (MR) images obtained in patients with autoimmune hepatitis (AIH) and to determine if there is a correlation between MR imaging findings and severity of clinical disease as measured with the Mayo end-stage liver disease (MELD) score.

Materials And Methods: This study was compliant with the Health Insurance Portability and Accountability Act and approved by the institutional review board. The need for informed consent was waived.

The Australian EEG database.

The Australian EEG Database is a web-based de-identified searchable database of 18,500 EEG records recorded at a regional public hospital over an 11-year period. Patients range in age from a premature infant born at 24 weeks gestation, through to people aged over 90 years. This paper will describe the history of the database, the range of patients represented in the database, and the nature of the text-based and digital data contained in the database.

Future horizons in MR imaging.

In this article, we defined the major areas of active research in clinical MR imaging. Further increases in the number of parallel coils within an imaging array and in advances in parallel imaging pulse sequences and postprocessing will lead to further reductions in imaging time analogous to the impact of multidetector CT on helical CT. The synergism between parallel and high-field imaging will aid the development of high-field imaging.

MRI findings of primary small-cell carcinoma of kidney.

We report the MRI findings of primary small-cell carcinoma of the kidney (PSCCK) in a 59-year-old female. This tumor appeared as a 16-cm mass that arose from the right kidney. This lesion had diminished signal on T1-weighted images and heterogeneous mixed signal on T2-weighted images.

MRI of acute abdominal and pelvic pain in pregnant patients.

Objective: The purpose of this study was to show the usefulness of MRI in the evaluation of pregnant women with acute abdominal or pelvic pain.

Subjects And Methods: All MRI studies of pregnant patients who were referred for examination because of acute abdominal or pelvic pain between June 2002 and May 2004 were included in this study (n=29). The use of MRI was at the discretion of the clinician.

Immunoblastic large B-cell lymphoma of the peripancreatic head region: MR findings.

We report the magnetic resonance (MR) appearance of a large B-cell lymphoma in the peripancreatic head region, in a 38-year-old male who presented with a 1-month history of pruritus and jaundice. Routine laboratory examination at presentation revealed an elevated bilirubin. The tumor was a large, solitary well-defined mass with no evidence of necrosis, which showed mild diffuse heterogeneous enhancement.

Four-dimensional spectral-spatial imaging using projection reconstruction.

An n-dimensional (n-D) filtered backprojection image reconstruction algorithm has been developed and used in the reconstruction of 4-D spectral-spatial magnetic resonance imaging (MRI) data. The algorithm uses n-1 successive stages of 2-D filtered backprojection to reconstruct an n-D image. This approach results in a reduction in computational time on the order of N(n-2) relative to the single-stage technique, where N(n) is the number of elements in an n-D image.

Sources of the increased longitudinal relaxation rates observed in melanotic melanoma. An in vitro study of synthetic melanins.

Researchers have suggested that the increased longitudinal relaxation rates (1/T1) of solvent water protons often found in melanoma result either from the paramagnetism of stable free radicals occurring in melanin or from that of methemoglobin in nonacute hemorrhagic regions of the tumor. However, field-cycling relaxometry and model solutions of synthetic melanin produced data which show that free radicals in melanin do not contribute significantly to 1/T1; instead, aggregation of melanin into macromolecular particles and binding of biologically-common paramagnetic metal ions (ie Fe3+, Mn2+, and Cu2+) to melanin effectively do increase 1/T1. These data have been combined with published histochemical data on melanin-containing tissues, while disregarding any additional effect related to hemorrhage.