Management of localized prostate cancer and an incidental ureteral duplication with upper pole ectopic ureter inserting into the prostatic urethra.

Ectopic ureters are rare congenital malformations of the renal system that most commonly present in females. It is extremely rare to encounter an ectopic ureter in an older man undergoing radical prostatectomy. We report herein a case of a 66-year-old man with prostate cancer and a complete duplication of the left renal collecting system, with an upper pole ectopic ureter and associated normal functioning renal parenchyma entering into the prostatic urethra.

Diffusion-weighted MR imaging of the kidneys and the urinary tract.

There is currently a growing interest in applications of diffusion-weighted imaging (DWI) in the abdomen and pelvis. DWI provides original functional information where the signal and contrast are determined by the microscopic mobility of water. DWI can provide additional information over conventional MR sequences, and could potentially be used as an alternative to contrast-enhanced sequences in patients with chronic renal insufficiency at risk of nephrogenic systemic fibrosis.

MRI of pelvic floor dysfunction: dynamic true fast imaging with steady-state precession versus HASTE.

Objective: The objective of our study was to retrospectively compare the degree of pelvic organ prolapse shown on dynamic true fast imaging with steady-state precession (FISP) versus HASTE sequences in symptomatic patients.

Materials And Methods: Fifty-nine women (mean age, 57 years) with suspected pelvic floor dysfunction underwent MRI using both a sagittal true FISP sequence, acquired continuously during rest alternating with the Valsalva maneuver, and a sagittal HASTE sequence, acquired sequentially at rest and at maximal strain. Data sets were evaluated in random order by two radiologists in consensus using the pubococcygeal line (PCL) as a reference.

Chronic hepatitis: role of diffusion-weighted imaging and diffusion tensor imaging for the diagnosis of liver fibrosis and inflammation.

Purpose: To determine the diagnostic performance of liver apparent diffusion coefficient (ADC) measured with conventional diffusion-weighted imaging (CDI) and diffusion tensor imaging (DTI) for the diagnosis of liver fibrosis and inflammation.

Materials And Methods: Breathhold single-shot echo-planar imaging CDI and DTI with b-values of 0 and 500 second/mm(2) was performed in 31 patients with chronic liver disease and 13 normal volunteers. Liver biopsy was performed in all patients with liver disease with a median delay of two days from MRI.

Early hepatocellular carcinoma: pathology, imaging, and therapy.

Background: In 1987, Japanese researchers proposed to define the pathological concept of early hepatocellular carcinoma (HCC). However, there are some conceptual differences between the East and the West in the diagnosis and treatment of early HCC.

Methods: To provide up-to-date data for making a worldwide consensus, this article has collected six papers focused on the management of early HCC, which were presented in the Fifth International Meeting of "Hepatocellular Carcinoma: Eastern and Western Experiences" in Houston in January 2007.

Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging.

Purpose: To retrospectively compare diffusion-weighted (DW) magnetic resonance (MR) imaging with standard breath-hold T2-weighted MR imaging for focal liver lesion (FLL) detection and characterization, by using consensus evaluation and other findings as the reference standard.

Materials And Methods: Approval for this retrospective HIPAA-compliant study was obtained from the institutional review board; informed consent was waived. Fifty-three consecutive patients (30 men, 23 women; mean age, 60.

Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging--initial experience.

Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. The purpose of this study was to prospectively evaluate sensitivity and specificity of various estimated perfusion parameters at three-dimensional (3D) perfusion magnetic resonance (MR) imaging of the liver in the diagnosis of advanced liver fibrosis (stage >or= 3), with histologic analysis, liver function tests, or MR imaging as the reference standard. Whole-liver 3D perfusion MR imaging was performed in 27 patients (17 men, 10 women; mean age, 55 years) after dynamic injection of 8-10 mL of gadopentetate dimeglumine.

Dynamic MR angiography of upper extremity vascular disease: pictorial review.

Unlike peripheral lower extremity vascular disease, upper extremity vascular disease is relatively uncommon. While atherosclerosis and embolic disease are the most common causes of upper extremity ischemia, a wide variety of systemic diseases and anatomic abnormalities can affect the upper extremity. Upper extremity ischemia poses a significant diagnostic and therapeutic challenge for both clinicians and radiologists.

Perspectives on body MR imaging at ultrahigh field.

As investigators consider approaching the challenge of MR imaging at field strengths above 3T, do they follow the same paradigm, and continue to work around the same problems they have encountered thus far at 3T, or do they explore other ways of answering the clinical questions more effectively and more comprehensively? The most immediate problems of imaging at ultrahigh field strength are not unfamiliar, as many of them are still pressing issues at 3T: radiofrequency coils, B1 homogeneity, specific absorption rate, safety, B0 field homogeneity, alterations in tissue contrast, and chemical shift. In this article, these issues are briefly reviewed in terms of how they may affect image quality at field strengths beyond 3T. The authors propose various approaches to overcoming the challenges, and discuss potential applications of ultrahigh field MR imaging as it applies to specific abdominal, pelvic, peripheral vascular, and breast imaging protocols.

Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience.

Objective: The purpose of this study was to evaluate our preliminary experience using diffusion-weighted MRI for quantification of liver fibrosis.

Subjects And Methods: Diffusion-weighted MRI with single-shot echo-planar technique at b values of 50, 300, 500, 700, and 1,000 s/mm2 was prospectively performed on 23 patients with chronic hepatitis and on seven healthy volunteers. The apparent diffusion coefficient (ADC) was measured in four locations in the liver.

Intrahepatic portal cavernoma as an indication for liver transplantation.

Cavernous transformation of the portal vein (portal cavernoma) consists of a periportal or/and intrahepatic venous collateral network, developed as a result of acute or long-standing portal vein thrombosis. Better control of hemorrhagic and thrombotic complications in the patients with portal cavernoma substantially improves their life span and the clinical outcome. However, biliary complications that occur in the late stages of this disease have been recently recognized as challenging management issues because they recur and are difficult to treat.

Body and cardiovascular MR imaging at 3.0 T.

Potential advantages of magnetic resonance (MR) imaging at 3 T include higher signal-to-noise ratios, better image contrast, particularly in gadolinium-enhanced applications, and better spectral separation for spectroscopic applications. In terms of clinical imaging, these advantages can mean higher-spatial-resolution images, faster imaging, and improved MR spectroscopy. However, achieving superior imaging and spectroscopic quality at 3 T can be challenging.

Imaging the female pelvis at 3.0 T.

Three-Tesla whole body imaging is rapidly becoming part of routine clinical practice. Although it is generally thought that pelvic imaging at 3.0 T will be beneficial because of increased signal to noise and greater spectral separation, adjustments in protocol and sequence parameters are necessary to optimize image quality.

Diagnostic imaging of hepatocellular carcinoma in patients with cirrhosis before liver transplantation.

1. The lack of whole-liver explant correlation has led to an overestimation of the sensitivity of imaging tests for the diagnosis of HCC in the radiological literature. 2.

Opposed-phase MRI for fat quantification in fat-water phantoms with 1H MR spectroscopy to resolve ambiguity of fat or water dominance.

Objective: The purpose of the study was to quantify the fat fraction in nine fat-water phantoms containing 0-80% fat using opposed-phase imaging with the qualitative guidance of 1H MR spectroscopy (MRS), which was used by observer 1 to visually assess the sizes of the water and fat peaks to apply two alternative mathematic formulas for the calculation of the fat fraction. In addition, the fat fraction was also quantified directly with 1H MRS as an independent method by two observers (observers 2 and 3).

Conclusion: The fat fraction calculated with opposed-phase imaging (FF(OPI)) and that calculated with 1H MRS (FF(MRS)) correlated well with the known fat fractions of the phantoms (FF(P)): r = 0.

Hepatocellular carcinoma in the cirrhotic liver: gadolinium-enhanced 3D T1-weighted MR imaging as a stand-alone sequence for diagnosis.

Purpose: To retrospectively assess the usefulness of contrast material-enhanced T1-weighted magnetic resonance (MR) imaging alone and with T2-weighted MR imaging in the diagnosis of hepatocellular carcinoma (HCC).

Materials And Methods: A waiver of informed consent and institutional review board approval for this retrospective study were granted. The study was HIPAA compliant.

[MR spectroscopic imaging for evaluation of prostate cancer].

MR spectroscopic imaging (MRSI) provides a noninvasive method of evaluating metabolic markers of prostate cancer or healthy prostatic tissue (the metabolites choline and citrate), and is performed in conjunction with high-resolution MR anatomic imaging. Multiple studies have showed the incremental role of MRSI combined with the anatomical information provided by MRI for assessment of cancer location and extent within the prostate, staging, and cancer aggressiveness. In addition, MRSI has a potential role for pre- and post-treatment evaluation in non surgical patients.

Growth rate of hepatocellular carcinoma: evaluation with serial computed tomography or magnetic resonance imaging.

Objective: To evaluate the growth rate of untreated hepatocellular carcinoma (HCC) by calculating tumor volume doubling time (TVDT) on serial computed tomography (CT) or magnetic resonance imaging (MRI) and to predict TVDT based on initial tumor size.

Methods: Sixteen untreated HCCs in 11 patients with cirrhosis who underwent serial CT or MRI at our institution were retrospectively identified. Two independent readers recorded bidimensional measurements for all tumors, which were used to determine tumor volume (TV).

Imaging of bone erosion in rheumatoid arthritis.

Rheumatoid arthritis (RA) is the most common type of inflammatory arthritis, with a prevalence of 1% in the United States. Recently introduced disease-modifying antirheumatic drugs have been extremely successful in preventing irreversible joint damage, particularly if initiated early. Accordingly, accurate and early diagnosis of RA has become imperative.

Magnetic resonance imaging of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC), the most common primary hepatic malignancy, usually develops in patients with cirrhosis, growing sequentially from low-grade dysplastic nodules to frank malignant HCC. Its recognition is critical because curative treatment and prognosis require early diagnosis. Survival in patients with HCC relates directly to the number, size, and extent of lesions at diagnosis.

Parallel imaging and diffusion tensor imaging for diffusion-weighted MRI of the liver: preliminary experience in healthy volunteers.

Objective: Our aim was to determine whether parallel imaging and diffusion tensor imaging affect the measurement of apparent diffusion coefficient (ADC) during diffusion-weighted MRI of the liver in healthy volunteers.

Subjects And Methods: We performed breath-hold single-shot echo-planar diffusion-weighted MRI of the liver in 10 healthy volunteers using conventional diffusion, conventional diffusion with parallel imaging, and diffusion tensor with parallel imaging sequences. TE values for the three sequences were 83, 74, and 63, respectively.

Rheumatoid arthritis of the hand and wrist: comparison of three imaging techniques.

Objective: The purpose of this study was to compare the relative results from conventional high-field-strength 1.5-T MRI, 0.2-T low-field-strength dedicated extremity MRI, and radiography to detect and grade bone erosions, joint-space narrowing, and synovitis in the hands and wrists of patients with rheumatoid arthritis.

Biliary tract depiction in living potential liver donors: comparison of conventional MR, mangafodipir trisodium-enhanced excretory MR, and multi-detector row CT cholangiography--initial experience.

Purpose: To compare biliary tract depiction in living potential liver donors at conventional magnetic resonance (MR), mangafodipir trisodium-enhanced excretory MR, and multi-detector row computed tomographic (CT) cholangiography.

Materials And Methods: Eight living potential liver donors underwent iodipamide meglumine-enhanced CT cholangiography. Eight different potential liver donors then underwent conventional MR cholangiography and mangafodipir trisodium-enhanced excretory MR cholangiography.