Transjugular intrahepatic portosystemic shunt (TIPS) complications: what diagnostic radiologists should know.

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective therapy for portal hypertension complications and can successfully treat variceal bleeding and refractory ascites. Although TIPS is relatively safe, procedural- or shunt-related morbidity can reach 20%, and procedural complications have a fatality rate of 2%. Delayed recognition and treatment of TIPS complications can lead to life-threatening clinical scenarios.

Bile duct anatomical variations: Relevance for liver division and preparing left split liver grafts for pediatric transplantation: Cohort study.

Background: liver lateral section graft is the most common graft type used for transplantation in children worldwide. Compared to whole liver grafts, a higher rate of biliary complications has been described. Historically, 2 techniques have been described for transection of liver - trans-hilar or trans-umbilical parenchymal transection.

Imaging of calcified hepatic lesions: spectrum of diseases.

Hepatic calcifications have been increasingly identified over the past decade due to the widespread use of high-resolution Computed Tomography (CT) imaging. Calcifications can be seen in a vast spectrum of common and uncommon diseases, from benign to malignant, including cystic lesions, solid neoplastic masses, and inflammatory focal lesions. The purpose of this paper is to present an updated review of CT imaging findings of a wide range of calcified hepatic focal lesions, which can help radiologists to narrow the differential diagnosis.

Resting-State Functional Connectome in Patients with Brain Tumors Before and After Surgical Resection.

Purpose: High-grade glioma surgery has evolved around the principal belief that a safe maximal tumor resection improves symptoms, quality of life, and survival. Mapping brain function has been recently improved by resting-state functional magnetic resonance imaging (rest-fMRI), a novel imaging technique that explores networks connectivity at "rest."

Methods: This prospective study analyzed 10 patients with high-grade glioma in whom rest-fMRI connectivity was assessed both in single-subject and in group analysis before and after surgery.

Imaging of hepatic hemangioma: from A to Z.

The hemangioma is the most common solid lesion of the liver. Therefore, radiologists must know the typical and atypical imaging findings of this lesion in order to reach a correct diagnosis and avoid diagnostic errors. However, only few papers have comprehensively described the entire spectrum of atypical and uncommon imaging features.

Budd-Chiari Syndrome and hepatic regenerative nodules: Magnetic resonance findings with emphasis of hepatobiliary phase.

Budd-Chiari syndrome (BCS) is a disorder with numerous causes that is a result of hepatic outflow obstruction, in the absence of right heart failure or constrictive pericarditis. Acute Budd-Chiari syndrome is uncommon and clinically characterized by ascites, hepatomegaly, and hepatic insufficiency. In the majority of cases, patients present with chronic BCS, showing a dysmorphic liver disease with variable fibrosis deposition.

Magnetic resonance imaging of fibropolycystic liver disease: the spectrum of ductal plate malformations.

Fibropolycystic liver diseases, also known as ductal plate malformations, are a group of associated congenital disorders resulting from abnormal development of the biliary ductal system. These disorders include congenital hepatic fibrosis, biliary hamartomas, polycystic liver disease, choledochal cysts and Caroli disease. Recently, it has been thought to include biliary atresia in this group of diseases, because ductal plate malformations could be implicated in the pathogenesis of this disease.

Multimodality imaging of the Meso-Rex bypass.

Extrahepatic portal vein obstruction (EHPVO) is the most common cause of upper gastrointestinal bleeding in children. It is defined as thrombosis of the extrahepatic portal vein with or without extension to the intrahepatic portal veins. The Meso-Rex shunt is the gold standard treatment in children with favorable anatomy since it restores physiological portal liver reperfusion.

Intrahepatic mass-forming cholangiocarcinoma: enhancement pattern on Gd-BOPTA-MRI with emphasis of hepatobiliary phase.

Purpose: To describe the Gd-BOPTA MRI findings of intrahepatic mass-forming type cholangiocarcinomas (IMCs), with emphasis on the hepatobiliary phase (HBP).

Methods: We reviewed retrospectively 29 IMC patients who underwent Gd-BOPTA-MRI between June, 2004 and June, 2014. Images were acquired prior to, and after, administration of 15-20 mL of Gd-BOPTA in the dynamic phase (arterial phase, portal venous phase, and 3-5 min phase), 10-15-min late phase, and 2-3 h HBP phase.

Multidisciplinary imaging of liver hydatidosis.

Liver hydatidosis is a parasitic endemic disease affecting extensive areas in our planet, a significant stigma within medicine to manage because of its incidence, possible complications, and diagnostic involvements. The diagnosis of liver hydatidosis should be as fast as possible because of the relevant complications that may arise with disease progression, involving multiple organs and neighboring structures causing disruption, migration, contamination. The aim of this essay is to illustrate the role of imaging as ultrasonography (US), multi detector row computed tomography, and magnetic resonance imaging (MRI) in the evaluation of liver hydatidosis: the diagnosis, the assessment of extension, the identification of possible complications and the monitoring the response to therapy.

Multidetector CT-guided endovascular treatment of a splenic artery aneurysm in a child with split-liver transplant and surgically ligated splenic artery origin.

We report the case of a child who underwent left lateral split-liver transplantation for biliary atresia and surgical ligation of the origin of the splenic artery at the time of the transplantation. Post-transplant portal vein thrombosis was initially treated with a meso-rex shunt. This shunt subsequently thrombosed and was replaced by a splenorenal shunt.

Thoracic complications following lung transplantation: 64-MDCT findings.

The aim of this review is to present the wide spectrum of common and uncommon thoracic complications that can affect the lung after transplantation. These complications were analyzed using 64 multi-detector row helical CT (MDCT). Sixty-four MDCT techniques and parameters are illustrated.

Biliary cystadenoma with bile duct communication depicted on liver-specific contrast agent-enhanced MRI in a child.

Biliary cystadenoma is a benign, but potentially malignant, cystic neoplasm of the biliary ducts occurring most commonly in middle-aged females and very rarely in children. We present a 9-year-old boy with biliary cystadenoma, diagnosed by MRI using a new liver-specific contrast agent (gadoxetic acid) that is eliminated by the biliary system. The images clearly demonstrate the communication between the multiloculated cystic mass and the biliary tree, suggesting the possibility of biliary cystadenoma.

Diffuse liver diseases in neonatal and pediatric liver transplant candidates: a pictorial essay.

A wide spectrum of common and uncommon diffuse liver diseases affecting neonatal and pediatric liver transplant candidates is presented and analyzed using 16 and 64 multi-detector row helical CT (MDCT) and 1.5 T MRI fast imaging. Correlation of imaging findings and explanted liver or histology is illustrated in representative cases.

Focal liver diseases in neonatal and pediatric liver transplant candidates: a pictorial essay.

The aim of this review is to present the wide spectrum of common and uncommon focal liver diseases affecting neonatal and pediatric liver transplant candidates, analyzed using ultrasonography (US), 16- or 64-multidetector row helical CT (MDCT) and 1.5-T magnetic resonance (MR) fast imaging. Correlation of imaging findings and explanted liver or histology is illustrated in representative cases.

Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants.

Aim: To define the prevalence of different multidetector-row computed tomography (MDCT) vascular patterns and their histopathological correlation with liver explants, and to evaluate the accuracy of MDCT for the diagnosis of hepatocellular carcinoma (HCC).

Methods: We retrospectively reviewed 125 cirrhotic patients imaged by MDCT before liver transplantation. Three main vascular patterns were identified: hypervascular lesion with washout (Hyper-L-Wo), hypervascular lesion without washout (Hyper-L) and non-hypervascular lesion (Hypo-L).

Interventional radiology procedures in pediatric patients with complications after liver transplantation.

Interventional radiologists play a key role in treating vascular and nonvascular complications of pediatric liver transplantation, improving graft and patient survival and in most cases avoiding the need for surgical revision or repeat transplantation. The interventional radiology procedures most commonly used in this context include percutaneous and transjugular liver biopsies performed with ultrasonographic and fluoroscopic guidance for the diagnosis of graft disease; angioplasty and stent placement for treatment of vascular and biliary occlusion, stenosis, and stricture; and catheter placement for drainage of fluid collections. Since interventional radiology procedures themselves may lead to complications, it is important that the radiologist be familiar with the indications for a particular procedure, the technical considerations, and the expected results, as well as with normal and abnormal postintervention imaging appearances.

Interventional radiology procedures in adult patients who underwent liver transplantation.

Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

Changes in the volume and density of calvarial split bone grafts after alveolar ridge augmentation.

Objectives: One main problem occurring after bone grafting is resorption, leading to insufficient bone volume and quality, and may subsequently cause dental implant failure. Comparison of graft volume and bone density of iliac crest and calvarial transplants determined by animal studies demonstrates significantly lower resorption of bone grafts harvested from the skull. This paper is the first clinical study evaluating bone volume and density changes of calvarial split bone grafts after alveolar ridge reconstruction.

Development of a low-cost DICOM-server for teaching and research purposes.

Purpose: This paper describes our experience in developing a DICOM (Digital Imaging and Communications in Medicine) server based on widely available personal computers enabling to use X-ray digital images for teaching and scientific purposes.

Materials And Methods: The system is based on a DICOM server running on a widely used personal computer. The selected DICOM images are collected directly from the radiological equipment or from a dedicated 3D image processing workstation through a LAN connection and converted into one of the standard formats (JPEG or GIF) to allow their direct importing into multimedia presentations for teaching or scientific purposes.