Usefulness of conventional MRI sequences and diffusion-weighted imaging in differentiating malignant from benign portal vein thrombus in cirrhotic patients.

Objective: The objective of our study was to determine the value of diffusion-weighted imaging (DWI) and conventional MRI (non-DWI sequences) in differentiating benign portal vein thrombus (PVT) from malignant PVT in cirrhotic patients.

Materials And Methods: A retrospective search of the department of radiology's MRI database of examinations performed from October 2006 through December 2010 for "portal vein thrombosis" and "cirrhosis" and "hepatocellular cancer" was performed. Patients who underwent diagnostic DWI and had thrombus shown to be rapidly (< 3 months) increasing in size despite anticoagulation therapy were considered to have malignant PVT (n = 16 cases) and patients with MRI findings showing stability or reduction in the extent of thrombus over a 12-month follow-up were considered to have benign PVT (n = 20 cases).

Secretin-enhanced MR cholangiopancreatography: spectrum of findings.

Magnetic resonance cholangiopancreatography (MRCP) is the most effective, safe, noninvasive magnetic resonance (MR) imaging technique for the evaluation of the pancreaticobiliary ductal system. The MRCP imaging technique has substantially improved during the past 2 decades and is based mainly on the acquisition of heavily T2-weighted MR images, with variants of fast spin-echo sequences. MRCP can also be performed by utilizing the hormone secretin, which stimulates a normal pancreas to secrete a significant amount of fluid while transiently increasing the tone of the sphincter of Oddi.

Use of diffusion-weighted MRI to differentiate chronic pancreatitis from pancreatic cancer.

Objective: The purpose of this study was to compare diffusion-weighted MRI (DWI) and conventional (non-DWI) MRI sequences in differentiating mass-forming chronic pancreatitis from pancreatic cancer.

Materials And Methods: A retrospective cohort study included 36 patients who underwent pancreatic resection for pancreatic cancer (n = 13) and chronic pancreatitis (n = 23) after preoperative MRI with DWI. Two independent reviewers assessed the DW images for signal intensity and apparent diffusion coefficient (ADC) values.

Response criteria in oncologic imaging: review of traditional and new criteria.

There has been a proliferation and divergence of imaging-based tumor-specific response criteria over the past 3 decades whose purpose is to achieve objective assessment of treatment response in oncologic clinical trials. The World Health Organization (WHO) criteria, published in 1981, were the first response criteria and made use of bidimensional measurements of tumors. The Response Evaluation Criteria in Solid Tumors (RECIST) were created in 2000 and revised in 2009.

MRCP in patient care: a prospective survey of gastroenterologists.

Objective: MRCP is increasingly used to evaluate pancreaticobiliary disease, yet its effect on patient care is unknown. The purpose of this study was to measure the effect of MRCP on referring physicians' initial diagnoses, the physicians' confidence in their diagnoses, and the influence of MRCP results on clinical management.

Subjects And Methods: We prospectively surveyed gastroenterologists who referred patients for nonurgent MRCP for pancreaticobiliary evaluation.

CT of the hip prosthesis: appearance of components, fixation, and complications.

Multidetector computed tomography (CT) is an excellent way to supplement the radiographic evaluation of problematic hip prostheses. Multidetector CT is well suited for assessing periprosthetic bone, determining precise acetabular cup position, and evaluating periprosthetic fluid collections or ossified masses. Metal implants pose a number of challenges in the performance and interpretation of CT examinations.

Learning to interpret the extracardiac findings on coronary CT angiography examinations.

Coronary computed tomography angiography (CTA) plays an important role in the identification of coronary artery disease in low- to intermediate-risk patients. Even with a "restrictive" field of view, coronary CTA data sets will include visualization of structures adjacent to the heart, including the thoracic great vessels, pericardium, mediastinum, lungs, and bones. CT images enable detailed assessment of these structures, at times identifying a potential noncoronary cause of the patient's presenting symptom.

Outcomes of pancreas allografts procured simultaneously with an isolated intestine allograft: single-center and national data.

Background: Simultaneous procurement of pancreas and isolated intestine allografts from the same donor may compromise one graft or both given the shared vasculature between these two organs. This study reports the transplant outcomes for pancreas allografts procured simultaneously with an intestine graft.

Methods: Separate analyses are reported from (1) 10-year US national data obtained from the United Network for Organ Sharing database including all donors from 2000 to 2010 in whom both the pancreas and isolated intestine were procured and transplanted into separate recipients and (2) local, single-center data for all donors of simultaneous pancreas and isolated intestine procurement.

Peritoneal and retroperitoneal anatomy and its relevance for cross-sectional imaging.

It is difficult to identify normal peritoneal folds and ligaments at imaging. However, infectious, inflammatory, neoplastic, and traumatic processes frequently involve the peritoneal cavity and its reflections; thus, it is important to identify the affected peritoneal ligaments and spaces. Knowledge of these structures is important for accurate reporting and helps elucidate the sites of involvement to the surgeon.

Treatment outcomes of secondarily impetiginized pediatric atopic dermatitis lesions and the role of oral antibiotics.

Patients with atopic dermatitis (AD) are predisposed to infection with Staphylococcus aureus, which worsens their skin disease; it has been postulated that the lack of antimicrobial peptides due to aberrant allergic inflammation in skin with AD could mediate this enhanced bacterial susceptibility. We sought to characterize the amounts of S. aureus and biological products found in infected AD lesions and whether treatment with topical corticosteroids and oral cephalexin as the only antimicrobial improved outcomes.

Clinical spectrum and risk of PHACE syndrome in cutaneous and airway hemangiomas.

Objective: To describe the clinical presentation and risk of PHACE syndrome in infants with large facial hemangiomas and concomitant airway hemangiomas.

Design: The study involved a case series of infants with cutaneous hemangiomas and airway hemangiomas extracted from a prospective multicenter cohort study. Data regarding clinical features, diagnosis, treatment, and clinical course were obtained from medical charts and physician intake forms.

Serum vitamin D concentrations and unexplained elevation in ALT among US adults.

Background: Low serum levels of vitamin D are associated with metabolic syndrome. Participants in NHANES III with unexplained elevation in ALT levels have high prevalence of metabolic syndrome. We hypothesized that the serum concentrations of vitamin D were inversely associated with unexplained elevation in ALT.

Endoscopic pancreatic necrosectomy.

Traditionally, patients with symptomatic sterile pancreatic necrosis or infected necrosis have been managed by open surgical debridement and removal of necrotic tissue. Within the last decade, however, reports of endoscopic pancreatic necrosectomy, an alternative minimally invasive approach, have demonstrated high success rates and low mortality rates. This report describes the indications, technique, and study outcome data of the procedure.

Progression of toxic epidermal necrolysis after tanning bed exposure.

Background: In addition to recreational tanning bed use, UV radiation exposures are sometimes sought to self-treat skin conditions. The ability of tanning bed radiation exposure to trigger toxic epidermal necrolysis has not been reported.

Observations: A young woman attempted to treat a self-limiting drug hypersensitivity reaction via tanning bed radiation exposure, which resulted in a systemic toxic epidermal necrolysis-like reaction.

Functional imaging of the pelvic floor.

The clinical treatment of patients with anorectal and pelvic floor dysfunction is often difficult. Dynamic cystocolpoproctography (DCP) has evolved from a method of evaluating the anorectum for functional disorders to its current status as a functional method of evaluating the global pelvic floor for defecatory disorders and pelvic organ prolapse. It has both high observer accuracy and a high yield of positive diagnoses.

Incidence and risk factors for lymphoma in a single-center inflammatory bowel disease population.

Aims: Previous studies on the risk of lymphoma in inflammatory bowel disease (IBD) have yielded conflicting results. We aim to determine the incidence and risk factors for lymphoma in a large IBD population.

Methods: Patients with lymphoma were identified from a single-center IBD database.

Relationship between alcohol intake and dietary pattern: findings from NHANES III.

Aim: To examine the association between macronutrient dietary patterns and alcohol consumption using the Third National Health and Nutritional Examination Survey III.

Methods: A total of 9877 subjects (5144 males) constituted the study cohort. Dietary interviews were conducted with all examinees by a trained dietary interviewer in a mobile examination center (MEC).

Pancreatic cancer: utility of dynamic contrast-enhanced MR imaging in assessment of antiangiogenic therapy.

Purpose: To prospectively evaluate the utility of dynamic contrast material-enhanced magnetic resonance (MR) imaging in predicting the response of locally advanced pancreatic cancer to combined chemotherapy and antiangiogenic therapy.

Materials And Methods: This prospective, institutional review board-approved, HIPAA-compliant study with informed consent assessed dynamic contrast-enhanced MR imaging in 11 patients (mean age, 54.3 years; six men and five women) with locally invasive pancreatic cancer before and 28 days after combined chemotherapy and antiangiogenic therapy.

Recent trends in systemic psoriasis treatment costs.

Objectives: To analyze the current total cost of systemic therapy for psoriasis and to compare annual trends in the cost of both generic and brand-name therapies with trends in the Consumer Price Index-Urban since 2000.

Design: A cost model was developed that includes costs for prescription drugs, office visits, and suggested laboratory tests and monitoring procedures. Annual trends in psoriasis drug costs from 2000 through 2008 were analyzed by calculating the percentage change in the average wholesale price from the previous year; these values were compared with changes in the yearly Consumer Price Index-Urban values.

Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy: a prospective study.

Objective: The purpose of this study was to determine the accuracy of IV contrast-enhanced MDCT and MRI for evaluation of the severity and cause of neural foraminal stenosis in patients with cervical radiculopathy.

Subjects And Methods: Eighteen patients with cervical radiculopathy prospectively underwent contrast-enhanced MDCT and MRI. Contrast-enhanced MDCT scans were acquired at 1-mm thickness and reconstructed in oblique axial (parallel to disk) and sagittal (perpendicular to neural foramen) 2-mm sections without a gap.