Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors s...Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.展开更多
BACKGROUND： In order to preserve functional liver parenchyma, extended central hepatectomy （segments 4, 5, 7 and 8 resection） was proposed for the management of centrally located hepatocellular carcinoma invading t...BACKGROUND： In order to preserve functional liver parenchyma, extended central hepatectomy （segments 4, 5, 7 and 8 resection） was proposed for the management of centrally located hepatocellular carcinoma invading the right and middle hepatic veins, reconstructing segment 6 outflow in the absence of the thick inferior right hepatic vein. The present study was to describe our surgical techniques of extended central hepatectomy.METHODS： Between 2008 and 2012, 5 patients with centrally located hepatocellular carcinoma invading or in the vicinity of the right and middle hepatic veins underwent extended central hepatectomy. The thick inferior right hepatic vein was preserved during dissection. Gore-Tex graft was used for segment 6 outflow reconstruction in the absence of the thick inferior right hepatic vein.RESULTS： The mean future remnant liver volume for segments 2 and 3 was 28% versus 45% on segment 6 preservation. The mean tumor diameter was 7.4 cm. The thick inferior right hepatic vein was found in 1 patient. Outflow reconstruction from segment 6 was performed in 4 patients. Postoperative complications included bile leakage （1 patient）, pleural effusion （2） and liver failure （1）. The rate of graft patency was 75%. There was no perioperative mortality.CONCLUSION： Extended central hepatectomy is a safe alternative for extended hepatic resection in selected patients attempting to preserve the functional liver parenchyma.展开更多
Background Precise evaluation of the live donor＇s liver is the most important factor for the donor＇s safety and the recipient＇s prognosis in living donor liver transplantation （LDLT）. Our study assessed the clini...Background Precise evaluation of the live donor＇s liver is the most important factor for the donor＇s safety and the recipient＇s prognosis in living donor liver transplantation （LDLT）. Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT. Methods Computer-assisted three-dimensional （3D） quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method. A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome. Results There was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches （（856.76±162.18） cm3 vs. （870.64±172.54） cm3, P=0.796）. Estimated volumes by either method had good correlation with the actual graft weight （r-manual-traced method： 0.921, r-3D quantitative assessment method： 0.896, both P 〈0.001）. However, the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method （（16.91±1.375） minutes vs. （39.27±2.102） minutes, P 〈0.01） to estimate graft volume. We performed the reduced monosegmental LDLT, a pediatric case, with the surgical planning tool （188 g graft in the operation, which was estimated at 208 cm3 pre-operation）. The recipient recovered without large-for-size syndrome. Conclusions Computer-assisted 3D quantitative assessment provided precise evaluation of the graft volume. It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.展开更多
目的:观察速效降脂舒肝汤治疗非酒精性脂肪肝的临床疗效。方法:78例非酒精性脂肪性肝炎患者随机分为对照组和观察组,每组39例。对照组给予多烯磷脂酰胆碱胶囊,观察组在对照组治疗基础上给予速效降脂舒肝汤。治疗结束后,比较两组血脂、...目的:观察速效降脂舒肝汤治疗非酒精性脂肪肝的临床疗效。方法:78例非酒精性脂肪性肝炎患者随机分为对照组和观察组,每组39例。对照组给予多烯磷脂酰胆碱胶囊,观察组在对照组治疗基础上给予速效降脂舒肝汤。治疗结束后,比较两组血脂、肝功能以及肝纤维化指标的变化,观察肝脏B超和肝脏及脾脏CT检查的变化,并比较临床疗效。结果:与治疗前比较,两组总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)以及低密度脂蛋白(low density lipoprotein,LDL)水平降低(P<0.01),高密度脂蛋白(high density lipoprotein,HDL)水平升高(P<0.01),总胆红素(total bilirubin,TBIL)、γ-谷氨酰转肽酶(gamma-glutamyl transpeptidase,γ-GT)、丙氨酸转氨酶(alanine aminotransferase,ALT)以及天门冬氨酸氨基转移酶(aspartate amino transferase,AST)水平均降低(P<0.01),血清层黏蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原(procollagen III,PCⅢ)以及Ⅳ型胶原(collagen type IV,Ⅳ-C)水平均降低(P<0.01),肝脏B超积分降低(P<0.01),肝脾CT比值升高(P<0.01);与对照组比较,观察组TC、TG以及LDL水平较低(P<0.01),HDL水平较高(P<0.01),TBIL、γ-GT、ALT以及AST水平均较低(P<0.01),LN、HA、PCⅢ以及Ⅳ-C水平均较低(P<0.01),肝脏B超积分较低(P<0.01),肝脾CT比值较高(P<0.01);对照组有效率为48.72%,观察组有效率为76.92%,两组有效率比较,差异有统计学意义(P<0.05)。结论:速效降脂舒肝汤治疗非酒精性脂肪性肝炎临床疗效显著,能抑制肝纤维化,改善肝脏影像学及肝功能。展开更多
BACKGROUND: Living donor liver transplantation(LDLT)has been widely accepted over the past decade, and hepatic dysfunction often occurs in the donor in the early stage after liver donation. The present study aimed to ...BACKGROUND: Living donor liver transplantation(LDLT)has been widely accepted over the past decade, and hepatic dysfunction often occurs in the donor in the early stage after liver donation. The present study aimed to evaluate the effect of intraoperative cholangiography(IOC) and parenchymal resection on liver function of donors in LDLT, and to assess the role of IOC in influencing the biliary complications and improving the overall outcome.METHODS: Data from 40 patients who had donated their right lobes for LDLT were analyzed. Total bilirubin(TB), alanine aminotransferase(ALT), aspartate aminotransferase(AST),alkaline phosphatase(ALP) and γ-glutamyl transpeptidase(GGT)at different time points were compared, and the follow-up data and the biliary complications were also analyzed.RESULTS: The ALT and AST values were significantly increased after IOC(P<0.001) and parenchymal resection(P<0.001).However, the median values of TB, ALP and GGT were not significantly influenced by IOC(P>0.05) or parenchymal resection(P>0.05). The biochemical changes caused by IOC or parenchymal resection were not correlated with the degree of post-operative liver injury or the recovery of liver function. The liver functions of the donors after operation were stable, and none of the donors suffered from biliary stenosis or leakage during the follow-up.CONCLUSIONS: IOC and parenchymal resection may induce a transient increase in liver enzymes of donors in LDLT, but do not affect the recovery of liver function after operation. Moreover,the routine IOC is helpful to clarify the division line of the hepatic duct, thus reducing the biliary complication rate.展开更多
目的:根据体表面积(body surface area,BSA)调整碘剂量(17.1 g I/m2BSA)、固定注射时间(25 s),比较双能量CT(dual energy CT,DECT)增强扫描中两种不同碘浓度对比剂之间血管和肝实质的强化。方法:300例患者被前瞻性随机分为4组,A组及C组...目的:根据体表面积(body surface area,BSA)调整碘剂量(17.1 g I/m2BSA)、固定注射时间(25 s),比较双能量CT(dual energy CT,DECT)增强扫描中两种不同碘浓度对比剂之间血管和肝实质的强化。方法:300例患者被前瞻性随机分为4组,A组及C组注射300 mg/m L对比剂,B组及D组注射370 mg/m L对比剂,碘剂量根据BSA调整,对比剂注射时间固定为25 s。分别于肝动脉晚期(A、B组)或门静脉期(C、D组)采用双能量扫描,在80 k Vp、140 k Vp及彩色编码碘覆盖图中,比较高、低碘浓度对比剂间腹主动脉、门静脉及肝实质强化程度。组间强化程度差异采用Mann-Whitney U检验。结果:在80 k Vp、140 k Vp或彩色编码碘覆盖图中,注射高碘浓度对比剂时,动脉期主动脉平均强化程度较高,但两组差异没有统计学意义;两种碘浓度对比剂间门静脉期门静脉及各扫描期内肝实质强化程度差异没有统计学意义(P>0.05)。结论:在肝脏增强DECT成像中,根据BSA调整碘剂量,固定注射时间,注射300 mg I/m L或370 mg I/m L对比剂,可获得相等的血管及肝实质的强化。展开更多
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been widely applied to evaluate microcirculatory parameters in clinical settings. However, pre-clinical studies involving DCE-MRI of small animals rem...Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been widely applied to evaluate microcirculatory parameters in clinical settings. However, pre-clinical studies involving DCE-MRI of small animals remain challenging with the requirement for high spatial and temporal resolution for quantitative tracer kinetic analysis. This study illustrates the feasibility of applying a high temporal resolution (2 s) protocol for liver imaging in mice by analyzing the DCE-MRI datasets of mice liver with a dual-input two-compartment tracer kinetic model. Phantom studies were performed to validate the T1 estimates derived by the proposed protocol before applying it in mice studies. The DCE-MRI datasets of mice liver were amendable to tracer kinetic analysis using a dual-input two-compartment model. Estimated micro-circulatory parameters were consistent with liver physiology, indicating viability of applying the technique for pre-clinical drug developments.展开更多
Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific...Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific properties. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Yet, in some cases it is difficult to differentiate these lesions. Purpose: The purpose of this study was to retrospectively investigate the usefulness of combining Fluid-attenuated inversion recovery (FLAIR) with Gd-EOB-DTPA enhanced MRI. Material and Methods: Gd-EOB-DTPA enhanced MRIs of 47 patients (19 male, 27 female) with a mean age of 68 years (range 32 - 85 years old) with a total of 121 lesions (68 cysts, 37 metastasis, 16 hemangiomas) were included in the study. T1WI, T2WI, heavy T2WI, dynamic contrast enhanced MRI, and FLAIR images of these lesions were evaluated. The patients were randomly divided into two groups (Groups A and B), and two independent radiologists were asked to give a diagnosis for each lesion. The radiologists were allowed to view FLAIR images for only Group B. Diagnostic performance regarding the differentiation of cysts, hemangiomas and metastases was assessed. MRI examinations were scanned using a 1.5 Tesla system (Echlon Vega, Hitachi,) with an 8 channel multiple array coil (RAPID body coil). Results: An statistically significant improvement (p < 0.05) of the specificity for cysts was seen from 71.9% (Group A) to 90.9% (Group B) for Reader 1, and 75.0% (Group A) to 93.3% (Group B) for Reader 2. No statistical differences were seen between the two groups for sensitivity and specificity of hemangiomas. Although no statistical difference was seen between the two groups, an improvement (77.8 in Group A to 97.2 in Group B for Reader 1, and 85.7 in Group A to 100 in Group B for Reader 2) was seen for the sensitivity of metastasis with the addition of FLAIR. Co展开更多
A 27-years-old female with history of venous thromboembolism secondary to Lupus anticoagulant presented with sudden onset of chest pain and dyspnea. A CT angiogram of the chest showed superior vena caval (SVC) obstruc...A 27-years-old female with history of venous thromboembolism secondary to Lupus anticoagulant presented with sudden onset of chest pain and dyspnea. A CT angiogram of the chest showed superior vena caval (SVC) obstruction with anterior chest wall venous collaterals and hepatic portal vein gas (HPVG), which resolved without intervention on a repeated CT-scan of the abdomen. Previously, HPVG was considered to be a dangerous radiologic sign, however with the advancement in imaging technology more benign causes are being identified. This case highlights that this finding alone, if found, does not indicate aggressive management and that clinical correlation should be considered if found.展开更多
The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recen...The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recent literature and is only found incidentally on diagnostic imaging. Hence, it constitutes a classic pitfall in the diagnosis of false right pneumoperitoneum. We deem interesting to report a case of Chilaiditi syndrome in a 44-year-old patient with no significant history who was admitted at emergency department for abdominal trauma following a road accident.展开更多
文摘Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.
文摘BACKGROUND： In order to preserve functional liver parenchyma, extended central hepatectomy （segments 4, 5, 7 and 8 resection） was proposed for the management of centrally located hepatocellular carcinoma invading the right and middle hepatic veins, reconstructing segment 6 outflow in the absence of the thick inferior right hepatic vein. The present study was to describe our surgical techniques of extended central hepatectomy.METHODS： Between 2008 and 2012, 5 patients with centrally located hepatocellular carcinoma invading or in the vicinity of the right and middle hepatic veins underwent extended central hepatectomy. The thick inferior right hepatic vein was preserved during dissection. Gore-Tex graft was used for segment 6 outflow reconstruction in the absence of the thick inferior right hepatic vein.RESULTS： The mean future remnant liver volume for segments 2 and 3 was 28% versus 45% on segment 6 preservation. The mean tumor diameter was 7.4 cm. The thick inferior right hepatic vein was found in 1 patient. Outflow reconstruction from segment 6 was performed in 4 patients. Postoperative complications included bile leakage （1 patient）, pleural effusion （2） and liver failure （1）. The rate of graft patency was 75%. There was no perioperative mortality.CONCLUSION： Extended central hepatectomy is a safe alternative for extended hepatic resection in selected patients attempting to preserve the functional liver parenchyma.
文摘Background Precise evaluation of the live donor＇s liver is the most important factor for the donor＇s safety and the recipient＇s prognosis in living donor liver transplantation （LDLT）. Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT. Methods Computer-assisted three-dimensional （3D） quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method. A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome. Results There was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches （（856.76±162.18） cm3 vs. （870.64±172.54） cm3, P=0.796）. Estimated volumes by either method had good correlation with the actual graft weight （r-manual-traced method： 0.921, r-3D quantitative assessment method： 0.896, both P 〈0.001）. However, the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method （（16.91±1.375） minutes vs. （39.27±2.102） minutes, P 〈0.01） to estimate graft volume. We performed the reduced monosegmental LDLT, a pediatric case, with the surgical planning tool （188 g graft in the operation, which was estimated at 208 cm3 pre-operation）. The recipient recovered without large-for-size syndrome. Conclusions Computer-assisted 3D quantitative assessment provided precise evaluation of the graft volume. It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.
文摘目的:观察速效降脂舒肝汤治疗非酒精性脂肪肝的临床疗效。方法:78例非酒精性脂肪性肝炎患者随机分为对照组和观察组,每组39例。对照组给予多烯磷脂酰胆碱胶囊,观察组在对照组治疗基础上给予速效降脂舒肝汤。治疗结束后,比较两组血脂、肝功能以及肝纤维化指标的变化,观察肝脏B超和肝脏及脾脏CT检查的变化,并比较临床疗效。结果:与治疗前比较,两组总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)以及低密度脂蛋白(low density lipoprotein,LDL)水平降低(P<0.01),高密度脂蛋白(high density lipoprotein,HDL)水平升高(P<0.01),总胆红素(total bilirubin,TBIL)、γ-谷氨酰转肽酶(gamma-glutamyl transpeptidase,γ-GT)、丙氨酸转氨酶(alanine aminotransferase,ALT)以及天门冬氨酸氨基转移酶(aspartate amino transferase,AST)水平均降低(P<0.01),血清层黏蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原(procollagen III,PCⅢ)以及Ⅳ型胶原(collagen type IV,Ⅳ-C)水平均降低(P<0.01),肝脏B超积分降低(P<0.01),肝脾CT比值升高(P<0.01);与对照组比较,观察组TC、TG以及LDL水平较低(P<0.01),HDL水平较高(P<0.01),TBIL、γ-GT、ALT以及AST水平均较低(P<0.01),LN、HA、PCⅢ以及Ⅳ-C水平均较低(P<0.01),肝脏B超积分较低(P<0.01),肝脾CT比值较高(P<0.01);对照组有效率为48.72%,观察组有效率为76.92%,两组有效率比较,差异有统计学意义(P<0.05)。结论:速效降脂舒肝汤治疗非酒精性脂肪性肝炎临床疗效显著,能抑制肝纤维化,改善肝脏影像学及肝功能。
基金supported by grants from the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81121002)Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents(2012-236)+1 种基金Zhejiang Provincial Education Department Project(Y201018972)Zhejiang Provincial Natural Science Foundation of China(LQ12H03002)
文摘BACKGROUND: Living donor liver transplantation(LDLT)has been widely accepted over the past decade, and hepatic dysfunction often occurs in the donor in the early stage after liver donation. The present study aimed to evaluate the effect of intraoperative cholangiography(IOC) and parenchymal resection on liver function of donors in LDLT, and to assess the role of IOC in influencing the biliary complications and improving the overall outcome.METHODS: Data from 40 patients who had donated their right lobes for LDLT were analyzed. Total bilirubin(TB), alanine aminotransferase(ALT), aspartate aminotransferase(AST),alkaline phosphatase(ALP) and γ-glutamyl transpeptidase(GGT)at different time points were compared, and the follow-up data and the biliary complications were also analyzed.RESULTS: The ALT and AST values were significantly increased after IOC(P<0.001) and parenchymal resection(P<0.001).However, the median values of TB, ALP and GGT were not significantly influenced by IOC(P>0.05) or parenchymal resection(P>0.05). The biochemical changes caused by IOC or parenchymal resection were not correlated with the degree of post-operative liver injury or the recovery of liver function. The liver functions of the donors after operation were stable, and none of the donors suffered from biliary stenosis or leakage during the follow-up.CONCLUSIONS: IOC and parenchymal resection may induce a transient increase in liver enzymes of donors in LDLT, but do not affect the recovery of liver function after operation. Moreover,the routine IOC is helpful to clarify the division line of the hepatic duct, thus reducing the biliary complication rate.
文摘目的:根据体表面积(body surface area,BSA)调整碘剂量(17.1 g I/m2BSA)、固定注射时间(25 s),比较双能量CT(dual energy CT,DECT)增强扫描中两种不同碘浓度对比剂之间血管和肝实质的强化。方法:300例患者被前瞻性随机分为4组,A组及C组注射300 mg/m L对比剂,B组及D组注射370 mg/m L对比剂,碘剂量根据BSA调整,对比剂注射时间固定为25 s。分别于肝动脉晚期(A、B组)或门静脉期(C、D组)采用双能量扫描,在80 k Vp、140 k Vp及彩色编码碘覆盖图中,比较高、低碘浓度对比剂间腹主动脉、门静脉及肝实质强化程度。组间强化程度差异采用Mann-Whitney U检验。结果:在80 k Vp、140 k Vp或彩色编码碘覆盖图中,注射高碘浓度对比剂时,动脉期主动脉平均强化程度较高,但两组差异没有统计学意义;两种碘浓度对比剂间门静脉期门静脉及各扫描期内肝实质强化程度差异没有统计学意义(P>0.05)。结论:在肝脏增强DECT成像中,根据BSA调整碘剂量,固定注射时间,注射300 mg I/m L或370 mg I/m L对比剂,可获得相等的血管及肝实质的强化。
文摘Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been widely applied to evaluate microcirculatory parameters in clinical settings. However, pre-clinical studies involving DCE-MRI of small animals remain challenging with the requirement for high spatial and temporal resolution for quantitative tracer kinetic analysis. This study illustrates the feasibility of applying a high temporal resolution (2 s) protocol for liver imaging in mice by analyzing the DCE-MRI datasets of mice liver with a dual-input two-compartment tracer kinetic model. Phantom studies were performed to validate the T1 estimates derived by the proposed protocol before applying it in mice studies. The DCE-MRI datasets of mice liver were amendable to tracer kinetic analysis using a dual-input two-compartment model. Estimated micro-circulatory parameters were consistent with liver physiology, indicating viability of applying the technique for pre-clinical drug developments.
文摘Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific properties. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Yet, in some cases it is difficult to differentiate these lesions. Purpose: The purpose of this study was to retrospectively investigate the usefulness of combining Fluid-attenuated inversion recovery (FLAIR) with Gd-EOB-DTPA enhanced MRI. Material and Methods: Gd-EOB-DTPA enhanced MRIs of 47 patients (19 male, 27 female) with a mean age of 68 years (range 32 - 85 years old) with a total of 121 lesions (68 cysts, 37 metastasis, 16 hemangiomas) were included in the study. T1WI, T2WI, heavy T2WI, dynamic contrast enhanced MRI, and FLAIR images of these lesions were evaluated. The patients were randomly divided into two groups (Groups A and B), and two independent radiologists were asked to give a diagnosis for each lesion. The radiologists were allowed to view FLAIR images for only Group B. Diagnostic performance regarding the differentiation of cysts, hemangiomas and metastases was assessed. MRI examinations were scanned using a 1.5 Tesla system (Echlon Vega, Hitachi,) with an 8 channel multiple array coil (RAPID body coil). Results: An statistically significant improvement (p < 0.05) of the specificity for cysts was seen from 71.9% (Group A) to 90.9% (Group B) for Reader 1, and 75.0% (Group A) to 93.3% (Group B) for Reader 2. No statistical differences were seen between the two groups for sensitivity and specificity of hemangiomas. Although no statistical difference was seen between the two groups, an improvement (77.8 in Group A to 97.2 in Group B for Reader 1, and 85.7 in Group A to 100 in Group B for Reader 2) was seen for the sensitivity of metastasis with the addition of FLAIR. Co
文摘A 27-years-old female with history of venous thromboembolism secondary to Lupus anticoagulant presented with sudden onset of chest pain and dyspnea. A CT angiogram of the chest showed superior vena caval (SVC) obstruction with anterior chest wall venous collaterals and hepatic portal vein gas (HPVG), which resolved without intervention on a repeated CT-scan of the abdomen. Previously, HPVG was considered to be a dangerous radiologic sign, however with the advancement in imaging technology more benign causes are being identified. This case highlights that this finding alone, if found, does not indicate aggressive management and that clinical correlation should be considered if found.
文摘The interposition of the colon or the small intestine between the liver and the diaphragm otherwise called Chilaiditi syndrome remains a rare condition. Its incidence varies between 0.025% and 0.28% according to recent literature and is only found incidentally on diagnostic imaging. Hence, it constitutes a classic pitfall in the diagnosis of false right pneumoperitoneum. We deem interesting to report a case of Chilaiditi syndrome in a 44-year-old patient with no significant history who was admitted at emergency department for abdominal trauma following a road accident.
