1,721,063 research outputs found
Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT.
Full text linkDespite advances in patient and graft management, biliary complications (BC) still represent a challenge both in the early and delayed period after orthotopic liver transplantation (OLT). Because of unspecific clinical presentation, imaging is often mandatory in order to diagnose BC. Among imaging modalities, magnetic resonance cholangiography (MRC) has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively, using both the conventional technique (based on heavily T2-weighted sequences) and contrast-enhanced MRC (based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents). On this basis, MRC is generally indicated to: (1) avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications; and (2) provide a road map for interventional procedures or surgery. As illustrated in the review, MRC is accurate in the diagnosis of different types of biliary complications, including anastomotic strictures, non-anastomotic strictures, leakage and stones
Solitary fibrous tumor of the omentum: Presentation of a case and literature review
Full text linkSolitary fibrous tumor (SFT) and hemangiopericytoma (HPC) were considered, since their firsts description in the literature, as separate entities. The World Health Organization (WHO) classification of soft tissue tumors in 2013 declared the term HPC obsolete, and considered these lesions as features of the extrapleural SFT category. Herein we present a rare case of SFT originating from the great omentum. A 68 years old woman was admitted to our hospital with acute abdominal pain. Computed tomography revealed a 142 x 102 x 100 mm solid mass located in the pelvis, that simulated an adnexal lesion. An explorative laparotomy was performed, and a mass of the great omentum with a significant vascular pedicle arising from a branch of the left gastroepiploic artery was revealed. The tumor was completely resected. Microscopically it was composed by non-organized and spindle-shaped cells exhibiting atypical nuclei, arranged in short fascicles, and was diagnosed as. An extensive search was conducted in public scientific databases for published articles on the topic, with the aim to comprehensively describe the demographic, clinical, pathological and prognostic features of SFT; 60 previous cases have been identified and reviewed
Risonanza Magnetica pesata in Diffusione (DW-RM) nella valutazione dei pattern di motilità dell'acqua in fegati sani e cirrotici: risultati preliminari.
No full textBiliary complications after orthotopic liver transplantation: MRCP findings
No full textOrthotopic liver transplantation is a widely accepted
treatment for end-stage liver disease and selected cases of
hepatocellular carcinoma. Despite surgical progresses,
biliary complications after transplantation remain a
serious cause of morbidity, mortality, and graft dysfunction
or failure in recipients. Early complications
occur within a few weeks after transplantation and are
mainly represented by bile leakage. Late complications,
which become evident from 3 months to years, include
strictures, stones, intraductal debris or sludge formation,
kinking and ampullary dysfunction. Donor-to-recipient
common bile duct disproportion has been reported as a
borderline condition. Diagnosis is challenging because of
the low specificity of clinical and biologic findings.
Sonography does not provide projectional images of the
biliary tract or direct evaluation of the anastomoses.
Moreover, direct cholangiographic procedures have an
unacceptable rate of complications to be used in patients
with low clinical suspicion. Magnetic resonance cholangiography
is a safe and accurate tool, playing an
increasing role in the diagnosis and management of biliary
complications. Heavily T2-weighted images provide
panoramic, detailed evaluation of the biliary tract,
showing biliary complications as a variable combination
of bile duct dilatation, strictures, filling defects, fluid
collections and peculiar morphologic changes, as described
in this paper
Impatto del angio-TC del torace nel management dei pazienti con sospetta embolia polmonare (EP) acuta: yield diagnostico e proporzione di altri reperti clinicamente rilevanti
No full text
MRI Follow-through evaluation in patients with Crohn's disease of the terminal ileum using an activity score including motility study: preliminary results.
No full textPur pose: to investigate the value of an MRI scoring system including dynamic motility evaluation in assessing small bowel Crohn’s disease activity.
Materials and Methods: from March 2005 to December 2006 52 symptomatic patients with suspected Crohn’s disease onset or relapse underwent MRI on a 1.5T magnet. Bowel distension was achieved orally assuming a mean of 1.6L of a Poli-etylen-glicole (PEG) preparation. Per-patient assessment of disease activity was based on a scoring system including morphological and kinematic evaluation of the small bowel and perivisceral structures (true-FISP, cine-true-FISP and HASTE T2w sequences), and dynamic assessment of parietal contrast enhancement (VIBE T1w sequence). Patients were classified in three categories, using endoscopic biopsy as the standard reference: no activity/quiescent disease, low to moderate activity, severe activity. Patients without terminal ileum involvement were excluded from data analysis.
Results: MRI achieved a detailed and panoramic evaluation of the small bowel in all cases, showing . terminal ileum involvement in 45 cases. Overall, MRI determined a per-patient misdiagnosis of disease activity in a not significant proportion of subjects (4/45; 8.8%) (p>0.05), showing sensitivity, specificity, PPV, NPV and overall accuracy in determining disease activity of 93.1%, 87.5%, 93.1%, 87.5% and 91.1%, respectively.
Conclusion: MRI follow-trough provides a highly accurate assessment of Crohn’s disease activity.
Clinical relevance/Application: MRI is a promising tool in assessing Crohn’s disease activity, but to date no activity scores have proven suitable for everyday clinical use. A simple activity score to provide an overall interpretation of MRI findings of Crohn’s disease is proposed in this study
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