OBJECTIVE: To seek CT and angiographic appearances that characterize torsion of the wandering spleen. MATERIALS AND METHODS: The CT and angiographic findings of two cases of preoperatively diagnosed torsion of the wandering spleen were reviewed, and the findings were closely compared with intraoperative and histopathological findings. RESULTS: Characteristic CT appearance seemed to be a whirled appearance formed at the medial side of the displaced spleen. The angiographic finding that was characteristic of the disease was a tapered and abruptly twisted distal splenic artery. CONCLUSION: These findings were useful in making the early and correct diagnosis of this rare but fulminant condition.

Adolescent↗

PubMedDate not supplied

Anterior extension of acute pancreatitis: CT findings.

OBJECTIVE: The purpose of this study is threefold: (a) to specify the pathway of the extension of pancreatitis to the anterior abdominal wall, which is clinically famous as the Cullen sign; (b) to assess if this pattern of involvement affects a patient's prognosis; and (c) to seek its association with the inflammatory processes that take place in the vicinity of the pancreatic head. MATERIALS AND METHODS: The CT findings of 277 patients with acute pancreatitis were retrospectively reviewed. RESULTS: Inflammatory changes involved the anterior abdominal wall in 5 of 277 cases (1.8%) with acute pancreatitis. Inflammatory processes seemed to have been delivered to the anterior abdominal wall from the pancreatic head and the hepatoduodenal ligament and along the falciform ligament. The probable triggers of acute pancreatitis in such cases were endoscopic retrograde cholangiopancreatography in two cases, alcohol intake in one case, and one case unknown. Three of five cases had proven or suspected choledocholithiasis or cholelithiasis. All five patients got well after proper treatments for acute pancreatitis. CONCLUSION: The results of our review suggest that the anterior extension of acute pancreatitis does not directly mean extensive retroperitoneal involvement of the phlegmon or pseudocysts nor fatal prognosis either and that this style of extension might be associated with inflammatory processes that occur around the pancreatic head.

Acute Disease↗

PubMedDate not supplied

Evaluation of reconstructed hepatic veins with breath-hold 2D time-of-flight MR venography.

PURPOSE: The purpose of this study was to assess the ability of magnetic resonance (MR) venography to evaluate the patency of reconstructed hepatic veins after surgery. PATIENTS AND METHODS: Five normal volunteers with normal hepatic veins and eight patients who underwent reconstruction of the hepatic veins after resection of hepatic tumors were included. All subjects underwent breath-hold two-dimensional (2D) time-of-flight MR venography using a fast low angle shot (FLASH) technique with a 1.5 Tesla magnet. The initial imaging plane was coronal, and sagittal and/or transverse planes were added when necessary. Data were postprocessed with a maximum intensity projection (MIP) algorithm. In six patients, the MR findings were verified by iodinated hepatic venography. RESULTS: The confidence level increased when patency was evaluated using a combination of MIP and source images or other imaging planes compared with the use of MIP images alone (3.0 to 3.6, p < 0.05). A signal drop near the orifice at the inferior vena cava was observed in three normal patients. The severity of stenosis was overestimated by MR venography in five patients. Obstruction was correctly suggested in one patient. CONCLUSION: Although 2D time-of-flight MR venography overestimated stenosis of the hepatic vein at the site of connection, it might provide information on the patency of reconstructed hepatic veins especially when more than one orthogonal plane is used and both MIP and source images are evaluated.

Adult↗