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. The potential peritoneal spaces; the peritoneal reflections that form the peritoneal ligaments, mesenteries, and omenta; and the natural flow of peritoneal fluid determine the route of spread of intraperitoneal fluid and disease processes within the abdominal cavity. The peritoneal ligaments, mesenteries, and omenta also serve as boundaries for disease processes and as conduits for the spread of disease.

Annular pancreas can be diagnosed without the finding of a radiologically complete ring of pancreatic tissue. A crocodile jaw configuration of pancreatic tissue is suggestive of the presence of annular pancreas.

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Fiducial marker (FM)-guided stereotactic body radiation therapy (SBRT) allows for precise targeting and delivery of radiation to a tumor site. In this article, we briefly discuss SBRT, provide examples to describe CT-guided FM placement to guide SBRT, and discuss some of the associated risks and benefits. This article serves as a pictorial review for body imagers and interventional radiologists who perform CT-guided procedures and interpret diagnostic studies for oncology patients. CT-guided FMs were placed in patients who were appropriate candidates for SBRT. One week following placement, patients underwent diagnostic CT and/or MR examinations in order to include the FM data in the development of a treatment plan. From October 2007-November 2009, a total of 89 patients were implanted with FMs. Sites of implantation included lung, liver, bone, chest and abdominal wall, and peritoneum/retroperitoneum. Complications included pneumothorax and FM migration. Twenty-one patients (33%) with lung FM placement experienced at least a small pneumothorax and 6 patients (9%) required thoracostomy tubes. FM migration occurred in 5 patients (8%) with lung placement. SBRT provides a safer and more effective alternative to conventional radiotherapy, and CT-guided FM implantation of tumor sites increases the precision of SBRT. Technical improvements in FM placement can limit the complications associated with the procedure and further enable highly localized tumor therapy.

Urological Survey 788 Editorial CommentLaparoscopic live donor nephrectomy (LDN) has become the standard of care at most major academic centers. The benefits of laparoscopic over open donor nephrectomy have extensively been demonstrated since the first report by Kavoussi et al. Recently, the LESS Urological procedures are gaining popularity.The authors studied 50 consecutive LESS-DN patients versus a matched cohort of 50 LDN patients. They demonstrated that LESS-DN patients recovered faster and complications were comparable with equal graft function and warm ischemia time. This report is valuable since convalescence and recovery is pivotal variables that may influence the decision to become a kidney donor increasing the pool of donors for the current high demand. The Gelport was used in this study that may also facilitate the learning curve compared to other single ports. Roentgenol. 2011; 197: 132-8 Objective: The purpose of this article is to assess the role of diffusion-weighted MRI in characterizing adrenal masses. Materials and Methods: A retrospective review of the MRI database from August 2007 to July 2009 was performed. The MRI examinations of 48 patients, with 49 lesions, were reviewed independently and blindly by two experienced abdominal radiologists who measured the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). ADC measurements and quantitative parameters of chemical shift imaging (signal intensity index and adrenal-to-spleen ratio) were assessed separately and in combination. Lesions with indeterminate signal intensity index (< 16.5%) were considered benign if ADC was greater than or equal to 1.0 × 10(-3) mm(2)/s and malignant if ADC was less than 1.0 × 10(-3) mm(2)/s. Stepwise logistic regression analysis and receiver operating characteristic curves analysis were performed. Results: There were 12 malignant and 37 benign lesions. On multivariate analysis, the only significant predictors of lesion status were signal intensity index from reviewer 2 (p = 0.05) and lesion size (p = 0.04); ADC values were not found to be useful. On receiver operating characteristic curve analysis, there was no significant difference in area under the curve for ADC, signal intensity index, adrenal-to-spleen ratio, or the combined signal intensity index and ADC assessment. For lesions that were indeterminate according to signal intensity index, ADC values greater than 1.50 × 10(-3) mm(2)/s were found only in benign lesions, and nine of 11 lesions with ADC less than 1.0 × 10(-3) mm(2)/s were malignant.

ObjectiveTo describe the imaging findings of primary and secondary pancreatic malignant lymphoma on magnetic resonance imaging (MRI), to help differentiate lymphoma of the pancreas from primary adenocarcinoma and autoimmune pancreatitis among others, and to discuss a few atypical presentations of pancreatitis mimicking lymphoma.ConclusionKnowledge of these imaging manifestations of lymphoma may be helpful to arrive at an accurate diagnosis and avoid unnecessary morbidity and mortality from inadvertent surgery.Main Messages• Pancreatic malignant lymphoma is shown as a nodular low-density area with mild enhancement on CT.• It sometimes shows variable manifestations mimicking other tumours and inflammatory conditions.• MRI provides useful information for differentiating malignant lymphoma from other mimickers.

SBD exam is easier, faster to perform, with no brain function recovery and leads to similar donation rates, equivalent or better organ function status at the time of BD and lower cost than conventional DBD exams.

Abdominal compartment syndrome is not well reported in the radiology literature. In this review, we discuss a range of CT signs such as elevated diaphragm, collapsed inferior vena cava, bowel wall thickening, bowel mucosal hyperenhancement, hemoperitoneum, and increasing abdominal girth, which, in combination, may allow the radiologist to raise the possibility of abdominal compartment syndrome.