The incidence of HCC in patients with small liver nodules is significantly higher compared to patients with cirrhosis without liver nodules. The presence of small liver nodules warrants increased imaging surveillance for HCC.
Purpose:To determine the accuracy of MRI including T1-weighted gadolinium (Gd)-enhanced three-dimensionalgradient-echo (3D-GE) sequences to distinguish pancreatic cancer from chronic pancreatitis in patients with pancreatic mass or focal enlargement.
Materials and Methods:The study included 22 patients (15 males and seven females; mean age Ϯ SD, 56.2 Ϯ 11.5 years) with pancreatic mass or focal enlargement. Fourteen had pancreatic carcinoma and eight had chronic pancreatitis based on the histopathological and clinical findings. MRI examinations of all patients were retrospectively evaluated by two independent reviewers for the predetermined imaging findings of carcinoma and chronic pancreatitis. The accuracy of MRI for differentiating pancreatic carcinoma from chronic pancreatitis was determined. MRI findings of both entities were compared using t-tests, chi-squared tests, and logistic regression analyses for the differentiation of these two entities. The extent of agreement between two reviewers was determined with Kappa statistics.
Results:The sensitivity and specificity of MRI including T1-weighted 3D-GE sequences for differentiating pancreatic carcinoma from chronic pancreatitis were 93% (13/14) and 75% (6/8), respectively. The most discriminative finding for pancreatic carcinoma was relative demarcation of the mass compared to background pancreas in contrast to chronic pancreatitis on post-Gd 3D-GRE sequences (P Ͻ 0.05).
Conclusion:MRI including Gd-enhanced T1-weighted 3D-GE sequences can differentiate pancreatic carcinoma from chronic pancreatitis successfully in most cases.
Venous aneurysms are uncommon. Despite their infrequency, venous aneurysms can present with significant clinical complications such as thrombosis, pulmonary embolism, and death. In this report, we present the case of a thrombosed inferior vena cava aneurysm discovered in a 16-year-old male who had deep vein thrombosis of the right lower extremity. Thrombosis of the inferior vena cava is uncommon in the pediatric population. Therefore, congenital abnormalities such as an inferior vena cava aneurysm should be considered when evaluating pediatric patients who present with deep vein thrombosis.
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