Conclusion. DE-MRI can identify myocardial fibrosis in a significant percentage of patients with SSc and may be a useful noninvasive tool for determining cardiac involvement.

Purpose:To investigate the correlation between the degree of hepatic, splenic, pancreatic, vertebral bone marrow (VBM), and myocardial siderosis, as expressed by relaxation rate (R2 ϭ 1/T2) values, in patients with thalassemia. Materials and Methods:R2 relaxation rate values of liver, spleen, VBM, pancreas, and myocardium were estimated in 68 consecutive transfusion-dependent patients with ␤-thalassemia major and 10 healthy controls using a respiratory triggered 16-echo Carr-Purcell-Meiboom-Gill (CPMG) spin echo sequence. Results:Hepatic R2 values were significantly increased in all 68 patients; VBM, pancreatic, and myocardial R2 values were increased in 67/68, 35/47, and 47/61 patients, whereas five patients showed decreased pancreatic R2 attributed to fatty degeneration. Of the 39 nonsplenectomized patients, splenic R2 values were decreased in 30 and normal in nine patients. Hepatic R2 values correlated with splenic (r ϭ 0.63, P Ͻ 0.001), VBM (r ϭ 0.52, P Ͻ 0.001), but not with myocardial and pancreatic R2 values. Conclusion:Despite positive correlations between the degree of hepatic, splenic, and VBM siderosis, as expressed by respective R2 values, there was variability of iron distribution patterns in thalassemic patients. Unpredictable patterns of iron distribution may be seen, such as normal signal of the spleen in the presence of siderotic liver, resembling primary hemochromatosis. Fatty degeneration of the pancreas was not uncommon.

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Our results suggest that the iterative acquisition protocol provides great potential for reducing radiation exposure and maintaining or improving image quality in CAP CT examinations.

This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children.

We describe the imaging findings in a rare case of multifocal nodular form of hepatic epithelioid hemangioendothelioma on ultrasound (US) and dynamic contrast-enhanced spiral computed tomography (CT) and MRI. The nodules showed multilayered target appearance on MR images with prominent peripheral rim with high signal intensity (SI) on T1-weighted and very low SI on T2-weighted images, corresponding to thrombosed vascular channels. The above combination of imaging findings is to our knowledge distinct and should suggest the diagnosis of hepatic epithelioid hemangioendothelioma. HEPATIC EPITHELIOID hemangioendothelioma is a rare liver tumor of vascular origin, presenting in diffuse, multifocal, or solitary nodular form (1-3). The latter is considered the earlier form of the neoplasm, gradually evolving into the diffuse one (2). Although the tumor is considered malignant it carries a better prognosis compared to other hepatic malignancies, even in the presence of distal metastases, and it is therefore important to distinguish it from them (2,4). Relatively specific imaging findings include peripheral location of the nodules, capsular flattening or retraction (present in less than 25% of cases), and occasionally a target-like configuration with more sclerotic-fibrous center and cellular proliferative periphery (5). Because of the relative rarity of the nodular form of epithelioid hemangioendothelioma, many published cases were initially misdiagnosed. We present a rare case of multifocal form of epithelioid hemangioendothelioma and describe its discrete imaging findings, consisting of multiple nodules with capsular flattening, retraction, and a multilayered target-like appearance better seen on MR imaging. To our knowledge this is the first report of a multilayered appearance with a peripheral ring of high signal intensity (SI) on T1-weighted images and very low SI on T2 weighted images corresponding to thrombosed vascular channels. These imaging findings in the appropriate clinical setting should be considered highly suggestive of epithelioid hemangioendothelioma. CASE REPORTA 40-year-old male patient presented to our hospital complaining of repeated episodes of low to medium grade fever over a period of six months. Clinical examination was unremarkable except for vague upper abdominal quadrant discomfort. The laboratory workup showed a slight elevation of alkaline phosphatase (ALP), ␥-glutamyl transferase (␥-GT), and lactic dehydrogenase (LDH) levels. There was a gradual increase of erythrocyte sedimentation rate (20 mm at the day of admittance to 90 mm at the 10th day) and C-reactive protein (CRP) levels.Abdominal grayscale ultrasound (US) performed on an ATL HDI 3500 scanner, revealed multiple subcapsular nodules with maximum diameter of 3.5 cm, and a bull's eye appearance with hyperechoic center and hypoechoic periphery (Fig. 1a). Subsequently, a spiral computed tomography (CT) was performed on a spiral scanner (Highspeed DX/i; General Electric Medical Systems), with beam collimation of 7 mm, table increment of ...

The abnormality prevalences of aspartate transaminase, alanine transaminase, and γ-glutamyl transferase were significantly higher in the PSC group. Nevertheless, PSC-type lesions frequently occur in pediatric IBD, even if the biochemical profile is hardly indicative of this probability.