No abstract

Living donor liver transplantation is emerging as an alternative to cadaveric liver transplantation. The authors present multimodality images obtained in 44 cases of living donor liver transplantation. The images in this article were derived from the pre-, intra-, and postoperative imaging protocol for their institutional transplantation program. Preoperative magnetic resonance (MR) imaging in the donor allows detection of focal liver lesions and accurate determination of liver volume. The latter is crucial to ensure adequate postoperative liver function for donors and recipients. MR cholangiography depicts donor biliary anatomy. MR angiography and digital subtraction arteriography are performed to assess vascular anatomy. Intraoperative ultrasonography (US) helps determine the resection plane during donor hepatectomy. Postoperative MR imaging documents liver regrowth. MR imaging, US, and computed tomography help assess complications in donors and recipients.

Leiomyomatosis peritonealis disseminata (LPD) is a rare disorder usually discovered incidentally in women of child-bearing age and is characterized by multiple subperitoneal smooth muscle nodules. Case reports of two patients with complications related to LPD and a review of the literature are presented. In one case, the patient carried the diagnosis of LPD for 11 years and experienced sarcomatous transformation; this is the first report of the magnetic resonance appearance of this entity. In the second case, LPD was diagnosed after an LPD implant on the ovary-induced ovarian torsion. We also present a patient in whom large, pedunculated uterine leiomyomas mimicked LPD. The clinical presentation, possible pathogenesis, imaging features, and therapeutic options of LPD are reviewed. Because this uncommon condition is being reported with increasing frequency, familiarity with its imaging features and pitfalls is important to suggest the diagnosis in the appropriate clinical setting.

After external-beam radiation therapy, radiation-induced changes may be observed in abdominal and pelvic organs at imaging. In the liver, an area of low attenuation corresponding to the radiation port (or an area of hyperattenuation if the underlying liver tissue shows fatty change) can be seen at computed tomography (CT) performed within 3-6 months after therapy. Later, the liver may be fibrotic and contracted. In the stomach, small intestine, and colon, wall thickening and edema are early manifestations. Ulcers may also be observed. Long-term complications include strictures and fistulas. After irradiation of the kidneys, altered attenuation of the renal parenchyma may be seen at CT. Ureteral strictures, typically involving the distal ureter, may be observed after pelvic irradiation. The bladder may be small and contracted with a thickened wall after radiation exposure. Fistulas between the bladder and other pelvic organs sometimes occur. Typical musculoskeletal changes include growth abnormalities in skeletally immature patients, fatty replacement of bone marrow, and radiation osteitis. Radiation-induced neoplasms are also recognized after therapy.