There is encouraging data with regard to technical success, safety, and oncologic efficacy of TACE for colorectal liver metastases. The majority of studies are non-randomized single-center series mostly after failure of systemic therapies in the 2nd line and beyond. Emerging techniques including embolization with calibrated microspheres, with or without additional cytotoxic drugs, degradable starch microspheres, and technical innovations, e.g., cone-beam computed tomography (CT) allow a new highly standardized TACE procedure. The real efficacy of TACE for colorectal liver metastases in a neoadjuvant, adjuvant, and palliative setting has now to be evaluated in prospective randomized controlled trials.
Pancreatic lymphangiomas are rare benign tumours with a histogenesis not yet completely understood. Predominantly the cystic aspect of this lesion can complicate the differentiation from other neoplastic and non-neoplastic cystic tumours of the pancreas. We present a case of a middle-aged woman with a lymphangioma involving the duodenal wall and the pancreatic head. With special regard to MR imaging findings differential diagnosis is discussed.
This study provides the first in vivo and in vitro data of P03277, an experimental extracellular MR contrast agent. P03277 demonstrates significantly better enhancement properties as compared with gadobutrol in experimental hepatic colorectal cancer metastases. In addition, in vitro data demonstrate superior relaxivities of P03277 at a broad spectrum of different field strengths. Hence, this new agent has the potential to improve lesion conspicuity and subsequently sensitivity in diagnostic imaging for both clinical magnetic resonance imaging at 1.5 or 3 T and ultra-high field applications between 4.7 and 9.4 T.
RSG-FLASH is preferable for cine imaging of the aorta. It provides the same quantitative data as PT-FLASH cine imaging but is less prone to flow and trigger artifacts. RSG-FLASH permits more homogeneous depiction of the cardiac cycle and is faster than the PT-FLASH sequence. PT-FLASH is more prone to misregistration of the respiratory cycle or the ECG by the external monitoring device used for acquisition. This effect may be even more pronounced in animals with disease models that are less stable in terms of heart and respiration rate during anesthesia.
Pulmonary CTA should be performed in the resting expiratory position, and patients should be instructed to avoid inspiration to achieve the highest possible attenuation in the pulmonary arteries.
Since its introduction in the early 1990s, contrast-enhanced (CE) cardiac magnetic resonance imaging (MRI) has evolved rapidly for the assessment of cardiac pathologies, including in particular ischemic heart disease and inflammatory conditions. Likewise, CE-magnetic resonance angiography (MRA) is now used routinely to evaluate the thoracic vasculature. This article reviews the current use of extracellular gadolinium-based agents in CE cardiovascular imaging, focusing on ischemic heart disease, inflammatory myocardial conditions, and the use of CE-MRA in imaging of the pulmonary and aortic vasculature. Recent advances in fast and ultrafast MRI combined with the use of extracellular contrast media allow noninvasive measurements of multiple parameters of the cardiovascular system in less than 40 minutes. Beyond the assessment of left ventricular wall motion and morphology, CE cardiac MRI allows depiction of myocardial perfusion and thereby provides information regarding microvascular integrity and myocardial viability. The excellent spatial resolution of MRI, especially for the distinction of nontransmural versus transmural extent of pathology, has been shown to be superior to other modalities that are often nonlocalizing, nonspecific, or more invasive. Additional advantages of CE-MRA, particularly for the thoracic vasculature, include safety, its noninvasive character, large field of view, and the ability to demonstrate complicated three-dimensional relationships without the need for iodinated, nephrotoxic contrast media.
Biliary cystadenoma is a rare epithelial cystic neoplasm representing only 5% of intrahepatic cystic lesions of biliary origin. Commonly, the lesions are solitary cystic structures with multiple thin-walled septa predominantly arising from the right hepatic duct. Although the lesions are generally intrahepatic, extrahepatic tumors have been reported. Biliary cystadenomas range in diameter from 1.5 to 35 cm. The tumor usually affects middle-aged women. Clinical symptoms are related to the mass effect and comprise episodes of jaundice due to biliary obstruction and intermittent upper abdominal pain. Laboratory parameters are nonspecific. As the tumor is considered a premalignant lesion, complete surgical resection is the treatment of choice. We report a case of typical biliary cystadenoma of the left hepatic duct.
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