Non-breath-hold MR cholangiography is a reliable method for depiction of the biliary system.

Percutaneous cecostomy (PCC) was evaluated in dogs and cadavers and by means of review of intraperitoneal contrast material-enhanced computed tomographic (CT) scans and clinical experience in five patients with Ogilvie syndrome. It was shown that PCC can be accomplished with a variety of techniques (e.g. Seldinger or trocar puncture, tacking) and instruments (various types and sizes of retention and nonretention catheters). Anatomic studies revealed that the cecum is surrounded by the peritoneum for as much as 270 degrees of its circumference, so that a retroperitoneal approach to PCC would probably be unfeasible in most patients. PCC was effective in treating all five patients in this study, despite their advanced age and complicated medical conditions. Decompression of colonic gas was achieved with 8-12-F catheters, and no major complications occurred. Endoscopic decompression had been unsuccessfully attempted in four of the patients previously. It is concluded that PCC may be an important option in the treatment of Ogilvie syndrome and that the procedure may obviate surgery and be lifesaving in certain high-risk patients.

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To compare liver lesion detection rates, tissue signal and noise data, and qualitative parameters for breath-hold (BH) and non-breath-hold (NBH) hybrid rapid acquisition with relaxation enhancement (RARE) and conventional spin-echo (CSE) T2-weighted (CSE-T2) MR sequences, 20 patients were imaged using all three sequences. Lesion detection rates were 73.5% for the CSE-T2 sequence and 81.1% and 88.6% for the BH-RARE and NBH-RARE sequences, respectively (P = .027). Mean lesion-to-liver signal-difference-to-noise ratio for the NBH-RARE sequence was 14.0 +/- 11.5, significantly greater than 9.8 +/- 7.8 obtained for the BH-RARE sequence (P = .050) and 9.0 +/- 6.2 obtained for the CSE-T2 sequence (P = .015). The NBH-RARE sequence demonstrated fewer artifacts and greater overall image quality compared to the CSE-T2 sequence. The NBH-RARE sequence is a useful alternative to the liver signal-difference-to-noise ratio and lesion detection rate and better overall image quality.