胰腺体尾部先天性缺如并胰腺实性-假乳头状瘤1例

女,23岁。体检B超发现胰腺实性占位性病变,无任何临床症状。化验检查无异常。CT检查：胰腺体尾部部分缺如,胰头及胰体部分别可见稍低密度结节,边界清楚,密度均匀,增强扫描呈明显强化（见图1～5）,CT诊断：胰头及体部良性占位性病变（胰腺实性-假乳头状瘤？）。患者行胰腺部分切除术。     

Displacement of the abdominal aorta by a pseudocyst of the pancreas

Cystic lesions are generally thought not to displace the abdominal aorta. A case involving a large cystic mass near the pancreas which was proven to be a pancreatic pseudocyst is presented, with a dynamic nuclear angiogram and a CT scan of the abdomen showing displacement of the aorta.     

Neuroblastoma of the tail of the pancreas. Apropos of a case

We describe the case of a four-year-old child who presented a neuroblastoma of the tail of the pancreas. Diagnosis was evoked on computer tomography and confirmed thanks to the pathological examination of the resected tumour. Malignant tumours of the pancreas are rare in children and most of the cases are carcinoma. Three cases of pancreatic neuroblastoma have been described. Evolution and prognosis depend on the staging once the diagnosis is established.     

Embolization of the left gastric artery in the absence of angiographic extravasation

Nine high-risk patients with endoscopic evidence of bleeding from the left gastric artery teritory without angiographic extravasation were embolized to prevent rebleeding. Three were embolized with Gelfoam particles, 1 with Gianturco coils, and 5 with Gelfoam plus coils. Three patients rebled; 2 were embolized with Gelfoam only, and the third with coils only. No rebleeding occurred in the 5 patients treated with Gelfoam plus coils. No ischemic complications occurred. We conclude that embolization of the left gastric artery, despite absence of extravasation, is effective in preventing rebleeding in high-risk patients and that both Gelfoam and coils be used.     

Contour variations of the body and tail of the pancreas: evaluation with MDCT

Purpose

To analyze morphology/contour variations of the pancreatic body and tail in subjects free of pancreatic disease.

Methods

We retrospectively reviewed triple-phase, contrast-enhanced multi-detector row computed tomography (3P-CE-MDCT) examinations of 449 patients who had no clinical or CT evidence of pancreatic diseases. These patients were evaluated for morphologic/contour variations of the pancreatic body and tail, which were classified into two types. In Type I, a portion of normal pancreatic parenchyma protrudes >1 cm in maximum diameter from the body or tail (Ia-anteriorly; Ib-posteriorly). Type II was defined as a morphologic anomaly of the pancreatic tail (IIa-globular; IIb-lobulated; IIc-tapered; IId-bifid).

Results

Thirty-eight (8.5%) out of 449 patients had body or tail variations. Of those, 23 patients showed Type I variant: Ia in 21 and Ib in two. Type II variant was identified in 15 patients: IIa in eight, IIb in two, IIc in two and IId in three. Protrusion of the anterior surface of the normal pancreas, especially in the tail, was the most frequently occurring variant.

Conclusions

Recognizing the types and subtypes of morphology/contour variations of the pancreatic body and tail could help prevent misinterpretation of normal variants as pancreatic tumors on unenhanced MDCT.

     

Fat replacement with absence of acinar and ductal structure in the pancreatic body and tail

We report an unusual case of fat replacement of the pancreatic body and tail. Findings on contrast-enhanced computed tomography and ERCP could be confused with dorsal pancreas agenesis. Histopathologic examination of the resected specimen revealed massive fat replacement with complete absence of the acinar and ductal tissue and scattered islets of Langerhans.     

Transient left ventricular dilatation in the absence of epicardial disease on angiography

A 58-year-old woman with a previous anterior myocardial infarction, recurrent chest pain, transient adenosine-induced left ventricular dilatation but no apparent epicardial disease on angiography is presented. Transient ischemic dilatation during myocardial perfusion imaging, and the reported causes of transient left ventricular dilatation in the absence of epicardial disease, are discussed.     

Right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas.

Dysphagia due to secondary involvement of the oesophagus by pancreatic carcinoma is relatively rare. Occasionally, the oesophagus may be involved by direct extension of a carcinoma of the body and/or tail of the pancreas or metastatic lymphadenopathy in the posterior mediastinum. Although the literature contains a few case reports in which barium studies revealed displacement or obstruction of the distal oesophagus, a benign-appearing, smooth, tapered narrowing of the distal oesophagus with a fixed, right-angled configuration is a radiological finding which has not been previously emphasised. In the author's experience, this abnormality may be a helpful radiological clue to the diagnosis of carcinoma of the tail of the pancreas. The clinical, radiological and pathological findings in four patients with dysphagia and a right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas are described and illustrated; the radiological differential diagnosis is briefly discussed.     

Computer tomography of congenital absence of the left lobe of the liver

Computed tomography of absence of the left lobe of the liver is described. Liver scintigraphy may be misinterpreted as indicating tumor of the left lobe. Computed tomography correctly identifies absence of the left lobe and compensatory hyperplasia of the caudate lobe. Two illustrative cases with a peculiar "tongue-like projection" of the caudate lobe are presented.     

智能化血管跟踪MRA在胰肾联合移植中的应用

目的：探讨智能化血管跟踪MRA在胰肾联合移植(SPKT)中的应用。方法：搜集我院SPKT病例5例，采用GE1.5TMR扫描机，先行常规扫描，再行MRCP和MRU检查。在此基础上行Smart Prep MRA成像。所有智能化血管跟踪MRA的源影像均采用IVI软件包进行分析处理。结果：5例SPKT的智能化血管跟踪MRA的腹主动脉远端、髂内外动脉、主要移植动脉及其1～2级分支均清晰显示，其中3例患者血管异常被DSA证实。1例胰腺急性排斥反应者显示胰腺分支血管闭塞，另1例显示脾动脉的动脉瘤形成及血管连接处和胰十二指肠下动脉的近端狭窄。第3例为急性肾脏排斥反应伴肾梗死者显示肾动脉的近端及远端血管闭塞。结论：智能化血管跟踪MRA能显著提高动脉的信噪比，减少流动伪影，进而提高MRA的图像质量。     

Pseudothrombosis of the iliac vein in patients following combined kidney and pancreas transplantation

Pseudothrombosis of the infrarenal inferior vena cava is a well recognized sign seen on helical CT of the abdomen. We report on pseudothrombosis of the iliac vein related to combined kidney and pancreas transplantation in the pelvis.