Contrast-enhanced MR cholangiography (MRCP) with GD-EOB-DTPA in evaluating biliary complications after surgery

Purpose

We assessed the usefulness of contrast-enhanced magnetic resonance cholangiography (CE-MRC) with liver-specific contrast agent in evaluating the biliary tree after hepatic surgery.

Materials and methods

A total of 142 patients with suspected biliary complications after liver surgery underwent hepatobiliary MR before and after administration of gadolinium ethoxy benzylic diethylenetriamine pentaacetic acid (Gd-EOB-DTPA). Unenhanced MR cholangiopancreatography (MRCP) and postcontrast MRC were obtained in all patients. Blinded image evaluation and semiquantitative analysis comparing MRCP and CE-MRC were performed by two experienced radiologists.

Results

In all cases, optimal postcontrast visualisation of the biliary tract was obtained. In 22 patients, a postsurgical biliary complication was confirmed. MRCP detected 64% of lesions, but in 36% of cases, an alteration was only suspected but not clearly defined. CE-MRC allowed definite diagnosis in 100% of cases.

Conclusions

Hepatobiliary-specific contrast agents allow for accurate and extensive study of biliary tract alterations, especially in assessing postsurgical complications.     

Skin‐derived mesenchymal stem cells (S‐MSCs) induce endothelial cell activation by paracrine mechanisms

Please cite this paper as: Skin‐derived mesenchymal stem cells (S‐MSCs) induce endothelial cell activation by paracrine mechanisms. Experimental Dermatology 2010; 19 : 848–850. Abstract: The mesenchymal stem cells (MSCs) are able to accumulate at the site of tissue damage. For this reason, they must transmigrate across the endothelium. In this study, we focused on skin‐derived MSCs (S‐MSCs), because the skin represents a useful stem cell source, and we analysed the VEGF released by S‐MSCs, because it is known to promote endothelial cell proliferation and vascular permeability. Moreover, we evaluated the influence of S‐MSC‐conditioned medium on human aortic endothelial cell intracellular calcium concentration ([Ca²⁺]_i) and nitric oxide (NO) production, given their important role in endothelial permeability modulation. Our results suggest that human S‐MSCs may interact with the endothelium via paracrine mechanisms, probably leading to an alteration of the endothelial barrier. Consequently, we could hypothesize that a therapeutic approach based on human skin‐derived MSCs may have a positive effect on tissue repair.     

Acute monophasic focal demyelinating diseases of the central nervous system: longitudinal cliniconeuroradiological study of two patients

We report the clinical features and laboratory-instrumental findings in two patients with acute monophasic demyelinating disease with focal clinical expression: one case of incomplete cervical transverse myelitis and one of focal supratentorial encephalitis. We describe the clinical course and evolution of the neuroradiological findings (CT and MRI) and discuss their pathological meaning and diagnostic value.

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Sommario Descriviamo le caratteristiche cliniche e i riscontri laboratoristici-strumentali di due pazienti con malattia demielinizzante acuta monofasica ad espressione clinica focale: un caso di mielite trasversa cervicale incompleta ed uno di encefalite sopratentoriale focale.Sono illustrati il decorso clinico e l'evoluzione dei reperti neuroradiologici (TAC e RMN), discutendone il significato patologico e l'utilità diagnostica.

     

Morphological studies of the corpus callosum by MRI in children with malformative syndromes

Summary A morphological analysis of the corpus callosum has been carried out in an MRI study of 34 children with malformative syndromes and 35 normal children. We used a new morphometric method based on measurement of five specific angles. Values outside the range of normality have been found in patients with malformations of the skull, including turricephaly, acrocephaly and frontonasal dysplasia. The results have confirmed the reliability of this method for study of the conformation of the corpus callosum and of its topographical relations with the other cerebral structures.     

Expanding experience with spontaneous dermoid rupture in the MRI era: diagnosis and follow-up

With widespread use of CT and MR imaging, experience with spontaneous dermoid rupture has significantly increased. What was previously believed to be a generally severe or even fatal accident, being the diagnosis made either at surgery or autopsy, or in patients with such consequent conditions as chemical meningitis or obstructive hydrocephalus, now appears to be more frequent than previously thought, and there is some evidence that it may also cause only a slight symptomatology or even be quite asymptomatic. We reviewed the clinical and imaging data of our series of five patients with spontaneously ruptured dermoids, spinal in one case, and intracranial supratentorial in four. These had their diagnosis following mild symptoms (number two cases) or incidentally (number two cases); the spinal tumor caused acute bladder dysfunction, possibly while undergoing rupture, and was associated with indolent intracranial fat spread. Three of the patients also had MR demonstration of asymptomatic persistence of fat spread in the subarachnoid spaces, respectively, 3, 4, and 5 years after rupture. One of the five cases, concerning a parasellar dermoid followed up over 6 years, provides the first demonstration of MR signal intensity change of the tumor prior to rupture.     

Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach

Objective

The discrimination between recurrent glioma and radiation injury is often a challenge on conventional magnetic resonance imaging (MRI). We verified whether adding and combining proton MR spectroscopic imaging (¹H-MRSI), diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) information at 3 Tesla facilitate such discrimination.

Materials and methods

Twenty-nine patients with histologically verified high-grade gliomas, who had undergone surgical resection and radiotherapy, and had developed new contrast-enhancing lesions close to the treated tumour, underwent MRI, ¹H-MRSI, DWI and PWI at regular time intervals. The metabolite ratios choline (Cho)/normal( _n )Cho _n , N-acetylaspartate (NAA)/NAA _n , creatine (Cr)/Cr _n , lactate/lipids (LL)/LL _n , Cho/Cr _n , NAA/Cr _n , Cho/NAA, NAA/Cr and Cho/Cr were derived from ¹H-MRSI; the apparent diffusion coefficient (ADC) from DWI; and the relative cerebral blood volume (rCBV) from PWI.

Results

In serial MRI, recurrent gliomas showed a progressive enlargement, and radiation injuries showed regression or no modification. Discriminant analysis showed that discrimination accuracy was 79.3 % when considering only the metabolite ratios (predictor, Cho/Cr _n ), 86.2 % when considering ratios and ADC (predictors, Cho/Cr _n and ADC), 89.7 % when considering ratios and rCBV (predictors, Cho/Cr _n , Cho/Cr and rCBV), and 96.6 % when considering ratios, ADC and rCBV (predictors, Cho/Cho _n , ADC and rCBV).

Conclusions

The multiparametric 3-T MR assessment based on ¹H-MRSI, DWI and PWI in addition to MRI is a useful tool to discriminate tumour recurrence/progression from radiation effects.