Magnetic resonance imaging of fibrosing mediastinitis

Magnetic resonance imaging (MRI) was performed in seven patients with fibrosing mediastinitis. Comparison was made in each case to standard chest radiography and computed tomography (CT). Angiography was performed in three cases. Although MRI and CT were found to be equivalent in defining the extent of adenopathy, CT was superior at demonstrating calcifications, often important in making the diagnosis of fibrosing mediastinitis. MRI, however, offered complementary information, particularly in assessing vascular patency without the need for intravenous contrast media. On T2-weighted images, the adenopathy associated with fibrosing mediastinitis was noted to be of relatively low signal intensity, possibly indicating its benign nature.     

Pancreatic transplant imaging

Forty-four clinical episodes of suspected (pancreas) transplant rejection in 17 pancreatic transplantation patients were reviewed retrospectively. The clinical impression of acute graft rejection, chronic rejection, or nonrejection in each episode was correlated with the results of 19 nuclear medicine, 12 ultrasound (US), and 44 magnetic resonance (MR) imaging studies. US was found to be a moderately sensitive (82%) method of detecting graft rejection. US also was effective in identifying intra- and peripancreatic fluid accumulations. Nuclear medicine imaging was also a sensitive technique (86%) and the only modality that provided physiologic information regarding graft perfusion. MR imaging allowed correct prediction of the presence or absence of graft rejection in 39 of 44 cases (sensitivity, 100%; specificity, 76%) and was an effective means of detecting pathologic fluid collections. Nuclear medicine, US, and MR imaging are all believed to be sensitive methods of detecting graft rejection and are complementary adjuncts to the clinical evaluation of pancreatic transplants.