Challenges in hepatic and pancreatic imaging

Department of Radiology, Adiyaman University School of Medicine, Adiyaman, Turkey, The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018Introduction: Les pathologies hépatobiliaires et pancréatiques sont relativement fréquentes et continuent à présenter divers défis diagnostiques. Contenu: Les caractéristiques d’imagerie des lésions hépatiques et pancréatiques seront examinées en mettant l’accent sur les résultats de l’imagerie par résonance magnétique (IRM) et de la tomodensitométrie (TDM). Les cas cliniques seront utilisés comme exemples pour illustrer des présentations typiques et atypiques ainsi que des pièges courants et des défis diagnostiques. La première partie de la conférence est consacrée à la caractérisation par imagerie de diverses lésions hépatiques, en particulier dans le cadre clinique de la cirrhose du foie. Diagnostic différentiel de pathologies telles que nodules hépatiques régénératifs et dysplasiques, hyperplasie nodulaire focale (HNF), cholangiocarcinome intrahépatique, carcinome hépatocellulaire (CHC), échinococcus alvéolaire hépatique et kystes hydatiques, hémangiomes atypiques, métastases hépatiques. La deuxième partie de la conférence est consacrée à l’imagerie et aux caractéristiques démographiques des lésions kystiques pancréatiques courantes, y compris les pseudokystes, les cystadénomes séreux, les tumeurs kystiques mucineuses, les tumeurs intracanalaires papillaires mucineuses (IPMN), les tumeurs pseudopapillaires solides du pancréas etc. Des questions / réponses interactives avec le public seront également utilisées. Conclusions: Les participants se familiariseront avec les caractéristiques de l’IRM et de l’imagerie CT des lésions hépatiques et pancréatiques, des pièges courants et des problèmes de diagnostic.Background: Hepatobiliary and pancreatic pathologies are relatively common and continue to present a variety of diagnostic challenges. Content: Imaging features of hepatic and pancreatic lesions will be reviewed with a special emphasis on magnetic resonance imaging (MRI) and computed tomography (CT) findings. Clinical cases will be used as examples to illustrate typical and atypical presentations as well as common pitfalls and diagnostic challenges. The first part of the lecture is dedicated to imaging characterization of various liver lesions, especially in the clinical setting of liver cirrhosis. Differential diagnosis of such pathologies as regenerative and dysplastic liver nodules, focal nodular hyperplasia (FNH), intrahepatic cholangiocarcinoma, hepatocellular carcinoma (HCC), hepatic echinococcus alveolaris and hydatid cysts, atypical hemangiomas, hepatic metastases are discussed. The second part of the lecture is dedicated to discussing imaging and demographic features of common pancreatic cystic lesions, including pseudocysts, serous cystadenomas, mucinous cystic tumours, intraductal papillary mucinous neoplasms (IPMN), solid pseudopapillary tumors, solid pseudopapillary tumours of the pancreas, etc. Interactive questions/answers with audience will be also used. Conclusions: Attendees will increase their familiarity with MRI and CT imaging features of hepatic and pancreatic lesions, common pitfalls and diagnostic challenges

Challenges in hepatic and pancreatic imaging

Department of Radiology, Adiyaman University School of Medicine, Adiyaman, Turkey, The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018Background: Hepatobiliary and pancreatic pathologies are relatively common and continue to present a variety of diagnostic challenges. Content: Imaging features of hepatic and pancreatic lesions will be reviewed with a special emphasis on magnetic resonance imaging (MRI) and computed tomography (CT) findings. Clinical cases will be used as examples to illustrate typical and atypical presentations as well as common pitfalls and diagnostic challenges. The first part of the lecture is dedicated to imaging characterization of various liver lesions, especially in the clinical setting of liver cirrhosis. Differential diagnosis of such pathologies as regenerative and dysplastic liver nodules, focal nodular hyperplasia (FNH), intrahepatic cholangiocarcinoma, hepatocellular carcinoma (HCC), hepatic echinococcus alveolaris and hydatid cysts, atypical hemangiomas, hepatic metastases are discussed. The second part of the lecture is dedicated to discussing imaging and demographic features of common pancreatic cystic lesions, including pseudocysts, serous cystadenomas, mucinous cystic tumours, intraductal papillary mucinous neoplasms (IPMN), solid pseudopapillary tumors, solid pseudopapillary tumours of the pancreas, etc. Interactive questions/answers with audience will be also used. Conclusions: Attendees will increase their familiarity with MRI and CT imaging features of hepatic and pancreatic lesions, common pitfalls and diagnostic challenges

Rare Variants of Carotid-Vertebrobasilar Anastomoses

Carotid-vertebrobasilar anastomoses generally disappear during embryogenesis. However, if a problem exists during regression, these arteries persist in adult period and are named as persistent arteries. Their persistence in adult patients is sometimes pathological and may result in the development of an aneurysm or a compressive syndrome. These anastomoses are frequently associated with proximal or distal arterial pathology. Herein, we present three rare variants of carotid-vertebrobasilar anastomoses: a persistent trigeminal artery, persistent hypoglossal artery, and a persistent otic artery. These variants should be kept in mind to avoid errors both in clinical reporting and surgical procedures

Comparison of MRI and 18F-FDG PET/CT in the Liver Metastases of Gastrointestinal and Pancreaticobiliary Tumors

Objectives: To compare the efficacy of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) in the detection of liver metastases originating from the gastrointestinal system (GIS) and the pancreaticobiliary (PB) system

Can peritoneal thickening and enhancement be used to determine perforation in patients with acute appendicitis ?

BACKGROUND: Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold standard with the highest sensitivity and specificity, and it is also an im-portant modality, especially in patients with complicated AA. In this study, we aimed to evaluate age and laboratory findings, as well as specific CT findings in differentiating between perforated and non-perforated appendicitis. METHODS: We retrospectively analyzed 252 patients diagnosed with AA and underwent appendectomy between November 2015 and December 2019 in Somalia Mogadishu Recep Tayyip Erdogan Education and Research Hospital. Patients under 18 years of age and those with no pre-operative CT scans were excluded from the study. The demographic, laboratory, CT findings, and pathological data of all patients were evaluated. RESULTS: This study included 80 patients, 32 (40%) classified as perforated appendicitis (Group-1) and 48 (60%) as non-perforated appendicitis (Group-2). The C-reactive protein value was found to be statistically higher in Group-1 than in Group-2 (177.5 +/- 118.9 and 100.2 +/- 87.3 mg / L, respectively; p=0.001). The appendix lumen diameter (p=0.002), appendix wall defect (p<0.001), peritoneal thickening and enhancement (p<0.001), ascites (p=0.031), intra-abdominal abscess (p=0.003), jejunal thickening (p=0.019), ileal thick-ening (p=0.008), and ileus (p=0.035) values were significantly higher in Group-1. In the binominal logistic regression analysis performed with statistically significant data, an appendiceal wall defect (OR: 0.069, 95% CI=0.014-0.327, p=0.001) and peritoneal thickening and enhancement (OR: 0.131, 95% CI=0.024-0.714, p=0.019) were identified as independent variables for perforated appendicitis. CONCLUSION: Among CT findings, appendix wall defects and peritoneal thickening and enhancement play an important role in detecting perforation