Multiple Esophageal Squamous Papillomas.

We report a rare case of multiple esophageal squamous papillomas (ESPs). A 42-year-old man underwent a medical examination, and abnormalities of multiple elevated lesions were noted using a esophagogastroduodenoscope. He underwent upper gastrointestinal tract radiography with an orally ingested barium sulfate and gastrointestinal endoscopy, which revealed multiple elevated lesions in the esophagus, predominantly on the distal esophagus. We performed an endoscopic esophageal mucosal resection using a cap-fitted esophagogastroduodenoscope to obtain sufficient specimens. Based on the pathological findings, we diagnosed multiple ESPs. Although single ESPs or a few ESPs in a patient are often encountered, multiple ESP cases are rare.

Obliteration of the Biliary System after Administration of an Oral Contrast Medium Is Probably due to Regurgitation: A Pitfall on MRCP.

PURPOSE: We retrospectively evaluated the incidence and related factors of obliteration of the lower bile duct after oral administration of contrast medium (OCM) probably resulting from its regurgitation into the biliary system (OCMRB) as observed on images of MR cholangiopancreatography (MRCP). METHODS: We retrospectively analyzed 305 MRCP images in 278 patients obtained between February 2010 and March 2011 using negative OCM with 1.0- and 1.5-tesla clinical units. OCMRB was defined as positive when visualization of the common bile duct was clear on precontrast 2-dimensional (2D) MRCP but obliterated on postcontrast 3-dimensional (3D) MRCP. Two abdominal radiologists reviewed all images in consensus. The incidence of OCMRB was correlated to various clinicoradiological factors. RESULTS: We observed OCMRB on 11 MRCP images in 10 patients (3.6%). Among various clinicoradiological factors, the presence of juxtapapillary diverticula, pneumobilia, and history of intervention to the papilla were suggested as significant factors related to positive OCMRB with multivariate analysis (P < 0.05). CONCLUSION: OCMRB occurs in about 4% of the patients who undergo MRCP, typically in those with juxtapapillary diverticula, pneumobilia, and history of papillary intervention. Acquisition of MRCP images before OCM may secure visualization of the common bile duct in these patients.

Measurement consistency of MR elastography at 3.0 T: comparison among three different region-of-interest placement methods.

PURPOSE: To test inter- and intraobserver consistency of liver stiffness measurement on MR elastography (MRE) at 3.0 T. MATERIALS AND METHODS: Two abdominal radiologists independently measured stiffness of the liver on MRE in three volunteers and seven patients with chronic liver diseases using three different region-of-interest (ROI) placement methods. Methods 1 and 2 involved placing circular and free-hand-drawn ROIs, respectively, visually referring to anatomical (three-dimensional T1-weighted) and wave images. Method 3 involved placing ROIs on the fused images of MRE and anatomical images developed on a work station, visually referring to wave images. The inter- and intraobserver consistency was assessed with regression and Bland-Altman analysis. RESULTS: Thirty-eight images were available for measurement in total. As for interobserver consistency, method 3 showed the best regression coefficient, correlation coefficient, and y intercept. The absolute values of the interobserver differences for method 3 were significantly smaller than those of method 1 or method 2 (p < 0.05, each). Intraobserver consistency of method 3 was excellent for both observers. CONCLUSION: Stiffness measurement of the liver on MRE performed with the fusion method at 3.0 T provides the highest inter- and intraobserver consistency.