Autoimmune hepatitis: CT and MR imaging features with histopathological correlation.

BACKGROUND: To describe the CT and MRI features of autoimmune hepatitis (AIH) and correlate them with histological grade and stage. Observed changes associated with treatment are also described. METHODS: A retrospective analysis of the initial CT scans (n = 22) and MRI exams (n = 12) of 27 patients with pathologically-proven AIH was conducted. Multiple objective and subjective imaging features were evaluated. Correlation of imaging features with histological inflammatory grade and fibrotic stage was performed using the Fisher exact test and Spearman's rank correlation coefficient. In eight patients serial CT and MR imaging during treatment was used to describe the changes associated with treatment. RESULTS: The presence of ascites, expanded gallbladder fossa, spleen size, and enlarged preportal space had significant positive correlations with fibrotic stage. No significant positive correlations existed between imaging features and portal or lobular inflammatory grade. Seven patients (25.9%) were normal. The most common abnormal finding was surface nodularity: CT (n = 11 [50%]) and MRI (n = 8 [66.7%]). There was a wide variability in imaging appearances of patients who had serial scans on treatment. CONCLUSIONS: There is a wide spectrum of CT and MR imaging features in patients with AIH. Several MRI features demonstrate a significant positive correlation with fibrotic stage.

Magnetic resonance imaging of anorectal neoplasms.

Among imaging techniques, magnetic resonance imaging (MRI) has evolved as the most robust technique for the detection, characterization, and staging of anorectal cancers. With its superior contrast resolution, multiplanar imaging capability, and nil radiation risk, it has become the standard preoperative imaging tool in rectal tumors. In this article we aim to outline the various types of anorectal cancers, highlight the complex anatomy of this region, and discuss the immensely useful role of MRI in the management of anorectal cancers. Existing limitations and future applications in this area will also be discussed. Because rectal adenocarcinomas constitute the majority of tumors in this region, we will be discussing the input of MRI in the management of this condition in greater detail. This will be followed by an overview of MRI in anal carcinoma and other less common anorectal neoplasms.

Diaphragm disease of the small intestine: an interesting case report.

Diaphragm disease of small intestine usually presents with nonspecific clinical features. Radiological investigations often fail to differentiate it from small intestinal tumors and inflammatory bowel disease. It is therefore diagnosed on final histology after surgical resection. We hereby report an interesting case of a suspected small bowel tumor later diagnosed as diaphragm disease on histology.

Efficacy of renal artery angioplasty and stenting in a solitary functioning kidney.

OBJECTIVE: The aim of this study was to share our experience of percutaneous renal artery angioplasty and stenting (PTRAS) in our patients with a solitary functioning kidney over a 10-year period. METHODS: The procedures were performed on 75 patients from 1995 to 2004. Data were collected retrospectively from case notes of patients. The definition for solitary functioning kidney was a contralateral kidney size of <8 cm, complete occlusion of contralateral renal artery or previous nephrectomy. Serum creatinine was considered improved or worse if the deviation from the baseline value was >20%. RESULTS: For the purpose of halting renal deterioration (n=47), there were improvement and stabilization in 21% and 55% at 3 months and 28% and 28% at 12 months. Systolic blood pressure (n=27) improvement and stabilization were achieved in 33% and 56% both at 3 and 12 months. Diastolic blood pressure (n=27) improvement and stabilization were 22% and 70% at 3 months and 33% and 48% at 12 months. Five out of seven patients with acute renal failure (serum creatinine>500 micromol/l and requiring haemodialysis) pre-procedure were dialysis-free at 12 months. Complications occurred in 19 (25%) patients and these included bleeding (n=16), pseudoaneurysm (n=3), renal artery dissection (n=2) and cholesterol embolization (n=1). CONCLUSION: PTRAS in a solitary functioning kidney produced clinical benefits in the majority of patients with resistant hypertension and renal function deterioration.