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Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass

World Journal of Gastroenterology 2010年第18期16卷 2298-2301页

作者： Stefano Palmucci Letizia Antonella Mauro pietro milone Francesco Di Stefano Antonino Scolaro Antonio Di Cataldo Giovanni Carlo Ettorre Department DOGIRA Section of Radiological Sciences"Policlinico-Vittorio Emanuele" University Hospital Division of Phlebologic Vascular Surgery Hospital "Garibaldi Nesima" Department of General and Colorectal Surgery "Policlinico-Vittorio Emanuele" University Hospital

Aneurysms and pseudoaneurysms of the superior mesenteric artery are potentially lethal and should be treated as urgently as *** a 52-year-old man with occasional epigastric pain,we accidentally discovered a superior mesenteric artery aneurysm that was ruptured with spontaneous tamponade in the uncinate process and in the head of the *** ruptured aneurysm had a heterogeneous appearance due to its thrombotic and hemorrhagic content,and it simulated a voluminous mass in the head and uncinate process of the pancreas,associated with mild dilatation of the main pancreatic *** advances in multidetector computed tomography and magnetic resonance imaging have enabled radiologists to develop a correct diagnosis of mesenteric aneurysms and pseudoaneurysms of the visceral branches of the abdominal aorta,and to differentiate this diagnosis from that of pancreatic or peripancreatic masses;angiography is currently used to confirm a diagnosis and to develop therapeutic treatments.

关键词： Superior mesenteric artery Magnetic resonance imaging Computed tomography Ruptured aneurysm

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Diffusion-weighted MRI in a liver protocol: Its role in focal lesion detection

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World Journal of Radiology 2012年第7期4卷 302-310页

作者： Stefano Palmucci Letizia Antonella Mauro Martina Messina Brunella Russo Giovanni Failla pietro milone Massimiliano Berretta Giovanni Carlo Ettorre Radiodiagnostic and Oncological Radiotherapy Unit University Hospital "Policlinico-Vittorio Emanuele" 95123 Catania Italy Department of Medical Oncology National Cancer Institute 33081 Aviano (PN) Italy

AIM: To evaluate the role of diffusion-weighted imaging (DWI) in the detection of focal liver lesions (FLLs), using a conventional magnetic resonance imaging (MRI) protocol. METHODS: Fifty-two patients (22 males, average age 55.6 years, range: 25-82 years), studied using a 1.5 Tesla magnetic resonance scanner, were retrospectively analyzed; detection of FLLs was evaluated by considering the number of lesions observed with the following sequences: (1) respiratory-triggered diffusion-weighted single-shot echo-planar (DW SS-EP) sequences; (2) fat-suppressed fast spin-echo (fs-FSE) T2 weighted sequences; (3) steady-state free precession (SSFP) images; and (4) dynamic triphasic gadolinium-enhanced images, acquired with three-dimensional fast spoiled gradient-echo (3D FSPGR). Two radiologists independently reviewed the images: they were blinded to their respective reports. DW SS-EP sequences were compared to fs-FSE, SSFP and dynamic gadolinium-enhanced acquisitions using a t -test. Pairs were compared for the detection of: (1) all FLLs; (2) benign FLLs; (3) malignant FLLs; (4) metastases; and (5) hepatocellular carcinoma (HCC). RESULTS: Interobserver agreement was very good (weighted = 0.926, CI = 0.880-0.971); on the consensus reading, 277 FLLs were detected. In the comparison with fs-FSE, DW SS-EP sequences had a significantly higher score in the detection of all FLLs, benign FLLs, malignant FLLs and metastases; no statistical difference was observed in the detection of hepatocellular carcinoma (HCCs). In the comparison with SSFP sequences, DW SS-EP had significantly higher scores (P < 0.05) in the detection of all lesions, benign lesions, malignant lesions, metastases and HCC. All FLLs were better detected by dynamic 3D FSGR enhanced acquisition, with P = 0.0023 for reader 1 and P = 0.0086 for reader 2 in the comparison with DW SS-EP sequences; with reference to benign FLLs, DW SS-EP showed lower values than 3D FSPGR enhanced acquisition (P < 0.05). No statistical diff

关键词： Diffusion weighted magnetic resonance imaging Liver Liver disease Magnetic resonance imaging

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