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Diffusion weighted imaging in the liver

World journal of Gastroenterology 2010年第13期16卷 1567-1576页

作者： Petra G Kele eric j van der jagt Department of Radiology University Medical Center Groningen University of Groningen

Diffusion weighted magnetic resonance imaging (DWI) is an imaging technique which provides tissue contrast by the measurement of diffusion properties of water molecules within tissues. Diffusion is expressed in an apparent diffusion coefficient (ADC), which reflects the diffusion properties unique to each type of tissue. DWI has been originally used in neuroradiology. More recently, DWI has increasingly been used in addition to conventional unenhanced and enhanced magnetic resonance imaging (MRI) in other parts of the body. The reason for this delay was a number of technical problems inherent to the technique, making DWI very sensitive to artifacts, which had to be overcome. With assessment of ADC values, DWI proved to be helpful in characterization of focal liver lesions. However, DWI should always be used in conjunction to conventional MRI since there is considerable overlap between ADC values of benign and malignant lesions. DWI is useful in the detection of hepatocellular carcinoma in the cirrhotic liver and detection of liver metastases in oncological patients. In addition, DWI is a promising tool in the prediction of tumor responsiveness to chemotherapy and the follow-up of oncological patients after treatment, as DWI may be capable of detecting recurrent disease earlier than conventional *** review focuses on the most common applications of DWI in the liver.

关键词： Diffusion Magnetic resonance imaging Diffusion weighted imaging Benign neoplasms Liver neoplasms

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Colonoscopic yield of colorectal neoplasia in daily clinical practice

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World journal of Gastroenterology 2009年第9期15卷 1085-1092页

作者： jochim S Terhaar sive Droste Mike E Craanen Rene WM van der Hulst joep F Bartelsman Dick P Bezemer Kim R Cappendijk Gerrit A Meijer Linde M Morsink Pleun Snel Hans ARE Tuynman Roy Lj van Wanrooy eric IC Wesdorp Chris jj Mulder Department of Gastroenterology and Hepatology VU University Medical CentrePO Box 70571007 MBAmsterdamThe Netherlands Gastroenterology and Hepatology Kennemer Gasthuis2000 AKHaarlemThe Netherlands Gastroenterology and Hepatology Academic Medical Centre1100 DDAmsterdamThe Netherlands Epidemiology and Biostatistics VU University Medical Centre1007 MBAmsterdamThe Netherlands Pathology VU University Medical Centre1007 MBAmsterdamThe Netherlands Gastroenterology and Hepatology Slotervaart Hospital1006 BKAmsterdamThe Netherlands Gastroenterology and Hepatology Medical Centre Alkmaar1800 AMAlkmaarThe Netherlands Gastroenterology and Hepatology Sint Lucas Andreas Hospital1061 AEAmsterdamThe Netherlands

AIM:To assess the prevalence and location of ad-vanced neoplasia in patients undergoing colonoscopy,and to compare the yield per ***:In a multicenter colonoscopy survey (n = 18 hospitals) in the Amsterdam area (Northern Holland),data of all colonoscopies performed during a three month period in 2005 were analyzed. The location and the histological features of all colonic neoplasia were recorded. The prevalence and the distribution ofadvanced colorectal neoplasia and differences in yield between indication clusters were evaluated. Advanced neoplasm was defi ned as adenoma > 10 mm in size,with > 25% villous features or with high-grade dyspla-sia or ***:A total of 4623 eligible patients underwent a total colonoscopy. The prevalence of advanced neo-plasia was 13%,with 281 (6%) adenocarcinomas and 342 (7%) advanced adenomas. Sixty-seven percent and 33% of advanced neoplasia were located in the distal and proximal colon,respectively. Of all patients with right-sided advanced neoplasia (n = 228),51% had a normal distal colon,whereas 27% had a syn-chronous distal adenoma. Ten percent of all colono-scopies were performed in asymptomatic patients,7% of whom had advanced neoplasia. In the respective procedure indication clusters,the prevalence of right-sided advanced neoplasia ranged from 11%-57%. CONCLUSION:One out of every 7-8 colonoscopies yielded an advanced colorectal neoplasm. Colonoscopy is warranted for the evaluation of both symptomatic and asymptomatic patients.

关键词： Colorectal cancer Screening Advanced neoplasia Colonoscopy Adenoma

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