Abdominal manifestation and complications in systemic lupus erythematosus: emphasis on CT findings.

OBJECTIVE: To describe computed tomography (CT) features in SLE patients with suspected abdominal involvement or complications. MATERIAL AND METHOD: SLE Patients who presented with suspected abdominal involvement or complications and underwent CT between 2001 and 2005 were retrospectively reviewed. All CT studies were performed within 21 days of the onset of symptoms. RESULTS: Thirty-two SLE patients with 53 CT examinations including imaging findings and clinical data were reviewed. There were 29 cases with abdominal findings related to SLE including gastrointestinal vasculitis (6 cases), acute pancreatitis (8 cases), genitourinary abnormality (13 cases), hepatosplenomegaly, and ascites. Bowel wall thickening with target sign in CT is characteristics of GI vasculitis. Mild pancreatitis by CT scoring index was found in most cases. Five cases had diffuse bladder wall thickening and three cases also had bilateral hydronephrosis and hydroureter. Sixteen cases had other findings not related to SLE including bowel obstruction, splenic infarction, appendicitis, and hematoma. CONCLUSION: The common CT findings and complications in SLE patients who suspected abdominal involvement were presented CT is useful for detecting the primary cause of abdominal symptoms, planning treatment, and monitoring for complication.

Combined hepatocellular and cholangiocarcinoma: CT findings with emphasis on multiphasic helical CT.

OBJECTIVE: To describe CT findings of patients with combined hepatocellular carcinoma and cholangiocarcinoma (HCC-CC) in correlation with clinical data and histopathological results. MATERIAL AND METHOD: Ten from 31 cases whose CT study was available were reviewed retrospectively in the aspect of imaging findings, clinical data, and pathological results. RESULTS: Most of the tumors were hypodense solitary mass with gradually enhanced after contrast administration. Bile duct dilatation was observed in two cases. The overall CT findings were more similar to CC rather than HCC despite the pathological result showing predominant HCC component. Serum alpha-fetoprotein level was normal or mildly elevated while an elevated concentration of carbohydrate antigen 19-9 was observed. Hepatitis profiles showed positive to hepatitis B virus infection in four cases and hepatitis C virus infection in one case. CONCLUSION: The diagnosis of combined HCC-CC should be considered if the tumor has similar findings to CC without bile duct dilatation on cirrhotic liver and the patient has normal or low rising of the AFP level with or without elevated CA 19-9 level. In non-cirrhotic liver, the finding is non-specific.

The efficacy of roselle (Hibicus sabdariffa Linn.) flower tea as oral negative contrast agent for MRCP study.

OBJECTIVE: To evaluate the efficacy of roselle flower tea (RFT) administration as oral negative contrast agent for MRCP study. MATERIAL AND METHOD: Roselle flower tea was prepared by packing 4,000 mg of dry ground roselle flower in a tea bag and soaked with 480 ml of hot distilled water RFT was tested in phantom, volunteer subjects and was studied in patients for MRCP study. Quanlitative analysis was made by evaluation of the conspicuity of biliary system after RFT administration. Quantitative comparison was performed by comparing the contrast-to-noise ratio between each part of the biliary system with stomach and duodenum. RESULTS: Roselle flower tea can effectively reduce signal intensity of the stomach and duodenum. There was statistically significant (p < 0.05) improvement in conspicuity of the common bile duct. There was slight improvement of conspicuity of common hepatic duct, ampulla and main pancreatic duct. Contrast-to-noise ratios were all statistically significantly improved. RFT contains 0.6 mg of iron and 1.28 mg of manganese content. CONCLUSION: Roselle flower tea is a very efficient oral negative contrast agent. It is natural, safe, inexpensive and palatable for oral administration.