Colonic wall thickening in cirrhotic patients CT findings and clinical significance

The purpose of this study was to determine the spectrum of colonic wall changes in patients with cirrhosis and to assess its clinical significance by CT. 80 patients clinically diagnosed as liver cirrhosis underwent triphasic CT study of the liver. They were evaluated for the degree and extent of colonic involvement. Other features of cirrhosis including portal hypertension, ascites and splenomegaly were also recorded. Colonic wall thickening >6mm was seen in the 41% [33/80] of the patients. The ascending colon and ceacum were involved in 17 cases. The ascending and transverse colon were involved in 11 cases while the ascending, transverse and descending colon were involved in 5 cases. Portosystemic collaterals were present in 33 cases of colonic wall thickening. Splenomegaly, was present in all the examined cases. Ascites was present in 20 cases, all of them has colonic wall thickening. Colonic wall thickening was limited predominantly to the right colon which could be explained due to portal hypertension and can be used as one of the indicators of poor prognosis in cirrhotic patients. CT can be used as one of the indicators of poor prognosis in patients of liver cirrhosis

Value of post contrast FLAIR in the diagnosis of cerebral metastases in cancer patients

Metastases to the brain, epidural space and meninges constitute the major cause of neurological dysfunction in cancer patients. MRI, FLAIR imaging is a useful non invasive screening modality for brain metastases. Post contrast FLAIR imaging effectively depicts parenchymal and leptomeningeal metastases. To evaluate the usefulness of pre- and post contrast FLAIR images in the detection of intracranial lesions which may be encountered in cancer patients, compared to conventional T1, T2W as well as post contrast T1W images. Seventy patients with known malignancy and suspected cranial metastases underwent FLAIR and spin echo T1W before and after contrast as well as T2W images. Images were compared for lesion conspicuity and enhancement, number of parenchymal metastases and extension of leptomeningeal cisternal metastases. Parenchymal metastases were demonstrated in 59 patients. Compared with T1W images, post contrast FLAIR images showed 10 metastases more in 5 patients, an equal number [45 lesions in 20 patients] and fewer numbers of 8 lesions in 5 patients. Regarding lesion conspicuity, post contrast FLAIR images were superior in 5, equal in 16 and inferior in 9. Superior FLAIR results for lesion number, conspicuity and enhancement were observed in the same 5 patients. Postcontrast FLAIR is a useful adjunct to post contrast T1W imaging and the routine use of FLAIR imaging before and after the administration of contrast material is particularly useful for delineating leptomeningeal cisternal and cranial nerve metastases