Canadian Association of Radiologists Breast Disease Imaging Referral Guideline.

The Canadian Association of Radiologists (CAR) Breast Disease Expert Panel consists of breast imaging radiologists, a high-risk breast clinician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 30 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 69 recommendation statements across the 20 scenarios. This guideline presents the methods of development and the recommendations for referring asymptomatic individuals, symptomatic patients, and other scenarios requiring imaging of the breast.

Recurrent Enlarging Mesenteric Desmoid Tumor following Remote Surgical Resection.

Intra-abdominal desmoid tumors are commonly associated with genetic syndromes such as familial polyposis coli. Radiological cross imaging studies such as CT and MRI are used in the preoperative work-up of such tumors. Postoperatively, CT and MRI are useful in the assessment of recurrent desmoid tumors. MRI is more accurate in tissue characterization. Where possible, surgical resection remains the standard first-line treatment. For patients where surgery is not possible, or the resection margins are not clear, other forms of treatment are possible. These include hormonal and nonhormonal options. We present a case of a recurrent sporadic intra-abdominal (mesenteric) desmoid tumor. Such an entity is rare with few cases reported in the literature. Treatment options regarding intra-abdominal desmoid tumors will be discussed.

MRCP imaging of duplicate gallbladder: a case report and review of the literature.

PURPOSE: Duplicate gallbladder is a rare congenital abnormality of the hepatobiliary system that has an incidence of roughly 1 in 4000. Many surgical studies have demonstrated that congenital anomalies of the gallbladder and anatomical variations of its position are associated with an increased risk of complications after laparoscopic cholecystectomy. METHODS: Using ultrasound, MRCP and 3D reconstructions, we report a case of a 29-year-old female who was incidentally revealed to have a duplicated gallbladder. A review of the literature surrounding this variant, its anatomical classifications and relevance to surgical practice is included. CONCLUSION: The double gallbladder is a rare congenital condition that is often not considered in the differential diagnosis for a patient with gallbladder disease or intraoperatively. At present, it is only detected via pre-operative imaging in 50% of cases, but an understanding of the limitations of ultrasound combined with more frequent and thorough use of MRCP before surgical intervention could prevent serious complications of laparoscopy in these patients.