MR imaging of the thoracoabdominal junction.

Recent advances in MR imaging techniques and its multiplanar capability allow for improved detection and characterization of benign and malignant processes occurring in the thoracoabdominal region. It is important to the staging process of patients with known malignancy to correctly diagnose incidental masses in this region, including hepatic or adrenal lesions, which initially may be identified by other imaging modalities. MR imaging provides a complimentary role in lesion detection and diagnosis that may ultimately affect therapeutic management and outcome.

Torsion of intraperitoneal renal transplants: imaging appearances.

OBJECTIVE: Torsion of a renal transplant is a rare complication with nonspecific clinical manifestations. Prompt detection is necessary to allow surgical treatment and to preserve renal function. We describe the radiologic appearances of torsion of intraperitoneal renal transplants in patients who have undergone simultaneous renal and pancreatic transplantation or dual renal transplantation. CONCLUSION: Renal transplant torsion should be suspected when a change in renal axis associated with abnormal perfusion occurs in an intraperitoneal kidney.

The role of large core needle biopsy in locally advanced breast cancer.

The appropriate management of locally advanced breast carcinoma (LABC) is controversial. It is evident that overall survival in patients treated with locoregional control remains dismal. The trend towards a more effective means of improving response rates and overall survival in LABC has shifted towards earlier aggressive treatment to include neoadjuvant chemotherapy. A known histopathological diagnosis is required prior to the implementation of therapy, which is dependent upon the initial method used to obtain tissue. We advocate the use of large core (14 g) needle breast biopsy over other commonly employed techniques. This technique is reliable, safe, and efficient.

MR imaging of congenital anomalies of the thoracic veins.

Congenital anomalies of the thoracic veins are infrequent but important developmental abnormalities. Thoracic venous anomalies can be classified as systemic or pulmonary. Systemic venous anomalies are often incidental findings, whereas pulmonary venous anomalies are more likely to manifest with cyanosis and to be associated with congenital cardiac abnormalities, especially atrial septal defect. Magnetic resonance (MR) imaging provides excellent delineation of the abnormal vessels and associated cardiac defects. Conventional spin-echo (SE) techniques show blood flow as a signal void and are sufficient for demonstrating the aberrant venous anatomy in most cases. Gradient-echo images show flowing blood as high signal intensity and are useful for clarifying the course of anomalous veins when vessel walls are difficult to visualize on SE images. Phase-contrast images are valuable for ascertaining the direction of blood flow and thus provide a physiologic method of distinguishing the vertical vein of anomalous pulmonary venous return from a left superior vena cava. MR imaging is useful for delineating both the thoracic venous and accompanying intracardiac anomalies and is a valuable, complementary technique to echocardiography, angiography, and computed tomography in the evaluation of patients with these abnormalities.