Diagnostic accuracy of MRI with MRCP and B-Mode-sonography with elastography of the pancreas in patients with cystic fibrosis: a point-to-point comparison.

OBJECTIVE: For patients with cystic fibrosis, the imaging of the pancreas is of crucial importance for the early detection of pancreatic carcinoma. Comparative studies between Magnetic Resonance Imaging (MRI) and sonographic pancreas sonography are not yet available. The aim of the study was to compare MRI, sonography and point-shearwave elastography (pSWE). A total of 19 patients were included (10 male, 9 female; age 29.7 ± 14.3 years) in the study. Ultrasonography with pSWE and contrast enhanced MRI with MRCP were performed. RESULTS: Significant differences between measurements of pancreatic body were registered in MRI with 1.4 ± 0.6 cm vs 1.0 ± 0.4 cm in ultrasound (p = 0.049), however not for pancreatic head and tail. In 10/19 patients (52.6%) pancreatic parenchyma did not show in MRI because of complete lipomatous transformation, but could be detected in ultrasound. pSWE-values showed no significant differences between the full and partial fatty transformation in pancreatic head (p = 0.968), body (p = 0.657) and tail (p = 0.840). pSWE-values did not correlate with measured signal intensity in T1w flash (p = 0.930, r = 0.025) and T2w HASTE sequences (p = 0.152, r = - 0.375). In patients with CF ultrasound is superior to MRI for displaying full fibro-fatty parenchymal transformation, pancreatic duct. Ultrasound elastography did not provide additional clinical relevant information.

Point shear wave elastography of the pancreas in patients with cystic fibrosis: a comparison with healthy controls.

PURPOSE: Manifestations of cystic fibrosis in the pancreas are gaining in clinical importance as patients live longer. Conventional ultrasonography and point shear wave elastography (pSWE) imaging are non-invasive and readily available diagnostic methods that are easy to perform. The aim of this study was to perform conventional ultrasonography and obtain pSWE values in the pancreases of patients with cystic fibrosis and to compare the findings with those of healthy controls. METHODS: 27 patients with cystic fibrosis (13 women/14 men; mean age 27.7 ± 13.7 years; range 9-58 years) and 60 healthy control subjects (30 women/30 men; mean age 30.3 ± 10.0 years; range 22-55 years) underwent examinations of the pancreas with conventional ultrasound and pSWE imaging. RESULTS: Patients with cystic fibrosis have an echogenic pancreatic parenchyma. We found cystic lesions of the pancreas in six patients. pSWE imaging of the pancreatic parenchyma gave significantly lower shear wave velocities in patients with cystic fibrosis than in the control group (1.01 m/s vs 1.30 m/s; p < 0.001). CONCLUSIONS: Using pSWE imaging in vivo, we have shown that the pancreas is considerably softer in patients with cystic fibrosis than in a healthy control population.

Prevalence of sporadic renal angiomyolipoma: a retrospective analysis of 61,389 in- and out-patients.

PURPOSE: To calculate the prevalence, localization, and growth of sporadic angiomyolipomas and to identify the predominant sex in the largest patient population reviewed to date. METHODS: Abdominal ultrasound analyses of 61,389 patients (49.7% women; 50.3% men) were consecutively collected using a PC-based, standardized documentation system from September 1999 to December 2012. The present study evaluates and presents this data. RESULTS: The population studied includes 270 cases of sporadic angiomyolipoma (184 females; 86 males). This represents an overall prevalence of 0.44%, with 0.60% in the female and 0.28% in the male subpopulations. Mean tumor size was 10.8 ± 5.8 mm. Fifty-seven percent of cases involved the right kidney and 43.0% the left kidney. Only 14 of the 270 patients presented with multiple angiomyolipomas, four of which were bilateral. Sixty-one cases were followed over a mean period of 25 months (range: 1-105 months) and showed no significant increase in tumor size during the period of observation. CONCLUSION: The analysis of 61,389 patients revealed a higher prevalence of sporadic angiomyolipoma than previously observed in smaller studies. There was a significantly higher prevalence in females than in males. Multiple and bilateral angiomyolipomas were rare, and tumor growth was marginal.