MDCT evaluation of early pulmonary infection types after liver transplantation.

INTRODUCTION: Opportunistic pulmonary infections frequently occur after liver transplantation, and affect mortality and morbidity significantly. The purpose of this study was to define the incidence, types, and imaging characteristics of pulmonary infections in liver transplant recipients with multidetector CT (MDCT) evaluation. METHODS: Thirty-five adult transplant recipients diagnosed with a pulmonary infection within the first 45 days posttransplantation were reviewed retrospectively from March 2002 to December 2013. MDCT features were evaluated retrospectively by 2 radiologists in consensus. All diagnoses were made by sputum analysis, cultures, biopsies, and postmortem histopathologic evaluation. RESULTS: Pneumococcus pneumonia was found in 7 patients. Five patients had nonspecific pneumonia, Candidiasis, Klebsiella, and Aspergillosis separately. S aureus pneumonia was detected in 2 patients and the other 2 patients had Escherichia coli pneumonia. Two patients had active tuberculosis and 1 patient had Acinetobacter pneumonia also. Four main MDCT patterns were identified: patchy infiltrations (10%), tree-in-bud pattern (9.5%), ground-glass opacity (8.5%), and nodules with halo sign (6%). One patient had a cavitary lesion owing to tuberculosis. CONCLUSION: Although the incidence of pulmonary complications in liver recipients was relatively low, mortality from serious infections was high. Care must be taken with pulmonary infectious complications in the posttransplant period. For any suspicious case, MDCT evaluation for specific patterns of early accurate diagnosis is very important.

Pancreatic cystic lymphangioma: diagnostic approach with MDCT and MR imaging.

Lymphangiomas are rare congenital benign tumors arising from the lymphatic system mostly encountered in the neck and axillary regions of pediatric patients. Pancreatic cystic lymphangiomas very rarely occur in adults. Radiologically, the lesion may mimic pancreatic carcinoma and should be considered in the differential diagnosis of any patient found to have an abdominal cystic mass. In this article, we present a 50-year-old man who presented with pain in the upper abdomen, nausea, and abdominal swelling. On computed tomography (CT) and magnetic resonance (MR) imaging, a gross septated cystic lesion was detected in the upper abdomen which extended from the pancreatic corpus to the left liver lobe. The patient underwent complete resection of tumor. Pathology revealed a cystic lymphangioma.

Giant retroperitoneal liposarcomas: diagnostic approach with multidetector computed tomography and magnetic resonance imaging.

Liposarcomas are the most common mesenchymal tumors of the retroperitoneal space. Retroperitoneal liposarcomas are usually grown slowly and frequently reach a very large size before clinical recognition. Precise diagnosis and distinct multiplanar evaluation is essential for complete resection of these tumors. Here in we reported two cases with giant retroperitoneal liposarcomas which were evaluated multiplanary with multidetector computed tomography and magnetic resonance imaging.

Comparison of combined oral and i.v. contrast-enhanced versus single i.v. contrast-enhanced mdct for the detection of acute appendicitis.

OBJECTIVE: The aim of our study was to compare the diagnostic ability of oral added intravenous (IV) contrast-enhanced multidetector computed tomography (MDCT) versus only IV contrast-enhanced MDCT in diagnosing of acute appendicitis. MATERIALS AND METHODS: MDCT images of 200 patients were evaluated prospectively in this study. Patients were randomized into one of two groups: Group 1 (Gp1) patients underwent 16-MDCT performed with oral and IV contrast-enhanced and Group 2 (Gp2) subjects underwent 16-MDCT with only IV contrast-enhanced protocol. Final decision was based on histopathologic operative data and follow-up of patients. RESULTS: In Gp1, Reader1 had 96.9% and 98.5% and Reader2 had 84% and 94.7% sensitivity and specificity values respectively. For Gp2, the values for Reader1 were 81% and 94%. For Reader2 in Gp2, the values were 76% and 91%. We achieved higher sensitivity and specificity values with combined contrast administration versus only IV contrast-enhanced MDCT imaging. However, there was no statistically significant differences between two readers in the AUC values of each group for the detection of acute appendicitis. CONCLUSION: It is statistically concluded that oral contrast do not contribute to the a better accuracy. So in the routine practice, oral contrast has not to be recommended.

Adrenal myelolipoma: case report with a review of the literature.

A 40 year old woman who was pre-operatively diagnosed as possibly having adrenal myelolipoma is reported. Adrenal myelolipomas are rare, non-functional benign tumours comprising varying amounts of fat and haematopoietic elements. Albeit possibly coincidental, there is a frequent association with obesity, hypertension, and/or diabetes mellitus. A growing number of patients are being diagnosed during ultrasonographic or computerized tomographic scanning for unrelated problems.