Low-carbohydrate diet induced reduction of hepatic lipid content observed with a rapid non-invasive MRI technique.

Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effects at organ level are not well understood, especially the effect on liver fat storage. Such studies require serial hepatic fat measurements, for which liver biopsy is impractical. In 10 healthy volunteers we demonstrate the use of rapid (total 2 min acquisition time, 10 min magnet room time), non-invasive, quantitative MRI to serially measure hepatic fat changes induced by following a low carbohydrate diet for 10 days. A significant (p<0.01) reduction in hepatic fat after 3 days of dieting was observed in 5 subjects. All subjects demonstrated significant (p<0.01) reductions in hepatic fat by day 10. A strong correlation (kappa = 0.81) existed between the initial fat content and the percentage fat content reduction in the first 3 days of the diet. All subjects lost weight (average 1.7 kg at day 3 and 3.0 kg at day 10), but this was not correlated with hepatic fat loss after 3 days or 10 days of dieting. The results presented illustrate the potential value of MR hepatic fat quantification in longitudinal studies of hepatic fat content.

Fast-track management of malignant superior vena cava syndrome.

We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.