MRI Evaluation of cooperative and non-cooperative patients with non-traumatic acute abdominal pain - preliminary observations.

PURPOSE: To compare diagnostic performance of two MRI protocols, motion resistant and conventional breath-hold, in patients with acute abdominal pain. MATERIALS AND METHODS: Thirty-five patients unable to breath-hold underwent a motion-resistant protocol (Radial group). Twenty-seven patients able to breath-hold underwent conventional protocol. The diagnostic performance of MRI was calculated. Cartesian and radial 3D-GRE sequences were compared. RESULTS: In Radial group, diagnosis was correct in 31/35 patients (88.5%), with sensitivity and specificity of 85.7% and 87.5%. In Cartesian group, diagnosis was correct in 24/27 patients (88.9%), with sensitivity and specificity of 93.7% and 81.8%. CONCLUSION: MRI appeared moderately successful for non-cooperative patients presenting with acute abdominal pain, with comparable accuracy to the standard breath-hold protocol.

Cardiovascular risk in lupus nephritis: Do renal disease-related and other traditional risk factors play a role?

This study was performed to evaluate the prevalence of thickened carotid intima media thickness (CIMT) in a Sri Lankan cohort of lupus nephritis (LN) patients and to identify associations between traditional cardiovascular disease (CVD) and LN-related risk factors with increased CIMT. Consecutive patients with biopsy-proven LN were evaluated for conventional CVD risk factors, renal parameters and extent of organ involvement in this cross-sectional study. Current disease activity and damage were assessed by the British Isles Lupus Activity Group (BILAG) score and the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) damage index, respectively. CIMT was assessed by B Mode grey scale ultrasonography. Increased CIMT was defined as CIMT more than the 75th percentile based on cutoffs from the "Carotid Atherosclerosis Progression Study." Forty patients (98% female), with a mean age of 38 years (age range of 20-50) and of South Asian descent, were evaluated. The mean duration of disease of 6.15 years (SD = 4.66). The overall prevalence of cardiovascular events was low and included previous acute coronary syndromes in 7.5%, stable angina in 5%, cerebrovascular accidents in 7.5% and transient ischemic attacks in 2.5% of the patients; 72.5% had hypertension (HTN) [mean blood pressure (BP) 140/80 mm Hg]; 32.5% had dyslipidemias (mean serum cholesterol 5.9; SD = 5.6) and 25% had diabetes (mean blood sugar 103.7; SD = 15.6). Forty percent were obese and 20% were overweight (Asian cutoffs). Increased CIMT (57.5%) and atherosclerotic plaques (15.36%) indicated a high CVD risk in this cohort. Diabetes (P = 0.016), HTN (P = 0.002), dyslipidemia (P = 0.002) and obesity (P = 0.048) were associated with thickened CIMT. The only LN-related risk factor associated with thickened CIMT (P <0.05) was the SLICC/ACR damage index. The independent predictors of thickened CIMT determined by logistic regression analysis were HTN and dyslipidemia.

Pancreatitis-imaging approach.

Pancreatitis is defined as the inflammation of the pancreas and considered the most common pancreatic disease in children and adults. Imaging plays a significant role in the diagnosis, severity assessment, recognition of complications and guiding therapeutic interventions. In the setting of pancreatitis, wider availability and good image quality make multi-detector contrast-enhanced computed tomography (MD-CECT) the most used imaging technique. However, magnetic resonance imaging (MRI) offers diagnostic capabilities similar to those of CT, with additional intrinsic advantages including lack of ionizing radiation and exquisite soft tissue characterization. This article reviews the proposed definitions of revised Atlanta classification for acute pancreatitis, illustrates a wide range of morphologic pancreatic parenchymal and associated peripancreatic changes for different types of acute pancreatitis. It also describes the spectrum of early and late chronic pancreatitis imaging findings and illustrates some of the less common types of chronic pancreatitis, with special emphasis on the role of CT and MRI.

Gastrointestinal imaging-practical magnetic resonance imaging approach.

Over the past two decades, advances in cross-sectional imaging such as computed tomography and magnetic resonance imaging (MRI) have dramatically changed the concept of gastrointestinal imaging. MR is playing an increasing role in the evaluation of gastrointestinal disorders. MRI combines the advantages of excellent soft-tissue contrast, noninvasiveness, functional information and lack of ionizing radiation. Furthermore, recent developments of MRI have led to improved spatial and temporal resolution as well as decreased motion artifacts. In this article we describe the technical aspects of gastrointestinal MRI and present a practical approach for a well-known spectrum of gastrointestinal disease processes.