Esophageal emergencies: another important cause of acute chest pain.

A variety of esophageal pathologies can present emergently with a chief complaint of acute chest pain. Computed tomography (CT) is often the first line of imaging in esophageal emergencies and provides useful information-even without an initial suspicion-when used in conjunction with other imaging modalities such as esophagography and direct visualization. We review various urgent and emergent esophageal disease entities which may manifest as acute chest pain, with an emphasis on CT and ancillary imaging appearances, while discussing management according to their emergency. Radiologists should be familiar with the imaging findings of these esophageal emergencies in order to provide an accurate diagnosis and recommend timely and appropriate management.

Slow-growing buttock mass after failure of incorporation of autologous fat transfer for gluteal augmentation: ultrasound and MRI features.

Gluteal augmentation procedures are gaining popularity and encompass a variety of surgical techniques and methods of graft preparation. While surgical history remains essential for diagnosis, the radiologist must avoid pitfalls and rely on imaging features to recognize both the expected appearance and complications of gluteal augmentation procedures. We report a case of a slowly growing buttock mass after gluteal augmentation with autologous fat transfer 1 year after surgery. The potential diagnostic imaging pitfalls and characteristics on ultrasound and contrast-enhanced MRI are discussed. Multiplicity of fat-containing lesions depicted on large field-of-view images and granulated appearance of the intralesional fat on MRI should allow the radiologist to recognize the appearance of failed fat graft incorporation that can present as a slowly growing encapsulated collection with layered fat and fluid contents.

Initial experience with arterial spin-labeling MR imaging to assess histology of renal masses.

It is standard practice to presume that solid renal tumors are malignant and perform a nephrectomy without a biopsy. In many clinical situations, renal biopsies lack sufficient diagnostic accuracy to justify altering management. Lanzman and colleagues propose the use of arterial spin-labeling magnetic resonance imaging to assess renal histology and grade. They used histopathologic data as the reference standard, and reported a statistically significant difference in measured tumor perfusion between papillary renal tumor, oncocytomas, and all other histologic subtypes examined. If confirmed in larger studies, this imaging modality may play a role in triaging patients with solid renal masses for surgery or renal biopsy.