Pancreatic mucinous cystic neoplasm size using CT volumetry, spherical and ellipsoid formulas: validation study.

CONTEXT: The accuracy for determining pancreatic cyst volume with commonly used spherical and ellipsoid methods is unknown. The role of CT volumetry in volumetric assessment of pancreatic cysts needs to be explored. OBJECTIVES: To compare volumes of the pancreatic cysts by CT volumetry, spherical and ellipsoid methods and determine their accuracy by correlating with actual volume as determined by EUS-guided aspiration. Setting This is a retrospective analysis performed at a tertiary care center. Patients Seventy-eight pathologically proven pancreatic cysts evaluated with CT and endoscopic ultrasound (EUS) were included. Design The volume of fourteen cysts that had been fully aspirated by EUS was compared to CT volumetry and the routinely used methods (ellipsoid and spherical volume). Two independent observers measured all cysts using commercially available software to evaluate inter-observer reproducibility for CT volumetry. MAIN OUTCOME MEASURES: The volume of pancreatic cysts as determined by various methods was compared using repeated measures analysis of variance. Bland-Altman plot and intraclass correlation coefficient were used to determine mean difference and correlation between observers and methods. The error was calculated as the percentage of the difference between the CT estimated volumes and the aspirated volume divided by the aspirated one. RESULTS: CT volumetry was comparable to aspirated volume (P=0.396) with very high intraclass correlation (r=0.891, P<0.001) and small mean difference (0.22 mL) and error (8.1%). Mean difference with aspirated volume and error were larger for ellipsoid (0.89 mL, 30.4%; P=0.024) and spherical (1.73 mL, 55.5%; P=0.004) volumes than CT volumetry. There was excellent inter-observer correlation in volumetry of the entire cohort (r=0.997, P<0.001). CONCLUSIONS: CT volumetry is accurate and reproducible. Ellipsoid and spherical volume overestimate the true volume of pancreatic cysts.

Radiologic-pathologic findings of solitary fibrous tumor of the prostate presenting as a large mass with delayed filling-in on MRI.

We report a case of a solitary fibrous tumor of prostate presenting with urinary retention and a large prostate mass. We describe the clinical presentation, magnetic resonance imaging findings, and histopathology of this rare, benign tumor. Although clinical and radiologic appearances embrace various differential diagnoses including sarcoma, this mass was confirmed by histologic analysis following surgical resection. We report this rare, benign tumor to help the radiologist suggest the diagnosis when presented with a similar case.

Herlyn-Werner-Wunderlich syndrome with a partially obstructed hemivagina.

Uterine didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare congenital anomaly of the Müllerian duct system referred to as Herlyn-Werner-Wunderlich syndrome. Because of its rare occurrence, a high level of suspicion is often required for diagnosis. Clinically, these patients usually present after menarche with pelvic pain, dysmenorrhea, and a palpable pelvic mass. We present a case of a 31-year-old female patient with infertility. Imaging findings were consistent with Herlyn-Werner-Wunderlich syndrome, with a congenital defect in the longitudinal vaginal septum resulting in partial spontaneous decompression of right-sided hematocolpos.