IgG4 aortitis of the ascending thoracic aorta: A case report and literature review.

IgG4 aortitis is a recently recognized entity that can have clinical and imaging features that mimic acute aortic syndrome. Therefore, it is imperative for radiologists to be aware of how to potentially differentiate the two. Although this entity has been previously described via case reports and meta-analysis in the context of inflammatory abdominal aortic aneurysm, very few cases of ascending aortic involvement have been reported. In this case report, we present a case of a 60-year-old female transferred from another facility for an initial diagnosis of intramural hematoma of the ascending aorta and later found to have IgG4 aortitis post aortic root repair. This is a histologically confirmed case of multi-segmented IgG4 aortitis with rare involvement of both ascending and infra-renal aorta. We will briefly discuss the pathophysiology of IgG4 aortitis, along with review of literature.

Imaging and Management of Pancreatic Cancer.

Pancreatic cancer is an aggressive disease with rising incidence and high mortality despite advances in imaging and therapeutic options. Surgical resection is currently the only curative treatment, with expanding roles for adjuvant and neoadjuvant chemoradiation. Accurate detection, staging, and post-treatment monitoring of pancreatic cancer are critical to improving survival and imaging plays a central role in the multidisciplinary approach to this disease. This article will provide a broad overview of the imaging and management of pancreatic cancer with a focus on diagnosis and staging, operative and nonoperative treatments, and post-therapeutic appearances after surgery and chemoradiation therapy.

Tracheobronchitis with stridor in a patient with ulcerative colitis.

Bronchopulmonary involvement is a rare but well documented extraintestinal manifestation of inflammatory bowel disease (IBD). IBD-related pulmonary disease can range from subglottic stenosis to tracheobronchitis to interstitial lung disease and is often misdiagnosed on initial presentation. We present a case of tracheobronchitis with stridor in a 23-year-old-woman with well controlled ulcerative colitis (UC).

The "injection jet sign": an innovative method of needle position confirmation during ultrasound guided injections.

Ultrasound (US)-guided therapeutic and diagnostic injections play an important role in day-to-day clinical practice for many radiologists. When compared with fluoroscopic or computed tomographic (CT) methods of localization, US offers the benefit of real-time confirmation of instrument position without exposing the patient to any ionizing radiation. Target delivery is usually confirmed by direct needle tip visualization and with real-time demonstration of capsular or bursal distention. While often more technically difficult in deeper anatomic spaces, larger patients and smaller delivery needles, US should still be considered the preferred method of image guidance because of these outlined benefits. We present here three cases demonstrating an innovative method of needle-tip position confirmation, termed the "injection jet sign." This technique represents a useful supplement to routine sonographic guidance and allows the clinician to enjoy the benefits of this imaging modality even in the face of other technical challenges.