Diffusion-limited extraction of organic ions by a track-membrane interfaced vacuum inlet

Glycerol-wetted track membranes (polyethylene terephthalate) were used to interface a low-vacuum facility (approximately (10(-3) Torr) to an ambient pressure liquid analyte. High-field charge extraction conditions were routinely maintained between the liquid samples and a grid collector. The latter was positioned just near to the vacuum-facing side of such membranes. Upon establishing a steady-state charge extraction regime, the collector currents were monitored and recorded at various solute concentration levels. The collector currents, which depend on solute concentration, were found to agree with recent theoretical treatments of such processes. Both positively- and negatively-charged species from organic solutions were routinely extracted. Ion injection for the low- and the high-mobility species has favored the diffusion-limited and the evaporation-limited schemes, respectively. Variable concentrations of 1-pyrenoyl-methylpyridinium bromide as well as naphthylacetic and anthracenecarboxylic acids in glycerol were used.

Origin of the peak-dip-hump line shape in the superconducting-state (pi,0) photoemission spectra of Bi2Sr2CaCu2O8

From detailed high-resolution measurements of the photon energy dependence of the (pi,0) superconducting-state photoemission spectrum of the bilayer Bi high-temperature superconductors, we show that the famous peak-dip-hump line shape is dominated by a superposition of spectral features originating from different electronic states which reside at different binding energies, but are each describable by essentially identical single-particle spectral functions. The previously identified bilayer-split CuO2 bands are the culprit: with the "superconducting" peak being due to the antibonding band, while the hump is mainly formed by its bonding bilayer-split counterpart.

Accuracy of CT in local staging of gallbladder carcinoma

PURPOSE

To evaluate the accuracy of CT for staging gallbladder cancers, especially the T-factor of the TNM staging system.

MATERIAL AND METHODS

CT investigations of 100 patients with surgically proven gallbladder cancers were retrospectively analyzed. Dynamic helical CT was performed in 16 patients and conventional CT in the remaining 84. On CT, three radiologists attempted tumor staging for these patients; the majority opinion was used for final decision. According to CT protocols (dynamic helical CT vs. conventional CT) and each tumor type (thickened wall/intraluminal mass/massive), the accuracy of CT staging was compared. The CT staging was correlated with the surgico-pathologic results.

RESULTS

The overall accuracy of CT for staging gallbladder cancers was 71%; it was 79% for T1 and T2 tumors, 46% for T3 tumors, and 73% for T4 tumors. For all three readers, the poorest accuracy was obtained in T3 tumors. No statistically significant difference was noted in the accuracy between the groups undergoing conventional CT and dynamic helical CT. A statistically significant difference was noted in the accuracy for staging thickened wall and intraluminal mass types of tumors (p<0.05); the highest accuracy was obtained in the intraluminal mass type (89%) and the massive type (83%), while it was 54% in the thickened wall type.

CONCLUSION

The accuracy of tumor staging with CT in patients with gallbladder cancer depends on the morphological type of tumor. The poorest result is obtained in the thickened wall type.

Synthesis and phosphodiesterase inhibitory activity of new sildenafil analogues containing a carboxylic acid group in the 5'-sulfonamide moiety of a phenyl ring

New sildenafil analogues possessing a carboxylic acid group in the 5'-sulfonamide of the phenyl ring, 9a-l, were prepared from the readily available starting compounds 6a-b and cyclic amines 3-5 in a three-step sequence. In the enzyme assays, it has been shown that all the target compounds 9a-l proved to be more potent in inhibiting phosphodiesterase type 5 (PDE5) than sildenafil by 4-38-fold. The effects on the IC(50) values were investigated by varying the alkoxy group (R) of the phenyl ring, the sulfonamide type (X), and the length of the methylene chain linking the carboxylic acid, and the results were discussed in detail. From this study, we have clearly demonstrated that introduction of a carboxylic acid group to the 5'-sulfonamide moiety of the phenyl ring greatly enhanced PDE5 inhibitory activity, probably by mimicking the phosphate group of cGMP. The piperidinyl propionic acid derivative 9i, which showed the highest PDE5 inhibitory activity and comparable to better selectivity over PDE isozymes in comparison with sildenafil, has been selected for more detailed biological investigations.

The anatomic relationship of the brachial plexus and axillary artery to the glenoid. Implications for anterior shoulder surgery

Iatrogenic brachial plexus injury is an uncommon but potentially severe complication of shoulder reconstruction for instability that involves dissection near the subscapularis muscle and potentially near the brachial plexus. We examined the relationship of the brachial plexus to the glenoid and the subscapularis muscle and evaluated the proximity of retractors used in anterior shoulder surgical procedures to the brachial plexus. Eight fresh-frozen cadaveric shoulders were exposed by a deltopectoral approach. The subscapularis muscle was split in the middle and dissected to reveal the capsule beneath it. The capsule was split at midline, and a Steinmann pin was placed in the equator of the glenoid rim under direct visualization. The distance from the glenoid rim to the brachial plexus was measured with calipers with the arm in 0 degrees, 60 degrees, and 90 degrees of abduction. The brachial plexus and axillary artery were within 2 cm of the glenoid rim, with the brachial plexus as close as 5 mm in some cases. There was no statistically significant change in the distance from the glenoid rim to the musculocutaneous nerve, axillary artery, medial cord, or posterior cord with the arm in various degrees of abduction. Retractors placed superficial to the subscapularis muscle or used along the scapular neck make contact with the brachial plexus in all positions tested.

Comparison of contrast-enhanced fundamental imaging, second-harmonic imaging, and pulse-inversion harmonic imaging

RATIONALE AND OBJECTIVES

To investigate the feasibility of recent contrast-specific ultrasound techniques in depicting vascular flow and the effects of changing the output power of the transducer and insonation mode on contrast enhancement, the authors performed an experimental study with a flow phantom.

METHODS

While changing the mechanical index and the sound insonation mode (continuous and intermittent), images were obtained with three contrast-enhanced ultrasound techniques: fundamental, second-harmonic, and pulse-inversion harmonic imaging (PIHI) after a bolus injection of microbubble contrast agent. The images were compared on a time-intensity curve.

RESULTS

In assessing fixed flow (10 cm/s), PIHI showed the best depiction of flow signal. In intermittent scanning, increases in the mechanical index caused stronger flow signals and longer enhancement duration in all techniques. However, continuous scanning revealed poor depiction of flow signal regardless of the technique or changes in the mechanical index because of significant bubble destruction.

CONCLUSIONS

Microbubble-enhanced PIHI with intermittent scanning at a high mechanical index can depict vascular flow highly effectively without shortening the duration of enhancement.

Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT

PURPOSE

To determine the prevalence of arterioportal shunt associated with hepatic hemangiomas, describe the two-phase spiral computed tomographic (CT) findings, and correlate the presence of arterioportal shunt with the size and rapidity of enhancement of hemangiomas.

MATERIALS AND METHODS

The study group consisted of 109 hepatic hemangiomas in 69 patients who underwent two-phase spiral CT during 1 year. CT scans were obtained during the hepatic arterial (30-second delay) and portal venous (65-second delay) phases after injection of 120 mL of contrast material (3 mL/sec). Arterioportal shunts were diagnosed when hepatic arterial phase CT scans showed a wedge-shaped or irregularly shaped homogeneous enhancement in the liver parenchyma adjacent to the tumor and when portal venous phase CT scans showed isoattenuation or slight hyperattenuation, compared with normal liver in that area, and when there was no demonstrable cause of these attenuation differences. The presence of arterioportal shunt in hemangioma was correlated with the size of the tumor and the rapidity of intratumoral enhancement.

RESULTS

Arterioportal shunt was found in 28 (25.7%) of 109 hemangiomas. There was no statistically significant relationship between lesion size and presence of the arterioportal shunt (P =.653). Arterioportal shunt was more frequently found in hemangiomas with rapid enhancement (P <.01).

CONCLUSION

Arterioportal shunts are not uncommonly seen in hepatic hemangiomas at two-phase spiral CT. Hemangiomas with arterioportal shunts tend to show rapid enhancement.

Pharmacokinetic studies of 2-amino-9-(3-acetoxymethyl-4-isopropoxycarbonyl-oxybut-1-yl)purine, an oral prodrug for the antiviral agent penciclovir

2-Amino-9-(3-acetoxymethyl-4-isopropoxycarbonyloxybut-1-yl)- purine (SK1899) was tested as an oral prodrug for penciclovir. SK1899 was administered orally to rats and dogs at doses up to 2 and 0.68 mmol/kg, respectively. SK1899 was well absorbed, and the major metabolites detected in plasma and urine were penciclovir, the active antiviral compound, and 6-deoxypenciclovir (M4) in both species. In rats, SK1899 was rapidly and extensively metabolized to penciclovir, which reached the peak plasma concentration (C(max)) of 39.5 microM at 0.5 h after 0.2-mmol/kg dosing. The area under the plasma concentration-time curve (AUC) for penciclovir was 57.5 microM x h. After an oral dose of 0.034 mmol/kg to dogs, extensive conversion of SK1899 to penciclovir also occurred with slower rate of formation of penciclovir from M4 than in rats. The mean C(max) and AUC for penciclovir were 4.5 microM at 2.7 h and 28.2 microM x h, respectively. The 0- to 24-h urinary recovery of penciclovir represented 36.1 and 36.3% of dose to rats and dogs, respectively. Radioactivity was found in fetuses following an oral administration of [(14)C]SK1899 to pregnant rats, but no significant accumulation was observed. Although substantial milk transfer of [(14)C]SK1899 occurred in rats, the radioactivity in milk was rapidly cleared. The values of C(max), AUC, and urinary recovery of penciclovir after dosing with SK1899 to rats and dogs were similar or slightly higher than those from famciclovir. These data indicate that introduction of an isopropoxy carbonate group into one of the two hydroxyl groups of M4 did not significantly alter the oral bioavailability of penciclovir compared with famciclovir.

Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features

PURPOSE

To assess the computed tomographic (CT) features of abdominopelvic actinomycosis involving the gastrointestinal tract.

MATERIALS AND METHODS

CT scans were analyzed in 18 patients with pathologically proved abdominopelvic actinomycosis involving the gastrointestinal tract. Eight patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness, length, bowel involvement patterns, inflammatory infiltration, and features of peritoneal or pelvic mass, if present, were evaluated at CT.

RESULTS

Of the gastrointestinal tract, the sigmoid colon was most commonly involved (50%). All patients showed concentric (n = 15) or eccentric (n = 3) bowel wall thickening, with a mean thickness of 1.2 cm and a mean length of 8.3 cm. The thickened bowel enhanced homogeneously in nine patients and heterogeneously in the other nine. Inflammatory infiltration was mostly diffuse and severe. In 17 patients, a peritoneal or pelvic mass (mean maximum diameter, 3.2 cm) was seen adjacent to the involved bowel and appeared to be heterogeneously enhanced in most cases; infiltration into the abdominal wall was seen in four patients.

CONCLUSION

Actinomycosis should be included in the differential diagnosis when CT scans show bowel wall thickening and regional pelvic or peritoneal mass with extensive infiltration, especially in patients with abdominal pain, fever, leukocytosis, or long-term use of intrauterine contraceptive devices.

Synthesis and phosphodiesterase 5 inhibitory activity of new 5-phenyl-1,6-dihydro-7H-pyrazolo[4,3-d]pyrimidin-7-one derivatives containing an N-acylamido group phenyl ring

New sildenafil analogues with an N-acylamido group at the 5'-position of the phenyl ring, 6a--e, were prepared from the readily available starting compound 2 in four straightforward steps. Enzyme assays demonstrated that all the target compounds 6a-e showed higher PDE5 inhibitory activities than sildenafil. It was observed that the PDE5 inhibitory activity was enhanced as the chain length of R group increased, but introduction of the branched alkyl groups such as isopropyl (6d) and cyclohexyl (6e) resulted in the drop of potency compared with 6c. In particular the N-butyrylamido derivative 6c exhibited the highest PDE5 inhibitory activity, and was about 6-fold more potent than sildenafil. However, all the compounds exhibited somewhat weak selectivity (1--3-fold) over PDE6, indicating that the compounds 6a--e have intrinsically lower selectivity than sildenafil.

Synthesis and phosphodiesterase 5 inhibitory activity of novel phenyl ring modified sildenafil analogues

New sildenafil analogues containing an ether ring fused into the phenyl moiety, 6a--d and 7a--d, were efficiently synthesized from the readily available starting materials, 1a--d and 2, in five steps. Ab initio calculations indicated that introduction of a cyclic ether to the phenyl group might enhance the co-planarity of the molecule. The torsional angles were calculated to be 2--3 degrees for the 5-membered cyclic ether derivatives, 6a, 6c, 7a, and 7c, and 12--16 degrees for the 6-membered ones, 6b, 6d, 7b, and 7d. On the other hand, sildenafil showed the least co-planarity with the torsional angle of 23 degrees compared with the target compounds, 6a--d and 7a--d. In the enzyme assay, however, the in vitro PDE 5 inhibitory activity was found out to be inversely related to the degree of co-planarity. In other words, the least planar sildenafil showed the highest activity, and the most planar 5-membered cyclic ether derivatives were least active by 100--200-fold compared with sildenafil. Our study clearly demonstrated that the open chain 2'-alkoxy group of the phenyl ring, although less effective for inducing the co-planarity, seemed to act as a much better lipophilic requirement than the cyclic alkoxy moiety.

Synthesis and biological evaluation of novel A-ring modified hexacyclic camptothecin analogues

Eleven A-ring modified hexacyclic analogues of camptothecin (CPT) containing a 1,4-oxazine ring were synthesized from 10-hydroxycamptothecin (11a) and 7-ethyl-10-hydroxycamptothecin (3) (SN-38) in four to five steps and were subjected to the biological tests such as cytotoxicity, topoisomerase I (Topo I) inhibitory activity, acetylcholinesterase (AChE) inhibition, and stability in human plasma. Four compounds 15a, 15b, 16a, and 16c were about 2-fold more potent than topotecan and as potent as CPT toward human cancer cell lines A549, H128, WiDr, MKN45, SK-OV-3, and SK-BR-3 in vitro, even though the most active compound 15b was slightly less potent than SN-38. The potency of Topo I inhibition of these compounds showed relatively good correlation with their cytotoxicity. Most of the compounds exhibited AChE inhibitory activity weaker (9 +/- 2 to 20 +/- 3%) than CPT (23 +/- 5%) or topotecan (20 +/- 4%) and similar to SN-38 (13 +/- 2%), indicating that they might have little effect on causing early diarrhea. The stability of lactone forms of these compounds in human plasma seemed to be much higher than that of CPT and similar to that of topotecan but lower than that of SN-38. Among the new hexacyclic CPT analogues, compound 15b showed higher antitumor activity against human tumor xenograft, WiDr, in nude mice compared to that of SN-38. The most promising compound 15b has been selected for further development.

Three-dimensional spiral CT cholangiography with minimum intensity projection in patients with suspected obstructive biliary disease: comparison with percutaneous transhepatic cholangiography

BACKGROUND

To evaluate the diagnostic potential of spiral computed tomographic (CT) cholangiography with minimum intensity projection (minIP) in the diagnosis of patients with suspected biliary obstruction.

METHODS

Nine consecutive patients with obstructive biliary disease were enrolled in this study. Spiral CT data (3-mm slice thickness, pitch 1-2:1) obtained 65 s after the start of contrast medium injection (150 mL Ultravist 370, 3 mL/s) were reconstructed at 1-mm intervals. Three-dimensional (3D) CT cholangiography with minIP (3D CTC) was generated with a Siemens software package. The quality of 3D CTC in its ability to demonstrate the anatomic detail, the level of obstruction, and the presence or absence of isolated hepatic segments was evaluated using percutaneous transhepatic cholangiography as a gold standard.

RESULTS

In all patients, 3D CTC demonstrated dilated intrahepatic ducts up to tertiary branches. 3D CTC correctly diagnosed the level of biliary obstruction and demonstrated isolated segments in all patients. In determining the cause of biliary obstruction, one patient with hilar cholangiocarcinoma was misdiagnosed as having biliary invasion by hepatocellular carcinoma.

CONCLUSION

3D CTC with minIP can determine the level and cause of biliary obstruction. 3D CTC can be obtained from regular thin-section helical CT data and may be a strong competitor against diagnostic magnetic resonance cholangiography because of its superior resolution and information on adjacent soft tissues and the duct itself.

Peripheral T-cell lymphoma of the colon: double-contrast barium enema examination findings in six patients

PURPOSE

To evaluate radiologic findings of peripheral T-cell lymphoma (PTCL) of the colon at double-contrast barium enema examination.

MATERIALS AND METHODS

Double-contrast barium enema findings in six patients with pathologically proved PTCL of the colon were retrospectively evaluated and compared with colonoscopic and histopathologic findings.

RESULTS

There was a diffuse involvement of almost all segments of the colon in four patients and a focal segmental involvement in two. Frequent findings at double-contrast barium enema examination included geographic ulcerations (n = 6), aphthous ulcerations (n = 4), pseudopolyps (n = 4), circumferential luminal narrowing (n = 4), and ileocecal deformity (n = 4).

CONCLUSION

PTCL of the colon manifested as either a diffuse or a focal segmental lesion and showed extensive mucosal ulceration at double-contrast barium enema examination. These findings are similar to those of inflammatory bowel disease and are different from those of colorectal lymphoma with the B-cell phenotype.

Quantitative comparison of tumor vascularity of hepatocellular carcinoma after intravenous contrast agent: conventional versus harmonic power Doppler US

BACKGROUND

The purpose of this study was to make a quantitative comparison between conventional and harmonic power Doppler (PD) ultrasound (US) in depicting vascularity of hepatocellular carcinoma (HCC).

METHODS

Ten nodular HCCs in 10 patients were prospectively examined using a 2-4-MHz convex transducer and a standardized examination protocol. Serial US images were obtained before and 20, 30, 40, 50, 60, 90, 120, 150, 180, 240, and 300 s after intravenous injection of 2 g of contrast agent using conventional and harmonic PD US. The percentage of area with Doppler signal within each HCC nodule (%PDA) was calculated in each image with a PC-based image analysis program, and the results with both US techniques were compared.

RESULTS

In the majority of cases, %PDA was greater on conventional PD US than on harmonic PD US. Mean %PDA of 10 HCCs was significantly higher on conventional PD US than on harmonic PD US except at 20 s after injection. The highest values of mean %PDA were 34.9% in conventional PD US and 19.5% in harmonic PD US at 60 s after injection.

CONCLUSION

Area with PD signals within the HCC is smaller and the duration of effective enhancement is shorter in harmonic PD US than in conventional PD US.

Castleman disease of the abdomen: imaging spectrum and clinicopathologic correlations

PURPOSE

The purpose of this work was to define the imaging spectrum of Castleman disease of the abdomen and to correlate the results with clinicopathologic findings.

METHOD

Seventeen patients (male/female 7:10; mean age 35.6 years) with pathologically proved Castleman disease in the abdomen were included in this study. Radiologic findings (CT, n =17; US, n =10; MR, n =1) were retrospectively reviewed by two readers and were correlated with clinical and pathologic findings.

RESULTS

Subjects were divided into those with localized (n = 11) and disseminated (n = 6) disease. In localized disease, the pathologic subtypes were hyaline vascular type in eight and plasma cell type in three. Radiologic studies showed a single large mass in six and a single dominant mass with small satellite nodules in five. Central low attenuation was seen in two cases, and calcification was seen in three cases. Regional lymphadenopathy was found in five cases. In disseminated disease, there were three hyaline vascular types and three plasma cell types. Radiologic findings included diffuse lymphadenopathy (n = 6), hepatosplenomegaly (n = 5), ascites (n = 3), and thickening of the retroperitoneal fascia (n = 3). Disseminated disease revealed symptoms and abnormal laboratory findings (anemia, hypoalbuminemia, elevated erythrocyte sedimentation rate/C-reactive protein, etc.) more frequently than localized disease and showed poor prognosis.

CONCLUSION

There are two distinctive types of radiologic manifestations in Castleman disease of the abdomen: localized and disseminated. The localized type usually shows single or multiple discrete masses, and the disseminated type frequently shows nonspecific organomegaly and lymphadenopathy.

Alteration of cell growth and morphology by overexpression of transforming growth factor beta type II receptor in human lung adenocarcinoma cells

TGF-beta is a potent inhibitory regulator of cell growth, which is transduced through interaction between type I (RI) and type II (RII) receptors that form heteromeric kinase complexes. Abnormal expression of these receptors has been identified in several human epithelial cancers and has been shown to be highly associated with resistance to TGF-beta. In this study, we investigated the expression of RI and RII in 13 human non-small cell lung cancer cell lines (NSCLCs) and demonstrated decreased or loss of RII expression in five lung cancer cell lines, but not of RI. Of these cell lines, the role of RII in NCI-H358 adenocarcinoma, which lacks RII and is insensitive to TGF-beta, was investigated by transducing this cell line with a recombinant retrovirus expressing full-length TGF-beta RII. Stably transfected cells showed significant increase in RII mRNA and protein expression. These cells responded to exogenous TGF-beta1 with suppressed proliferation in a dose-dependent manner and G1 arrest accompanied by morphological change distinct from control cells. We also investigated whether overexpression of dominant-negative RII (dnRII) in NCI-H441 adenocarcinoma, which is sensitive but expresses low levels of RII, could block signaling through the receptor complex. The overexpression of this kinase-domain-truncated RII by expressing the retroviral dnRII construct led to loss of the ability to respond to TGF-beta1 and an exhibition of uncontrolled growth. These results suggest a close association between the loss of the expression of wild-type TGF-beta RII and carcinogenesis in human lung cancer cells.

Formulation and release characteristics of poly(lactic-co-glycolic acid) microspheres containing chemically modified protein

Chemical modification of proteins may influence their formulation into and release from polymeric microspheres. Three chemical modifications of rat serum albumin (RSA) were effected on the amine groups of this protein: conjugation with a polyanion using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide, intermolecular cross-linking using glutaraldehyde, and reductive alkylation using propyl aldehyde. The modified proteins had different physicochemical properties as well as improved encapsulation efficiencies compared with native RSA microspheres. The microspheres were incubated at 37 degrees C for over one month to investigate the influence of protein modification on the release profiles. Microsphere degradation accelerated from the ninth day of the release studies and this coincided with an increase in the release rates. The degradation rates of poly(lactic-co-glycolic acid) microspheres containing either native or cross-linked RSA were more rapid than those containing either heparin conjugated or propylated RSA. This was in agreement with the release data, since the release of the native and cross-linked RSA were more rapid than those of the other modified proteins. The release profiles of the RSA-heparin conjugates and the propylated RSA were approximately zero rather than first order between the tenth and thirtieth day of study. Chemical modification of protein may be a useful method to increase encapsulation efficiency and to decrease release rates of proteins that are to be used in microsphere formulations of potent therapeutic proteins.

Ultrasonographic evaluation of the gallbladder: comparison of fundamental, tissue harmonic, and pulse inversion harmonic imaging

The purpose of our study was to compare pulse inversion harmonic imaging, tissue harmonic imaging, and fundamental imaging in the evaluation of normal and diseased gallbladder. Gallbladders in 170 patients were examined with fundamental imaging, tissue harmonic imaging, and pulse inversion harmonic imaging using a 2- to 5-MHz curved array transducer. Images were divided into normal and abnormal groups. The sharpness of the wall and degree of internal artifact were evaluated in normal groups, and lesion conspicuity and internal artifact were evaluated in abnormal groups. In images of both normal and abnormal gallbladder, significant differences were demonstrated among the 3 imaging methods (P < .001), and pulse inversion harmonic imaging provided the best image quality and the least artifact. Tissue harmonic imaging was the next best, providing better image quality and less artifact than fundamental imaging. In conclusion, pulse inversion harmonic imaging provided the best image quality and the least artifact among the 3 ultrasonographic methods in the evaluation of both normal and abnormal gallbladder.

Biliary ascariasis: MR cholangiography findings in two cases

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.

Improved imaging of hepatic metastases with delayed pulse inversion harmonic imaging using a contrast agent SH U 508A: preliminary study

To investigate the feasibility of delayed pulse-inversion harmonic imaging (PIHI) with the SH U 508A to improve imaging of hepatic metastases, we evaluated 20 patients with known hepatic metastases. Conventional ultrasound (US) was performed before administration, and PIHI was performed 5 min after a bolus injection of 4 G of microbubble contrast agent (300 mg/mL of SH U 508A). Intense, homogeneous enhancement in the liver parenchyma was seen in all patients on delayed PIHI. In 10 patients (50%), 1 or more focal liver lesions that were not seen on unenhanced imaging were detected on delayed PIHI. When comparing 55 lesions that were seen on both techniques, delayed PIHI was superior to unenhanced imaging in terms of lesion conspicuity and lesion-to-liver contrast (p < 0.001, respectively). Delayed PIHI with SH U 508A can improve conspicuity of hepatic metastases and reveal focal liver lesions that are not detected on unenhanced imaging.

Neoplasms containing normal hepatic vessels: imaging features

BACKGROUND

We investigated the incidence and imaging features of hepatic neoplasms containing normal hepatic vessels.

METHODS

Among 3183 patients with various hepatic neoplasms, we found nine patients with normal hepatic vessels traversing hepatic neoplasms. The presence of mass effect on the vessel traversing hepatic neoplasms was evaluated. Other suggestive findings of neoplasms such as altered hepatic contour, portal vein thrombosis, mass effect on extratumoral vessel, and bile duct dilatation were analyzed.

RESULTS

Thirteen hepatic vessels (nine hepatic veins and four portal veins) extended through hepatic neoplasms in nine patients. Undisturbed hepatic vessels within the neoplasms were found in five patients with either primary or metastatic hepatic neoplasm. In one patient with undisturbed hepatic vessels within the neoplasm, there were no associated abnormal findings such as biliary dilatation, change of hepatic contour, or any changes involving the vessels external to neoplasms.

CONCLUSION

Although rare, various primary and secondary hepatic neoplasms can have normal hepatic vessels passing through them without mass effect. However, correct diagnosis in most neoplasms would be possible with careful examination of associated findings.

Fat replacement with absence of acinar and ductal structure in the pancreatic body and tail

We report an unusual case of fat replacement of the pancreatic body and tail. Findings on contrast-enhanced computed tomography and ERCP could be confused with dorsal pancreas agenesis. Histopathologic examination of the resected specimen revealed massive fat replacement with complete absence of the acinar and ductal tissue and scattered islets of Langerhans.