Imaging is required if complication is suspected in acute pyelonephritis to assess the nature and extent of the lesions, and to detect underlying causes. The current imaging modality of choice in clinical practice is computed tomography. Because of associated radiation and potential nephrotoxicity, CEUS is an alternative that has been proven to be equally accurate in the detection of acute pyelonephritis renal lesions. The aims of this study of 48 patients are to describe in detail the CEUS findings in acute pyelonephritis, and to determine if abscess and focal pyelonephritis may be distinguished. Very characteristic morphologic and temporal patterns of enhancement are described. These allow differentiation of focal pyelonephritis from renal abscess, and detection of tiny suppurative foci within focal pyelonephritis. The detection of abscesses is important because follow-up in 25 patients revealed a longer clinical course. Typical pyelonephritis CEUS features permit distinction from other renal lesions. As a whole, CEUS is an excellent tool in the work-up of complicated acute pyelonephritis, so it may be considered as the imaging technique of choice in the evaluation and follow-up of these patients who frequently are very young, so as to minimise radiation exposure.

Preliminary Resultshis series describes 2 patients whose early and accurate diagnosis of sinusoidal obstructive syndrome may have been responsible for their good clinical courses. The aim of this article is to report the acoustic radiation force (ARFI) impulse elastographic findings in both patients and the contrast-enhanced sonographic findings in one of these patients. To our knowledge, there are no previous reports on the ARFI elastographic or contrastenhanced sonographic features in this disease. Clinical data, B-mode findings, and spectral and color Doppler findings in both cases and multidetector row computed tomographic (CT) findings in one of them also contributed to the diagnosis.Teresa Fontanilla, MD, Concepción González Hernando, MD, Juan Cristóbal Valenzuela Claros, MD, Guiomar Bautista, MD, Javier Minaya, MD, Maria del Carmen Vega, MD, Ana Piazza, MD, Santiago Méndez, MD, Claudio Rodriguez, MD, Rafael Pérez Arangüena, MD Received March 31, 2011, from CASE SERIESWe report quantitative liver acoustic radiation force impulse (ARFI) elastographic findings in 2 cases of sinusoidal obstructive syndrome and liver contrast-enhanced sonographic features in one of these cases. To our knowledge, findings in this condition from these techniques have not been reported previously. Acoustic radiation force impulse elastography showed median high shear wave velocities (case 1, 2.75 m/s; case 2, 2.58 m/s) that normalized after specific treatment for sinusoidal obstructive syndrome; therefore, ARFI elastography provided quantitative information that helped diagnose this condition as well as monitor the response to treatment. Contrast-enhanced sonographic findings in one of the cases showed patchy liver enhancement that correlated with the high-velocity patchy distribution on ARFI elastography in that case and enhanced multidetector row computed tomographic findings in the other case. This contrast-enhanced sonographic pattern progressively normalized during follow-up after specific treatment. The elastographic features in both cases and contrast-enhanced sonographic features in one of them contributed to early diagnosis and follow-up of sinusoidal obstructive syndrome in both patients. Further prospective studies are necessary to define the role of ARFI elastography and contrast-enhanced sonography in the early diagnosis and clinical follow-up of this condition.

Conventional diagnostic magnetic resonance imaging (MRI) techniques have focused on improving the spatial resolution and image acquisition speed (whole-body MRI) or on new contrast agents. Most advances in MRI go beyond morphologic study to obtain functional and structural information in vivo about different physiological processes of tumor microenvironment, such as oxygenation levels, cellular proliferation, or tumor vascularization through MRI analysis of some characteristics: angiogenesis (perfusion MRI), metabolism (MRI spectroscopy), cellularity (diffusion-weighted MRI), lymph node function, or hypoxia [blood-oxygen-level-dependent (BOLD) MRI]. We discuss the contributions of different MRI techniques than must be integrated in oncologic patients to substantially advance tumor detection and characterization risk stratification, prognosis, predicting and monitoring response to treatment, and development of new drugs.

INTRODUCTION: Ovarian Cancer (OC) is the first death cause by gynaecological cancer in developed countries and the third cause of gynaecological cancer in the world. Detecting irresectable disease is crucial to select surgical candidates and Peritoneal Carcinomatosis (PC) depiction helps to get a complete debulking without residual disease >1cm, the best prognostic predictor in advanced OC. CT is the elective technique for abdominal imaging, although its accuracy for PC in OC and cytoreduction success prediction ability is limited. PET/CT is considered for systemic evaluation in OC however, it is not a reference standard for PC. PC presents as high signal foci in DWI, with higher contrast than conventional MRI. Whole Body DWI with Background Suppression MRI (WB-DWIBS/MRI) combines conventional anatomic with Diffusion Weighted Imaging (DWI). This study aims to assess the diagnostic performance and tumour burden correlation of WB-DWIBS/MRI in ovarian PC using PCI, referred to cytoreduction surgery as standard reference. MATERIAL AND METHODS: Our local ethical board approved this prospective study and all participants signed written informed consent. 50 out of 217 consecutive patients with disseminated primary or recurrent OC were eligible for cytoreduction and WB-DWIBS/MRI. Peritoneal Cancer Index (PCI) scores (0-3) tumour burden in 13 anatomical regions, hence global ranging 0-39. Two radiologists (R1 and R2) preoperatively assessed PCI and the gynaecologic-oncologist team after. Diagnostic performance was calculated for each of the PCI regions and globally. We evaluated interobserver agreement using Cohen´s Kappa, statistic differences with the *Manuscript containing Abstract, Sections and References (Without corresponding author details) Click here to view linked References