No abstract

[5, 6]. This series demonstrates the spectrum of radiologic findings and provides new evidence as to the pathogenesis of false cysts. Materials and MethodsFor 52 cases of nonneoplastic, nonparasitic splenic cysts with radiographs in the files of the Registry of Radiologic Pathology at the AFIP, clinical data were derived from summaries submitted by the case contributors.All diagnoses were confirmed by review of both gross and histologic data by the Department of Hematologic Pathology. The cysts were categorized as either "true' or "false.

Ten cases of hemangioma of the spleen were reviewed. Plain abdominal radiographs and scintigrams are helpful in specifying the splenic location. Calcification, either central punctate or peripheral curvilinear, can be detected on radiographs or computed tomographic (CT) scans. The spectrum form solid to cystic change observed in the pathologic specimens is reflected in analogous patterns on CT scans and sonograms: predominantly solid mass; mass with cystic spaces. The angiographic findings are nonspecific. It is possible to suggest the diagnosis of hemangioma of the spleen when an asymptomatic patient presents with a discrete splenic mass, particularly if there is evidence of calcification and cystic change within the lesion.

Twenty-eight patients undergoing elective coronary artery bypass surgery were allocated randomly to receive either propofol 2 mg kg-1 or an equivalent volume of its vehicle during cardiopulmonary bypass with constant pump flow. Peripheral vascular resistance (PVR) was calculated from perfusion pressure and pump flow. After propofol, PVR decreased from 1767 (SD 415) dyn s cm-5 to a minimum of 1263 (283) dyn s cm-5 at 2 min, and remained significantly less than the control value until 12.5 min after administration of propofol. In the group given the vehicle, PVR did not change significantly. In a second study in 10 patients, venous blood samples were withdrawn before and 2, 4, 6, 8, 10, 20 and 30 min after injection of propofol 2 mg kg-1 during cardiopulmonary bypass, for measurement of blood concentrations of propofol. Concentrations were greater than predicted by a computer simulation based on published pharmacokinetic data. The decrease in PVR may be an important factor in the hypotension caused by propofol during induction of anaesthesia.

We assessed the magnetic resonance cholangiopancreatographic (MRCP) findings in patients with asymptomatic, mild elevations of serum amylase and lipase levels to determine whether there might be a pathoanatomic cause for these laboratory abnormalities. MRCP was performed in 633 consecutive patients. Of these, 54 (8.5%) images were obtained in patients with asymptomatic serum hyperamylasemia and hyperlipasemia. MRCP was performed on a 1.0-T MR system; breath-hold gradient-recall, half-Fourier acquisition, and rapid acquisition with relaxation enhancement sequences were obtained. Findings were verified by follow-up, biopsy, or surgery. One-sided, large-sample z tests were used to compare the incidence of abnormalities between the study and control groups (579 patients). The pancreas appeared abnormal on MRCP in 31 patients (57%), including the pancreas divisum in 10 patients (18.5%). Other findings included morphologic changes compatible with chronic pancreatitis in nine patients (16.6%) and a healed pancreatic laceration, juxtapapillary duodenal diverticulum, papillary sclerosis, intraductal pancreatic lithiasis, and hemochromatosis in one patient each (1.9%). Small cystic lesions (< 1 cm) within the pancreas were seen in 15 patients (27.8%). In eight patients, these were associated with other abnormalities (pancreas divisum in three patients, chronic pancreatitis in four, and pancreatic laceration in one). No malignancy was diagnosed. The incidences of normal examination (p = 0.01), pancreas divisum (p < 0.005), and a small cystic lesion (p = 0.01) as solitary findings in this subgroup of patients were significantly higher when compared with the remainder of the studied population. Investigation of asymptomatic patients with nonspecific hyperamylasemia and hyperlipasemia by means of MRCP yielded pancreatic findings in more than 50% of these patients. Pancreas divisum was found more often than expected in the general population.