Purpose: To determine the MR imaging findings of autosomal dominant polycystic kidney disease using current imaging techniques. Materials and Methods:We reviewed our five-year experience with MR imaging of autosomal dominant polycystic kidney disease (ADPKD) to determine the spectrum of appearance of kidney disease, the occurrence of cysts in other abdominal organs, the size and number of cysts in the kidneys and other organs, and the association with other benign or malignant disease. Thirty patients (17 men and 13 women, age range 30 to 88 years old) with ADPKD were included in this study. All patients were examined by MR imaging including T2-weighted single-shot echo-train spinecho and pre-and post-gadolinium chelate spoiled gradient-echo imaging.Results: All kidneys were involved with multiple, varying sized cysts scattered throughout the parenchyma. Giant renal cysts (Ͼ8 cm) were associated with pain in the only two patients who possessed them. Hemorrhage in renal cysts was observed in all kidneys with a heterogeneous pattern of involvement on non-contrast T1-and T2-weighted images, reflecting hemorrhage of varying age. The mean kidney size for the right kidney was 17.4 cm in length, 10.3 cm in transverse, and 9.4 cm in antero-posterior diameter (AP); and for the left kidney, 15.9 cm in the length, 9.3 cm in the transverse, and 9.3 cm in AP diameter. Other organs involved included the liver (22 patients), the pancreas (three patients), with two of the above-mentioned patients having both liver and pancreas cysts, and the spleen (one patient) who had both liver and splenic cysts. Massive liver involvement with large cysts was associated with abdominal pain. Malignant disease was present in five patients, including two patients with renal cell carcinoma, one with bladder cancer, one with lung cancer, and one patient with anal adenocarcinoma. Comparison of preand post-contrast T1-weighted images was essential to detect renal cancer. Conclusion:All kidneys in patients with ADPKD had extensive, varying-sized cysts and in all cases some cysts showed evidence of hemorrhage. The liver was the second most common organ to be involved with cystic disease, in 73% of patients. Large cysts in the kidneys and liver were associated with abdominal pain.

Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.

No abstract

Although MRCP is still an evolving technique, it has established itself as clinically useful and comparable with ERCP for the evaluation of various biliary or pancreatic ductal diseases. MRCP is not only comparable with ERCP in its diagnostic ability, but it has the tremendous advantage of being noninvasive. Furthermore, MR imaging is useful in patients with incomplete or failed ERCP, and in patients with certain biliary or gastrointestinal surgical procedures it is the imaging modality of choice. ERCP will remain an extremely important modality because of the great clinical importance for interventional biliary procedures with this technique. Nonetheless, MRCP may in the near future replace most of the diagnostic imaging of the biliary tree, with diagnostic results even more improved with further developments of hardware and technique.

Purpose: The purpose of this study was to investigate the eŠect and usefulness of gadolinium-chelated contrast medium in phase-contrast magnetic resonance (MR) portography.Methods: Twenty-six patients (21 men, 5 women; aged 34 to 79 years, mean 62 years) underwent respiratory-triggered 3-dimensional phase-contrast portography before and after administration of gadolinium in a 1.5T MR unit. Coronal maximum intensity projection (MIP) images of the portal vein were reconstructed and compared to conventional arterial portograms regarding visualization. Signal-to-noise ratio (SNR) and portal vein-to-liver contrast-to-noise ratios (CNR) of main, right, right anterior, right posterior, left portal veins, and umbilical portion were measured on both non-enhanced and gadolinium-enhanced images and compared.Results: Portal veins and branches were more clearly visualized on the gadoliniumenhanced than on the non-enhanced images. Compared to arterial portography, gadolinium-enhanced portography showed similar performances in visualization, except in the right posterior branch and left portal vein. No severe image degradation from respiration was experienced. SNR was signiˆcantly higher on the gadolinium-enhanced than on non-enhanced images except in the right anterior branch. CNR was signiˆcantly higher on the gadolinium-enhanced than on the non-enhanced images at all measured locations.Conclusions: Administration of gadolinium improves the SNR and CNR of phasecontrast portography and visualization of the portal vein. The phase-contrast technique with gadolinium enhancement can be used to evaluate the portal vein as a supplemental technique.