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Abdominal cocoon, or sclerosing encapsulating peritonitis, is supposed to be rare cause of intestinal obstruction. It is characterized by totally or partially encasement of small bowel with a thick, fibrotic, cocoon-like membrane. We think this entity is not rare as previously thought. We reported two case-s clinical and imaging findings which diagnosed abdominal cocoon by surgery to increase awareness of this diagnosis. (C) 2013 Elsevier Inc. All rights reserved.

Cystic abdominal masses in children are not an infrequently encountered condition of childhood. These lesions usually present with large size and mimick each other with similar presenting symptoms. Imaging examinations have an important role to determine the type of the cystic abdominal masses, which is crucial for management of patients and presurgical planning. In this pictorial essay, we summarized the imaging features of common cystic abdominal masses of children, including cystic lesions arising from liver, biliary ducts, kidney, pancreas, bowel, ovary, mesentery, and miscellaneous tissues. (C) 2013 Elsevier Inc. All rights reserved.

Purpose: To investigate the effect of fat infiltration on the apparent diffusion coefficient (ADC) of liver, and assess the relationship between ADC and hepatic fat fraction (HFF). Materials and Methods: MRI scans of 120 consecutive patients were included in this retrospective study. Of these, 42 patients were included in the fatty liver group and 78 in the control group. ADC values were measured from a pair of diffusion-weighted (DW) images (b 0 mm(2)/s and 1000 mm(2)/s). HFFs were measured using T1W GRE dual-echo images. The difference between the ADCs of the two groups was assessed with the t-test. The relationship between HFF and ADC was determined using linear regression analysis and the Pearson correlation coefficient (r). Results: Mean HFFs were 0.85 +/- 2.86 and 13.67 +/- 8.62 in the control and fatty liver groups, respectively. The mean ADC of fatty liver group 1.20 +/- 0.22 x 10 (-3) mm (2)/s was significantly lower than that of the control group 1.32 6 0.23 x 10(-3) mm (2)/s (P = 0.02). Linear regression analysis revealed an inverse relationship between ADC and HFF (r = 0.39, P 5% HFF, and ADC and HFF exhibit an inverse relationship. Key Words: MRI; diffusion-weighted; fatty liver; imaging; chemical shift J. Magn. Reson. Imaging 2012; 35: 1108-1111. (C) 2011 Wiley Periodicals, Inc.

The aim of this study was to investigate the diagnostic role of the apparent diffusion coefficient (ADC) measurement in the diagnosis of focal parenchymal lesions and to understand the discriminating role of the ADC value for differentiating Fasciola lesions from other focal liver lesions.We measured ADC values of parenchymal lesions and liver parenchyma in 18 patients with Fasciola hepatica infestation at b 100, b 600, and b 1000 s/mm(2) gradients. We further measured average ADC values of hepatic metastases (n = 21), hepatocellular carcinomas (n = 21), cholangiocarcinomas (n = 7), hydatid cysts (n = 12), and focal nodular hyperplasia (FNH) (n = 12) and compared them with average ADC values for Fasciola hepatica.The differences between average ADC values of lesions (2.16 ± 0.36 × 10(-3) mm(2)/s) and parenchyma (1.64 ± 0.2 × 10(-3) mm(2)/s) at three gradients were statistically significant (P0.05). Mean ADC values of Fasciola hepatica lesions were significantly different from most of the other focal hepatic lesions, except FNH at all gradients and hydatid cyst at only the b 100 gradient.ADC measurement may be a complementary method in the diagnosis of Fasciola hepatica, and it may be used to differentiate these lesions from other focal liver lesions.

Background Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results Left renal vein entrapment was observed in 10.9% (109), retro-aortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% ( 3 ) of patients. Mean diameters of right (8.8±1.9 mm) and unentrapped left (8.9±1.8 mm) renal veins were not significantly different ( P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3±2 mm) was significantly greater ( P = 0.04) than contralateral renal veins (8.6±2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

The purpose of our study was to evaluate the utility of the apparent diffusion coefficient (ADC) value measurement in the diagnosis of peritoneal metastases on diffusion weighted magnetic resonance imaging.Diffusion weighted imaging with conventional magnetic resonance imaging sequences was performed on twenty consecutive oncology patients (group I) with peritoneal metastases. The ADC values of the metastases, the peritoneal fat around the metastases (group I) and the peritoneal fat in patients with no malignancy (group II) at b(0-100), b(0-600), and (b 0-1000) s/mm(2) gradients were measured and compared.The apparent diffusion coefficient values of three gradients in peritoneal metastases (2.27±0.4; 1.67±0.7 and 1.09±0.4×10(-3) mm(2)/s at b 100, 600 and 1000 gradients, respectively) were significantly lower than the ADC values of the peritoneal fat around metastases (3.07±0.4; 2.07±0.4; 1.33±0.3×10(-3) mm(2)/s at b 100, 600 and 1000 gradients, respectively) (p0.05). There was no significant difference between the ADC values of peritoneal fat in the patients of group I and group II at the 3 diffusion gradients (p0.05).The measurement of ADC values may be used as a complementary diagnostic method in differentiating peritoneal metastases from peritoneal fat on Diffusion Weighted MRI (DWMRI DWMRI).Bu çalışmanın amacı difüzyon ağırlıklı manyetik rezonans görüntülemede (MRG) peritoneal metastazların tanısında görünür difüzyon katsayısı (ADC) değerlerinin yararlılığını değerlendirmektir.Peritoneal metastazı bulunan 20 onkoloji hastasına (grup 1) konvansiyonel MRG sekansları ile birlikte difüzyon ağırlıklı görüntüleme gerçekleştirildi. Peritoneal metastazların, metastaz çevresindeki yağ dokusunun ve malignansisi olmayanların (grup 2) peritoneal yağ dokusunun ADC değerleriPeritoneal metastazların 3 gradientte elde edilen ADC değerleri (Difüzyon ağırlıklı görüntülemede peritoneal metastazların peritoneal yağ dokusundan ayırtedilmesinde ADC değerlerinin ölçümü yardımcı bir tanı yöntemi olarak kullanılabilir.

Objective: To examine the effectiveness of apparent diffusion coefficient (ADC) values and to compare the reliability of different b-values in detecting and identifying significant liver fibrosis. Subjects and Methods: There were 44 patients with chronic viral hepatitis (CVH) in the study group and 30 healthy participants in the control group. Diffusion-weighted magnetic resonance imaging (DWI) was performed before the liver biopsy in patients with CVH. The values of ADC were measured with 3 different b-values (100, 600, 1,000 s/mm2). In addition, liver fibrosis was classified using the modified Ishak scoring system. Liver fibrosis stages and ADC values were compared using areas under the receiver-operating characteristic (ROC) curve. Results: The study group's mean ADC value was not statistically significantly different from the control group's mean ADC value at b = 100 s/mm2 (3.69 ± 0.5 × 10-3 vs. 3.7 ± 0.3 × 10-3 mm2/s) and b = 600 s/mm2 (2.40 ± 0.3 × 10-3 vs. 2.5 ± 0.5 × 10-3 mm2/s). However, the study group's mean ADC value (0.99 ± 0.3 × 10-3 mm2/s) was significantly lower than that of the control group (1.2 ± 0.1 × 10-3 mm2/s) at b = 1,000 s/mm2. With b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s for the diagnosis of liver fibrosis, the mean area under the ROC curve was 0.702 ± 0.07 (p = 0.0015). For b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s to diagnose significant liver fibrosis (Ishak score = 3), the mean area under the ROC curve was 0.759 ± 0.07 (p = 0.0001). Conclusion: Measurement of ADC values by DWI was effective in detecting liver fibrosis and accurately identifying significant liver fibrosis when a b-value of 1,000 s/mm2 was used.

The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) values in differentiation between solid adrenal masses. The ADC values of 73 adrenal lesions (54 benign, 19 malignant) in 69 patients were measured at b 100, 600 and 1000 gradients on diffusion-weighted magnetic resonance imaging (DW-MRI). No statistically significant difference was found between ADC values of benign and malignant adrenal masses, nonadenomatous benign adrenal masses and malignant adrenal masses, adrenal adenomas and nonadenomatous lesions, adenomas and metastases, adenomas and pheochromocytomas, metastases and pheochromocytomas. ADC values are not helpful in the differentiation between solid adrenal masses. (C) 2014 Elsevier Inc. All rights reserved.

To determine the utility of different contrast enhancement phases (unenhanced, arterial, and venous), slice thicknesses (0.5, 3, and 5 mm), and planes (axial and coronal) in the evaluation of appendix vermiformis (AV) on multidetector computed tomography (MDCT), CT examinations of 600 patients were obtained. No significant difference was found between the different imaging planes, slice thicknesses, and contrast enhancement phases in terms of detection rates of AV. The mean diameter of AV in the axial plane (5.93 +/- 0.06 mm) was significantly lower than that in the coronal plane (6.18 +/- 0.06 mm). Evaluation of AV on MDCT is enhanced by combined interpretation on axial and coronal planes. (C) 2012 Elsevier Inc. All rights reserved.

To evaluate the utility of apparent diffusion coefficient (ADC) measurement in characterization of focal solid hepatic lesions and determine the role of ADC values in differentiation of solid benign and solid malignant hepatic lesions.Between June 2006 and December 2010, a total of 95 focal solid hepatic lesions in 95 consecutive patients were evaluated by abdominal MRI. Diffusion weighted MRI was performed with b 100, b 600 and b 1000 gradients with ADC measurements. Comparison of mean ADC values between solid benign (focal nodular hyperplasia and other solid benign lesions) and solid malignant lesion (hepatocellular carcinoma, metastasis, and cholangiocarcinoma) groups and between each benign and malignant lesion was done. The ROC analyses were performed in order to determine cut-off ADC values for differentiation of benign and malignant lesion groups at 3 different gradients.Twenty-six of 95 lesions were benign and 69 were malignant. Mean ADC values of solid benign lesions at b 100, b 600 and b 1000 gradients were 2.25±0.54×10(-3), 1.97±0.64×10(-3) and 1.52±0.47×10(-3) mm2/s, respectively. Mean ADC values of solid malignant lesions at b 100, b 600 and b 1000 gradients were 1.84±0.57×10(-3), 1.37±0.38×10(-3) and 1.08±0.22×10(-3) mm2/s, respectively. The ADC values of solid benign lesions were significantly higher than solid malignant lesions at all 3 gradients (P0.05). Differentiation of benign and malignant subtype lesions from each other in their groups did not yield as significant findings as comparing results between benign and malignant lesions.Although ADC measurements were not helpful for differentiating subtypes of solid benign or solid malignant lesions, ADC measurements at 3 different gradients may be useful in differential diagnosis of benign lesions from malignant ones.

Objectives: Our aim was to investigate the role of simultaneous apparent diffusion coefficient (ADC) measurement and diffusion-weighted MRI (DWMRI) in the diagnosis and differentiation of bladder masses. Methods: Weexamined 45 patients presenting with hematuria by dynamic and diffusion MRI (at b100, b600, b1000 gradients) and cystoscopy. Thirty healthy volunteers without hematuria were also included in the study. Results from imaging techniques were compared to cystoscopic and histopathologic findings. The ADC values of benign and malignant bladder masses, and bladder tissue in healthy subjects were measured and compared with each other. Results: The mean ADC values of benign (n = 10) and malignant lesions (n = 35) were significantly lower than the mean ADC values of adjacent bladder walls and bladder walls of healthy subjects at all 3 gradients (p < 0.05). However, no significant difference was detected between benign and malignant lesions (p > 0.05). Mean ADC values of invasive tumors were significantly lower than superficial malignancies at b600 and b1000 gradients. The mean ADC values of transitional cell tumors were significantly higher than squamous cell tumors at b100 and b600 gradients. Conclusion: Simultaneous measurement ofADC and DWMRI provided useful information in the diagnosis, staging and histopathological classification of bladder tumors.