Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibr...Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrastenhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.展开更多
BACKGROUND Pancreatitis is a severe inflammatory pancreatic disease commonly due to bile duct stones or excessive alcohol usage,with clinical manifestations of abdominal pain,nausea,fever,and fluid collections.Healthy...BACKGROUND Pancreatitis is a severe inflammatory pancreatic disease commonly due to bile duct stones or excessive alcohol usage,with clinical manifestations of abdominal pain,nausea,fever,and fluid collections.Healthy persons with less symptomatic pancreatitis are quite rare.Herein,we report a case of a patient with an undetermined onset of pancreatitis mimicking left arm cellulitis due to thrombotic vasculitis of the brachiocephalic vein.CASE SUMMARY A 50-year-old woman visited our hospital for tenderness in the left arm over several recent days.She was diagnosed with cellulitis on the left arm due to left elbow tenderness.Intravenous antibiotics administration did not improve symptoms and laboratory data worsened;thus,chest and abdominal computed tomography(CT)was performed.CT demonstrated pancreatitis with pseudocyst around the pancreas extending to the mediastinum.Thrombotic vasculitis of the brachiocephalic to left brachial vein was observed,which could be the cause of left elbow pain.A pancreatic fistula was found in the head of the pancreas by endoscopic retrograde cholangiopancreatography,so a pancreatic cyst drainage tube via the duodenum was placed in the pseudocyst.Cyst content culture was positive for Escherichia coli infection.Clinical symptoms,imaging findings,and inflammatory reactions resolved gradually after starting therapeutic intervention.The mediastinal pancreatic pseudocysts shrunk,and the venous thrombi remained but shrunk.CONCLUSION The case of a patient with pancreatitis with an undetermined onset that mimics left arm cellulitis is reported.Deep vein thrombosis should be kept in mind when treating patients with severe inflammatory disease.展开更多
文摘Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrastenhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.
文摘BACKGROUND Pancreatitis is a severe inflammatory pancreatic disease commonly due to bile duct stones or excessive alcohol usage,with clinical manifestations of abdominal pain,nausea,fever,and fluid collections.Healthy persons with less symptomatic pancreatitis are quite rare.Herein,we report a case of a patient with an undetermined onset of pancreatitis mimicking left arm cellulitis due to thrombotic vasculitis of the brachiocephalic vein.CASE SUMMARY A 50-year-old woman visited our hospital for tenderness in the left arm over several recent days.She was diagnosed with cellulitis on the left arm due to left elbow tenderness.Intravenous antibiotics administration did not improve symptoms and laboratory data worsened;thus,chest and abdominal computed tomography(CT)was performed.CT demonstrated pancreatitis with pseudocyst around the pancreas extending to the mediastinum.Thrombotic vasculitis of the brachiocephalic to left brachial vein was observed,which could be the cause of left elbow pain.A pancreatic fistula was found in the head of the pancreas by endoscopic retrograde cholangiopancreatography,so a pancreatic cyst drainage tube via the duodenum was placed in the pseudocyst.Cyst content culture was positive for Escherichia coli infection.Clinical symptoms,imaging findings,and inflammatory reactions resolved gradually after starting therapeutic intervention.The mediastinal pancreatic pseudocysts shrunk,and the venous thrombi remained but shrunk.CONCLUSION The case of a patient with pancreatitis with an undetermined onset that mimics left arm cellulitis is reported.Deep vein thrombosis should be kept in mind when treating patients with severe inflammatory disease.
