Chronic airspace disease:Review of the causes and key computed tomography findings

Chronic airspace diseases are commonly encountered by chest,body or general radiologists in everyday practice.Even though there is significant overlap in the imaging findings of different causes of chronic airspace disease,some key clinical,laboratory and imaging findings can be used to guide the radiologist to the correct diagnosis.The goal of this article is to review and compare these features.

肝脏纤毛前肠囊肿:三例报道和影像学特征复习

Ciliated hepatic foregut cysts(CHFCs)are rare cystic lesions which are most commonly asymptomatic.They can be clinically important as they may,on rare occasions,undergo malignant transformation or cause mass effect if significantly enlarged.Three cases of CHFCs are presented in this article and their imaging features are reviewed.

Utility of Doppler ultrasonography for predicting improvement of platelet count after transjugular intrahepatic portosystemic shunt

Objective.Portal pressure gradient(PPG)after transjugular intrahepatic portosystemic shunt(TIPS)<12mmHg has been reported as the only factor predictive of increase in platelet count.As flow velocities measured on Doppler ultrasound are related to pressure gradient based on the Bernoulli equation,we used this parameter to predict increased platelet count after TIPS placement.Methods.A total of 161 consecutive patients who underwent TIPS placement entered this retrospective study.The platelet count was measured before,one week after and one month after TIPS placement.Clinically significant thrombocytopenia was defined as platelet count≤100000.Pre-and post-TIPS PPGs were measured.The velocity of blood flow in the proximal,mid and distal TIPS stent was measured using Doppler ultrasound,and the difference in the highest and lowest measured velocity was entitled flow velocity gradient(FVG),which was considered normal when≤100 cm/s.Results.In 121 patients with pre-TIPS thrombocytopenia,the mean platelet count one week and one month after TIPS placement increased 25.7×10^(3) and 35.0 × 10^(3) in 90 patients with PPG≤12mmHg(P=0.028 and P=0.015),while there was no significant change in platelet count in patients with a PPG>12mmHg(P=0.098 and P=0.075).Platelets increased significantly when FVG≤100 cm/s(n=95)vs FVG>100 cm/s(n=26)one week(37.0×10^(3) vs 11.0×10^(3);P=0.005 vs 0.07)and one month after TIPS placement(17.0×10^(3) vs 5.2×10^(3);P=0.01 vs 0.21).Conclusion.FVG>100 cm/s is not associated with increase in post-TIPS platelet count.On the other hand,findings suggestive of proper TIPS function(FVG≤100 cm/s and PPG≤12mmHg)predict a significant increase in post-TIPS platelet count.

Steatosis and hepatitis C

Hepatitis C virus(HCV)infection is a common liver disease worldwide with a high rate of chronicity(75–80%)in infected individuals.The chronic form of HCV leads to steatosis,cirrhosis and hepatocellualr carcinoma.Steatosis is prevalent in HCV patients(55%)due to a combination of viral factors(effect of viral proteins on some of the intracellular pathways)and host factors(overweight,insulin resistance,diabetes mellitus,and alcohol consumption).The response rates to treatment of chronic HCV with pegylated interferon(PEG-IFN)and(in the case of genotype-1 HCV,the most common infecting genotype in the USA)ribavirin(RBV)is low,with a sustained viral response rate40%.Adding direct-acting antiviral agents—recently approved by the FDA—to the standard protocol has increased the response rate;however HCV-related end-stage liver disease is still the primary indication for liver transplantation in the USA.The focus of this article is on the interrelation between HCV,steatosis and metabolic syndrome.

An unusual cause of acute anemia in an immunosuppressed patient

Gastrointestinal mucormycosis is an uncommon,invasive,opportunistic fungal infection with a high mortality rate,seen more commonly in immunocompromised patients.This lethal infection has a wide range of presentations,from colonization of peptic ulcers to infiltrative disease and eventually vascular invasion.Here we present a case of upper gastrointestinal bleeding in an immunocompromised patient,which was proved to be secondary to gastric involvement by mucormycosis.