Abstract Objective: To evaluate the diagnostic accuracy of multi-echo Dixon magnetic resonance imaging (MRI) in hepatic fat quantification, in comparison with that of magnetic resonance spectroscopy (MRS), on 3.0-T MRI. Materials and Methods: Fifty-five adults with no known liver disease underwent MRI in a 3.0-T scanner for determination of the hepatic fat fraction, with two techniques: multi-echo Dixon, in a manually drawn region of interest (ROI) and in the entire liver parenchyma (automated segmentation); and MRS. The diagnostic accuracy and cutoff value for multi-echo Dixon were determined, with MRS being used as the reference standard. Results: The mean fat fraction obtained by multi-echo Dixon in the manually drawn ROI and in the entire liver was 5.2 ± 5.8% and 6.6 ± 5.2%, respectively, whereas the mean hepatic fat fraction obtained by MRS was 5.7 ± 6.4%. A very strong positive correlation and good agreement were observed between MRS and multi-echo Dixon, for the ROI (r = 0.988, r2 = 0.978, p < 0.001) and for the entire liver parenchyma (r = 0.960, r2 = 0.922, p < 0.001). A moderate positive correlation was observed between the hepatic fat fraction and body mass index of the participants, regardless of the fat estimation technique employed. Conclusion: For hepatic fat quantification, multi-echo Dixon MRI demonstrated a very strong positive correlation and good agreement with MRS (often considered the gold-standard noninvasive technique). Because multi-echo Dixon MRI is more readily available than is MRS, it can be used as a rapid tool for hepatic fat quantification, especially when the hepatic fat distribution is not homogeneous. Objective multiecho multi echo (MRI quantification , (MRS) 3.0T 30T T 3.0 3 0 Methods Fiftyfive Fifty five techniques (ROI automated segmentation segmentation) determined standard Results 52 5 2 5. 58 8 5.8 66 6 6. 5.2% respectively 57 7 64 4 6.4% r 0988 988 0.988 0978 978 0.978 0.001 0001 001 0960 960 0.960 0922 922 0.922 0.001. . participants employed Conclusion often goldstandard gold technique. technique) homogeneous (MRS 0T 30 3. 6.4 098 98 0.98 097 97 0.97 0.00 000 00 096 96 0.96 092 92 0.92 09 9 0.9 0.0 0.

Resumo Objetivo: Avaliar a acurácia diagnóstica da técnica multieco Dixon na quantificação da gordura hepática em comparação com a espectroscopia por ressonância magnética (ERM), em exames de RM 3.0-T. Materiais e Métodos: Cinquenta e cinco participantes adultos sem doença hepática conhecida foram submetidos a RM 3.0-T para determinação da fração de gordura hepática, usando duas técnicas: multieco Dixon (em ROI desenhada manualmente e em segmentação automatizada para todo o parênquima hepático) e ERM. A precisão diagnóstica e o valor de corte para multieco Dixon foram determinados usando a ERM como padrão de referência. Resultados: A fração de gordura média usando multieco Dixon na ROI desenhada manualmente e na segmentação automatizada do fígado inteiro foi 5,2 ± 5,8% e 6,6 ± 5,2%, respectivamente. A fração de gordura hepática média usando ERM foi 5,7 ± 6,4%. Correlação positiva muito alta e forte concordância foram observadas entre ERM e multieco Dixon, tanto para ROI (r = 0,988, r2 = 0,978, p < 0,001) quanto para todo o parênquima hepático (r = 0,960, r2 = 0,922, p < 0,001). Correlação positiva moderada foi observada entre a fração de gordura hepática e o índice de massa corpórea dos participantes usando ambas as técnicas de estimativa de gordura. Conclusão: Multieco Dixon demonstrou correlação positiva muito alta e concordância com a ERM (muitas vezes considerada padrão de referência não invasivo) para quantificação de gordura hepática. Uma vez que o multieco Dixon está mais prontamente disponível do que a ERM, pode ser usado como uma ferramenta rápida para a quantificação da gordura hepática, especialmente na distribuição não homogênea da gordura. Objetivo , (ERM) 3.0T. 30T T 3.0 T. 3 0 Métodos 3.0T Resultados 52 5 2 5, 58 8 5,8 66 6 6, 5,2% respectivamente 57 7 64 4 6,4% r 0988 988 0,988 0978 978 0,978 0,001 0001 001 0960 960 0,960 0922 922 0,922 0,001. . Conclusão muitas invasivo (ERM 0T 30 3. 6,4 098 98 0,98 097 97 0,97 0,00 000 00 096 96 0,96 092 92 0,92 09 9 0,9 0,0 0,

BACKGROUND: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive OBJECTIVES: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. METHOD: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups. RESULTS: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p < 0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p < 0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p < 0.05). CONCLUSION: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs. CONTRIBUTION: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV.

Pancreatic pseudocyst is a common complication that can occur following acute or chronic pancreatitis. Commonly, they are peripancreatic in location. Rarely, they can extend to the mediastinum, and further extension to the neck is even rarer. A 55-year-old man who presented with neck stiffness and dysphagia and on imaging, was found to have a cystic lesion in the neck. Aspiration of the lesion revealed raised amylase levels suggestive of a pancreatic pseudocyst.