Coronary arteries: potential for MR imaging

Article Abstract:

Coronary artery disease (CAD) is a leading cause of death and disease in the United States. Presently, the most accurate CAD diagnostic technique available is coronary angiography. This technique, although very accurate, is invasive, inconvenient, expensive, and poses some risk to the patient. An accurate, noninvasive diagnostic technique for CAD is very desirable. Ultrasound (US) imaging and computed tomography (CT) techniques have previously been studied for use in evaluating CAD. Both techniques were found useful in limited situations, but neither could replace angiography for general use. Magnetic resonance (MR) imaging is another diagnostic imaging technique that holds promise as a noninvasive means for evaluating CAD. MR imaging uses the inherent magnetic properties of the elements to accurately differentiate tissues and organs. These magnetic properties not only vary for all elements, but also vary within each element depending on the compounds of which it is composed. Studies evaluating this usage of MR imaging have not provided promising results so far. This is likely a result of our limited understanding of MR and how it can be used, rather than a limitation of MR itself. A report by Edelman and colleagues in the December 1991 issue of Radiology shows that MR imaging techniques used in evaluating CAD are being improved. The method they evaluated was partially successful in overcoming the cardiac and respiratory artifacts that have complicated previously evaluated techniques. Other recent studies of MR techniques for CAD evaluation have also been encouraging. Although the use of MR imaging for CAD evaluation is in its early stages, it holds great promise for the future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Editorial, Innovations, Coronary heart disease, Magnetic resonance imaging, Coronary arteries

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Root of the superior mesenteric artery in pancreatitis and pancreatic carcinoma: evaluation with CT

Article Abstract:

Computed tomography (CT), a scanning X-ray technique, is used in diagnosing pancreatic cancer and other pancreatic diseases. CT findings of thickening of the root of the superior mesenteric artery (SMA) and obliteration of surrounding fat tissue were originally thought to be specific indicators of pancreatic ductal carcinoma. Recent research has indicated these findings are also obtained with other types of cancer affecting the pancreas, but not with noncancerous pancreatic disease. A more recent study reported CT findings of obliteration of fat tissue surrounding the SMA in a patient with pancreatitis, a noncancerous, inflammation of the pancreas. To study this further, 173 CT images of the root of the SMA were obtained from 131 patients, 75 with diagnosed pancreatitis and 56 with diagnosed pancreatic ductal adenocarcinoma. Of the 70 CT images taken from 56 patients with diagnosed cancer, 25 (36 percent) showed streaky, fat infiltration at the root of the SMA. Similar results were seen in 27 of 56 (48 percent) CT images taken from 36 patients with acute pancreatitis, in 4 of 24 (17 percent) CT images taken from 21 patients with chronic pancreatitis, and in 12 of 23 (52 percent) of CT images taken from 18 patients with pancreatitis with abscesses. Periarterial lymph nodes appeared on some CT images from all four groups of patients. A focal mass near the root was seen on 16 images from patients with pancreatitis, and on 24 images from patients with cancer. These results showed that CT image findings of obliteration of fat tissue surrounding the root of the SMA are not specific for pancreatic cancer and are seen with other pancreatic diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pancreatic cancer, Pancreatitis

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