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We successfully created a percutaneous transhepatic portacaval shunt under ultrasonography (US) guidance in a 46-year-old man with refractory ascites. The shunt was created to salvage an attempt to create a transjugular intrahepatic portosystemic shunt (TIPS) that failed because of the elevated level of portal vein bifurcation due to alcoholic liver cirrhosis. Under US guidance, we simultaneously punctured the right branch of the portal vein and the inferior vena cava (IVC) using a two-step biliary drainage set. An Amplatz gooseneck snare was introduced transjugularly to retrieve the percutaneously inserted guidewire. The intrahepatic tract between the portal vein and the IVC was dilated using a balloon catheter, and a stent was placed in the tract. The patient showed complete resolution of ascites at discharge. We assume that our method is an alternative method for TIPS creation in patients with inadequate anatomical relations between the portal vein branches and the hepatic veins. This approach is thought to be feasible for patients with occluded or small hepatic veins. [ABSTRACT FROM AUTHOR]

Papillary renal cell carcinoma (PRCC) is the second most common class of renal cell carcinoma. PRCCs have typically been reported to demonstrate homogeneous, low-intensity signals in T2-weighted magnetic resonance imaging (MRI) scans and rarely high-intensity signals. We reported two cases of PRCC with high signal intensity on T2-weighted images. These two cases were accompanied by a small amount of hemosiderin deposition and intense edema in the tumor. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the usefulness of computed tomographic (CT) features for identifying acute torsion of uterine subserosal leiomyoma (USL)., Subjects and Methods: We analyzed contrast-enhanced CT examinations of 7 USLs with torsion and 44 USLs without torsion. Two radiologists evaluated the CT features, which consisted of poor contrast enhancement inside the USL, thin rim enhancement around the USL, calcification within the USL, a beak sign between the uterus and USL, fan-shaped poor contrast enhancement in the uterus area adjacent to the USL (dark fan sign), and ascites. We analyzed the frequencies of these CT features in the USLs with versus without torsion using Fisher's exact test., Results: The respective frequencies of CT features in USLs with and without torsion were as follows: poor contrast enhancement, 86 and 5% (P = 0.001); thin rim enhancement, 71 and 9% (P = 0.001); calcification, 29 and 18% (P = 0.61); beak sign, 57 and 86% (P = 0.10); dark fan sign, 57 and 0% (P = 0.001); and ascites, 100 and 20% (P = 0.01)., Conclusions: The CT features of poor contrast enhancement, thin rim enhancement, and dark fan sign are valuable for identifying acute torsion of USL.