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Purpose: To compare the computed tomographic (CT) features of pancreatic fatty replacement in adolescents and adults with cystic fibrosis (CF) with those in control subjects and to correlate the degree of fatty replacement with the functional status of the pancreas., Materials and Methods: CT scans in 15 patients with CF (group 1) and in 15 control subjects without CF (group 2) were evaluated for thickness and degree of pancreatic fatty replacement. Thickness was measured at four anatomic levels. The pattern of pancreatic fatty replacement was visually evaluated in four pancreatic regions. Images were semiquantitatively analyzed by two readers. The degree of fatty replacement was correlated with the functional status of the pancreas., Results: In group 1, pancreatic glandular tissue was significantly thinner (P < .001) and the degree of fatty replacement was significantly greater in the four regions (P < .001) than those in group 2. In Group 1, no relationship was found between the degree of pancreatic fatty replacement and that of pancreatic endocrine dysfunction. A significant relationship was found between the degree of fatty replacement and that of pancreatic exocrine dysfunction (P < .001)., Conclusion: In patients with CF, pancreatic glandular tissue is significantly reduced in size. Pancreatic fatty replacement is the most frequent pattern in older patients with CF and correlates with pancreatic exocrine dysfunction.

Purpose: The propose of this study was to describe the imaging findings in four patients with emphysematous pyelonephritis and to perform a review of the literature., Material and Methods: Four cases of emphysematous pyelonephritis are presented. US and CT examinations were available for all patients., Results: Gas within the kidney may be diagnosed by plain film or rarely by ultrasound, but its location and its extent are best evaluated by CT. A review of the literature shows that emphysematous pyelonephritis is a rare and life-threatening infection typically occurring in diabetic patients., Conclusion: CT is useful for diagnosing emphysematous pyelonephritis, especially when symptoms fail to resolve promptly with medical therapy.

Purpose: To evaluate a MR cholangiographic technique using a non breath-hold fast spin-echo technique in patients with suspected bile duct obstruction., Material and Methods: Twenty patients with suspected bile duct obstruction were prospectively investigated with MR cholangiography using a T2-weighted non breath-hold fast spin-echo technique (TR = 8000-9000 mse, effective TE = 120-266 msec, ETL = 16-32, acquisition time = 1-3 min) with a body coil. Results of MR cholangiography were compared to those obtained with endoscopic retrograde cholangiography (n = 20 patients) and endoscopic sonography (n = 12 patients) that were considered as reference., Results: MR cholangiography provided high-quality images in 19 out of 20 cases (95%). MR cholangiography had 100% sensitivity, 100% specificity and 100% accuracy in the diagnosis of bile duct dilation. MR cholangiography had 73% sensitivity, 75% specificity and 73% accuracy in the diagnosis of bile duct obstruction. MR cholangiography failed to depict small stones (< 3 mm) of the main bile duct in 4 cases in which no bile duct dilatation was found., Conclusion: MR cholangiography using a non breath-hold fast spin-echo technique depicts bile duct dilatation with a degree of accuracy comparable to that achieved with endoscopic examination. In the absence of bile duct dilatation, small stones of the main bile duct may be undetected with MR cholangiography.

Objective: Our objective was to determine the prevalence of nontumorous hepatic pseudolesions seen around the falciform ligament on dynamic spoiled three-dimensional (3D) gradient-recalled echo (GRE) MR imaging obtained during i.v. injection of a gadolinium chelate., Subjects and Methods: The gadolinium chelate-enhanced spoiled 3D GRE examinations of the liver of 103 patients were prospectively analyzed by two readers for the presence of a nontumorous hepatic pseudolesion around the falciform ligament to determine the prevalence of this finding. For all pseudolesions, pathologic examination or follow-up imaging studies excluded true tumors., Results: A total of 15 nontumorous hepatic pseudolesions were found on 13 (13%) of 103 examinations. The size of pseudolesions ranged from 5 to 15 mm (mean, 9 mm). Twelve pseudolesions were located in segment IV, and three were in segment III. On two MR examinations, two pseudolesions (one in segment IV and one in segment III) were found. Fourteen (93%) of 15 pseudolesions were seen during the arterial phase of the bolus injection. All pseudolesions (100%) were seen during the portal phase, and one pseudolesion (7%) remained visible during the equilibrium phase. The presence of true tumors was excluded in one case by pathologic examination and in twelve cases by follow-up imaging examinations., Conclusion: Nontumorous hepatic pseudolesions around the falciform ligament are not rarely seen on gadolinium chelate-enhanced spoiled 3D GRE examinations. Thus, recognition of these pseudolesions is crucial because they may be misinterpreted as true tumors.

Objective: Our objective was to compare the sensitivity of non-breath-hold T2-weighted fast spin-echo with and without fat suppression, breath-hold T2-weighted fast spin-echo without fat suppression, and spoiled gradient-recalled echo (GRE) MR imaging for detecting hepatic tumors using surgical findings as the standard of reference., Subjects and Methods: Eighteen patients with 36 surgically proven hepatic tumors had non-breath-hold T2-weighted fast spin-echo (6000/117 [TR/effective TE; echo train length, 16) MR imaging with and without fat suppression, breath-hold T2-weighted fast spin-echo MR imaging (2700/105; echo train length, 20), and spoiled GRE images (10.1/1.9; flip angle, 30 degrees) obtained before and after injection of a gadolinium chelate. Images were analyzed separately by two independent readers, with disagreements resolved by consensus reading., Results: Non-breath-hold T2-weighted fast spin-echo MR imaging with and without fat suppression depicted 22 (61%; 95% confidence interval [CI], 43-77%) and 20 (56%; 95% CI, 37-72%) of 36 hepatic tumors, respectively. Breath-hold T2-weighted fast spin-echo imaging allowed detection of 19 (53%; 95% CI, 35-69%) of 36 hepatic tumors. Unenhanced and gadolinium chelate-enhanced spoiled GRE images allowed depiction of 18 (50%; 95% CI, 33-67%) and 29 (81%; 95% CI, 63-91%) of 36 hepatic tumors, respectively. Gadolinium chelate-enhanced spoiled GRE images allowed depiction of significantly more hepatic tumors than any of the other pulse sequences., Conclusion: Gadolinium chelate-enhanced spoiled GRE imaging is more sensitive than T2-weighted MR imaging obtained with a breath-hold or a non-breath-hold technique.

An assay of human hemoglobin by immunonephelometry-electroimmunodiffusion is proposed. Concentrations in the range from 5 to 180 mg% can be determined to within 2--5% accuracy. The immunonephelometric assay is independent of the presence of haptoglobin whereas the electroimmunodiffusion assay is not. This immunochemical assay, independent of the peroxydase activity of hemoglobin, can be carried out in any biological fluid (plasma, urine, gastric fluid).

Immunochemical methods have been used to determine the concentration of haptoglobins. The dependence on the phenotype was tested with highly purified Hp 2-1, Hp 2-2 and Hp 1-1, by immunonephelometry and radial immunodiffusion (RID). Measurements with three different instruments: automated immunonephelometer (AIP, Technicon), laser nephelometer (LN, Behring) and immunochemistry system (ICS, Beckman) were performed. For each type of apparatus antisera against a pool of haptoglobins were provided by the respective manufacturers. Some experiments were done with an antiserum to the haptoglobin heavy chain prepared in the laboratory. This study shows that haptoglobin determination depends neither on the physical geometry of the instruments or on the type of antiserum used in this work. In contrast, the data display a dependence on haptoglobin phenotype. When Hp 2-1, the most common phenotype, is taken as a standard, thd values obtained for Hp 2-2 are in good agreement with those obtained for Hp 2-1. However, the values obtained for Hp 1-1 are overestimated unless they are corrected by an experimental factor which has been determined in this study.

In 100 patients suffering from intravascular haemolysis, a "protein profile" was made on the basis of measurement of haptoglobin, haemopexin and orosomucoid. The estimations were carried out using a rapid precise automatic technique using monospecific immune serum. The results obtained indicate that these tests are sensitive and reliable.