Imaging pancreas, kidney

Fig.7.3a,b. A 53-year-old man after simultaneous pancreas-kidney transplantation. (CIA Common iliac artery, d donor s, ElA external iliac artery, llA internal iliac artery, IPDA inferior pancreaticoduodenal artery, r right, RA renal artery, RV renal vein, SA splenic artery, SMA superior mesenteric artery), a Angiogram obtained 31 months after operation shows normal posttransplant arterial anatomy with right-sided pancreatic and left-sided renal graft, b Maximum-intensity-projection reconstruction of contrast-enhanced MR imaging obtained 47 months after operation with normal posttransplant arterial anatomy... 

Fig. 7.6. A 28-year-old man image obtained 3 weeks after simultaneous pancreas-kidney transplantation with systemic venous drainage. 3D volumerendering display of contrast-enhanced MDCT during dominant venous phase shows normal posttransplant venous anatomy. (CIV Common iliac vein, d donor s, IVC inferior vena cava, PV portal vein, r right, RV renal vein.) Annotations pancreatic graft (arrow), renal graft (black asterisk)...

Fig. 7.8. A 42-year-old man image obtained 7 days after simultaneous pancreas-kidney transplantation. Small bowel follow-through examination with water-soluble contrast material shows duodenojejunostomy (single arrow) and partly contrasted donor s duodenum (arrowheads). Contrast-filled small bowel loops and partially air-filled descending colon indirectly outline pancreas graft. Also seen are radioopaque cutaneous staples (double arrows) resulting from median laparotomy...

Fig. 7.14a,b. A 43-year-old woman with abdominal discomfort image obtained 12 days after simultaneous pancreas-kidney transplantation, a, b Contrast-enhanced multidetector CT displays acute thrombosis of superior mesenteric vein (arrowheads) and splenic vein (arrowhead) but homogeneous contrast enhancement of pancreatic graft (arrow) with donor s duodenum (arrows) and renal graft (asterisk). (CIA common iliac artery, CIV common iliac vein, d donor s, IPDA inferior pancreaticoduodenal artery, / left, r right, SA splenic artery, SMA superior mesenteric artery)... 

Fig. 7.16. Image from a 44-year-old man obtained 9 months after simultaneous pancreas-kidney transplantation with graft necrosis but without local infection or sepsis and subsequent graft extirpation. Contrast-enhanced multidetector CT shows absent parenchymal enhancement and emphysematous transformation of pancreatic graft arrow) consistent with innocuous gas collection. Annotation renal graft black asterisk) and ascites white asterisk)...

Fig. 7.17. Image from a 33-year-old man obtained 20 months after simultaneous pancreas-kidney transplantation with pancreatic graft dysfunction and acute rejection verified by histopathological examination. Helical CT is used for image-guided percutaneous biopsy arrows) of pancreatic graft arrow) adjacent to contrast-medium-filled small bowel arrowhead) and renal graft asterisk)...

Fig. 7.19. Image from a 51-year-old man obtained 4 weeks after simultaneous pancreas-kidney transplantation. Contrast-enhanced multidetector CT shows edematous swelling of donor s remaining mesenteric fat (arrows) and lymph nodes (white asterisk) attached to unremarkable, homogeneous contrast-enhancing pancreatic graft (arrow). Condition presumably results from ligature of donor s lymphatic vessels. CT also shows normal enhancement of donor s (d) vessels including superior mesenteric artery (SMA), external iliac artery (EIA), splenic artery (SA) and renal graft (black asterisk)...

Fig. 7.20. Image from a 38-year-old man obtained 5 weeks after simultaneous pancreas-kidney transplantation with necrotizing graft pancreatitis and subsequent graft extirpation. Contrast-enhanced helical CT displays remnants of contrast-enhanced pancreatic graft (arrow) surrounded by fluid and thin-walled membrane (arrowhead) representing pseudocyst formation due to necrotizing pancreatitis. Ascites (white asterisk) and renal graft (black asterisk) are also seen...

Fig. 7.21. Image from a 54-year-oldman obtained 5 months after simultaneous pancreas-kidney transplantation with graft pancreatitis and pseudocyst formation. Sonography shows large, partly septated cyst (white asterisk) adjacent to pancreatic graft (not shown) consistent with peripancreatic pseudocyst...

Fig. 7. 25. Image from a 29-year-old man obtained 3 weeks after simultaneous pancreas-kidney transplantation with infected peripancreatic pseudocyst and complex pancreatic-cutaneous fistula. Drainage catheter (arrows) was placed through a cutaneous fistula opening, and sonogram displays large central cavity (arrow) with communication to peritoneal cavity (black arrowhead) and sinus tracts (white arrowhead) in retroperitoneal location...

Fig. 4.4. RLD FLIM of (A) unstained freshly resected human pancreas imaged though a macroscope at 7.7 frames per second and (B) unstained sheep s kidney imaged through a rigid endoscope at 7 frames per second. Both samples illuminated at excitation wavelength of 355 nm and fluorescence imaged through a 375 nm long pass filter. Adapted from Fig. 3 of Ref. [18].

L-[ N]Alanine has been administered to rabbits, which were killed 5 min after injection. Pancreas/liver concentration ratios of 1.8 and 2.3 were reported for barbiturate-anesthetized and unanesthetized animals, respectively. The kidneys contained about 20% higher concentrations than did the liver (45). Label content of the liver itself was not reported. In gamma camera studies of hmnans, imaging of the heart and pancreas was reported with l-[ N]alanine (46). l-[ N]alanine has also been used to image the human myocardium and pancreas by positron emission tomography (47). It should be noted, however, that radioactivity derived from dl-[1- C] alanine did not localize in either organ in human subjects (48). 

Figure 6.8 In vivo fluorescence imaging of human prostate cancer xenograft tumors. Mice were injected intravenously with GPI-functionalized QDs and observed for 4 h. (a) The prostate-specific membrane antigen (PSMA)-positive LNCaP tumor and PSMA-negative PC-3 tumor are indicated. Shown are representative images for animals in the prone position, (b) In situ (top row) and resected (bottom row) organs from a imaged at 4 h post-injection with color video and NIR fluorescence. (Ki, kidneys Du, duodenum Sp, spleen In, intestines Lu, lungs Li, liver Pa, pancreas Ab, abdominal wall Bl, bladder.) Reproduced by permission from Macmillan Publishers Ltd. Nat. Nanotechnol. Copyright (2009).

The dynamic display of motion and perfusion is a new apphcation, which is enabled by the continuous or repeat acquisition of the target volume without table feed. The 16-cm detector width allows coverage of several organs including the pancreas, orthotopically located kidneys, the neck, the brain, and above all, the heart. When devising scan protocols for dynamic imaging, great care must be taken to minimize radiation exposure. 

Fig. 7.7a,b. A 58-year-old man image obtained 9 days after sequential pancreas-after-kidney transplantation, a Contrast-enhanced multidetector CT shows normal side-to-side duodenojejunostomy with hyperdense, circular staple line (arrows), donor s duodenum (black arrowhead), recipient s jejunum (black arrowheads), and ascites (white asterisk), b Contrast-enhanced multidetector CT 5 cm caudal of duodenojejunostomy displays donor s duodenum closed proximally (black arrowhead) and distally (white arrowhead) with hyperdense staple line, hyperdense mesenteric staple line (arrowheads), pancreatic graft (arrow), renal graft (black asterisk) and ascites (white asterisk)... 

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