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Gastroenterology Clinics of North America

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https://www.readbyqxmd.com/read/30115446/gastrointestinal-imaging-rapid-advancements-leading-to-improved-patient-care
#1
EDITORIAL
Perry J Pickhardt
No abstract text is available yet for this article.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115445/diagnostic-imaging-a-peephole-into-many-of-the-body-s-dressing-rooms
#2
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115444/pet-mri-for-gastrointestinal-imaging-current-clinical-status-and-future-prospects
#3
REVIEW
Tyler J Fraum, Daniel R Ludwig, Thomas A Hope, Kathryn J Fowler
Positron emission tomography (PET)/computed tomography (CT) with 2-deoxy-2-[18 F]fluoro-d-glucose (FDG) has become the standard of care for the initial staging and subsequent treatment response assessment for numerous gastrointestinal malignancies. However, it is often supplemented by magnetic resonance imaging (MRI) for local tumor staging. Hybrid PET/MRI scanners, which acquire PET data and MRI data simultaneously, have the potential to provide accurate whole-body staging in a single examination. Furthermore, to address certain limitations of FDG, many new PET tracers have been developed to probe distinctive aspects of tumor biology...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115443/mri-of-the-nontraumatic-acute-abdomen-description-of-findings-and-multimodality-correlation
#4
REVIEW
Bryan Dustin Pooler, Michael D Repplinger, Scott B Reeder, Perry J Pickhardt
Obtaining a specific diagnosis in the nontraumatic acute abdomen can be clinically challenging, because a wide range of disease processes affecting a number of different organ systems may have very similar presentations. Although computed tomography and ultrasound examination are the imaging tests most commonly used to evaluate the acute abdomen, MRI can often offer comparable diagnostic performance, and may be considered when other modalities are equivocal, suboptimal, or contraindicated. In some circumstances, MRI is emerging as an appropriate first-line imaging test...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115442/splenomegaly-a-combined-clinical-and-radiologic-approach-to-the-differential-diagnosis
#5
REVIEW
Brett P Sjoberg, Christine O Menias, Meghan G Lubner, Vincent M Mellnick, Perry J Pickhardt
An enlarged spleen (splenomegaly) is a common imaging finding and may be related to a broad array of underlying conditions. The multifaceted functions of the spleen make it susceptible to involvement by a variety of pathophysiologic processes. Understanding these conditions and incorporating all relevant clinical and radiologic data allow narrowing the differential diagnosis.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115441/percutaneous-biliary-interventions
#6
REVIEW
Rocio Perez-Johnston, Amy R Deipolyi, Anne M Covey
Biliary drainage is important in the care of patients with benign and malignant biliary obstruction. Careful preprocedure evaluation of high-quality cross-sectional imaging and inventory of symptoms are necessary to determine whether a percutaneous, endoscopic, or surgical approach is most appropriate. High bile duct obstruction is usually best managed percutaneously; a specific duct can be targeted and enteric contamination of isolated ducts can be avoided. Options for percutaneous biliary intervention include external or internal/external biliary drainage, stent placement, biliary stone retrieval, and bile duct biopsy...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115440/imaging-in-autoimmune-pancreatitis-and-immunoglobulin-g4-related-disease-of-the-abdomen
#7
REVIEW
Kumaresan Sandrasegaran, Christine O Menias
Autoimmune pancreatitis (AIP) is steroid-responsive fibroinflammatory disorder of the pancreas. There are 2 distinct subtypes of AIP, types 1 and 2. Type 1 is associated with systemic immunoglobulin (Ig)G4 disease and may affect multiple organs in the body. Type 2 is confined to the pancreas and shows an association with ulcerative colitis. This article describes the imaging findings of AIP and IgG4 disease in the liver, bile ducts, kidneys, and the retroperitoneal regions. The imaging differentiation of AIP from pancreas cancer is discussed...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115439/role-of-imaging-in-surveillance-and-diagnosis-of-hepatocellular-carcinoma
#8
REVIEW
Mohit Gupta, Helena Gabriel, Frank H Miller
The prognosis for hepatocellular carcinoma (HCC) is dependent on tumor stage at diagnosis, with curative treatment options more available to early-detected HCCs. Professional organizations have produced HCC screening guidelines in at-risk groups, with ultrasound the most commonly used screening tool and increased interest in MRI in specific populations. HCC may be diagnosed by imaging features alone and have been universally incorporated into management guidelines. The radiology community has standardized imaging criteria for HCC with the development of the Liver Imaging Reporting and Data System, which has expanded to incorporate computed tomography, MR, and contrast-enhanced ultrasound for diagnostic purposes...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115438/multidetector-computed-tomography-for-retrospective-noninvasive-staging-of-liver-fibrosis
#9
REVIEW
Meghan G Lubner, Perry J Pickhardt
Although not traditionally used to assess hepatic fibrosis, computed tomography (CT) is fast, accessible, robust, and commonly used for abdominal indications. CT metrics are often easily retrospectively obtained without special equipment. Metrics such as liver segmental volume ratio, which quantifies regional hepatic volume changes; splenic volume; and liver surface nodularity scoring show diagnostic performance comparable to elastography techniques for detecting significant and advanced fibrosis. Other emerging CT tools, such as CT texture analysis and fractional extracellular volume, have also shown promise in identifying fibrosis and warrant further study...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115437/defecography-an-overview-of-technique-interpretation-and-impact-on-patient-care
#10
REVIEW
Nathan Y Kim, David H Kim, Perry J Pickhardt, Evie H Carchman, Arnold Wald, Jessica B Robbins
Pelvic floor and defecatory dysfunction are common in the female patient population. When combined with physical examination, barium defecography allows for accurate and expanded assessment of the underlying pathology and helps to guide future intervention. Understanding the imaging findings of barium defecography in the spectrum of pathology of the anorectum and pelvic floor allows one to appropriately triage and treat patients presenting with defecatory dysfunction.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115436/rectal-mri-for-cancer-staging-and-surveillance
#11
REVIEW
Courtney C Moreno, Patrick S Sullivan, Pardeep K Mittal
MRI is an integral part of the multidisciplinary treatment of rectal adenocarcinoma. Staging MRI is performed to establish TNM stage and assess for prognostic factors, including circumferential resection margin status and presence of extramural vascular invasion. The results of staging MRI determine which patients will undergo preoperative neoadjuvant chemoradiation before resection. Restaging MRI is performed to evaluate for treatment response and may identify patients with no residual visible tumor who are candidates for a "watch and wait" strategy in lieu of resection...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115435/the-natural-history-of-colorectal-polyps-overview-of-predictive-static-and-dynamic-features
#12
REVIEW
Perry J Pickhardt, Bryan Dustin Pooler, David H Kim, Cesare Hassan, Kristina A Matkowskyj, Richard B Halberg
For decades, colorectal screening strategies have been largely driven by static features, particularly polyp size. Although cross-sectional features of polyp size, morphology, and location are important determinants of clinical relevance before histology, they lack any dynamic information on polyp growth rates. Computed tomography colonography allows for in vivo surveillance of colorectal polyps, providing volumetric growth rates that are providing new insights into tumorigenesis. In this article, existing cross-sectional and longitudinal data on colorectal polyps are reviewed, with an emphasis on how these features may affect clinical relevance and patient management...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115434/radiologic-assessment-of-gastrointestinal-bleeding
#13
REVIEW
Gene Kim, Jorge A Soto, Trevor Morrison
Gastrointestinal (GI) bleeding represents a broad differential of disease throughout the GI tract. The proper diagnostic evaluation of patients presenting with symptoms of GI bleeding depends on the overall clinical acuity and suspected source locations. The radiologic assessment of these patients is centered around computed tomography (CT) angiography, CT enterography, conventional angiography, and nuclear scintigraphy.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115433/computed-tomography-and-magnetic-resonance-small-bowel-enterography-current-status-and-future-trends-focusing-on-crohn-s-disease
#14
REVIEW
Seong Ho Park, Byong Duk Ye, Tae Young Lee, Joel G Fletcher
Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are presently state-of-the-art radiologic tests used to examine the small bowel for various indications. This article focuses on CTE and MRE for the evaluation of Crohn disease. The article describes recent efforts to achieve more standardized interpretation of CTE and MRE, summarizes recent research studies investigating the role and impact of CTE and MRE more directly for several different clinical and research issues beyond general diagnostic accuracy, and provides an update on progress in imaging techniques...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115432/ten-questions-about-barium-esophagography-and-dysphagia
#15
REVIEW
Marc S Levine
The barium esophagogram is a global test for patients with dysphagia that can simultaneously detect morphologic abnormalities in the pharynx and esophagus, pharyngeal swallowing dysfunction, esophageal dysmotility, and gastroesophageal reflux. The barium esophagram is an inexpensive, noninvasive, and widely available procedure that can serve as the initial diagnostic test for dysphagia and facilitate selection of other diagnostic studies such as endoscopy. This article addresses 10 questions about barium esophagography and dysphagia that should help gastroenterologists gain a better perspective about the utility of barium studies in this clinical setting...
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735036/gastrointestinal-transplantation
#16
EDITORIAL
Enrico Benedetti, Ivo G Tzvetanov
No abstract text is available yet for this article.
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735035/transplantation-of-abdominal-organs
#17
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735034/robotic-pancreas-transplantation
#18
REVIEW
Mario Spaggiari, Ivo G Tzvetanov, Caterina Di Bella, Jose Oberholzer
Obesity is considered a relative contraindication to pancreas transplantation due to an overall increased risk in wound-related complications and surgical site infections. The rationale for performing pancreas transplantation in a minimally invasive fashion is to reduce these risks, which can be associated with inferior patient and graft survival following pancreas transplantation in morbidly obese patients. At the University of Illinois at Chicago, the initial series of robotic-assisted pancreas transplantation in obese patient with type 1 and 2 diabetes has been performed...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735033/pancreas-transplantation-for-patients-with-type-1-and-type-2-diabetes-mellitus-in-the-united-states-a-registry-report
#19
REVIEW
Angelika C Gruessner, Rainer W G Gruessner
Successful pancreas transplantation is still the only method to restore short-term and long-term insulin independence and good metabolic control for patients with diabetes. Since the first transplant in 1966, tremendous progress in outcome was made; however, transplant numbers have declined since 2004. This article describes the development and risk factors of pancreas transplantation with or without a kidney graft between 2001 and 2016. Patient survival and graft function improved significantly owing to careful recipient and donor selection, which reduced technical failure and immunologic graft loss rates...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735032/composite-and-multivisceral-transplantation-nomenclature-surgical-techniques-current-practice-and-long-term-outcome
#20
REVIEW
Guilherme Costa, Neha Parekh, Mohammed Osman, Sherif Armanyous, Masato Fujiki, Kareem Abu-Elmagd
The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Recent data documented significant improvement in the long-term therapeutic indices of all types of visceral transplantation close to that achieved with thoracic and solid abdominal organs...
June 2018: Gastroenterology Clinics of North America
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