AIM： To determine in obese children with nonalcoholic fatty liver disease （NAFLD） the accuracy of magnetic resonance imaging （MRI） in assessing liver fat concentration. METHODS： A case-control study was performe...AIM： To determine in obese children with nonalcoholic fatty liver disease （NAFLD） the accuracy of magnetic resonance imaging （MRI） in assessing liver fat concentration. METHODS： A case-control study was performed. Cases were 25 obese children with biopsy-proven NAFLD. Controls were 25 obese children matched for age and gender, without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin. Hepatic fat fraction （HFF） by MRI was obtained using a modification of the Dixon method.RESULTS： HFF ranged from 2% to 44% [mean, 19.0% （95% CI, 15.1-27.4）] in children with NAFLD, while in the controls this value ranged from 0.08% to 4.69% [2.0% （1.3-2.5）, P 〈 0.0001]. HFF was highly correlated with histological steatosis （r = 0.883, P 〈 0.0001） in the NAFLD children. According to the histological grade of steatosis, the mean HFF was 8.7% （95% CI, 6.0-11.6） for mild, 21.6% （15.3-27.0） for moderate, and 39.7% （34.4-45.0） for severe fatty liver infiltration. With a cutoff of 4.85%, HFF had a sensitivity of 95.8% for the diagnosis of histological steato- sis ≥ 5%. All control children had HFF lower than 4.85%; thus, the specificity was 100%. Alter 12 mo, children with weight loss displayed a significant decrease in HFF. CONCLUSION： MRI is an accurate methodology for liver fat quantification in pediatric NAFLD.展开更多
Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponad...Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography （CT）. Only a few studies are reported in literature involving post-mortem （PM） cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.展开更多
基金Supported by A grant from Sapienza University of Rome (Progetti di Ricerca Universitaria 2008-2009)
文摘AIM： To determine in obese children with nonalcoholic fatty liver disease （NAFLD） the accuracy of magnetic resonance imaging （MRI） in assessing liver fat concentration. METHODS： A case-control study was performed. Cases were 25 obese children with biopsy-proven NAFLD. Controls were 25 obese children matched for age and gender, without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin. Hepatic fat fraction （HFF） by MRI was obtained using a modification of the Dixon method.RESULTS： HFF ranged from 2% to 44% [mean, 19.0% （95% CI, 15.1-27.4）] in children with NAFLD, while in the controls this value ranged from 0.08% to 4.69% [2.0% （1.3-2.5）, P 〈 0.0001]. HFF was highly correlated with histological steatosis （r = 0.883, P 〈 0.0001） in the NAFLD children. According to the histological grade of steatosis, the mean HFF was 8.7% （95% CI, 6.0-11.6） for mild, 21.6% （15.3-27.0） for moderate, and 39.7% （34.4-45.0） for severe fatty liver infiltration. With a cutoff of 4.85%, HFF had a sensitivity of 95.8% for the diagnosis of histological steato- sis ≥ 5%. All control children had HFF lower than 4.85%; thus, the specificity was 100%. Alter 12 mo, children with weight loss displayed a significant decrease in HFF. CONCLUSION： MRI is an accurate methodology for liver fat quantification in pediatric NAFLD.
文摘Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography （CT）. Only a few studies are reported in literature involving post-mortem （PM） cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.
