Charles Zwirewich

Vancouver General Hospital · Department of Radiology

Autoimmune pancreatitis (AIP) accounts for approximately 5% of chronic pancreatitis cases and is an important consideration in the differential diagnosis of pancreatic pathologies. The underlying pathophysiology of AIP is thought to involve lymphocyte infiltration and associated sclerosis. Although AIP is a benign condition that is treatable with c...

Autoimmune cholangitis remains an elusive manifestation of immunoglobulin G4-associated systemic disease most commonly encountered in patients with autoimmune pancreatitis. No strict diagnostic criteria have been described to date and diagnosis mainly relies on a combination of clinical and histopathologic findings. It is hence even more challengin...

To compare the prevalence of hypertension and diabetes mellitus (DM) in patients treated with an unmodified HM-3 lithotripter (USWL) and a second-generation modified HM-3 lithotripter (MSWL) 20 years ago at our Centre with that in the provincial population. To determine whether the type of lithotripter was differentially associated with the develop...

Ectopic pancreas is defined as pancreatic tissue found outside its usual anatomical position, with no ductal or vascular communication with the native pancreas. We describe a case of ectopic pancreas of the small bowel and mesentery causing recurrent episodes of pancreatitis, initially suspected on computed tomography (CT) and magnetic resonance ch...

Escherichia coli 0157:H7 is increasingly being recognized as a cause of infectious colitis, which typically results in bloody diarrhoea in an afebrile patient. The absence of fever often means that an infectious process is not considered in the differential diagnosis, particularly as this organism will not be detected in routine stool cultures. Ina...

The development of renal failure and hypertension due to extrinsic renal compression by hematoma in the subcapsular space is well-described and most commonly seen after blunt trauma. It may also occur as a complication of percutaneous renal biopsy, both in native kidneys and renal allografts, and is a rare cause of reversible allograft failure. We...

The diagnosis of urinary tract infection (UTI) in the adult is primarily based on typical patient symptomatology and urinary evaluation for the presence of bacteria and white blood cells. Uncomplicated UTI usually does not require radiological evaluation unless it is recurrent. Imaging should, in general, be reserved for those patients in whom conv...

In many patients, the diagnosis of SBO can often be made by a combination of clinical history, physical examination and plain radiographs. However, in many cases, the diagnosis of SBO may be difficult. Abdominal radiographs are limited in their ability to diagnose SBO and, more particularly, to identify a specific underlying cause. Although barium...

Gall-stone ileus is a well-known, but uncommon cause of intestinal obstruction. Preceding symptoms of biliary disease are absent in most cases and the presentation is often vague and non-specific (Reisner and Cohen, 1994). Plain abdominal X-ray is often inconclusive, but may show classical signs (Rigler et al, 1941). Ultrasound and computed tomogra...

A 40-year-old male patient had a 6-week history of intermittent pain and swelling of the metatarsophalangeal joint of the left great toe. There was no history of trauma. Past medical history was unremarkable and the patient was not taking any regular medication. Physical examination of the joint demonstrated swelling and warmth with the overlying s...

Computed tomography (CT) can provide essential anatomic and physiologic information required to determine management of intraabdominal and retroperitoneal injuries sustained during blunt abdominal trauma. It can help in evaluation of the type and severity of parenchymal injury, the extent of perirenal hemorrhage and parenchymal devascularization, a...

To determine the role of translabial sonography in the diagnosis of vaginal fibroids. Two women with vaginal masses of undetermined origin were examined by various imaging procedures, including translabial sonography. Initial examinations, which included transabdominal sonography, cystoscopy, and cystourethrography, yielded inconclusive findings. T...

To determine the diagnostic accuracy of helical computed tomography (CT) in the detection of blunt bowel and mesenteric injury in a clinical setting. We evaluated the helical CT and surgical findings in 31 patients with blunt abdominal trauma. Nineteen patients had surgically proven bowel and/or mesenteric injury, and 12 patients had no bowel or me...

Our goal was to determine the sensitivity and specificity of various CT signs of blunt bowel and mesenteric injury. The CT findings of 31 patients with blunt abdominal trauma were retrospectively assessed by three observers in consensus. All patients had laparotomy within 24 h of CT. The study group consisted of 19 patients with surgically proven b...

Lobar dysmorphism is one of a number of normal anatomic variants that may simulate renal mass lesions on cross-sectional imaging. The authors report the US and CT features in two patients with this unusual entity.

Pseudoaneurysms of the facial region are rare and usually result from direct penetrating or blunt trauma. The authors report a pseudoaneurysm of the facial artery in a 22-year-old man injured in a motor vehicle accident. Colour Doppler ultrasonography was used to locate the aneurysm sac and establish its relation to the adjacent facial artery. Succ...

The value of MR imaging was compared with that of high-resolution CT in assessing chronic infiltrative lung disease in 25 patients. The cases included nine patients with usual interstitial pneumonia, six with sarcoidosis, four with hypersensitivity pneumonitis, and six with miscellaneous conditions. The diagnosis was proved by biopsy (n = 17) or by...

To evaluate the efficacy of low-dose high-resolution computed tomography (HRCT) in the assessment of lung parenchyma, three observers reviewed the scans of 31 patients. The 1.5-mm-collimation, 2-second, 120-kVp scans were obtained at 20 and 200 mA at selected identical levels in the chest. The observers evaluated the visualization of normal pulmona...

Edge and internal characteristics of pulmonary nodules evaluated with high-resolution computed tomography (HRCT) were correlated with the pathologic specimens in 93 patients. Speculation correlated pathologically with irregular fibrosis, localized lymphatic spread of tumor, or an infiltrative tumor growth pattern and was observed in six of 11 benig...

To evaluate the sensitivity of computed tomography (CT) in detecting multicentric primary bronchogenic adenocarcinoma manifesting as a pulmonary nodule, the authors reviewed CT scans and pathologic specimens of 158 consecutive patients who underwent resection of a pulmonary nodule. Two independent observers assessed the scans without knowledge of t...

The high-spatial-frequency (bone) reconstruction algorithm has been shown to be superior to the standard algorithm in the assessment of thin-section images of the lung parenchyma. We compared the high-spatial-frequency and standard algorithms in the evaluation of normal and abnormal lung parenchyma and mediastinum on conventional 10-mm-collimation...

Photodynamic laser therapy is used in the palliation of advanced lung cancer. To minimize the complications of this form of therapy, physicians must evaluate correctly the extent of extraluminal disease. We undertook a study to compare CT and bronchoscopy in the evaluation of extent of disease before laser therapy in 20 patients with complete bronc...

Noncardiogenic pulmonary edema is a recognized but uncommon manifestation of type 2 decompression sickness. It typically occurs within 6 hours of a dive. Because the adult respiratory distress syndrome in this setting is believed to be due to microbubbles in the pulmonary vasculature, recompression in a hyperbaric chamber has been recommended as a...