Abstracts Magnetic Resonance Angiography* Martin R. Prince, MD, PhD Magnetic resonance imaging has long been recognized as a useful tool for the non-invasive evaluation of vasculature. Unlike computed tomography and conventional angiography, MRI is not limited by concerns related to ionizing radiation exposure or to contrast-related nephrotoxicity. MRI is also capable of oblique image acquisition and multiplanar reformation that aids the illustration of vessels which are inherently intertwined and complex in their arrangements. In addition, MRI using cine technique affords cardiac-referenced data that enables dynamic assessment of blood flow, yielding information comparable to an echocardiogram. Gadolinium (Gd)-enhanced three-dimensional (3D) magnetic resonance angiography (MRA) is a newer technique that provides high-resolution data very quickly. Improvements in gradient technology now allow a Gd-enhanced 3D MRA to be performed during a 10-20 second breath-hold and it can be acquired repeatedly while moving the MR table to contrast chase a bolus down the legs. In this way the entire peripheral vasculature can be imaged in just a few minutes. Because it relies on T1-shortening effects of Gadolinium instead of the in-flow phenomena, Gd-enhanced 3D MRA provides volumetric data that can be processed for multiplanar reformation (MPR) and maximum intensity projection (MIP) viewing. Probably the most important advantage of MRA is that it is completely free of nephrotoxicity. In particular, gadolinium, even at high doses, is safe for use in patients with renal insufficiency or other risk factors for contrast-induced renal failure. It is also safe for use in patients on dialysis and in patients who have a history of severe allergic reaction to iodinated contrast media. Yet the magnetic effect of gadolinium is so powerful that a small amount injected into a peripheral IV is sufficient to light up the entire vasculature. Alternatively, gadolinium can be diluted for imaging veins directly. It can also be used in place of iodinated contrast media for intra-arterial injection during conventional arteriography. In this lecture, the technical considerations and potential applications for Gd-enhanced 3D MRA will be discussed and illustrated. Abstracts "Dome Down" Laparoscopic Cholecystectomy Glenn L. Sandler, MD Endoscopic Drainage of Pancreatic Pseudocyst Gary C. Vitale, MD Thoracoscopic Splanchnicectomy for Pancreatic Pain Henry L. Laws, MD CT Guided Percutaneous Drainage of Infected Acute Necrotizing Pancreatitis Patrick C. Freeny, MD Management of Metastatic Carcinoma T. S. Ravikumar, MD Management of Liver Trauma Juan C. Asensio, MD Management of Benign Liver Tumors Leslie H. Blumgart, MD, FRCS Role and Techniques of "Dome-Down" Laparoscopic Cholecystectomy Glenn L. Sandler, MD Thoracoscopic Splanchnicectomy for Pancreatic Pain Henry L. Laws, MD Current ConceptsæAdequate Pain Management Young K. Choi, MD Prevention and Management of Infection Complicating Acute Pancreatitis Henry L. Laws, MD Indication for and Timing of ERCP in Biliary Pancreatitis John Baillie, MB, ChB, FRCP Timing of Laparoscopic Cholecystectomy After Biliary Pancreatitis Gary C. Vitale Magnetic Resonance Angiography Martin R. Prince, MD, PhD Pancreatic Imaging Patrick C. Freeny, MD Endoscopic Ultrasonography Charles Noyer, MD Limited Gastric Resection Jo Buyske, MD Current ConceptsæManagement of Pancreatic Carcinoma Henry A. Pitt, MD Watchful Waiting in the Management of Inguinal Hernia Robert J. Fitzgibbons, MD Treatment of Incisional (Ventral) Hernias: Open Repair Maximo Deysine, MD, FACP Treatment of Incisional (Ventral) Hernias: Laparoscopic Repair Adrian E. Park, MD Indications for Converting to Open Operation John G. Hunter, MD Medicolegal Implications of Common Bile Duct Injury During Laparoscopic Cholecystectomy Kenneth A. Kern, MD, FACS Role and Technique of Pylorus Preserving Pacreatectomy Henry A. Pitt, MD