Color Doppler Imaging of Hepatic Tumors

PURPOSE: To evaluate the color Doppler imaging patterns of hepatoma, hemangioma, and metastasis. MATERIALS AND METHODS: The study comprised 37 patients with liver mass lesions: 12 patients had hepatoma, 15 had hemangiomas and10 had metastatic liver cancers. All 37, who showed hepatic mass on gray scale ultrasonogrphy, were analyzed prospectively. Color mapping of tumors was performed for these patients, and the fastest or next fastest vessel was spectrally analysed to show blood pattern and to measure peak velocity. RESULTS: In all the 12 patients with hepatoma, spectral analysis revealed exteusive pulsating arterial blood flow within the tumor ; peak velocities were 7~65cm/sec(mean 34cm/sec). In ten hemangiomas(66%) color mapping revealed blood flow within the tumor and spectral analysis revealed this possibility in eight of the ten tumors. In none of these patients was a pulsating continous wave observed ; peak velocity was 5~21cm/sec(mean 12.8cm/sec). In no mestastatic tumors was blood flow observed. CONCLUSION: Color Doppler imaging is helpful in the differentiation of hepatoma, hemangioma, and metastatic tumor in the liver.

Minocycline Hydrochloride Sclerotherapy of Renal Cysts

PURPOSE: To report the effectiveness of Minocin sclerotherapy in the treatment of renal cysts. MATERIALS AND METHODS: We performed minocin sclerotherapy to 19 patients with 21 renal cysts composed of 17 cases of solitary renal cyst and three cases of multiple renal cyst and one case of polycystic kidney comfirmed by ultrasound and CT. After aspiration of cyst fluid, if the amount was less than 50ml, 500mg of minocin was mixed with 3ml of normal saline,if more than 50ml, 1000mg of minocin mixed with 5ml of normal saline were injected, and each case was followed-up over 3 months by ultrasound. RESULTS: Of all 21 renal cysts, 14 cases were followed-up three months after minocin sclerotherapy. In 12 of 14 cases, the size of the cysts decreased by 10% or collapsed completely. Of the remaining two cases, one collapsed after 6 months while the other recurred after 6months. Three cases were followed up after 20 months and only one of them recurred. 19 of all 21 cases(91%) were cured, and two of 21 cases(9%) were recurred. Pain was the only complaint. and four of 10'cases needed analgesics. CONCLUSION: Sclerotherapy with minocin has low recurrence-rate and low complication, and relatively early high cure-rate.

CT Findings of the Chronic Sinonasal Inflammatory Disease

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.

A comparison of high resolution CT scan of temporal bone and operative findings in middle ear cholesteatoma

To evaluate the value of HRCT imaging in middle ear cholesteatoma, we prospectively analysed the CT images in 28 surgically proven cases with cholesteatomas regarding main site of lesion, ossicular change, facial nerve exposure and fistula formation . The most common main site of lesion was the epitympanum (92.8%). The results of sensitivity, positive predictability, and accuracy by CT imagings were as follows: for ossicular involvement, 94.1%, 88.8%, and 86.2% in malleus, 96.0%, 88.8%, and 85.7% in incus, 81.2%, 81.2%, and 78.5% in stapes; for facial verve exposure, 66.6%, 57.1%, and 81.2%; for fistula formation, 100%, 75.0%, and 96.4%, respectively. In conclusion, the temporal bone HRCT imaging is an accurate preoperative method in detecting main lesion site, ossicular involvement, fistula formation. Because of the low sensitivity and positive predictability in detecting facial nerve exposure, it is necessary to correlate the HRCT images with the clinical status.

Diagnostic value of barium enema in acute appendicitis

No abstract available.

Diagnostic value of barium enema in acute appendicitis

No abstract available.

Value of infusion-DSA(digital subtraction angiography) in diagnosis of primary hepatocellular carcinoma

No abstract available.

Correlation of plain film and computed tomography findings of lobar atelectasis

No abstract available.

A case of intradural sparganosis in the thoracolumbar junction

No abstract available.

CT findings of nosomaxillary lesions: differential diagnosis by adjacent bony abnormality on CT

No abstract available.

Reevaluation of psoas sign analyzed by CT

The lateral margin of the psoas muscle, contrasted by retroperitoneal fat, is usually visualized o plainabdominal radiography. Failure to visualize all or segment of lateral margin of the psoas muscle, so called psoassing, has been emphasized as reliable finding of retroperitoneal pathology. But the significance of psoas sign hasbeen controversial. The authors reevaluated ‘psoas sign’ by comparing 160 abdominal radiography with CT. Theresults were as follows: 1. In 160 supine radiographys, good visualization was present in 106 cases(66.3%), faintvisualizatin in 24(15.0%), segmental nonvisualization in 18(11.3%), and completer nonvisualization in 12(7.5%). In113 erect radiographs, good visualization was present in only 36 cases(31.9%). 2. Asymmetric visualization waspresent in 84 out of 160 cases. In patient with scoliosis, lateral margin of convex side was seen more clearlythan concave side, and this finding was statistically significant (p<0.005). 3. Ascites did not directly influenceto psoa visualization contrary to common belief. 4. In 54 cases of faint or nonvisualization, normal was16(29.6%), intraperitoneal pathology was 16(29.6%), and retroperitoneal pathology was 22(40.7%). 1) In normalpatient, psoas contact with kidney or intestine and deformed psoas muscle were responsible for poor visualization. 2) The major cause of poor visualization in intraperitoneal pathology were psoas contact with displaced kidney byhepatomegaly, ascites with scanty retroperitoneal fat and derformed psaos muscle. 3) The major cause of poorvisualization in retroperitoneal pathology were psoas invasion by tumor or inflammation, psoas conntact withenlarged kidney or perirenal lesion. 5. In summary, the mechanism of faint or nonvisualization of psoas marginwere: 1) psoas contact with normal or pathologic organs 2) psoas invasion by tumor or inflammation 3) deformedpsoas muscle 4) scanty retroperitoneal fat

Computed tomographic findings of the gastrointestinal lymphoma

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common

The radiologic findings of neurofibromatosis

Neurofibromatosis, or von Recklinghausen's disease, is a hereditary, harmartomatous disorder that primarilyinvolves neuroectoderm and mesoderm. The estimated incidence is 1 in 2,500 to 3,000 births. The clinical featuresare skin manifestations such as cafe-au-lait spots, skeletal manifestations primarily in volving vertebrae,central and peripheral nervous manifestations, and other associated abnormalities with increased risk ofmalignancy. The authors analysed the radiologic findings of 18 cases of patients with neurofibromatosis whovisited Pusan Kosin Medical Center and Taegu Dongsan Medical Center during the last five years. All were proven bysurgery, biopsy and other diagnostic criteria. The results obtained were as follows: 1. The male ot female ratiowas 11:7 and the age ranged from 11 months to 51 years. 2. All the cases fulfilled the diagnotic criteria of Croweand associates. 3. Bone manifestations were present in 44% of the cases. The other radiologic findings wereintrathoracic meningocele, bilateral acoustic neurinomas, mediastinal or chest wall mass shadows, and peripheralsoft tissue masses. 4. One of the soft tissue masses was proved to be malignant.

Computed tomographic findings of intrahepatic peripheral cholangiocarcinoma

Cholangiocarcinoma is synonymous with bile duct carcinoma, and can originate in a small intrahepatic bileduct(peripheral type), a major intrahepatic duct including the hepatic hilus, an extrahepatic duct, or near thepapilla of Vater(central type). In a sense bile duct carcinoma of the peripheral type is cholangiocarcinoma of theliver; it has the same gross configuration as hepatocellular carcinoma, resulting in difficulty to differentiateon the CT. The authors studied CT findings of 14 cases of pathologically proven peripheral type cholangiocarcinomaof the liver during the last 4 years. The results were as follows: 1. Of 14 cases, 8 were female and 6 were male,and the age ranged from 5th to 7th decades. 2. Preoperative clinical diagnosis were as follows: hepatoma 8 cases,abscess 5 cases and metastasis 1 case in order of frequency. 3. Diagnosis were confirmed by hepatic lobectomy in 7cases, wedge resection in 5 cases and needle biopsy in 2 case. 4. Labratory findings were not specific, but therewere only 2 cases with elevated alpha-fetoprotein level. 5. Associated diseases were gallstones in 1 case,intrahepatic duct stones, in 1 case, extrahepatic duct stones in 2 cases, acute or chronic cholecystitis in 5cases and CS in 3 cases. 6. Angiographic and scintigraphic findings were helpful in differential diagnosis fromhepatoma but ultrasonography was non-specific. 7. The number of tumor were solitary in 12 cases and multiple in 2cases. Among solitary cases, the site of involvement of the liver were right lobe in 8 cases and left lobe in 4cases. 8. Common CT features of the intrahepatic peripheral cholangiocarcinoma of the liver were irregular,inhomogeneous, occasionally peripherally enhancing, low density liver mass, frequently accompained by diffuse orsegmental dilatation of the intrahepatic bile duct. If there were normal alphafetoprotein level, positive skinand/or stool examination for CS and difuse or segmental dilatation of the intrahepatic duct in low density livertumor on the CT, one should consider peripheral cholangiocarcinoma of the liver than hepatoma.

Clinical and cholangiographic evaluation of bile duct carcinoma

40 cases of bile duct carcinoma gathered over a 6-year period at Kosin Medical College were reviewed and theirclinical and cholangiographic findings were as follows: 1. There were 29 males and 11 females (the ratio of men towomen, 2.6:1) ranging from 37 to 74 years of age. The majority (70% of cases) were in 4th & 5th decades. 2.Clinical symptoms and signs: jaundice in 95%, RUQ or epigastric pain in 75%, pruritus in 52.5%, dark urine in 35%,weight loss in 32.5%, fever and chills in 22.5%, clay colored stool in 12.5%, and palpable mass in 12.5%. 3.Lab,findings: elevated serum total bilirubin(above 20.0mg% in 45%, 10.0-19.0mg% in 22.5%, 5.0-9.9mg% in 20%,1.3-4,9mg% in 5%), elevated alkaline phosphatase in 95%. Clonorchiasis were noted in 17.5%. 4. Histologic findingswere adenocarcinoma in most cases. 5. The location of bile duct carcinoma were common hepatic duct in 35%, commonbile duct in 32.5%, porta hepatis in 12.5%, junction with cystic duct in 10% and diffuse form in 10%. 6. In 33cases, PTC or post-operative cholangiographic examination were done. And the most frequent findings weredilatation of the proximal bile duct and abrupt narrowing or complete obstruction of distal lumen. In 27cases(82%), complete obstruction of bile duct was noted. Attempts were made to analyze the type of obstruction:Constricted type in 39%, Nipple type in 18%, round or flat type (smooth or slightly irregular) in 15%, andserratd type in 9%. Incomplete obstruction were noted in 6 cases(18%). Among them, abrupt narrowing of lumen wasnoted in 9% and diffuse narrowing in 9%. 7. ERCP was done in 7 cases. Findings were constricted type in 42.6%,constricted and slightly irregular type in 14.3%, downward convexity in 14.3%, diffuse irregular narrowing in14.3% and intraluminal filling defect in 14.3%.

CT finding of primary lung cancer

Authors retrospectively analyzed the CT findings of 102 cases of histologically proven bronchogenic carcinomaduring last 4 years from January 1980 to July 1984 at Kosin Medical College. The results were as follows; 1. Thesex ratio was 86 males to 16 females and the greatest number (66.7%) of cases were seen in fourth and fifthdecades. 2. The distribution of histoligic types of primary lung cancer as follows: squamous cell carcinoma 66cases, Adenocarcinoma 10 cases, small cell carcinoma 7 cases, Large cell carcinoma 5 cases, bronchiloalveolar cellcarcinoma 1 case, Unclassifed 13 cases. 3. Location of primary lesions as follows: Right lung 61 cases, Left lung40 cases. In both lungs, the greatest number of cases were found in the upper lobes. Ratio between central andperippheral mass was 2.5:1, except adenocarcinoma(6:4). 4. CT findings were as follows; Hilar or central mass(75cases), Peipheral mass(26), Bronchial abnormalities such as narrowing, obstruction, or displacement (60),Thickening of the posterior wall of the right upper lobe bronchus, bronchus intermedius, or left mainbronchus(17), Post-obstructive changes; Atelectasis, Pneumonitis, Emphysema(34, 17, 1 respectively), Hilaradenopathy(21), Mediastinal lymph node enlargement(50). Mediastinal invasion(51), Pericardial thickening(5), SVCsyndrom with collateral vessels(3), Pleural effusion (27), Pleural thickening or invasion(14), Chest wallinvasion(2), distant metastasis(26). 5. In most of patients(92 cases), the size of mass above 3cm, but in 9 casesbelow 3cm. Margins of the masses were serrated or lobulated in most cases. In 5 cases, cavitary formations werenoted, walls of which were thick and irregular, and air-fluid level was noted in 1 case. In 2 cases, eccentriccalcification were noted within mass. 6. Among 51 cases of whom direct mediastinal invasion was suspected, 8 caseswere operated upon, and this revealed that the masses were not resectable. Among the patients in whom no direct mediastinal invasion was suggested, 12 cases were operated uppon, and this revealed that the masses wereresectable in all cases. 7. Staging was as follows: stage I, 2 cases, Stage II, 13 cases, stage III, 86 cases.

Computed tomographic findings in pelvic cavity after radiation therapy for carcinoma of cervix

From July 1, 1981 to August 31, 1984, 59 patients who had radiation therapy for carcinoma of cervix had CTscanning at Departement of Diagnostic Radiology, Kosin Medical College. The authors analysed the CT findings ofthe patients in regard to the recurrence of the disease and postradiation changes. The results are as followings:1. The incidence of recurrence was most common in advanced stage over IIb. 77% 2. Changes in pelvic cavity were asfollowings; ; Widening of presacral space 78% ; Increased perirectal fat space 81% ; Symmetrical thickening ofperirectal fascia 97% ; Fibrous connectin between sacrum and rectum 92% ; Anterior conncetion between rectum andperirectal fascia 47% ; Increased bowel wall thickness 44% ; Increased bladder wall thickness with trabeculations51% 3. In most patients who had CT scanning within 3 months after radiation therapy, CT did not demonstratepostradiation changes characterized by an increased pelvic fibrous and fatty tissue. 4. In 10 patients who hadpostoperative radiation therapy, 8 patients show increased bowel wall thickness. 5. 30 patients with recurrentcarcinoma of cervix were as followings; ; Pelvic tumor recurrence 90% ; Parametrial and side wall extension 53% ;Pelvic and paraaortic lymphadenopathy 40% ; Hydronephrosis 23% ; Bladder involvement 23% ; Lumbar spineinvolvement 10% And 1 patient shows distant metastasis to paraaortic lymph node, 1 patient to lumbar spine, and 1patient to liver without recurrent tumor mass in pelvic cavity. 6. 2 patients showing mass wihout other sign inthe pelvic cavity were unable to be differentiated between irradiated uterus and recurrent tumor.

Computed tomography of the mediastinal lesions

Authors retrospectively analized the CT findings of mediastinal lesions in surgically or clinically confirmed 37 cases at kosin Medical College during the recent 4 years from Sept. 1979 to Aug. 1983. 1. Among 37 cases, malignant lymphoma were 7 cases, thymoma and vascular lesion or anomaly were 5 cases respectively, benign teratoma and tuberculous mediastinal lymphadentis and neurogenic tumor were 4 cases respectively. pericardial cyst were 2 cases, bronchogenic cyst, non-specific cyst, pancreatic pseudocyst, mesothelioma, Bochdalek hernia was 1 case respectively. 2. The sex ratio between male and female was about 1:1 and the majority of the patients with malignant lymphoma and teratoma was under 20 years old. 3. CT findings of the each mediastinal lesion. 1) Primary mediastinal malignant lymphoma. (1) A large, matted, continuous and midline-crossing mass was observed in the superior and the anterior mediastinums in all cases. (2) In 3 cases, irregular lower densities were seen in the center of the mass, representing the tumor necrosis. (3) CT was also able to show invovlement of other mediastinal lymph nodes and adjacent structures such as pleura, anterior chest wall and lung parenchyma. (4) Involving pleura,homogeneous band-like shadows were seen along the pleura, appearing denser than the associated pleural effusion.(5) Involving lung parenchyma, irregular-shaped nodules and band-llike densities were seen along the courses ofthe bronchi and the vessels. 2) Thyoma. (1) A discrete, soft tissue mass was seen in the superior and the anterior mediastinums(mainly posterior to manubrium and anterior to aortic arch) replacing the normal mediastinal fat. (2)In benign thymoma, the margin of the mass was smooth and the normal fat plane between the mass and the vascular structures was well preserved, but invasive thymoma showed obliteration of the normal fat plane, irregular and ragged tumor-lung interface, and irregular thickening of pleura and pericardium by tumor implantation to thesestructures. (3) The tumors spreaded to only one side of the chest cavity. 3) Teratoma (1) A discrete and smooth marginated mass was seen in anterior mediastinum and it has three or more of different tissue densities among fat,water, soft tissue and calcific densities. (2) 3 cases of teratomas showed the characteristic, thick-walled cystic appearances.

Computed tomographic findings of gallbladder carcinoma

It is well known the CT is very useful in the evaluation of gallbladder carcinoma. We have studied 19 cases of gallbladder carcinoma with whole body scanner from May 1980 to Aug. 1983. 1. The sex distribution were 11 males and 8 females with over 40 years of age. 2. The computed tomographic classificications of the cases were 7 of intraluminal fungating mass(single 5 and multiple 2), 5 of mass filling the gallbladder, 5 of irregular thickened GB and 2 of mixed type, irregular thickned wall and intraluminal fungating mass. 3. CT demonstrated metastasis of other organ, 8 cases of the liver, 5 cases of the extrahepatic bile duct, 3 cases of peritoneum, 2 cases of duodenum, 1 case of the stomach, 1 case of the pancreas, and 15 cases of lymph nodes. 4. Associated diseases were6 cases of gall stone, 2 cases of clonorchiasis, 1 case of pancreatic pseudocyst, and 1 case of renal cyst.