Accuracy of spiral CT in preoperative staging of gastric carcinoma: correlation with surgical and pathological findings.

OBJECTIVE: To assess the accuracy of spiral CT scan in the preoperative staging of gastric carcinoma by comparing it with surgical/pathological staging. MATERIAL AND METHOD: Twenty-eight patients with gastric carcinoma who underwent both preoperative CT scan and surgery were retrospectively studied for TNM classification. All CT scans were reviewed for tumor location, gastric wall thickness, tumor extension, N1 and N2 nodal involvement, and metastases to the liver, peritoneum and lung. RESULTS: Spiral CT staging was correct in 20 of 28 patients (71.4%). The preoperative CT scan had 96.1% sensitivity, 100% specificity and 96.4% accuracy for evaluating serosal invasion. The sensitivity, specificity and accuracy for assessing pathologic lymph node involvement were 73.1, 50.0 and 84.2 percent, respectively. In the present study, peritoneal metastasis could not be identified by CT but CT had 100% sensitivity for evaluating hepatic metastases. CONCLUSION: Spiral CT is a useful modality for preoperative staging of gastric carcinoma with high accuracy for evaluating serosal invasion and hepatic metastases.

Reversible posterior leukoencephalopathy caused by azathioprine in systemic lupus erythematosus.

The authors report a case of systemic lupus erythematosus with posterior leukoencephalopathy who presented with headache, tonic-clonic seizure, loss of consciousness and bilateral loss of vision, after taking azathioprine for three weeks. The patient had hypertension with normal eye grounds. The brain CT showed a hypodensity lesion at both bilateral occipital lobes, mainly in the white matter The symptoms and follow-up MRI were improved after the control of hypertension and discontinuation of azathioprine.

The role of CT scan in preoperative staging of colorectal carcinoma.

OBJECTIVES: To evaluate the role of CT scan in preoperative staging of colorectal carcinoma by comparing it with the surgical-pathologic staging and pathologic findings. MATERIAL AND METHOD: The CT scans of twenty four patients with pathological proven primary colorectal carcinoma from January 1998 to December 2002 at Srinagarind hospital Khon Kaen University were review. The CT findings were analyzed according to serosal and or pericolic fat invasion, involvement of lymphnodes, liver or other metastases, and correlated the CT staging with TNM staging. RESULTS: The CT imaging had 100% sensitivity, 57% specificity, 87.5% accuracy for evaluating serosal and/or pericolic fat invasion, 93.2% sensitivity, 54% specificity, 75% accuracy for evaluating involvement of the lymph nodes. In the present study, the distant metastases was not detected CONCLUSION: The role of CT in preoperative staging of colorectal carcinoma in this report can be summarized as: (1) The sensitivity in detecting serosal and/or pericolic fat invasion is relatively higher than in previous reports. (2) The criteria for evaluation of nodal disease increased accuracy of CT and its high sensitivity is considered clinically useful.