MRI Findings of Intracranial Hemangioblastoma

PURPOSE: Complete resection of the tumor nodule(mural nodule or solid portion of the tumor) is the essential goal of surgical treatment for heman-gioblastoma. The purpose of this study was to classify the morphologic types of intracranial hemangioblastoma on MRI and to compare the location and contour of tumor nodule on MRI with those on angiography. MATERIALS AND METHODS: The MRI findings of 34 lesions(38 lesions if 4 spinal cord lesions were included) in 26 patients(17 males and 9 females, range of age, 18-67 years, mean, 39 years) with surgically and histopathologically proved intracranial hemangioblastomas were reviewed. Seventeen patients underwent CT scanning in a short interval. Contrast-enahnced T1 -weighted imaging pa- tterns of hemangioblastoma were classified according to Ho's morphologic types. The location and contour of tumor nodule were compared between MRI and angiography in 15 patients(24 lesions). RESULTS: By location, cerebellar hemisphere was predominated(55%), followed by cerebellar vermis(26%), supratentorial region(5%), and medulla oblongata (3%). Spinal cord lesions(11%) were seen in 3 patients of 5 von HippeI-Lindau diseases. The frequency of morphologic types was as follows; Type 1 (purely cystic), 3%, Type 2(mural nodule), 50%, Type 3(cyst with wall enhancement), 3%, Type 4 (cystic nodule), 15%, Type 5(solid with internal cyst), 9%, and Type 6(solid), 20%. All tumor nodules(33 lesions) enhanced intensely with intravenous contrast material on MRI, of which 24 lesions(in 15 patients) revealed hypervascular masses fed by pial arteries on angiography. They were superficial and abutted pia mater partially or in large portion on both MR I and angiography. CONCLUSION: Over 70% of intracranial hemangioblastomas had a surrounding cyst, and superficial, pial-based location and number of the tumor nodules on MRI was correlated well with those on angiography. MRI is the examination of choice for preoperative evaluation of intracranial hemangioblastoma.

The Role of IVIRI in Early Ankylosing Spondylitis: Emphasis on the Sacroiliac and Hip Joints

PURPOSE: In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. MATERIALS AND METHODS: Authors evaluated 11 cases (36 joints;SIJ 14, hip 22) confirmed as spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its si, intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts,.~ osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement ofi pannus. RESULTS: MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, Hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). CONCLUSION: MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases.

Comparison of Clinical Application Modes of 3D TOF MR Angiography in the Brain: Normal Volunteers Study

PURPOSE: To compare the various imaging techniques including application of magnetization transfer(MT), administration of IV contrast materials, and imaging time after injection of contrast materials in 3D time-of-flight(TOF) cerebral magnetic resonance angiography(MRA) in normal volunteers. MATERIALS AND METHODS: Each of 11 healthy volunteers was prospectively studied with 3D TOF cerebral MRA using various imaging parameters. Various parameters of 3D TOF MRA were 1) pre-enhanced magnetization transfer(MT), 2) postenhanced MT, immediate phase, 3) postenhanced MT, 10-minutes delayed phase, 4) postenhanced MT, 20-minutes delayed phase, 5) pre-enhanced non-MT, 6) postenhanced non-MT, immediate phase, 7) postenhanced non-MT, 10-minutes delayed phase, 8) postenhanced non-MT, 20-minutes delayed phase. Image qualities of various parameters were compared with regard to depiction of cerebral arteries and veins by visual assessment For statistical analysis paired t-test was used. RESULTS: In pre-enhanced MRA, images with MT mode were better in arterial visualization than those with :n0n-MT mode(p<0.01). Postenhanced MT and non-MT images were better in arterial and venous visualization !than pre-enhanced MT and non-MT images(p<0.01), respectively. Images obtained immediately after injection of contrast material were better in both arterial and venous visualization than delayed images(p<0.01). CONCLUSION: Postenhanced cerebral 3D TOF MRA with MT obtained immediately after injection of contrast materal is the best to increase visualization of both cerebral arteries and veins, and may be indicated in some cranial vascular diseases.

Analysis of High Signal Intensities of Nontumorous Conditions of Corpus Callosum on Magnetic Resonance T2-Weighted Images

PURPOSE: To evaluate high signal intensity of nontumorous conditions of corpus callosum on T2-weighted MR images. MATERIALS AND METHODS: Fourty nine patients with nontumorous high signal intensities involving corpus callosum on sagittal T2-weighted image were restrospectively analyzed. Nontumorous condition of corpus callosum were diffuse axonal injury(DAI, 19 cases), cerebral infarctions(16 cases), multiple sclerosis(MS, 5 cases), Wilson's disease(2 cases) and hydrocephalus(7 cases) that were diagnosed by clinical and MR findings. Numbers, configuration, involved thickness and sites of high signal intensities of corpus callosum were analyzed. RESULTS: DAI and infarctions showed either single or multiple lesions. MS and hydrocephalus showed multiple lesions, but Wilson's diseases showed single lesion. In DAI, infarctions and MS the lesions involved any part of corpus callosum, splenium in WIIson's disease, and all parts of corpus callosum in hydrocephalus. Wilson's disease showed only partial thickness involvement, and others involved partial or full thickness of corpus callosum. Configuration of high signal intensity was linear in most cases of hydrocephalus, and oval in Wilson's disease, and oval and confluent in MS, and variable in DAI and infarctions. CONCLUSION: High signal intensities of nontumorous conditions of corpus callosum revealed variable findings, and therefore, analysis of nontumorous high signal intensities of corpus callosum is not made by only MR findings but by conjuction with clinical aspects.

Gray Matter Heterotopias: MR and Clinical Features

PURPOSE: To evaluate types of gray matter heterotopias, associated brain anomalies, and its correlation with the patterns of seizure. MATERIALS AND METHODS: We evaluated retrospectively 19 patients(male :female=10:9, mean age 21 years) with gray matter heterotopias on brain MRI. Using 1.0T superconducting MR unit, spin echo TI-, proton-density- and T2-weighted images in axial, coronal and sagittal planes were obtained. RESULTS: Types of gray matter heterotopias were single subependymal in four patients, multiple subependymal in one, focal subcortical in eight, diffuse subcortical in two, mixed multiple subependymal and focal subcortical in four. Associated anomalies were seen in 11 patients:other neuronal migration anomalies in eight patients, corpus callosum agenesis in two, and combined holoprosencephaly and Dandy-Walker malformation in one. Fifteen patients had seizure. The patterns of seizure were not correlated with the types of heterotopias. CONCLUSION: In addition to subependymal, focal subcortical, and diffuse subcortical types, gray matter heterotopias included mixed variant of of multiple subependymal and subcortical type. Schizencephaly was the most common form of accompanying anomalies, and patterns of seizure were not correlated with types of gray matter heterotopias, even though main clinical menifestation was seizure.

Is It Useful for Distinguishing between Benign and Malignant Solid Breast Masses? : Diagnostic Criteria of Japan Society of Ultrasonics in IVledicine(JSUM)

PURPOSE: To evaluate the effectiveness and the most accurate element of the diagnostic criteria of the Japan Society of Uitrasonics in medicine(JSUM, Nov. 1989) for distinguishing between benign and malignant solid breast masses on the US. METHODS AND MATERIALS: We analyzed the ultrasonic findings of histopathologically proved 51 fibroadenomas, 12 fibrocystic disease, and 39 breast cancers in relation to the diagnostic criteria of the JSUM (shape, border, boundary echo, internal echo, posterior echo, lateral echo, and depth/width ratio). RESULTS: The number of cases of fibroadenoma, fibrocystic disease, and breast cancer corresponding to the diagnostic criteria was in the shape(26/51, 5/12, 33/39), border(41/51, 9/12, 29/39), boundary echo(48/51, 12/12, 27/39), internal echo(43/51, 9/12, 24/39), posterior echo(32/51, 3/12, 21/39), and lateral shadowing(15/51, 1/12, 35/39). All diagnostic criterias showed statistical significance for differentiation of benign/malignant breast mass on the US(Chi-square test: p<0.05). The order of accuracy was boundary echo, internal echo, and border. The mean of depth/width ratio was 0.54 +/- 0.15, 0.52 +/- 0.12, and 0.69 +/- 0.21 in fibroadenoma, fibrocystic disease, and breast cancer respectively and it had statistical significance for differentiation of benign/malignant breast mass on the US(ANOVA test: p=0.0002). CONCLUSION: The diagnostic criteria of JSUM is effective for differentiation of benign/malignant breast solid masses on the US and has accuracy in the order of boundary echo, internal echo, and border. Depth/width ratio also has statistical significance.

Splenic Artery Pseudoaneurysm Complicating Chronic Pancreatitis: A Case Report

Splenic artery pseudoaneurysm is a relatively rare and potentially life-threatening complication of chronic pancreatitis. The authors present a case of splenic artery pseudoaneurysm complicating ,chronic pancreatitis. It was converting into a pseudoaneurysm by vessel rupturs. In this case report, color doppler US, CT, and MRI made the definite diagnosis.

MR Features in Lymphedema and Phlebedema of Extremities

PURPOSE: Authors analyzed the MR findings of swollen extremities to evaluate the MR features of lymphedema and phlebedema. MATERIALS AND METHODS: We reviewed MR imagings of 17 cases of swollen extremities, including 12 lymphedemas and 5 phlebedemas. We obtained axial TI-, T2-, and Gd-DTPA enhanced T1WIs using 1.0T superconducting magnet and measured cross-sectional areas of subcutaneous and subfascial tissues of a slice with grossly largest cross-sectional area using perimeter. We also analyzed changes in the signal intensities of the subcutaneous and subfascial tissues on T2WI, presence of enhancement on Gd-DTPA enhanced T1WI, and presence of skin thickening. RESULTS: Both subcutaneous and subfascial tissues of swollen extremities were increased in the cross-sectional areas than those of contralateral normal side. The subcutaneous compartment in lymphedema was statistically significantly increased in cross-sectional area than subfascial compartment in lymphedema(p<0.005) and subcutaneous tissue in phlebedema(p<0.05). Increased signal intensities and characteristic "honeycomb appearance" of subcutaneous tissue in the lymphedema were specific findings on T2WI. CONCLUSION: MR imaging was useful and noninvasive method in the diagnosis of swollen extremities. There were increased cross-sectional area of subcutaneous compartment with "honeycomb appearance" in lymphedema and increased signal intensities of both subcutaneous and subfascial compartment in phlebedema on the T2WI.

Ring Lesions in MR Imaging of the Liver

PURPOSE: The purpose of this study is to find some points that may help the differential diagnosis of ring lesions in magnetic resonance (MR) imaging of the liver through recognition of the characteristics of the morphology and the signal intensities of the ring lesions. MATERIALS AND METHODS: T1- and T2-weighted axial spin-echo images and gadolinium-enhanced Tl-weighted images were obtained with a 1.0 T superconducting MR imager. We reviewed the MR findings of 23 hepatic ring lesions which were confirmed as hepatocellular carcinomas (13), metastases (4), liver abscesses (4), hydatid cyst (1), and hematoma (1). RESULTS: There were 19 single rings and 4 double rings (all the cases were liver abscesses) on Tl-weighted images, and 8 single rings and 14 double rings on T2-weighted images. The signal intensity of the ring was low in hepatocellular carcinoma on Tl-weighted images and in hydatid cyst on T2-weighted images. It was high on Tl-weighted images in subacute hemaroma. Target lesion as an inner high-signal-intensity ring surrounded by a high-signal-intensity ring on T2-weighted images was seen in metatasis, liver abscess, and hepatocellular carcinoma. CONCLUSION: It is helpful to recognize the chracteristics of morphology and signal intensities of the ring lesions in the differential diagnosis of hepatic focal lesions.

High Signal Intensity of the Septum Pellucidum at MR Imaging:Significance in Hydrocephalus

PURPOSE: To evaluate the significance of high signal intensity of the septum pellucidum in hydrocephalus on proton density-weighted brain MR images. MATERIALS AND METHODS: Authors reviewed the MR images of 418 cases of patients with normal(175 cases), hydrocephalic(35 cases), atrophic(58 cases), and other groups(150 cases) retrospectively. We analyzed the signal intensity of the septum pellucidum in the normal group and the incidences of high signal intensities of periventricular area of frontal horn of lateral ventricle(area 1), periventricular area except area 1(area 2), callososeptal area(area 3), and septum pellucidum(area 4) in the normal and abnormal groups. RESULTS: In the normal group, the septurn pellucidum was isointense to the head of caudate nucleus on proton density-weighted image. High signal intensity of the septurn pellucidurn was seen in 31 cases (22 cases of hydrocephalus, 5 cases of brain atrophy, and 4 cases of others), and showed high specificity(91.4%) for hydrocephalus in spite of low sensitivity(62.9%), as compared with periventricular hyperintensities of other areas. CONCLUSION: High signal intensity of the septum pellucidum on proton density-weighted image may be caused by transependymal CSF migration in the patients with hydrocephalus, and considered as an additional finding of hydrocephalus in the cases of ventriculomegaly.

Comparative Evaluation of MR Imaging Findings of Spinal Neurilemmomas and Neurofibromas

PURPOSE:To find out the differential points between spinal neurilemmomas and neurofibromas. MATERIALS AND METHODS: Fourteen patients with pathologically proven neurilemmomas(n--6) and neurofibromas(n=8) of spinal canal were studied using magnetic resonance(MR) imaging. Contrast enhancement was performed with Gd-DTPA in all 14 patients. The size and shape of the tumor, absence or presence of adjacent bone erosion, location and extent of the tumor, signal intensity, degree and pattern of Gd-DTPA enhancement of the tumor were retrospectively analyzed. RESULTS: Rim enhancement was seen in five of six patients(83%) with neurilemmomas and three of eight patients(38%) with neurofibromas. Neurilemmomas showed moderate to marked enhancement in five of six patients(83%), whereas neurofibromas showed moderate to mild enhancement in all 8 cases(100%). The average size in longest diameter of the tumors was 2.8cm in neurilemmomas, while 5.4cm in neurofibromas. Neurilemmomas showed ovoid shape in 5 of 6 patients, no extra- or intradural extension, and erosion of adjacent bone in one patient, whereas neurofibromas showed Iobular shape in 6 of 8 patients, extra- or intradural extension in 6 of 8 patients, and erosion of adjacent bone in 4 of 8 patients. CONCLUSION: In differentiating neurofibroma from neurilemmoma, size, shape, extent of the tumor, absence or presence of adjacent bone erosion, and pattern and degree of enhancement of the tumor may be helpful.

MRI of the temporomandibular joint using flip back spin echo technique

The authors introduced flip back spin echo (FBSE) technique for MR imaging of the temporomandibular joint (TMJ) instead of conventional spin echo (SE) technique, and evaluated whether FBSE technique in MRI of TMJ is adequate for the diagnosis of the disorders or not. FBSE T1 parasagittal images in closed mouth state and sequential opening and closing mouth states using patient's own finger(s) were obtained and then FBSE T1 paracoronal image in closed mouth state and STAGE(short tip angle gradient echo) parasagittal T2WI were followed. All 30 images of the symptomatic TMJs using FBSE technique were excellent in the visualization of articular and their displacement, and we could easily diagnose the internal derangement. FBSE technique was adequate for the diagnosis of internal derangement of the TMJ, and the modified cine display from images using FBSE technique was advantageous in the diagnosis of the disorders by visualization of the dynamic motion of the TMJ.

Single breath-hold MR imaging of liver

Single breath-hold gradient echo images with Small Tip. Angle Gradient Echo(STAGE) were evaluated in the study of liver in 16 patients(4 normal liver, 5 hepatoma, 5 cholangiocarcinoma, 1 hemangioma, 1 cavernous transformation of portal vein). We obtained one slice of gradient echo during single breath-hold at the level of pathology defined on conventional spin echo inage. Single breath-hold gradient echo images were compared with spin echo images for image quality and artifacts. Single breath-hold gradient image showed improved resolution of vascular detail and excellent contrast between lesion and adjacent normal liver in hepatoma. Cholangiocarcinoma showed decreased contrast between lesion and biliary trees but improved contrast between lesion and blood vessel. Cavernous transformation of porta vein was noted as tortuous vessel of high signal intensity. Single breath-hold gradient echo scan increased vascular artifact, but decreased respiratory artifact leading to improved image quality. Single breath-hold technique can reduce can reduce imaging time and improve image quality and may be used as complementary method to the spin echo scan.

High signal intensity lesion in basal ganglia on MR imaging: Correlation with portal-systemic encephalopathy in liver cirrhosis

To evaluate of the relationship between basal ganglia lesion and portal-systemic encephalopathy, eleven patients who had clinically proved liver cirrhosis with superior mesenteric vein larger than 10mm in diameter on ultrasonogram underwent brain MR imaging. No evidence of clinical or neuropsychiatric disturbance was observed in any patient at the time of the MR examination. Brain MR imaging revealed basal ganglia lesion characterized by bilateral, symmetric, high signal intensity without edema or mass effect on spin echo T1-weighted images in nine patients which included three patients with the past history of portal-systemic encephalopathy. It was concluded that excepted in the circumstances of other causes of the high signal intensity in basal ganglia on T1-weighted images such as fat, methemoglobin, melanin, neurofibromatosis, dense calcification, and parenteral nutrition, bilateral and symmetric high signal intensity lesion, in basal ganglia would be a useful MR finding of subclinical portal-systemic encephalopathy in liver cirrhosis patients with no clinical or neuropsychiatric symptoms and larger than 10mm diameter of superior mesenteric vein in ultrasonography.

A Study of Venous Angiomas

The clinical significance of venous angiomas is controversial. Owing to the increased resolution of modern CT scannes and the advent of magnetic resonance imaging(MRI) as well as an increased awareness of these lesions, venous angiomas has been recognized more frequently in routine neuroradiographic examinations. In a retrospective study of 1998 brain MR imaging performed at our institute between April, 1990 and April, 1992, 18 cases of venous angioma were diagnosed. Among them, 13 cases(72.2%) occur supratentorially and 5 cases(27.8%) occur in cerebellum. Their symptoms were headache(7 cases), hemorrhage(4 cases) seizure(3 cases), focal neurological sign(1 case) and no associated symptoms(3 cases). All cases have been managed conservatibely except one case(with massive cerebellar hemorrhage). During follow up period, no significant complications was happened in all cases. Long-term follow up is necessary to develop meaningful recommendations regarding the management of venous angiomas.

Comparison of MR angiography and conventional angiography in intracranial arteriovenous malformations

In 10 cases with intracranial arterivenous malformation (AVMs) diagnosed by MR spin echo images, MR angiography was evaluated and compared with conventional angiography in regard to depiction of nidus, arterial feeders, and draining veins. Spin echo images demonstrated the nidus of the AVM in all cases, but displayed the feeding vassels inadequately. These vessels were directly visualized with 3 dimensional STAGE(small tip angle gradient echo) MR angiography using rephasing/dephasing pulse sequences. In 5 cases MR angiography and conventional angiography showed the same results. However, in the others, MR angiography showed lower resolution than conventional angiography. MR angiography is useful in preangiographic evaluation of intracranial AVM but improvement in image resolution, which is dependent on MR hard ware and pulse sequence, is still to be desired.

The significance of double contrast retrograde urethrocystography in prostatic tumors

DRUC( Double Contrast Retrograde Urethrocystography), which was a combination of air cystography andretrograde urethrography with the patient in an exaggerated Trendelenburg's position allowing the contrast mediuminjected into bladder to be accumulated at the bladder base and dome far from trigone, showed good visualization of the prostatic urethra, bladder neck, bladder base and wall in contrast to the conventional, retrogradeurethrography. The authors analyzed DRUC findings of 32 cases of benign prostatic hypertrophy, 3 case of prostaticcancer and 50 cases of normal healthy men performed at Pusan National University Hospital for 9 months from Jan.1984 to Sept. 1984. The results obtained were as follows: 1. DRUC findings of normal control group were normalpattern of prostatic urethra, semioval shaped bladder wall. 2. DRUC findings of B.P.H. were spreading of prostaticurethra, spreading, displacement, smooth multidirectional compression of bladder neck, widening of inner orificeof bladder neck, smooth elevation of bladder base, traveculation of bladder wall and variable type of intravesicalstream such as normal, broad, double central stream, associated peripheral umbrella stream and no intravesicalstream. 3. DRUC findings of prostatic cancer were rigidity of prostatic urethra, nodular multidirectionalcompression of bladder neck, multiseptation of peripheral intravesical stream, nodularity of bladder base andtrabeculation of bladder wall. 4. DRUC, which added to double contrast method and postion change of patient,showed more delicate changes of baldder neck, base and wall as well as prostatic urethra in contrast to simpleRUG. We observed that changes of bladder neck and intravesical stream were significant in analzing abnormalenlarged prostate, and could differentiate B.P.H. from prostatic cancer simply by noting sharply demarcatedbladder base.

Percutaneous Antegrade Pyelography Guided by Ultrasound

The authors performed percutaneous antegrade pyelography guided by ultrasound on 33 patients, from J une 1982 to October 1984, at the department of radiology, Busan National University Hospital. The results obtained were as follows: 1. Of the 31 cases,17 cases (5 1.5%) were female and 16 cases (48.5 %)were male,and age distribution was nearly even, but most prevalent age group was third decade. 2. Comparing intravenous pyelographic findings with ultrasonographic findings, pyelographically non. visualized kidney 15 cases (45 .5%) were hydronephrosis 12 cases, multiple cysts 2 cases, and intrarenal cystic mass 1 case, ultrasonographically. Pyelographically hydronephrosis 9 cases (27.3%) were all hydronephrosis, ultrasonographically. Intrarenal mass 5 cases (15.2%) were all intrarenal cystic mass, NVK with air in kidney 1 case (3.0%) was air in perirenal space, partial NVK 1 case (3.0%) was per. irenal fluid , suprarenal mass 1 case (3 .0%) was suprarenal intrarenal and huge perirenal cystic masses, ultraso nograp h ically. 3. On technical reliability of antegrade pyelography under ultrasound gUide, 31 cases (93 .9%) could be done fluid aspiration and visualization, and 2 cases (6.1 %) could be only done fluid aspiration but failed visualization . 31 successful cases were visualization of collecting systems 23 cases, visualization of cyst 6 cases, i!nd visualization of perirenal space 2 cases. 2 partial successful cases were perirenal injection 1 case and parenchymal injection 1 case. 4. On fluid aspiration, 22 cases (66.7%) were clear, but 11 cases (33.3%) were not clear, which were pus 7 cases, turbid urine 2 cases, bloody urine 1 case, and bloody pus and air 1 case. 5. Comparing ultrasonographic findings with antegrade pyelographic findings, ultrasonographically hydronephrosis 21 cases revealed obstruction in 16 cases, antegrade pyelographically, which were consisted of ureteral stricture 14 cases, ureteral stone 1 case, and ureteral mass 1 case, non-obstruction in 4 cases, which were consisted of pyonephrosis 2 cases, posterior urethral valve 1 case, and megaureter 1 case, and other 1 case was visualization failure. Ultrasonographically intrarenal cystic mass 6 cases were simple renal cyst 4 cases, and infected renal cyst 2 cases, antegrade pyelographically. Multiple cysts 2 cases were lobulated huge renal cyst 1 case, and visualization failure 1 case, which was multi.cystic kidney. Air in perirenal space 1 case was emphysematous pyelone. phritis, suprarenal cystic mass 1 case was complete duplication with ectopic ureteral orifice, perirenal fluid 1 case due to kidney fracture was perirenal fluid , and intrarenal and perirenal cystic mass was per irenal abscess, antegrade pyelographically. 6. On ana lysis of anteg rade pyelography result as next diagnostic step of ultrasound, 31 successful cases were 27 conclusive diagnostic cases (87.1%), and 4 heplful diagnostic cases (12.9%) with percutaneous antegrade pyelography guided by ultrasound . 7. Antegrade pyelography provides significant diagnostic information on the nature of the obstructive lesion and can be performed as an adjunct to retrograde study or as an alterative to a pyelogram. 8. Ultrasonographic examination could be performed easiJy in diagnosis of renal and perirenal diseases as non.invasive method without risk of radiation hazard , and was not influenced by renal function. 9. Ultrasound is considered a most advantageous aid to the performance of antegrade pyelography and has yie lded valuab le diagnostic information in patients with obstructive hydronephrosis.

An observation of ultrasonographic findings in thyroid disease

The authors analyzed ultrasonographically the total 45 cases of thyroid disease verified by historicaldiagnosis, functional diagnosis, and morphological diagnosis at the Departement of Radiology, Busan NationalUniversity hospital from June to Sept. 1982. The resuls obtained were as follows; 1. In the sex distributionfemale was 38 cases (84.4%), and male 7 cases (15.6%). 2. Among the total 4 cases thyroid adenoma was 24 cases(53.3%), nodular hyperplasia 8 cases (17.7%), thyroid carcinoma 7 cases (15.6%), diffuse hyperplasia 3 cases(6.7%), Hanshimoto's thyroiditis 1 cases (2.2%), subacute thyroiditis 1 cases(2.2%), tuberculous thyroiditis 1cases(2.2%) in orders. 3. On ultrasonogram, total 24 cases of thyroid adenoma showed a single nodule in 24 cases(100.0%), smooth outer margin in 23 cases (95.8%), capsular echo in 23 cases (95.8%), pure cystic nodule in 4cases (16.7%), and increased echogenicity in 17 cases (85.0%) among the 20 cases excluded the pure cystic nodules.4. Total 7 cases of thyroid carcinoma showed no capsular echo in 4 cases (57.1%), irregular outer margine in 4cases(57.1%), no pure cytic nodule in all cases, and enlargement of metastatic lymphnode in 4 cases (57.1%). 5.Total 8 cases of nodular hyperplasia showed enlargement of thyroid gland and multiple nodule in 8 cases (100.0%),and increased echogenicity in 7 cases (87.5%). 6. Total 3 cases of diffuse hyperplasia showed enlargement ofthyroid gland and increased echogenicity in 3 cases (100.0%). 7. Total 3 cases of thyroiditis showed decreasedechogenicity in 3 cases (100.0%) and enlargement of thyroid gland in 2 cases (66.7%). 8. The cold area visualizedon radionuclide scan could be differentiated from a solid mass and cystic one by utrasonogram.