MRI Findings of Traumatic Spinal Subdural Hematoma

PURPOSE: To describe the MR imaging findings of traumatic spinal subdural hematoma. MATERIALS AND METHODS: We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analysed the extent, location, configuration and signal intensity of the lesions. RESULTS: In five of six cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. CONCLUSION: In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at all spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding.

A Case of Zollinger-Ellison Syndrome with Gastrinoma Localized by 111In-Pentetreotide Scan / 대한핵의학회잡지

In patient with Zollinger-Ellison syndrome, it is difficult to localize gastrinoma because the tumor is frequently small and multiple. However, accurate localization of the tumor is important for the treatment. Among various imaging modalities, somatostatin receptor scintigraphy (SRS) has been recognized to be the most sensitive tool for the detection of neuroendocrine tumors such as gastrinomas based on the presence of high-affinity binding sites for somatostatin. Recently, we experienced a case of Zollinger-Ellison syndrome caused by gastrinomas which was localized by SRS. This is the first case report of gastrinoma detected by SRS in Korea. SRS can facilitate tumor detection in patient with Zollinger-Ellison syndrome and should be considered as the first-line diagnostic method in the early course of the disease.

Can Anterior Junction Line be Used to Distinguish Right Middle from Right Upper Lobe on CT Scan?

PURPOSE: To evalvate the usefulness on a CT chest scan, of the anterior junction line as an anatomical landmark to distinguish the right middle and the right upper lobe MATERIALS AND METHODS: We found that the anterior junction line has a constant anatomical relationship with the right upper and middle lobe, and with this in mind, analysed connvcntional CT films of 86 patients with normal lung (group A) and 30 with architectural distortion (group B). On a series of slices, we compared the location of slice 1 with that of slice 2 (slice 1: the slice which includes the lowest portion of the anterior junction line, slice 2: the initial slice, in which the right middle lobe occupies the whole of the lung anterior to the right major fissure). RESULTS: In group A (n=86), the right upper lobe, as seen in the anteromedial zone of slice 1, was present in 83 cases (96.5%). The right upper lobe on slice 1 was absent in two cases (2.3%) in which a minor fissure was almost completely abent. In group B (n=30), the right upper lobe on slice 1 was absent in 19 cases (63.3%). CONCLUSION: We suggest that on a CT chest scan, the anterior junction line can be used as an anatomical landmark in the differentiation of the right middle from the right upper lobe, and as an indicator of the presence of architectural distortion.