Color Doppler Energy(CDE): Initial Ten-Months Experience

PURPOSE: Color Doppler Imaging(CDI) has shortcomings, including random noise, aliasing, and angle dependence. To overcome these, a method using CD US, termed power doppler or Color Doppler Energy(CDE), has recently been introduced. The purpose of this study was to show the clinical usefulness of CDE. MATERIALS AND METHODS: We retrospectively analyzed the CDI and CDE of 61 cases(20 renal pseudotumors, 8 musculoskeletal inflammations, 17epididymitis or epididymo-orchitis, 3 vaicoceles, 1 normal testis, 1 hepatocellualar carcinoma, 7 renal cell carcinomas, 1 renal angiomyolipoma, and 3 splenic varices). CDI and CDE scans were obtained at the same region with constant scan plane. The color gain was increased until noise first became perceptible, and scans were always obtained in such a way that the maximum amount af vascularity was shown. There after, the vascularity, vascular displacement, and the vascular relationship between CDI and CDE were compared. RESULT: In 17 of 20 cases of pseudotumor in the kidney, normal vascularity was identified in CDI and CDE, but was more clearly visible in CDE. In three cases, there was no visible vascularity in CDI, but normal vascularity in CDE. In eight cases of musculoskeletal inflammation and 17 cases of epididymitis with or without or chitis, the vascularity was increased due to hyperemia, which was more prominently seen in CDE than in CDI. In three varicoceles, CDE appeared to bebetter in demonstration low velocity flow. In one patient who was suspected of having acute testicular torsion, CDE was helpful in excluding this suspicion. In one case of hepatocellular carcinoma, seven cases of renal cell carcinoma, one case of renal angiomyolipoma, and three cases of splenic varices, CDE was better than CDI in showing the vascularity, vascular relationship, and vascular displacement. CONCLUSION: CDE is a potential lyuseful adjunct to standard CDI.

CT Findings of Silicosis

PURPOSE: To describe chest radiographic and CT findings of silicosis, and to compare their findings. MATERIALS AND METHODS: Ten coal miners and six stonemasons were included in this study. All were male and their mean age was 53.1. The mean duration of dust exposure was 15.2 years(range, 5-30 years) in coal miners and 25.3years(range, 15|35 years) in stonemasons. Chest radiographs(n=16), conventional CT scans(n=4), and high resolutionCT(HRCT) scans(n=13) were evaluated. Parenchymal abnormalities were interpreted on the basis of ILO standardfilms(1980) in chest radiographs and on the basis of CAP(College of American Pathologists, 1979) in CT(HRCT)films. RESULTS: Chest radiographs revealed large opacities(n=8), small opacities(n=6), and normal findings(n=2).Type r(n=4) and category 1/1(n=2) were most common for small opacities, while for large opacities, category B(n=4) and category c(n=4) were most common. These small and large opacities were located predominantly in the area of the upper and middle lung. Associated findings were emphysema(n=7), eggshell nodal calcifications(n=3), pneumothorax(n=3), C-P angle blunting(n=4), and pleural thickening(n=1). CT scans revealed micronodules(n=16), nodules(n=3), and progressive massive fibrosis(PMF, n=8). All these lesions were located in the upper and middlelungs, especially in the central portion of the posterior lung. PMF showed diffuse and homogenous(n=3) andpuntate(n=2) calcifications, cavitations(n=5), air bronchograms(n=3), and necrosis(n=1). Peripheral paracicatricalemphysema was associated with PMF(n=8). Other findings were pneumothorax(n=4), emphysema(n=10), hilar andmediastinal nodal enlargement(n=11), bronchial wall thick-enings(n=6), bronchiectasis(n=1), pleuralthickening(n=7), parenchymal fibrosis(n=1), and pulmonary tuberculosis(n=2). CONCLUSION: Small and large opacities in chest radiographs and micronodules, nodules, and PMFs in CT(HRCT) films were located predominately inthe upper and middle lungs, especially in the central portion of the posterior lung in CT films. CT was superiorto plain chest radiographs in the following ways : (1) in the early detection of small opacities, including subpleural micronodules, and in the precise evaluation of their concentration and topography ; (2) in the detection of cavitation or calcification within conglomerate large opacity lesions ; (3) in the detection of hilarand mediastinal nodal enlargements ; and (4) in quantitative assessment of the severity of emphysema.

Miliary Tuberculosis: HRCT Findings in 14 Patientst

PURPOSE: To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significancy. MATERIAL AND METHOD: We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. RESULTS: On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 --2ram in 6 cases, and 3mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). CONCLUSION: HRCT findings of miliary tuberculosis are diffusely distributed micronodules of variable size, less than 5mm in diameter. The ground-glass opacity can be combined.

Observations of Arrhythmias by 24 Hour Ambulatory ECG Monitoring in Early Convalescent Phase of Acute Myocardial Infarction

In order to observe the arrhythmia which occured in early convalescent phase of acute myocardial infarction, a 24 hour ambulartory ECG monitiring was performed in 15 patients who is admitted at dept of Int Medicine, Ewha Womans University hospital from Aug. 1985 to Sept. 1986. during 7.5+/-3.4 days after admission. In all cases one or more of the following arrhythmias were observed;atrial premature beat, ventricular premature beat(VPB), transient paroxysmal ventricular thchycardia, atrial fibrillation, sinus arrest and junctional beat. Of 15 cases, 11(77.3%) had VPB's:Simple VPB's in 4 cases(26.7%) and complex VPB's(6.52+/-2.52)(P0.1). In addition, we compaired the arrhythmias in CCU with those of early convalescent phase of acute myocardial infarction. But there was no correlation between them.