Analysis of 62 Cases with Stereotaxic Breast Biopsy with a Prone Table System: Emphasis on Lesions with micro calcifications

PURPOSE: To evaluate the efficacy of stereotaxic breast core biopsy using a prone table system, and theeffects of operator experience, lesion characteristics and number of samples on biopsy results in cases involvingnonpalpable breast lesions. MATERIALS AND METHODS: We performed stereotaxic core biopsies of 62 nonpalpablemammographic lesions in 61 patients. Subsequent surgical excision was performed in 11 cases with micro calcifications and one case with a mass. We equally divided patients with micro calcifications into two groups(early and late periods) and analyzed the mammographic findings. Correlation of the pathologic results of corebiopsy with those of surgical excision were investigated. RESULTS: In two patients, stereotaxic biopsy wasimpossible due to poor visibility of micro calcifications and thinness of the compressed breast. In 59 patients,core biopsy was successfully performed and specimens were adequate for pathologic examination. The average numberof micro calcifications seen on specimen mammography in the two groups was 1.8 (range: 0~8) and 2.5 (range:0~4)respectively. In patients from whom less than five and five or more samples were taken, the average number of micro calcifications seen on specimen mammography was 1.5 (range: 0~6) and 2.6 (range: 0~8), respectively,throughout the whole period. The pathologic findings were fibrocystic change in 50 cases, fibroadenoma in four,ductal carcinoma in situ in four, invasive ductal carcinoma in one, and atypical ductal hyperplasia in one. Theagreement rate of pathologic results between core biopsy and surgical excision was 83% (10/12) for malignancy and75% for histology. In three cases with disagreement between core and surgical pathologic results, the samplingnumber was small (3~4 times) and in two of the three cases, micro calcifications were not visible on mammography. CONCLUSION: Operator experience and sampling numbers larger than five results in an increased number of micro calcifications in specimens and more reliable core biopsy.

Hepatic Abscess: Three-Phase Helical CT Appearance

PURPOSE: The purpose of this study was to evaluate the enhancement patterns and morphologic features ofhepatic abscesses, as seen on three-phase helical CT images. MATERIALS AND METHODS: Three-phase helical CT imagesof 22 clinically and pathologically proven hepatic abscesses more than 3 cm in diameter in 21 patients wereretrospectively reviewed. Three-phase helical CT scans were obtained at 30 sec(hepatic arterial phase, AP), 70sec(portal venous phase, PP) and 3 min(equilibrium phase, EP) after the start of intravenous infusion of contrastmaterial. We analyzed the number of abscess layers and their enhancement patterns during each phase, and evaluatedthe size and shape of abscess, the CT attenuation and presence of septae in the abscess cavity, and the thicknessand maturation of the granulation layer and collagenous wall. RESULTS: AP images showed that 13 abscesses(59%)had four layers; on PP images, half the abscesses were seen to have three layers, while EP images showed thattwo-thirds had two layers. Among the 13 abscesses with four layers seen on AP images, all abscess cavities andgranulation layers were hypo- and hyperattenuating, respectively, during all three phases. Most hypoattenuatingcollagenous walls seen on AP images became iso- or hyperattenuating on EP images, while hyperattenuatinghyperperfusion zones seen on AP images became isoattenuating during later phases. The degree of maturation of thecollagenous wall correlated with the number of abscess layers. CONCLUSION: As seen on AP, PP and EP three-phasehelical CT images, hepatic abscess frequently had four, three, or two layers respectively. More mature collagenouswalls tended to have more abscess layers.

Comparison of Colonic Transit Time Findings Between Spastic Pelvic Floor Syndrome and Normal on defecogram

PURPOSE: To evaluate colonic transit time (CTT) in patients with spastic pelvic floor syndrome (SPFS)diagnosed by defecography and compare the findings with those of patients with normal defecography. MATERIALS AND METHODS: Over a recent 15-month period, 140 patients underwent both defecography and CTT test because of chronicidiopathic constipation. Of these, 54 with SPFS diagnosed by defecography and 49 controls with normal defecographywere included in our study. CTT testing involved the radiopaque marker method. Subjects ingested 24 markers at9:00AM on three consecutive days and a plain film of the abdomen was obtained on day 4. We calculated total andsegmental CTT, and compared CTT test findings in the two groups. RESULTS: Delayed total CTT was found in 35% ofpatients (19/54) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 19% (10/54),44% (24/54), and 31% of cases(17/54), respectively. Total CTT was delayed in 31% of patients(15/49) with normaldefecography. In this group, segmental CTT in the left colon was delayed in 39% of cases. CONCLUSION: There was nosignificant difference in CTT findings between the SPFS and normal groups on defecogram.