The Clinical Value of Residual Urine Checked by Transrectal Ultrasonography / 대한비뇨기과학회지

PURPOSE: Post-voiding residual urine hasbeen evaluated by urethral catheterization or abdomen ultrasonography in patients with benign prostatic hyperplasia. However, urethral catheterization is invasive and abdomen ultrasonography is not cost-effective for patients with benign prostatic hyperplasia. Therefore, we wished to determine the efficacy of using transrectal ultrasonography for the evaluation of the residual urine volume. MATERIALS AND METHODS: A total of 37 patients were evaluated. The mean age of the patients was 69 years, ranging from 54-84 years. The empty bladder was instilled with a random volume of saline. In addition, the bladder volume was checked by transrectal ultrasonography. RESULTS: The total mean residual urine volume checked by transrectal ultrasonography and catheterization were different statistically. When we performed a simple linear regression of the residual urine volume determined by each method, the regression coefficient was 0.699 and the determination coefficient was 58.4%. We divided the patients into two groups-one group of patients with a residual urine volume of 150ml and the other group of patients with a prostate volume of 40ml. When the residual urine volume was less than 150ml and the prostate volume was less than 40ml, each mean residual urine volume was not different statistically. The determination coefficient was more than 60% by the simple linear regression. CONCLUSIONS: We could use transrectal ultrasonography for the purpose of a residual urine volume check. Especially when the residual urine volume was less than 150ml and the prostate volume was less than 40ml, we could estimate the residual urine volume by transrectal ultrasonography more accurately.

Gd-DTPA Enhanced Dynamic Renal MR Imaging of Experimentally

PURPOSE: The purpose of this study was to evaluate the utility of Gd-DTPA-enhanced dynamic MRI (DMRI) in earlydiagnosis and the assessment of disease processing in experimentally-induced crescentic glomerulonephritis (CGN)in rabbits. MATERIALS AND METHODS: In six rabbits, CGN was induced by an injection of anti-glomerular basementmembrane Ab. A time-signal intensity curve (TSC) was obtained from DMRI on the day before, and at 1, 4, 7, 15, 45and 113 days after the induction of CGN. Sequential renal biopsies and blood sampling (serum creatinine) wereperformed on the same days, and the results of DMRI and TSC, were compared. RESULTS: In normal kidneys, sequentialDMRI demonstrated the intratubular passage of Gd-DTPA as an inwardly migrating, thin, dark, band pattern. On days1 and 4, the thin dark band appeared but was poorly defined and TSC revealed a delay in peak time. On days 7 and15, movement of the band was seen to be weak and slow, and there was no centripetal migration. The maximal signalintensity of TSC was delayed, and the curves declined very slowly. On days 45 and 113, the dark band pattern wasvery weak and slow, and again there was no centripetal migration. CONCLUSION: GD-DTPA-enhanced DMRI may be ofvalue in the evaluation of disease processing and the severity of CGN.

Soft tissue sparganosis

Sparganosis is a rare tissue-parasitic infestation caused by a plerocercoid tapeworm larva(sparganum), genus Spirometra. The most common clinical presentation of sparganosis is a palpable subcutaneous mass or masses. Fifteen simple radiographs and 10 ultrasonograms of 17 patients with operatively verified subcutaneous sparganosis were retrospectively analyzed to find its radiologic characteristics for preoperative diagnosis of sparganosis. The locations of the subcutaneous sparganosis were lower extremity, abdominal wall, breast, inguinal region and scrotum in order of frequency. The simple radiographs showed linear or elongated calcification with or without nodular elongated shaped soft tissue mass shadows in 8 patients, soft tissue mass shadow only in 2 patients and lateral abdominal wall thickening in 1 patient. But no specific findings was noted in 4 patients with small abdominal and inguinal masses. We could classify the subcutaneous sparganosis by ultrasound into 2 types: one is long band-like hypoechoic structures, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva and the other is elongated or ovoid hypoechoic nodules, representing granulomas. Long band-like hypoechoic structures within or associated with mixed echoic granulomatous masses were noted in 6 patients and elongated or ovoid hypoechoic mass or masses were noted in 4 patients. In conclusion, sparganosis should be considered when these radiologic findings-irregular linear calcifications on simple radiograph and long ban-like hypoechoic structures on ultrasonography, corresponding to the subcutaneous tunnel-like tracks formed by migration of sparganum larva-are noted in the patients who have subcutaneous palpable mass or masses. And radiologic examination especially ultrasonography is very helpful to diagnose sparganosis.

Clonorchiasis and its complications: cholangiogram revisited

Clonorchiasis is known to be closely related with the development of recurrent pyogenic cholangitis and carcinoma of the bile ducts. In order to ascertain the cholangiographic signs for recurrent pyogenic cholangitis or carcinoma of the bile ducts arising in patients with clonorchiasis. we reviewed cholangiograms in 42 patients with proven clonorchiasis. The population consisted of 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone were intrahepatic multiple, oval, or elliptic filling defects measuring 2-10 mm in size, representing adult flukes (n=24). The peripheral bile duct were obstructed (n=18), and the margins were ragged (n=20) and hazy (n=12) the intrahepatic bile ducts were dilated diffusely (n=27), and the dilated peripheral small tributaries gave the impression of "too many ducts appearance" (n=7) and dilatation was mid (n=17) In six patients with clonorchiasis and recurrent pyogenic cholangitis, there were filling defects of stones, and the extrahepatic ducts and larger intrahepatic ducts were predominantly dilated. In seven patients with clonorchiasis and cholangiocarcinoma all the biliary tree proximal to the tumor was markedly and diffusely dilated In the latter two groups, filling defects of flukes and associated findings were less prominent, but there was disproportionately severe dilatation of too many intrahepatic ducts. In patients with recurrent pyogenic cholangitis or cholangiocarcinoma, clonorchiasis should be considered as a underlying cause when cholangiogram shows "disproportionately" severe dilatation of too many intrahepatic ducts. intrahepatic ducts.

Too many ducts sign: a characteristic cholangiographic finding of clonorchiasis?

Clonorchiasis procucts diffuse dilatation of the small and medium sized intrahepatic bile ducts and its cholangiogram shows visualization of many bile ducts, especially, tertiary, quaternary, and more peripheral tributaries up to the 6th tributaries. In an attempt to clarify this cholangiographic sign quantitively, we counted the visualized smaller bile ducts in clonorchiasis and compared the number of visualized ducts in normal cholangiogram, recurrent pyogenic chlangitis and carcinoma of the extrahepatic ducts. In clonorchiasis the number of visualized smaller bile ducts was considerably geater than in normal subjects and recurrent pyogenic cholangitis, but there was no singnificant statistical differences in the number of visualized bile duct tributaries between clonorchiasis and carcinoma of the bile ducts. Thus it is considered that too many ducts sign is not a unique cholangiographic finding of clonorchiasis, but we believe that in the presence of this sign with other we l known cholangiographic findings, diagnosis of clonorchiasis is very easy.