CT Findings and Differential Diagnosis of Cystic Neck Masses

PURPOSE: The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. RESULTS: Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were includded. Ten congenital cystic masses were located in typical locations as branchial cleft cyst(5) in mandibular angle, thyroglossal duct cyst(3) in visceral space embeded within the strap muscles, cystic hygroma(1) and cavernous hemangioma(1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. CONCLUSION: It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

An Experimental Study on Renal Functional Disturbance in Rabbits After Acute Ureteral Obstruction With Dynamic Gd-DTPA Enhanced MR Imaging

PURPOSE: To evaluate the anatomic and functional change in acutely obstructed kidneys, and the probability of functional recovery after resolving the obstruciton. MATERIALS AND METHODS: There were 5 animal groups(6 rabbits in each group)-normal control group, 4 acute ureteral obstruction group. Each of the latter group was imaged with Gd-DTPA enhanced dynamic MR 2, 6, 24, and 48 hours after ligation of the left proximal urter, respectively. We compared the findings of dynamic MR imaging and histopathological findings. RESULTS: We could observe centripetal movement of dark band pattern which could be defined as 3 phasesrenal cortex, outer medulla, and inner medulla in normal rabbits. The appearance of the dark band pattern was delayed or absent in ureteral obstruction group with a linear relationship to the duration of the obstruction. CONCLUSION: Gd-DTPA enhanced MR can be used to differentiate acute obstructive nephropathy from other causes of nephropathy and foretell the prognosis of the obstruction.

Percutaneous Transhepatic Biliary Drainage Using Large Needle: Complications and Usefulness

PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.

Evaluation of sonographic and radiographic findings of pelvic masses

Ultrasonographic and radiographic findings in 72 cases of pelvic masses which have been provedhistopathologically were analyzed. The results were as follows; 1. Among 72 cases, 28 cases were uterine massesand 44 cases were adnexal masses. 2. Pathologic accuracies of ultrasonographic diagnosis were 64.3% in uterinemasses, 70.5% in adnexal masses, and 68.1% in all pelvic masses. 3. Plain or IVP findings were not specific indiagnosis and showed secondary mass effects or functional disturbances. 4. Because of its high accuracy ofpathologic diagnosis and safety, ultrasonography can be regared as the most valuable and preferential study. Butin cases of cystic myomas, endometrioses, cystic missed abortions and huge masses, the accurate diagnoses weredifficult.

A study on the cholecystcholangiographic and ultrasonographic findings of biliary disease

In the 88 cases of biliary disease, which was proven in Seoul Red Cross Hospital from Jan. 1980 to Dec. 1981,comparative studies were made with oral and IV cholecystocholangiographic findings and ultrasonographic findings.The resuslts were ; 1. In the 18 cases of GB stones, there are 17 cases (94.4%) of positive findings incholecysto-cholangiography with detection of stone in 7 cases (38.9%), while in sonographic study, 16 cases(88.9%) are shown positive findings with detection of stones in 11 cases (61.1%). 2. In the 17 cases of acalculouscholecystitis, the diagnostic accuracy is 88.2% in cholecystocholangiography and 64.7% in sonography. 3. In the 7cases of CBD stones, all cases are shown positive findings in cholecystocholangiography with detection of stone inonly one case (14.3%), while 6 cases (85.7%) of positive findings are shown in sonography with detection stone inall cases. 4. I.V. cholanagiography is more accurate diagnsotic procedure rather than oral GB study in the casesof poor or non-functioning GB. 5. Sonography is the choice of procedure in the diagnosis of stones, while in thecases of colecystitis, cholecystocholangiography is more useful diagnostic procedure.