CT Evaluation of the Brain Abscess: Comparison of CT and Pathologic Findings of Brain

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.

Ultrasonographic evaluations of placenta previa

Diagnostic ultrasound has become one of the most useful tools in the practice of obstetics. It has been ofparticular utility in the placental localization. We analyzed 34 patients of placenta previa scanned byultrasound. The reults were as follows; 1. The age of patient ranged from 22 to 39 years, showing the highestincidence in 26 to 30 years. 2. The accuracy of correct localization was 70.6%. 3. Among 13 cases diagnosed byultrasound as total placenta previa, 2 cases were partial placenta previa and 1 was low-lying placenta at the timeof delivery. 4. Among 9 cases diagnosed by ultrasound as partial placenta previa, 1 case was total palcenta previaand 1 case was low-lying placenta and 1 case was upper segment placenta. 5. Among 10 cases diagnosed by utrasoundas low-lying placenta, 2 cases were partial placenta previa. 6. Among 2 cases diagnosed by utlrasound as uppersegment placenta, 1 case was total placental previa and 1 case was partial placenta previa. 7. Among 9 cases doneserial ultrasoud, 3 cases revealed that the placenta migrates toward fundus in the course of pregnancy, Therefore,the palcental scanning should be repeated in the last month before term to decide the mode of delivery.conclusively, ultrasonography is the imaging modality of choice in the evaluation of placental localization becuseit provides speedy and repeatable way without any known risk to both mother and fetus itself. Careful performanceand accurate interpretation shold be needed for more correct palcental localization.

Ultrasonographic findings of the pelvic masses

Ultrasonography is most commonly utillized diagnostic tool in obstetric and gynecology for the evaluation ofpatient with a pelvic mass or pregancy. For it is characterized by no radiation hazard, noninvasive examinationand high diagnoastic accuracy. Also it affords an accurate assessment of the presence, size, location and internalconsistency of a pelvic mass. The recent availability and improved resolution of realtime scanning have afforded amore flexible and complete approach to evaluation of normal and abnormal structures in the pelvis. We analyzedultrasonographic findings in 154 pathologically proven cases of pelvic mass examined at Korea General hospitalfrom Jan. 1983 to Apr. 1984. The results were as follows; 1. The age distribution was from 12 years to 66 yearsand the majority of patients were between the ages of 21 and 50 yeasrs (91.4%). 2. The incidence of pelvic masswas 27.9% in uterine leiomyoma, 22.7% in ovarian cyst, 13.0% in addenomyosis and 8.4% in serous cystadenoma. 3. Mild to moderately echogenic nodular uterine enlargement with some cystic change(81.5%) of leiomyoma and multiplesmall vesicular pattern of intrauterine contents with uterine enlargement of Homole were the most common ultrasonographic findings. The location and type of leiomyoma were most common in the fundus and body (95.3%), and intramural myoma(53.5%). The most frequent finding of ovarian teratoma was cystic mass with echogenic focus(41.7%) but the echogenic appearance of the lesions was extremely variable. The ultrasonographic findings ofectopic pregnancy were cystic or complelx adnexal mass(80.0%), with or without fluid in cul-de-sac and deviationof uterus by adenxal mass. 4. Accuracy of ultrasonography in detemining the overall correct diagnosis of thepelvic masses compared with proven diagnosis was approximately 61.7%. The diagnostic accuracy was 90.7% inluterine leiomyoma, 100% in H-mole nad 80.0% in ectopic pregnancy.