ABSTRACT
Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.
ABSTRACT
Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.
ABSTRACT
A paratracheal cyst is an air-filled cyst lined by a ciliated epithelium, commonly referred to as a tracheal diverticulum. The most common location of paratracheal cysts is the right side of posterolateral tracheal wall. It occurs in 0.3% to 8.1% of the total population. Most paratracheal cysts are asymptomatic and discovered incidentally on routine radiologic examination. Rarely, however, symptoms such as cough or fever are encountered and chronic infection of the paratracheal cyst usually present itself like a tucoberculosis or a tumor. There are few case reports of deep neck infection caused by a paratracheal cyst. We report a case of retropharyngeal abscess resulting from an infected paratracheal cyst.
ABSTRACT
The steady increase in imaging studies has led to the incidental discovery of many renal masses. Although most incidental solid renal masses are asymptomatic and small in size, they are mostly malignant renal cancers necessitating accurate diagnosis. Small-sized masses are more likely to be benign tumors; therefore, access is needed according to size. Because most malignant tumors are renal cell carcinoma, and most benign tumors are angiomyolipoma and oncocytoma. Knowledge of common imaging findings of these tumors is helpful for diagnosis and management. However, imaging techniques are often insufficient to characterize solid renal masses which are discovered incidentally in radiological examinations, especially small-sized masses. Herein, we describe the imaging features characteristic of incidental solid renal masses and discuss their management in cases when an accurate diagnosis could or could not be made.
ABSTRACT
OBJECTIVE: To evaluate the differences in subjective calcification detection rates and objective calcium volumes in lung nodules according to different reconstruction methods using hybrid kernel (FC13-H) and iterative reconstruction (IR). MATERIALS AND METHODS: Overall, 35 patients with small (< 4 mm) calcified pulmonary nodules on chest CT were included. Raw data were reconstructed using filtered back projection (FBP) or IR algorithm (AIDR-3D; Canon Medical Systems Corporation), with three types of reconstruction kernel: conventional lung kernel (FC55), FC13-H and conventional soft tissue kernel (FC13). The calcium volumes of pulmonary nodules were quantified using the modified Agatston scoring method. Two radiologists independently interpreted the role of each nodule calcification on the six types of reconstructed images (FC55/FBP, FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D). RESULTS: Seventy-eight calcified nodules detected on FC55/FBP images were regarded as reference standards. The calcium detection rates of FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D protocols were 80.7%, 15.4%, 6.4%, 52.6%, and 28.2%, respectively, and FC13-H/AIDR-3D showed the smallest calcium detection rate. The calcium volume varied significantly with reconstruction protocols and FC13/AIDR-3D showed the smallest calcium volume (0.04 ± 0.22 mm³), followed by FC13-H/AIDR-3D. CONCLUSION: Hybrid kernel and IR influence subjective detection and objective measurement of calcium in lung nodules, particularly when both techniques (FC13-H/AIDR-3D) are combined.
Subject(s)
Humans , Calcium , Lung , Research Design , Thorax , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). METHODS: A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. RESULTS: Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. CONCLUSION: The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.
Subject(s)
Humans , Arm , Cohort Studies , Diskectomy , Follow-Up Studies , Incidence , Magnetic Resonance Imaging , Neck , Radiography , Range of Motion, Articular , Retrospective Studies , Risk Factors , SpondylosisABSTRACT
OBJECTIVE: To report the learning curve of percutaneous endoscopic lumbar discectomy (PELD) for a surgeon who had not been previously exposed to this procedure based on the period and detailed technique with a retrospective matched comparative design. METHODS: Of 213 patients with lumbar disc herniation encountered during the reference period, 35 patients who were followed up for 1 year after PELD were enrolled in this study. The patients were categorized by the period and technique of operation : group A, the first 15 cases, who underwent by the 'in-and-out' technique; group B, the next 20 cases, who underwent by the 'in-and-out-and-in' technique. The operation time, failure rate, blood loss, complication rate, re-herniation rate, the Visual Analogue Scale (VAS) for back and leg were checked. The alteration of dural sac cross-sectional area (DSCSA) between the preoperative and the postoperative MRI was checked. RESULTS: Operative time was rapidly reduced in the early phase, and then tapered to a steady state for the 35 cases receiving the PELD. After surgery, VAS scores for the back and leg were decreased significantly in both groups. Complications occurred in 2 patients in group A and 2 patients in group B. Between the two groups, there were significant differences in operative time, improvement of leg VAS, and expansion of DSCSA. CONCLUSION: PELD learning curve seems to be acceptable with sufficient preparation. However, because of their high tendency to delayed operation time, operation failure, and re-herniation, caution should be exercised at the early phase of the procedure.
Subject(s)
Humans , Diskectomy , Learning Curve , Learning , Leg , Magnetic Resonance Imaging , Operative Time , Retrospective StudiesABSTRACT
When the circumstance of a death seems to be related with electric shock, most of the forensic pathologists tend to diagnose the cause of death as electrocution if they see the electric mark(s) with the notincompatible histology, and find no other definite causes of death at autopsy. But admittedly forensic pathologists know that the so-called electric mark(s) and its histology is not pathognomonic to diagnose electrocution, so the diagnosis should be confirmed by the appropriate investigation of the death scene and the electric devices. We present a case of a man who had a likely current mark that could be diagnosed as natural by ruling out the possibility of electrocution with the examination of the electric lamp which had been under the dead body at the scene. This case gives us the importance of appropriate probe about scene evidences supplied by forensic science in diagnosing and ruling out the electrocution.
Subject(s)
Autopsy , Cause of Death , Diagnosis , Forensic Sciences , ShockABSTRACT
Lumbar hernia presents as a reducible protruding mass in the flank region between the 12th rib and the iliac crest. The superior lumbar hernia (Grynfeltt's) is covered by the thin latissimus dorsi muscle and bounded by the erector spinae and internal obliquus abdominis muscle. The lumbodorsal fascia forms the floor of the Grynfeltt's triangle. Spontaneous or acquired non-traumatic lumbar hernia occurs more frequently after middle age. The untreated lumbar hernia progresses in size gradually. As in most hernias, the larger the defect, the more complicated and difficult is the repair. Here we report 2 female patients with spontaneous lumbar hernia diagnosed at Presbyterian Medical Center with computerized tomogram. Their treatment consisted of tension-free surgical repair utilizing the overlap method for defect edge and the application of prolene mesh.
Subject(s)
Female , Humans , Middle Aged , Fascia , Hernia , Polypropylenes , Protestantism , Ribs , Superficial Back MusclesABSTRACT
OBJECTIVE: This study investigated changes of voice and hearing in premenopausal and postmenopausal woman METHODS: We studied forty postmenopausal and forty premenopausal women. Each women was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The phonated sound in each case was recorded and analysed by the computerized speech lab (LSL 4300B, KAY Elemetrics Corp. USA). we also conducted audiometric pure-tone threshold testing on the same group. Statistical analysis of voice and hearing parameters was done by paired T test RESULTS: Jitter in menopausal group was significantly increased compared with premenopausal group, but other voice parameters showed no significant differences. There were no significant changes of vocal parameters between menopausal patients with or without vocal symptoms. And there were no significant changes of hearing parameters, either CONCLUSION: The change of voice parameters was objectively identified in menopausal women, and so therapist of menopausal symptoms must take the voice changes into consideration.
Subject(s)
Female , Humans , Hearing , Menopause , VoiceABSTRACT
No Abstract Available.
ABSTRACT
BACKGROUND: Prevalence of the coronary artery disease(CAD) has been reported to be high in patients with the atherosclerotic peripheral vascular disease of lower extremities(PVD). However, the evaluation of the coexisting coronary artery disease(CAD) in patients with the PVD was often difficult due to limitation of the exercise capacity in these patients. This prespective study was designed to determine the prevalence, clinical characteristics of the associated CAD in patioents with PVDd, and to determine the value of the preoperative coronary angiogram as a predictor of the perioperative cardiovascular complications. METHODS: Eighty-two patients with PVD(78 male, age 62+/-7.8) were included from February 1991 to May 1993. Coronary angiogram was performed on the day of periperal angiogram in all patients and patients were divided into two group ; patients with CAD and patients without CAD. Clinical characteristics were compared, and among patients in whom revascularization surgery were undertaken, the incidences of the perioperative cardiovascular complications were compared between two groups. RESULTS: Coronary artery disease(CAD) was present in 50 patients(61%) of 82 PVD patients. In patients with CAD(N=50), only 72% of the patients were suspected for having coexisting CAD on the basis of chest pain and resting electrocardiogram. Revascularization surgery were performed in 46 patients and significantly high incidence of the perioperative acute myocardial infarction was observed in patients with coexisting CAD(4/25, 16% vs. 0/21, 0%). CONCLUSION: Considering the high prevalence of the CAD in patients with PVD and frequent occurrence of perioperative revascularization surgery in patients with PVD, we recommend that simultaneous coronary angiogram with aortography and peripheral angiogram should be considered in patients with PVD.