Real-time ultrasonographic findings of gallbladder empyema

Although the ultrasonography has been regarded as a main procedure in the diagnosis of gallbladder diseases, no many papers concerning the ultrasonographic findings of gallbladder empyema appeared in the literature. Twenty-four cases of surgically proven gallbladder empyema were studied by ultrasonography in our hospital during last 15 months. The results were as follows; 1. The size of gallbladder was enlarged in 18 cases. 2. The thicknessof gallbladder wall was more than 3mm in 16 cases. 3. The echogenicity of gallbladder wall was diminished in all cases. the inner margin of gallblaldder wall was also ill-defined in all cases. These findings are considered to be important in the diagnosis of gallbladder empyema. 4. The internal echogenicity of gallbladder (diffuse or localized) was positive in 16 cases and negative in the remainders. The echo genility was thought to beproportional to the amount of pus in gallbladder. 5. The 7 cases presented periocholecystic sonolucent area hadperforation of gallbladder and pericholecystic abscess. 6. Gallstone was found in 17 cases.

Computed tomography of intracranial tuberculosis

CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosisis often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degreeof hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinical lyproven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen caseswere tuberculous meningitis and the rests were tuberculoma. The results were as follows; 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspcious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrastscan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricularsystem. Postcontrast scan showed dense enhancement of basal and sylvian sisterns. This type of finding was themost common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster ofcalcifications in suprsella area on precontrast scan was seen in far later stage or as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area inthe cerebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showeda small ring enhancement with central lucent area.