Usefulness of Turbo Spin-Echo MR Imaging in Meniscal Tears of the Knee

PURPOSE: To evaluate the usefulness and diagnostic accuracy of turbo spin-echo(TSE) proton-density andT2-weighted images of meniscal tears of the knee. MATERIALS AND METHODS: We retrospectively evaluated thesensitivity, specificity, and accuracy of TSE proton density and T2-weighted images of meniscal tears confirmedarthroscopically or surgically in 47 patients(98 menisci). The routine TSE parameters used in all patients werethe dual echo sequence with sagittal proton density and T2-weighed images(4000/16, 90/5/2 [TR/effectiveTE/ETL/NEX]), and fat-suppressed coronal proton density and T2-weighted images. The chi-square test was used forstatistical analysis. RESULTS: The sensitivity, specificity, and accuracy of TSE proton density images for thedetection of meniscal tears were 93.9%, 93.8%, and 93.9%, respectively, in the medial meniscus, and 92.9%, 91.4%,and 91.8% in the lateral. On T2-weighted images the corresponding figures were 87.9%, 93.8%, and 89.8%,respectively, in the medial meniscus, and 64.3%, 91.4%, and 83.7 % in the lateral. CONCLUSION: With regard tosensitivity and accuracy, TSE proton density images of meniscal tears were superior to TSE T2-weighted images.

CT Findings of the Pulmonary Tuberculosis in Patients with Diabetes Mellitus

PURPOSE: To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. MATERIALS AND METHODS: We retrospectively studied 34 cases of pulmonarytuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobesand eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobularconsolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, andassociated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine thetypical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusingby FBS 160 and HbA1C 8.0. RESULT: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesionon 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmentalconsolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavitieswere present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associatedfindings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardialeffusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases ofsecondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seenin patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CTfindings did not, however, differ according to diabetic duration and HbA1C. CONCLUSION: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-inthe usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not varyaccording to the diabetic control state, except that in patients with less than FBS 160 on admission, there was agreater degree of lobular consolidation.

A Case of Hutch's Diverticulum Associated with Severe Bilateral Vesicoureteral Reflux

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.

Early Avascular Necrosis of the Femoral Head: Relationship of the Findings of Preoperative MRI and the Long-Term Results of Core Decompression

PURPOSE: To evaluate potential correlation between the extent and site of avascular necrosis (AVN), as determined by preoperative magnetic resonance (MR) imaging, and the development of femoral head collapse. MATERIALS AND METHODS: Using clinical, radiographic and MR imaging criteria, twenty hips in 15 patients were selected for core decompression. Preoperative MR results were classified into three categories: group A, less than 15% involvement of the weight-bearing portion of the femoral head; group B, 15%-30% involvement; group C, more than 30% involvement, according to ARCO staging. We also established three groups according to site of involvement of the femoral head, namely medial, middle and lateral. RESULTS: Of 20 cases, three were stage Ia; two, Ib; four, Ic; three, IIa; two, IIb; and 6, IIc. Ten cases of Ia, Ib, IIa or IIb showed no femoral head collapse during follow-up of at least 24 months, while ten cases of Ic or IIc showed femoral head collapse. CONCLUSION: The prognosis of core decompression in patients with early AVN is related to the area of lesion in the femoral head.