Marrow Conversion Pattern of the Femora and Acetabulum Around Hip Joints According to Age Group : MR Evaluation

PURPOSE : Marrow edema and fatty degeneration of the hip joint bones could be initial and late signs inip joint and its bone diseases respectively, which might be differentiated from age-related marrow conversion pattern. So authors have investigated normal marrow conversion pattern of the femur and acetabulum around the hip joints. MATERIALS AND METHODS : Three coronal MR images of 288 hip joint bones in 144 subjects, aged 2 days to 76 years divided to 8 groups every 10 years, were retrospectively analysed for the location and appearance of the converted yellow marrow. The converted yellow marrow were divided to head, neck, and trochanter in the proximal femur and below and above 50% in acetabulum of the hip. RESULTS : The most common type of marrow conversion is the converted yellow marrow in the entire proximal femur and below 50% of acetabulum of the hip. We observed the start of marrow conversion in just before and after 2 years old and stopped at just before and after 20 years old. CONCLUSION : The understanding of age-related marrow conversion pattern of the hip joint bones would provide some information for differentiation from pathologic condition of them such as edema, fatty degeneration, metastasis, or leukemia.

Differentiation of Benign and Malignant Ulcers of the Stomach on Computed Tomography

PURPOSE: We wanted to determine the multidetector computed tomography (MDCT) findings for differentiating benign ulcers from malignant ones. MATERIALS AND METHODS: 18 clinicopathologically proven benign ulcers that had been detected by both endoscopy and MDCT were the focus of this study. 26 ulcerative advanced gastric cancers and 26 early gastric cancers with ulceration, all of which had been surgically proven, were selected as a control group. Five of the 26 early gastric cancers that were confined to the mucosa and that were not detected on CT were excluded in this study. The following CT findings were reviewed by two radiologists; ulcer size, the degree of enhancement and the thickness of inner enhancing layer in the ulcer base, the total thickness and the enhancing inner layer thickness in the largest part of the thickened ulcer mound, the presence of ulcer that projected beyond the healthy lumen, and the presence of perigastric fat infiltration and perigastric lymphadenopathy. RESULTS: An indiscernible thin-walled ulcer base (less than 1.5 mm) and suboptimal enhancement of the ulcer base for the discrimination of benign gastric ulcers from the malignant gastric ulcers showed sensitivities of 100% (18/18) and 78% (14/18), respectively, with specificities of 98% (46/47) and 92% (43/47), respectively. Ulcer projection was more significantly present in benign ulcer (13/18, 72%) than in the malignant gastric ulcers (7/47, 15%). The enhancing inner layer thickness in the ulcer mound was significantly greater in the AGC (mean: 7.4 mm) than in the benign gastric ulcers (mean, 2.2 mm). There were insignificant differences for ulcer size, total thickness of the ulcer mound, the perigastric fat infiltration and perigastric lymphadenopathy between the benign and malignant gastric ulcers. CONCLUSION: MDCT is an additional helpful diagnostic tool when benign gastric ulcers are histologically difficult to distinguish from malignant gastric ones.