CT and Angiographic Analysis of Posterior Communicating Artery Aneurysms: What Factors Influence the Amount of Subarachnoid Blood?

PURPOSE: To determine how clinical and angiographic factors relate to the amount of subarachnoid blooddetected by computerized tomography in patients with a ruptured aneurysm. MATERIALS AND METHODS: Between January1996 and December 1997, 22 patients with a posterior communicating artery aneurysm were retrospectively evaluated. RESULTS: Oval(three of four cases), funnel(both cases), and daughter-sac (four of five cases) types of aneurysmalsac were found among the 13 patients with a large amount of subarachnoid blood ; eight of these had a past historyof hypertension or diabetes. Seven of eleven cases of cylindrical-type aneurysmal sac were found among the 9patients with a small amount of sularachnoid blood ; eight of these had no past history of hypertension ordiabetes. The average S/N ratio (ratio of maximum sac length to neck diameter) of patients with a small amount ofblood was higher than that of patients with a large amount of blood(2.72 vs 2.07). CONCLUSION: Although manyfactors influence the amount of subarachnoid blood in an aneurysmal rupture, we found that a large amount of bloodwas frequently present in the oval, funnel and daughter sac types of aneurysm, when S/N ratio was low, and when anunderlying disease such as hypertension or diabetes was present. Conversely, a small amount of blood was presentin the cylindrical type, when S/N ratio was high, and where there was no of underlying disease.

Bone Scanning in the Evaluation of Lung Cancer

PURPOSE: We studied the diagnostic significance of bone scan in evaluation of bone metastasis by lung cancer, prevalence rate, and the causes of false positive bone scan and soft tissue accumulation of bone seeking agent. MATERIALS AND METHODS: The subject included 73 lung cancer patients with bone scan. We analyzed the frequency of bone metastasis, its distribution and configuration, and any relationship between bone pain and corresponding region on bone scan. The positive findings of bone scan were compared with simple X-ray film, CT, MRI and other diagnostic modalities. The false positive bone scan and the soft tissue accumulation of bone seeking agent were analized. RESULTS: The positive findings on bone scan were noted in 26 cases(36%) and they were coexistant with bone pain in 30%. The correspondance between bone scan and bone X-ray was 38%. False positive bone scans were seen in 12 cases(16%), which include fracture due to thoracotomy and trauma, degenerative bone diseases, and bifid rib. Accumulation of bone seeking agent in soft tissue were seen in 13 cases(18%), which included primary tumor, enlarged cervical lymph node, pleural effusion, ascites and pleural thickening. CONCLUSION: Bone scans should be carefully interpreted in detecting bone metastasis in primary malignancy, because of the 16% false positivity and 18% soft tissue accumulation rate. It is very important to note that the correlation between bone pain and positive findings of bone scans was only 38%.

Value of ultrasonography in the diagnosis of acute appendicitis

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.

High-resolution CT findings of pleuropulmonary involvement in systemic lupus erythematosus

To evaluate the high-resolution computed tomography (HRCT) findings of pleuropulmonary involvement in systemic lupus erythematosus (SLE), we analyzed HRCT findings of 12 patients of clinically confirmed SLE with respiratory symptoms. In four patients, HRCT findings before and after chemotherapy were compared. The common HRCT findings were ground-glass opacity (100%), bronchial wall thickening (66%), patchy parenchymal opacity (58%), septal or intralobular line thickening (58%), micronodule (58%), central core prominence (41%), small pleural effusion (91%), and pericardial effusion (33%). Follow-up HRCT obtained after treatment showed significant improvement of pleural effusion(4/4), pericardial effusion (3/3), pericardial thickening (1/1), patchy opacity (2/2), and ground glass opacity (2/4). But bronchial wall thickening (2/2) and micronodule (2/2) were not improved. Although there are no pathognomonic HRCT findings in SLE, bilateral small pleural effusion, ground glass opacity, subpleural patchy opacity, and micronodule are common and suggestive findings in the pleuropulmonary involvement of SLE.

MR measurements of corpus callosum in normal adults

To evaluate criterial for detecting corpus callosum (CC) abnormality, measurements of CC were done in 100 Korean adults on midline sagittal T1 weighted images using the spin echo technique with a 2.0 Tesla MR unit. The mean (±SD) anteroposterior diameter of CC, and the mean (±SD) thicknesses of genu, body, transition, and splenium were 71.1±5.0, 11.2±1.6, 5.7±1.0, 3.6±10, and 11.6±1.6mm, respectively. The outlines of CC were traced directly from the scans, and the maximal anteroposterior length of the CC was divided into quartiles. Area measurements of the anterior quartile, body, splenium, and whole CC were made with a digitizer pad and computer, and the mean (±SD) areas of these were 211±36, 194±36, 205±34, and 610±90mm, respectively. The following ratios were calculated; Maximum anteroposterior diameter of CC/length of brain, area of anterior quartile/area of whole CC, area of body/area of whole CC, and area of splenium/area of whole CC. There was a statistically significant increased of maximum anteroposterior diameter of CC/length of brain by age, and a statistically significant decrease of the area of the body by age. However, there were no statistically significant differences of all measurements between males and females.

Multiple coronary arteriovenous fistulae combined with ventricular septal defect: a case report

No abstract available in English.

Cineangiographic morphology of mitral valve

No abstract available.