Herpes Simplex Mastitis in an Adolescent Woman: Clinical and Ultrasound Features

Herpetic mastitis is extremely rare, and its imaging findings remain unclear. We report a case of herpes simplex mastitis in an adolescent woman and describe the clinical and ultrasound features. The patient showed unilateral nipple and areolar skin thickening and axillary lymphadenopathy on B-mode ultrasonography. Doppler ultrasonography revealed multiple linear and branching blood flows in the areolar area. The lesion was verified as herpes simplex mastitis via a skin biopsy. This report shows that the radiologic features of herpes simplex mastitis may be similar to those of Paget’s disease because of localized nipple and areolar skin thickening and increased vascularity.

Accuracy of Model-Based Iterative Reconstruction for CT Volumetry of Part-Solid Nodules and Solid Nodules in Comparison with Filtered Back Projection and Hybrid Iterative Reconstruction at Various Dose Settings: An Anthropomorphic Chest Phantom Study

OBJECTIVE: To investigate the accuracy of model-based iterative reconstruction (MIR) for volume measurement of part-solid nodules (PSNs) and solid nodules (SNs) in comparison with filtered back projection (FBP) or hybrid iterative reconstruction (HIR) at various radiation dose settings. MATERIALS AND METHODS: CT scanning was performed for eight different diameters of PSNs and SNs placed in the phantom at five radiation dose levels (120 kVp/100 mAs, 120 kVp/50 mAs, 120 kVp/20 mAs, 120 kVp/10 mAs, and 80 kVp/10 mAs). Each CT scan was reconstructed using FBP, HIR, or MIR with three different image definitions (body routine level 1 [IMR-R1], body soft tissue level 1 [IMR-ST1], and sharp plus level 1 [IMR-SP1]; Philips Healthcare). The SN and PSN volumes including each solid/ground-glass opacity portion were measured semi-automatically, after which absolute percentage measurement errors (APEs) of the measured volumes were calculated. Image noise was calculated to assess the image quality. RESULTS: Across all nodules and dose settings, the APEs were significantly lower in MIR than in FBP and HIR (all p < 0.01). The APEs of the smallest inner solid portion of the PSNs (3 mm) and SNs (3 mm) were the lowest when MIR (IMR-R1 and IMR-ST1) was used for reconstruction for all radiation dose settings. (IMR-R1 and IMR-ST1 at 120 kVp/100 mAs, 1.06 ± 1.36 and 8.75 ± 3.96, p < 0.001; at 120 kVp/50 mAs, 1.95 ± 1.56 and 5.61 ± 0.85, p = 0.002; at 120 kVp/20 mAs, 2.88 ± 3.68 and 5.75 ± 1.95, p = 0.001; at 120 kVp/10 mAs, 5.57 ± 6.26 and 6.32 ± 2.91, p = 0.091; at 80 kVp/10 mAs, 5.84 ± 1.96 and 6.90 ± 3.31, p = 0.632). Image noise was significantly lower in MIR than in FBP and HIR for all radiation dose settings (120 kVp/100 mAs, 3.22 ± 0.66; 120 kVp/50 mAs, 4.19 ± 1.37; 120 kVp/20 mAs, 5.49 ± 1.16; 120 kVp/10 mAs, 6.88 ± 1.91; 80 kVp/10 mAs, 12.49 ± 6.14; all p < 0.001). CONCLUSION: MIR was the most accurate algorithm for volume measurements of both PSNs and SNs in comparison with FBP and HIR at low-dose as well as standard-dose settings. Specifically, MIR was effective in the volume measurement of the smallest PSNs and SNs.

Acute Exogenous Lipoid Pneumonitis Following Siphoning of Diesel Fuel: A Case Report

Acute exogenous lipoid pneumonitis is a kind of chemical pneumonitis following the aspiration of volatile hydrocarbon compounds. The clinical and radiological findings are nonspecific. However, it can be diagnosed by the presence of lipid-laden macrophages in bronchoalveolar lavage fluid on the basis of a history of petroleum-based product aspiration. Herein, we report acute exogenous lipoid pneumonitis after unintentional aspiration of diesel fuel during siphonage in a 31-year-old male. Initially the patient had cough, chest pain, and blood-tinged sputum. The purpose of this case report is to review the radiologic manifestations and the previous literatures.

Pulsed Doppler Echocardiographic Left Ventricular Inflow Velocity Patterns of Mitral Stenosis and Severity Grading

42 patients with mitral stenosis(MS), diagnosed by M-mode, 2-D sector scan and pulsed Doppler echocardiography, were evaluated. Among them 28 patients were complicated with atrial fibrillation and one foruth was normal sinus rhythm. Pulsed Doppler echocardiographic left ventricular inflow velocity patterns(PELVIVP) were compaired with the EF slop of anterior mitral valve leaflet. The results were as follows; The normal PELVIVP showed a biphasic pattern during diastole. PEVIVP in MS were classified into 5 types and measured EF slop of anterior mitral valve leaflet in each type. Type I was characterized by a biphasic flow pattern showing a relative increase in the atrial contraction wave compared with the rapid filling wave and the prolonged deceleration time. EF slop was 24.7+/-6.1mm/sec. Type II was turbulent scaphoid pattern during diastole. EF slop was 14.5+/-4.4mm/sec. Type IIIa was monophasic with gradual descending slop during diastole. EF slop was 16.9+/-4.0mm/sec. Type IIIb was also turblent monophasic with gradual ascending slop during diastole. EF slop was 8.1+/-2.3mm/sec. Type IV was diastolic turblent and was characterized by dome shaped pattern. EF slop was 7.9+/-1.9mm/sec. There was a significant correlation between the 3 groups(I, II and IIIa, IIIb and IV) of LVIVP in MS and EF slop(P<0.005). This result indicated that type I of the flow pattern was well observed in mild MS, type II and IIIa in moderate MS, and type IIIb and IV in severe MS. Pulsed Doppler flow pattern in MS was alterable in the atrial fibrillation.

Value of Pulsed Doppler Echocardiography in the Diagnosis of Aortic Regurgitation

In order to assess the sensitively and specificity of the pulsed Doppler echocardiography in the aortic regurgitation, 44 patients with valvular heart diseases were examined by pulsed Doppler echocardiography. Every patient was examined in sequence of clinical examination including the physical, M-mode & 2D echocardiographic examination, Doppler technique and then angiocardiography. The obtained results were; 1) Pulsed Doppler echocardiography was very useful in the diagnosis of the aortic regugitation(sensitivity:100%, specificity:90%). 2) Pulsed Doppler echocardiography was especially useful in the detection of the aortic regurgitation in patients who were not detected by physical and conventional echocardiographic examination.

Characteristics of the Posterior Aortic Wall Motions in M-mode Echocardiogram of the Patients with Various Valvular Heart Diseases

To observe the characteristics of the posterior aortic wall motions of the patients with various valvular heart diseases the aortic root echocardiogram of the 60 patients with various valvular diseases were examined. 15 cases in each group of patients with mitral stenosis, mitral insufficiency, mitral stenoinsufficiency or aortic insufficiency. Thirty normal subjects were served as a control group. In each, the total amplitude of the aortic posterior wall motion(OV), the amplitude of the motion evented at atrial systole(AV), AV/OV ratio, atrial emptying index(AEI), left atrial and aortic root dimensions (LAD and AOD), and LAD/AOD were measured. The results were as follows ; 1) The AV was significantly increased in mitral stenosis(P<0.01) and decreased in mitral insufficiency(P<0.05) compared with control group. 2) The OV was increase in mitral insufficiency and aortic insufficiency(p<0.01, p<0.05), but decreased in mitral stenosis(p<0.05). 3) The AV/OV was increased in mitral stenosis(p<0.01) and decreased in mitral insufficiency and aortic insufficiency(p<0.01). 4) The AEI was decreased in all patient groups(p<0.01) and LAD was increase in all compared with control group(p<0.01). 5) The AOD was increased only in aortic insufficiency(p<0.01). 6) The LAD/AOD ratio was increased in all patient groups(p<0.01).