Small Bowel Enteroclysis Using a Hemodialysis Blood Pump

PURPOSE: To describe the usefulness of small bowel enteroclysis using a hemodialysis blood pump. MATERIALS AND METHODS: Over a 16 month period, 135 double contrast small bowel enteroclysis examinations were performed in132 patients using a hemodialysis blood pump. Following intubation of the proximal jejunum, barium at a dilutionof 50% and 0.5% methylcellulose were infused at a constant rate using a hemodialysis blood pump and multiple spotfilms of the small intestine were obtained. Success rate, quality of radiographs, positive findings, fluoroscopitime and complications were evaluated. RESULTS: Only two of 135 examinations (1.5%) failed due to lack ofcooperation by the patient. Rates of good distensability were 97.6% in the proximal portion, 91.2% in the minportion and 52% in the distal portion and rates of good transparency were 96%, 84% and 56% respectively.Transparency and distensability of the small intestine were better in proximal than distal small bowel. Theradiographs showed positive findings in 25% of cases. The mean fluoroscopic time was 21 min, 10 sec(8min,22sec-57min, 30sec). No major complication was found during or after exam ination. CONCLUSION: It spite of thelong fluoroscopic time and invasiveness, double contrast small bowel enteroclysis is useful for the evaluation ofsmall bowel disease. The infusion of barium and methylcellulose using a hemodialysis blood pump give radiographsof good quality.

Malignant Tumors of the Appendix: Imaging Findings

Malignant tumors of the appendix are rare and are histologically similar to those arising elsewhere in theintestines. The frequency of specific tumor types and the clinical presentation of symptomatic tumors are,however, significantly different. Before surgery, correct diagnosis of a malignant appendiceal tumor is rare; mosttumors are diagnosed by a pathologist while examining an appendectomy specimen. With the advent of high resolutionimaging modalities (ultrasound and helical CT), malignant tumors of the appendix may be more accurately diagnosed;this report describes the imaging findings of malignant appendiceal tumors.

Recurrent Dislocation of the Shoulder: MR Imaging and MR Arthrographic Findings

PURPOSE: To evaluate and compare the diagnostic findings and usefulness of MRI and MR arthrogram in recurrent anterior dislocation of the shoulder. MATERIALS AND METHODS: MRI and MR arthrogram of thirty-two cases of thirty patients with recurrent anterior dislocation of the shoulder were retrospectively analyzed to evaluate glenohumeral ligaments, pattern of labral injury, bony Bankart lesion, capsular stripping, Hill-Sachs lesion, and loose body. RESULTS: Labral abnormalities was detected on MRI in 23 cases(72%) and MR arthrogram in 22 cases(69%) as labral tear, detachment, and deficiency. All cases involved anteroinferior labrum. On MR arthrogram, labral abnormalities was confined to anteroinferior portion in 4 cases(18%), extended into midglenoid level in 13 cases(59%), and that into anterosuperior portion in 5 cases(23%). Capsular stripping was noted on MRI in 6 cases(19%) and MR arthrogram in 12 cases(38%). Loose body was detected only on MR arthrogram in 5 cases (16%). Bony Bankart lesion and Hill-Sachs lesion was detected equally on MRI and MR arthrogram in 2 cases (6%) and 21 cases(66%) respectively. We obtained identical findings on both MR arthrogram and operation field in 6 patients. CONCLUSION: MRI with its excellent soft tissue contrast resolution and multiplanar imaging capafility helps detection of labral injury in recurrent anterior dislocation of the shoulder. MR arthrogram is slightly invasive, but shows good artatomic details of labral-ligamentous-capsular relationship and thus provides accurate detec- tion of pattern of labral injury, capsular stripping, and loose body.

MRI Findings of Cervical Lymphadenopathy: Preliminary Study

PURPOSE: The purpose of this study is to evaluate findings in MRI which maybe useful in differential diagnosis of cervical lymph node enlargement. MATERIALS AND METHODS: We retrospectively analyzed the MRI findings of cervical lymph node enlargement in surgically proven 13 patients. We analyzed the location, size and shape, signal intensity, margin between node and surrounding structures degree and patterns of contrast enhancement RESULTS: No disease specificity in location and size of lymphadenopathy. was demonstrated in MRI. Most lymph nodes shows isointensity or slightly increased signal intensity to adjacent muscle on T1WI and high signal intensity on T2WI. Most of the cases showed contrast enhancement with metastatic lymph nodes showing ring-like and/or patchy enhancement. Tuberculous lymphadenopathy showed homogeneous or rather thick walled ring-like enhancement and one or multiple central nonenhancing portions of eccentrical location in the node. Relatively homogeneous enhancements were noted on reactive lymphold hyperplasia, Lymphoma and Castleman's disease. CONCLUSION: MR imaging was helpful in differentiation of cervical lymph node enlargements. Tuberculous lymphadenopathy showed characteristic findings of rather spherical shaped, thick walled ring enhancement and multiple eccentrically located central nonenhancing portions.

A case report of castleman disease in th neck: CT and MRI finding

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.

A case report of castleman disease in th neck: CT and MRI finding

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.

Double contrast CT arthrographic findings of shoulder instability

Gleno-humeral joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thirty-three persons underwent Double contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography(33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation(30 shoulders) or nonspecific shoulder pain(3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arthrography. Among 28 cases of the labral injury, detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16, and 7, respectivity, while, 16, 12, and, 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings, the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95, respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability.