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Abstract Introduction The vidian canal acts as landmark for the identification of the petrous carotid artery, especially during extended endoscopic endonasal approaches in cranial base surgeries. In order to localize the canal and to understand the relationship of pneumatization of pterygoid process to the type of vidian canal, this study was designed. Objectives The objective was to describe the anatomical relationship of pneumatization of the pterygoid process with types of vidian canal. The length of vidian canal, relationship to medial plate of pterygoid process and relationship to the petrous part of internal carotid artery were evaluated. Methods Head computer tomography scans of 52 individuals for suspected paranasal pathology were studied. The degree of sphenoid sinus pneumatization, pterygoid process pneumatization and types of vidian canal (type 1, 2 and 3) were noted. The length of vidian canal, distance from the plane of medial pterygoid plate and relation of vidian canal to the junction of petrous and Gasserian (ascending) part of internal carotid artery was noted. Results 46 (92%) sphenoid sinuses were of the sellar variety. Out of 104 sides that were studied, 57 sides demonstrated a pneumatised pterygoid process and 47 were not pneumatised. In 49 sides (47.1%) the vidian canal was on the same plane as that of the medial pterygoid plate in the coronal section. The vidian canal partially protruded into the sphenoid sinus (type 2) was the most common type (50.9%), found both on right and left sides. There is a statistically significant association between the pterygoid process pneumatization and occurrence of type 2 and type 3 vidian canal configuration. The average length of the vidian canal was 16.16 ± 1.8 mm. In 96 sides, the anterior end of vidian canal was inferolateral to petrous part of internal carotid artery in the coronal plane. Conclusion Pneumatization of the pterygoid process indicates either type 2 or type 3 vidian canal configuration.
Resumo Introdução O canal vidiano atua como ponto de referência para a identificação da artéria carótida petrosa, especialmente durante abordagens endoscópicas endonasais extensas em cirurgias de base do crânio. Este estudo foi projetado com o objetivo de localizar o canal vidiano e entender a relação da pneumatização do processo pterigoide sobre o tipo de canal. Objetivos Descrever a relação anatômica da pneumatização do processo pterigoide com os tipos de canal vidiano. Foram avaliados o comprimento do canal vidiano, a relação com a placa medial do processo pterigoide e com a porção petrosa da artéria carótida interna. Método Foram estudadas tomografias computadorizadas de 52 indivíduos submetidos a tomografia computadorizada de cabeça por suspeita de doença em seio paranasal. Foram observados o grau de pneumatização do seio esfenoidal, a pneumatização do processo pterigoide e os tipos de canal vidiano (Tipos 1, 2 e 3). Observou-se o comprimento do canal vidiano, a distância do plano da placa pterigoide medial e a relação do canal vidiano com a junção da porção petrosa e gasseriana (ascendente) da artéria carótida interna. Resultados Eram do tipo selar 46 (92%) seios esfenoidais. Dos 104 lados estudados, 57 eram do processo pterigoide pneumatizado e 47 não eram pneumatizados. Em 49 lados (47,1%), o canal vidiano estava no mesmo plano que o da placa pterigoide medial na seção coronal. O canal vidiano em protusão parcial no seio esfenoidal (tipo 2) foi o tipo mais comum (50,9%), encontrado nos lados direito e esquerdo. Houve uma associação estatisticamente significante entre a pneumatização do processo pterigoide e a ocorrência da configuração do canal vidiano tipo 2 e tipo 3. O comprimento médio do canal vidiano foi de 16,16 ± 1,8 mm. Em 96 lados, a extremidade anterior do canal vidiano era inferolateral à porção petrosa da artéria carótida interna no plano coronal. Conclusão A pneumatização do processo pterigoide indica a configuração do canal vidiano tipo 2 ou tipo 3.
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Objective:To investigate the effect of ultra-low dose (ULD) computed tomography (CT) scanning on the diagnosis of ankle fractures and the quality of a three-dimensional printing (3DP) model.Methods:This study was a prospective study. A total of 61 patients with clinical ankle fractures treated conservatively in Zhuhai Hospital of Guangdong Hospital of Traditional Chinese Medicine from November 2019 to January 2022 were included in this study. Patients underwent standard dose (SD) CT scan and ultra-low dose (ULD) CT scan, respectively. The tube voltage/tube current of SD and ULD were 120 kV/100 mAs and 80 kV/10 mAs, respectively. Two senior radiologists evaluated the presence of ankle fractures. The effective radiation dose ( E), noise, signal-to-noise ratio (SNR), contrast signal-to-noise ratio (CNR), and CT value of bone cortex minus CT value of peripheral fat (CTc) were compared. The radiologists also evaluated the discoverability, diagnosability, and overall image quality of the fracture line according to Likert′s 5-point scoring method. Two senior orthopedists subjectively evaluated the quality of each 3DP model (model clarity and operation guidance). A score ≥ 3 indicated that the quality of the CT diagnostic image and 3DP model were acceptable. Results:The interval between the two CT scans was (9.23 ± 1.92) d. A total of 94 fracture sites were found. There were no missed diagnosis or misdiagnosis based on the SD and ULD scans.Noise, SNR, and CNR were better on the SD CT scanning ( F=5.92, 9.70, 8.32, P=0.00), however, CTc was higher on the ULD scans ( F=27.55, P<0.01). The image scores of the SD and ULD scans were (4.97 ± 0.18) and (4.21 ± 0.71), and the quality scores of the 3DP model (4.99 ± 0.01) and (4.87 ± 0.34), respectively. The SD scans were better than the ULD scans with respect to CT image quality and 3DP model quality ( Z=-6.88, -2.91, P<0.01), but both were considered suitable to meet clinical needs (all ≥ 3 points). The E associated with SD and ULD scannings were (34.68 ± 4.96) μSV and (1.04 ± 0.10) μSV, respectively. The latter was thus significantly better than the former ( F=38.77, P =0.00). Conclusions:The E value of ULD scanning is about 3.00% of SD scanning E, which can meet the needs of clinical diagnosis of ankle fracture and 3DP model printing diagnosis.
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@#<b>Objective</b> To investigate the dose level of pediatric CT scan in one hospital, and to provide recommendations for optimized scanning. <b>Methods</b> The CT scan data of children were collected from this hospital to analyze the differences in typical dose values and typical scanning parameters between different age groups and different scanning parts. <b>Results</b> The sample size was >10 for routine cranial scan, routine maxillary sinus scan, and routine chest scan in each age group, and the 1-year-old group and the 5-year-old group had the same kV, mA, and CTDIvol values of routine cranial scan and maxillary sinus scan, but with relatively great differences in the parameters of chest scan. <b>Conclusion</b> Scanning parameters in this hospital can be further optimized, and optimization measures should be adopted continuously.
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Objective To explore the clinical effect of magnetic resonance imaging (MRI) and CT scanning in the diagnosis of acute craniocerebral injury.Methods From October 2012 to November 2016,100 patients with acute craniocerebral injury in Zhoushan Hospital were selected.According to the order of patients admitted to hospital,they were randomly divided into observation group and control group,with 50 cases in each group.The observation group received MRI inspection,the control group received CT scanning.The clinical examination results of the two groups were compared.Results The positive rate and missed diagnosis rate of the observation group were 98.0％,2.0％,respectively,which of the control group were 72.0％,24.0％,respectively,the differences were statistically significant (x2 =26.958,17.468,all P ＜ 0.05).The detection rate of craniocerebral injury position lesion in the observation group was significantly higher than control group,the differences between the two groups was statistically significant (x2 =5.030,5.110,11.250,5.430,all P ＜ 0.05).The clinical total effective rate of the observation group was 94.0％,which was higher than 78.0％ of the control group,the difference was statistically significant (x2 =15.432,P ＜ 0.05).Conclusion The clinical value of MRI in the diagnosis of acute craniocerebral injury issuperior to CT scanning.
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Objective To design a CT-guided puncture positioning device to shorten puncture time while increase the accuracy. Methods The device realized 3D positioning by the principle of plane geometry, which was composed of a positioner,a fixation mechanism and a direction guiding mechanism for puncture needle.The positioner and direction guiding mechanism were made of transparent plastic, and the fixation mechanism was made of elastic cloth. Results The device gained advantages over the traditional means in puncture time,times of needle insertion and times of CT scanning,and had the puncture success rate in one time being 90%. Conclusion The device behaves well in focal positioning and puncture needle guiding,and thus decreases the probability of failed puncture and the patient pains.
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Objective The objective of this study was to determine the lesion range between gastric cancer lesions and normal gastric wall,improve the early diagnosis of gastric cancer rate,distinguish between me-tastatic lymph nodes and non-metastatic lymph nodes,and accurate N staging by dual-source CT double-en-ergy enhanced scan parameters.Methods The dual energy enhanced scan of patients with preoperative gastric cancer was performed by Siemens Somatom Definition Flash dual-source CT.The collected data were analyzed by Syngo.Via software and reconstructed three-dimensionally to obtain the absolute iodine of gastric cancer,nor-mal gastric wall,metastatic lymph node and non-metastatic lymph node value,standardized iodine value and vir-tual single energy spectrum curve of the slope to combine with postoperative pathological results.The use of statis-tical methods was to determine the difference between the post-and preoperation.Results The absolute iodine values(IC)were(3.329±0.812)g/L in the gastric cancer lesion and(64.006±17.450)% for the standard io-dine values(NIC).The slope of the virtual single energy spectrum curve was-2.916±1.3227,IC(1.563±0.708)g/L in the normal gastric wall.The NIC were(37.122±16.267)%and-1.621±1.4028 for the slope of the virtual single energy spectrum curve.They were significantly statistical difference(P<0.05).The IC of meta-static lymph nodes were(2.968±0.547)g/L,(63.597±14.633)% for the NIC and(-2.532±0.753)for the slope of the virtual single energy spectrum curve.The IC of non-metastatic lymph nodes were(1.465±0.408)g/L,(35.240±14.357)%for the NIC and(-1.378±0.726)for the slope of the virtual single energy spectrum curve.They also had significantly statistical difference(P<0.05).Conclusion Dual-source CT dual-energy scan combined with three-dimensional reconstruction technique can help to determine the lesion range,improve the diagnostic rate of early gastric cancer,distinguish between metastatic and non-metastatic lymph nodes,and improve the accuracy of N staging.
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Objective The objective of this study was to determine the lesion range between gastric cancer lesions and normal gastric wall,improve the early diagnosis of gastric cancer rate,distinguish between me-tastatic lymph nodes and non-metastatic lymph nodes,and accurate N staging by dual-source CT double-en-ergy enhanced scan parameters.Methods The dual energy enhanced scan of patients with preoperative gastric cancer was performed by Siemens Somatom Definition Flash dual-source CT.The collected data were analyzed by Syngo.Via software and reconstructed three-dimensionally to obtain the absolute iodine of gastric cancer,nor-mal gastric wall,metastatic lymph node and non-metastatic lymph node value,standardized iodine value and vir-tual single energy spectrum curve of the slope to combine with postoperative pathological results.The use of statis-tical methods was to determine the difference between the post-and preoperation.Results The absolute iodine values(IC)were(3.329±0.812)g/L in the gastric cancer lesion and(64.006±17.450)% for the standard io-dine values(NIC).The slope of the virtual single energy spectrum curve was-2.916±1.3227,IC(1.563±0.708)g/L in the normal gastric wall.The NIC were(37.122±16.267)%and-1.621±1.4028 for the slope of the virtual single energy spectrum curve.They were significantly statistical difference(P<0.05).The IC of meta-static lymph nodes were(2.968±0.547)g/L,(63.597±14.633)% for the NIC and(-2.532±0.753)for the slope of the virtual single energy spectrum curve.The IC of non-metastatic lymph nodes were(1.465±0.408)g/L,(35.240±14.357)%for the NIC and(-1.378±0.726)for the slope of the virtual single energy spectrum curve.They also had significantly statistical difference(P<0.05).Conclusion Dual-source CT dual-energy scan combined with three-dimensional reconstruction technique can help to determine the lesion range,improve the diagnostic rate of early gastric cancer,distinguish between metastatic and non-metastatic lymph nodes,and improve the accuracy of N staging.
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Objective To explore the nursing intervention of adverse reactions of Iohexol Injection using CT scanning. Methods According to the different nursing intervention mode of patients in our hospital in January January 2015 to January 2017 performed CT scanning using the Iohexol Injection group in 50 cases as control group with routine nursing intervention, the observation group used routine nursing quality nursing intervention;adverse reaction a detailed record of the two groups of patients, and the incidence of adverse reactions compared to investigate the effect of nursing intervention of adverse reactions using the Iohexol Injection CT scan. Results Routine nursing quality nursing intervention (observation group) is better than the clinical effect of CT scanning using Iohexol Injection in patients with routine nursing intervention (control group) clinical the effect and adverse reaction rates in patients with lower than the control group, the difference was statistically significant (P<0.05). Conclusion CT scan. With Iohexol Injection patients regular nursing care, high quality nursing mode intervention effect is remarkable, can effectively reduce the incidence of adverse reactions in patients, it is worthy of clinical widely used.
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Objective To investigate the application of iohexol in enhanced CT scanning. Methods The total of 623 patients taking iohexol for enhanced CT scanning were sampled to record relevant data for reference. According to evaluation standards for rational use of contrast media,the risk factors,selection of contrast media,medication time,usage and dosage,and drug combination were analyzed statistically. Results Among 623 patients used iohexo for enhanced CT scanning,302 patients had the risk factors of adverse reaction(the incidence rate as 48.48%) and 115 patients received psychological intervention(the incidence rate as 18.46%).And 206 patients had been given with the reasonable fluid therapy before and after angiography(the incidence rate as 33.07%),there were only 124 patients who performed the renal function and urine routine examination 48-72 h before and after angiography(the incidence rate as 19.90%).And 33 patients occured allergic reaction with the incidence rate as 5.30%. Conclusion There existed irrational phenomenon in application of diodone in enhanced CT scanning.It is necessary to further standardize the clinical application of diodone and make complete measures for rational use of diodone.
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Objective To investigate the application of C- arm CT imaging technique in evaluating the efficacy of transarterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). Methods During the period from Sep. 2012 to Mar. 2013 at authors’ hospital, C- arm CT scanning was employed during the performance of TACE in 80 patients with HCC. The residual active tumor lesions, Lipiodol deposition and the embolization of the feeding arteries after TACE therapy were assessed by C- arm CT plain scan images and the images of early artery phase and parenchymal phase, as well as the post- processing images. The efficacy of TACE was thus evaluated. Results A total of 139 hepatic tumors were detected in 80 patients by C- arm CT imaging. C- arm CT scanning performed immediately after TACE showed that satisfactory result was obtained in 128 lesions of 75 patients(128/139, 92.9%). Fewer, medium and more residual active tumors were seen in 78, 29 and 21 lesions respectively, while dense, moderate and thin Lipiodol deposition was seen in 64, 39 and 25 lesions respectively. After TACE therapy obvious decrease in blood supply was demonstrated in 101 lesions, while no obvious decrease in blood supply was seen in 27 lesions. Conclusion C- arm CT scanning after TACE for patients with HCC can conveniently, accurately and comprehensively reveal the residual active tumors, Lipiodol deposition and embolization status of feeding arteries. Therefore, this technique should be regarded as an important means to evaluate the efficacy of TACE.
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Objective To compare the clinical usefulness of CT and DSA in evaluating the residual lesion and recurrence of tumor for primary hepatocellular carcinoma (PHC) after transcatheter arterial chemoembolization (TACE) with Lipiodol and to compare the effectiveness between CT and DSA. Methods Forty-five patients with HPC underwent CT and DSA within 1 - 6 months after 1 - 4 procedure(s) of TACE.The interval between two examinations was 3 - 5 days. The detection and demonstration of the residual lesions and the recurrence of tumor on CT and DSA were compared and the results were analyzed. Results The Lipiodol deposition appearance was classified into three patterns: complete compact pattern (n = 9,20% ), defect pattern (n = 32, 71.1% ) and discrete pattern (n = 4, 8.9% ). In patients with complete eompact pattern, no signs of recurrence were found on CT and DSA six months after the procedure. Of 32 patients with defect pattern, signs of recurrence on DSA and on dual-phase CT scans were found in 27 and in 19 respectively. During arterial phase, marked enhancement of the lesion was demonstrated in 16 cases,further enhancement in portal venous phase was manifested in 3 cases, which indicated that the portal vein participated in the tumor feeding. On DSA, the above enhancement areas showed pronounced opacification and vascularization. In another 8 cases, the CT signs and DSA findings were not in accord with each other, the lesions showed no enhancement on dual-phase CT scans but the lesions made their appearance as tumor's vessels and opacification. In patients of discrete pattern, only mild enhancement was seen on dual-phase CT scans, indicating that the tumor was of hypo-vascularization. Conclusion Both plain and dual-phase CT scanning can well demonstrate the residual lesions and the recurrence of hepatocellular carcinoma after TACE. Therefore, in evaluating the therapeutic results of TACE, CT study should be.considered as the examination of choice. DSA is the most sensitive and specific method for observing and assessing the therapeutic response. A combination of CT and DSA can more effectively guide the clinical treatment.
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Objective To study the effect of CT scanning condition on the target position coordinate with WIMRT radiotherapy planning system using the" Z" form localizing frame. Methods The whole Head Phantom containing three metal targets was scanned under the following conditions: localizing frame transver-sally tilting, CT gantry tilting and localizing frame axially tilting. Then the three target coordinates were com-puted respectively and compared with those under the standard condition. Results The height and width of coordinate under the localizing frame transversally tilting condition deviated from those under the standard scanning condition,which was in an angle dependent manner. On the other hand ,a tendency was shown that the greater the absolute height value of the targets coordinate, the greater the width value deviation. And so was the relation between the absolute width value of the coordinate and height value deviation. If CT gantry angle was not zero degree or localizing frame axis is not in the same line with the CT bed moving direction, the calculated longititude value of the targets coordinate was mainly affected. Conclusions CT scanning must be performed strictly under the standard localizing scanning condition by a proficient physicist.
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Objective To discuss clinical value of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma.Methods A retrospective study was carried out on data of 72 multiple trauma patients diagnosed with systemic 64-slice spiral CT scanning in our hospital from January 2006 to June 2008.Of all,28 patients with traffic injuries,24 with falling injuries,10 with blunt injuries,6 with stab injuries and 4 with explosive injuries.Results There were 72 multiple trauma patients with mean scanning time of 10.2 seconds.The CT scanning showed both craniocerebral and thoracic injuries in 30 patients,brain injuries in 16,thoracoabdominal injuries plus pelvic injuries in 10,extremity and brain injuries in 14 and systemic soft tissue injuries in 2.Isotropic characteristics and postprocessing function of 64-slice spiral CT scanning could accurately diagnose and evaluate injury severity of multiple trauma.Conclusions 64-slice spiral CT scanning is a fast and effective method for fast evaluating injury severity of multiple trauma,for it can not only shorten checking time,reduce movements of the patients and relieve the pain of the patients,but also can avoid defects induced by respiratory movement and provide fairly integrated imaging materials by its isotropic characteristics and pestprecessing function.
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Objective To compare the clinical usefulness of CT and DSA in evaluating the residual lesion and recurrence of tumor for primary hepatocellular carcinoma(PHC)after transcatheter arterial chemoembolization(TACE)with Lipiodol and to compare the effectiveness between CT and DSA.Methods Forty-five patients with HPC underwent CT and DSA within 1-6 months after 1-4 procedure(s)of TACE. The interval between two examinations was 3-5 days.The detection and demonstration of the residual lesions and the recurrence of tumor on CT and DSA were compared and the results were analyzed.Results The Lipiodol deposition appearance was classified into three patterns:complete compact pattern(n=9, 20%),defect pattern(n=32,71.1%)and discrete pattern(n=4,8.9%).In patients with complete compact pattern,no signs of recurrence were found on CT and DSA six months after the procedure.Of 32 patients with defect pattern,signs of recurrence on DSA and on dual-phase CT scans were found in 27 and in 19 respectively.During arterial phase,marked enhancement of the lesion was demonstrated in 16 cases, further enhancement in portal venous phase was manifested in 3 cases,which indicated that the portal vein participated in the tumor feeding.On DSA,the above enhancement areas showed pronounced opacification and vascularization.In another 8 cases,the CT signs and DSA findings were not in accord with each other,the lesions showed no enhancement on dual-phase CT scans but the lesions made their appearance as tumor's vessels and opacification.In patients of discrete pattern,only mild enhancement was seen on dual-phase CT scans,indicating that the tumor was of hypo-vascularization.Conclusion Both plain and dual-phase CT scanning can well demonstrate the residual lesions and the recurrence of hepatocellular carcinoma after TACE.Therefore,in evaluating the therapeutic results of TACE,CT study should be considered as the examination of choice.DSA is the most sensitive and specific method for observing and assessing the therapeutic response.A combination of CT and DSA can more effectively guide the clinical treatment.
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PURPOSE: To report the symmetric masses developed in both eyes, which were diagnosed with bilateral osseous choristoma and surgically excised. METHODS: A 6-year-old female was noted by her parents to have a mass under the conjunctiva of her left eye. The mass was white and firmly attached to the globe. The same lesion was present in the right eye. CT scan showed that the masses were high bone-density and did not invade the sclera deeply. Therefore, excisional biopsy of the lesions were performed. RESULTS: Histopathologic examination showed that the masses were episcleral osseous choristoma. There was no complication of recurrence or adhesion after surgery. CONCLUSIONS: In case of a hard mass under the conjunctiva, which is diagnosed with osseous choristoma by CT scanning, it is helpful to determine the accurate location and adhesion of the massfor successful surgery.
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Child , Female , Humans , Biopsy , Choristoma , Conjunctiva , Parents , Recurrence , Sclera , Tomography, X-Ray ComputedABSTRACT
The study on 6 cases of pyelonephritis of yellow granulatio at Hue Central Hospital showed a majority of female patients (2/3 of cases) aged 50-60 years old), having classic trilogy of great kidney with calculus and loss of function. Patients were admitted because of lumbago in 2/3 of cases. Urimia, fever and purulent fistula at lumbar side, each 1 case; large kidney touched in 1/2 of cases. Unprepared abdomen X ray image, UIV and ultrasound had found calculus in 1/2 of cases, 1/4 with pyhydrostasis, 3/4 loss of function. Especially color Doppler ultrasound found kidney arterio venous communicatio fistula in 1/2 of cases. CT scanning showed 6/6 cases with fat structure in the kidney parenchyma, 5/6 with large shade kidney, irregular border and heterogenous stain absorption.
Subject(s)
Tomography, X-Ray Computed , Diagnosis , PyelonephritisABSTRACT
The quality of CT diagnosis depends on the quality of scanning which is related to accurate scanning design and quality control on work process. The quality control of work procedure includes training of patients' breathing, reasonable application of window technique, accurate mark, size and CT value,washing and print of films. In addition, the coordination of clinical doctors, imaging doctors and CT technicians is very important. According to CT standards, precise CT scanning by CT design request, can provide a high quality CT images that reflect pathologic state of human body, thereby to raise the quality of CT diagnosis.
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Objective To study CT scanning for traumatic thoracolumbar vertebral compression fracture. Methods After routine examination, 16 cases with unsatisfying results were performed CT scanning. Results Wolter classification scheme was involved in and the positions of spinal stenosis and injury were signed with different numbers. The results by CT were consistent with those by operation examination. Conclusion For the diagnosis of traumatic thoracolumbar vertebral compression fracture, CT is more effective than X-ray.
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Objective To explore the diagnostic value of endoscopic retrograde cholangio-pancreatiography (ERCP),ultrasonography (US) and CT scanning on cholagio-pancreatic diseases caused by clonorchis sinensis infection.Methods The results of US,CF and ERCP examination in 65 cases of obstructive jaundice caused by clonorchiasis and confirmed by presence of imagoes or eggs in feces or bile juice were analyzed and compared retrospectively.Results US examination was the simplest and most convenient which was characterized by diffuse even dilatation,thickening of walls,strengthened echo with the shape of“equal sign”intrahepatic bile ducts.The characteristic findings of CT included saccular dilatation of bile ducts of the periphery of the liver,thickening of the walls of bile ducts.Under duodenoscopy,32.3% (21/65) of cases presented as abnormal papilla such as small opening,mucosa outward turned,trapping or stiffness.Alterations in ERCP were characterized by shm or oval filling defect,diffuse saccular dilatation of terminal intrahepatic bile ducts.The most common complications included cholangiolithiasis (40%,26/65),carcinoma of bile duct on papilla (9.8%,6/65),and pancreatitis (1.5%,1/ 65).Conclusions Three methods were all useful for diagnosis of cholangio-pancreatic diseases caused by clonorchis sinensis infection,which were identically characterized by diffuse saccular dilatation of terminal intrahepatic bile ducts.The gold standard of diagnosis was the presence of imagoes or eggs in bile juice aspirated by the route of ERCP.Endoscopic sphincterectomy with postoperative vermifugal was the first choice of the treatment.
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PURPOSE: Retroperitoneal soft tissue sarcomas are frequently found in advanced state due to the abscent or nonspecific symptoms, and the only hope for cure is a radical resection. The differentiation between benign and malignant tumor is a prerequisite for preoperative preparation and deciding the extent of resection. for the purpose of determining the malignancy of retroperitoneal tumor, we evaluate the clinic oradiologic features of the patients. METHODS: Retrospective study was done on 37 eases who were oper ated Korea University Hospital from Jan. 1990 to Dec. 1998. Their clinicoradiologic characters were analyzed and compared between benign and malignant tumor pationts. RESULTS: Among the 37 cases, 27 cases (73%) were benign tumors and the remaining 10 cases (27%) were malignant tumors. There was no significant difference in age distribution between malignant and benigntumor group (p>0.05) Among 20 male patients, 10 eases had malignant tumor (50%) but all 17 female patients had benign tumor (p=0.001) Preoperative symptoms were present in 29 cases (78.4%). and mean duration of symp toms in malignant cases was 20 months and in benign cases was 18 months but had no significance in differentiating between malignant and benign tumors (p>0.05) All eases were porformed abdominal CT scanning and it had 100% of sensitivity and 74% of specificity. Among the radiologic characteristics, size of tumor, irregular margin, and abscence of calcification were correlated with malignancy (p<0.05). CONCLUSION: Preoperative clinical symptoms and duration are not helpful in differentiating the malig naney but CT scanning has a good results for such purpose. So when the retroperitoneal tumor shows large size, irregular margin and no visible calcification especially in male patients, the patient, we should prepare and treat the patients according to malignant tumor.