Postoperative CT Findings of Aortic Aneurysm and Dissection

PURPOSE: To assess the postoperative CT findings of aortic aneurysms or dissections treared by resection- and-graft replacement or continuous-suture graft-inclusion technique MATERIALS AND METHODS: We reviewed postoperative follow-up CT findings of 14 patients, 19 cases. There were 8 patients(10 cases) of aortic aneurysm and 6 patients(9 cases) of aortic dissecton which involved the thoracic aorta in 9 patients(13 cases) and abdominal aorta in 5 patients(6 cases). The interval of follow-up after operation was from 9 days to 2 year 9 months. On CT scans, we analyzed the appearance of graft materials, differences of CT findings between two surgical techniques, and normal or abnormal postoperative CT findings. RESULTS: Most of grafts appeared as hyperdense ring on precontrast scan, and all of them were not seperated from aortic lumen on postcontrast scan. On CT findings of patients who were operated by continuous-suture graft-inclusion technique, perigraft thrombus was concentrically located with sharp demarcation by native aortic wall and its density was homogeneous, but in cases of those operated by resection-and-graft replacement, perigraft hematoma was eccentrically located with indistinct margin and its density was heterogeneous and native aortic wall could not be delineated. In patients without complication, perigraft thrombus or hematoma(15 cases), perigraft calcification(11 cases), residual intimal flap(6 cases), graft deformity(4 cases), perigraft air(2 cases) and reconstructed vessels(1 case) were noted. And in one patient with complication, perigraft flow was noted with more increased perigraft hemaroma. CONCLUSION: Precise knowledge of the differences of CT findings between two surgical techniques and nor- mal postoperative CT findings is crucial to evaluate the postoperative CT findings in aortic aneurysm and dissection.

Operated DeBakey Type III Dissecting Aortic Aneurysm: Review of 12 cases

PURPOSE: We evaluated the indications of operation and radiologic findings in 12 operated DeBakey type III aortic dissections. MATERIAL AND METHODS: We retrospectively reviewed radiologic findings of 12 operated DeBakey type III aortic dissections, using CT, MRI, or aortography, and correlations were made with clinical course of the patients. RESULTS: Three cases were uncomplicated dissections. There were aneurysm rupture in 4 cases, impending rupture in 4 cases, occlusion of common lilac artery in 2 cases, occlusion of renal artery in 1 case, and compression of bronchus and esophagus by dilated aorta in 1 case. Associated clinical sign and symptoms were chest and back pain in 12 cases, claudication in 3 cases, dyspnea and dysphagia in 1 case, hoarseness in 1 case, and hemoptysis in 1 case. Post-operative complications were death from aneurysm rupture in 1 case, paraplegia in 2 cases, acute renal failure in 3 cases, and hemopericardium in 1 case. CONCLUSION: Although medical therapy is preferred in management of DeBakey type Ill aortic dissection, surgical treatment should be considered in patients with radiological findings of aortic rupture, impending rupture, occlusion of aortic major branches.

Comparison and Analysis for CT Findings of Gastric Adenocarcinoma and Gastric Lymphoma

PURPOSE: The purpose of this study is to analyze and compare the CT findings of gastric adenocarcmoma and gastric lymphoma. MATERIALS AND METHODS: We retrospectively analyzed and compared the CT findings in 46 cases of adenocarcinoma and 12 cases of lymphoma, which were pathologically confirmed by operation and endoscopic biopsy. RESULTS: Antral involvement was more common in adenocarcinoma(71.7%) than in lymphoma(41.7%). Localized involvement was more common in adenocarcinoma(83.7%), while diffuse involvement was more common in lymphoma(55.6%). Adenocarcinoma tended to have smooth inner margin(83.8%), while lymphoma had nodular or irregular inner margin(36.4%). Mean gastric wall thickness of adenocarcinoma was 1.7cm, while mean thickeness of lymphoma was 2.7cm. The involved wall of adenocarcinoma tended to be highly enhanced (59.5%), while lymphoma was moderately enhanced(90.1%). Perigastric lymphadenopathy was present in 40% (group I) and 42%(group II) of adenocarcinoma and 33% of lymphoma(group I and II). Three cases of lymphoma had lymphadenopathy below renal vascular pedicles with no or minimal perigastric lymphadenopathy. When only the distal portion of the stomach was involved, disturbance in passage developed in six adenocarcinoma (12%), while none developed in the lymphoma. CONCLUSION: CT features help to differentiate between gastric adenocarcinoma and gastric lymphoma