Abdominal Ultrasonographic Findings of Yersiniosis in Children

PURPOSE: To review abdominal ultrasonography in Yersinia Pseudotuberculosis(YP) infection. MATERIALS AND METHODS: From June 1993 through June 1994, abdominal ultrasonograms were reviewed in 36 patients with YP infection. The age of patients was from 4 to 14 years. A diagnosis of YP infection was made on the basis ofisolation of YP from stool (n=15/36, 41.7%) and by documenting at least a minimum agglutination antibody titer of1:160 or greater (n=34/36, 94.4%). RESULTS: Abdominal US findings were identifed in 33/36 (91.7%) of patients with YP infection. US abnormalities included right lower quadrant abdominal lymphadenopathy in 28/36 (77.8%) of cases ;increased bilateral renal cortical echogenecity with renal enlargement, 11/36 (30/6%) of cases ;hepatosplenomegaly, 6/36 (16.7%) of cases ; bowel wall thickening in termnal ileum and cecum, 4/36 (11/1%) of cases ; and ascites, 2/36 (5.5%) of cases. Three patients revealed no abdominal sonographic finding. CONCLUSION: We conclude that abdominal US can help in the diagnosis of YP infection when US demonstrates multiple right lower quadrant abdominal lymphadenopathy, increased renal cortical echogenecity with renal enlargement, hepatosplenomegaly, intestinal wall thickening or ascites.

MRI of Vertebral Compression Fractures: Differentiation between Benign and Malignant Causes

PURPOSE: To evaluate the MR image in the differentiation of benign and malignant lesion in compression of the vertebral body. MATERIALS AND METHODS: MR images of 47 benign(acute traumatic within one month:19, chronic traumatic longer than one month or nontraumatic:28) and 21 metastatic compression fractures were respectively reviewed in terms of margin of lesions, signal intensity, paraspinal mass formation, soft tissue change, and involvement of posterior element of vertebra. MR images of TI-(T1WI) and T2*-weighted gradient echo (GE T2WI) sequences were obtained on 0.5T unit in sagittal and axial orientation with 5mm section thickness. RESULTS: The margin of benign compression fracture was usually indistinct (acute fracture:90% (17/19), chronic fracture:68% (19/28)), whereas it was sharply delineated in metastatic compression fracture (92%, (12/13) (p<0.001). Paraspinal mass was seen in both acute traumatic and metastatic compression fractures (acute fracture :26% (5/19), metastatic fracture: 52% (11/21). Soft tissue change was seen only in acute cornpression fractures (58%, 11/19). Involvement of posterior element of vertebra was noted in metastatic fracture (71%, 15/21), acute fracture (32%, 6/19) and chronic fracture (7%, 2/28) CONCLUSION: On MR imaging, involvement of entire portion of a given vertebral body, sharp margin between normal and abnormal areas in partially involved cases, paraspinal mass formation, and posterior element involvement are more frequently seen in metastatic compression fractures, which are considered to be useful in differentiation between benign and malignant causes of compression fracture.