Congenital tuberculosis

Congenital tuberculosis is an infection that is established in the fetus by hematogenous spread or by the aspiration or inhalation of infected amniotic fluid either before or during labor. The diagnosis can be confirmed only if both the tuberculous nature of the lesion and the antenatal origin of the infection can be proved. The authors analysed roentgen findings of two cases of pulmonary tuberculosis, thought to be congenital; 1. Diffuse distribution of nodular densities and some confluent densities were seen in the entire lungs in the inital film.The pulmonary markings were decreased in some degree. 2. Air bronchogram was noted. 3. Hepatosplenomegaly was associated.

Computed tomographic evaluation of acoustic neuroma

The advent of computerized cranial tomography represents a great advance in the diagnosis of very wide variety of intracranial lesions. The CT findings of acoustic neuroma have been reported by many authors, especially by Hatam in early contrast enhancement and evaluation of the internal auditory meatus. We have analysed 22pathologically proven cases of acoustic neuroma examined at the Kyung Hee University Hospital from Oct. 1977 to June 1981 and the results were as follows. 1. The sex ratio was 12 females to 10 males and the greatest number of cases (27%) were seen in fourth decade. 2. The precontrast CT scan of the tumor appeared as isodensity in 10 cases (46%), low density in 8 cases (36%) and high density in 4 cases (18%). The shape of tumor was round in 10 cases (46%), irregular amorphous in 9 cases (41%) and ovoid in 3 cases (13%). 3. The tumor was located at both anteriorand posterior sides of porus acousticus in 17 cases (77%), and only posterior side in 5 cases (23%), Associated hydrocephalus and intratumoral calcification were found in 18 cases (82%) and 1 case (4%), respectively. Bilateral involvement of the tumor was not seen. 4. In postcontrast CT scan, all of the acoustic neuromas but one, were enhanced and well defined. The most frequent enhancement pattern was heterogenous enhancement, seen in 10 cases (46%), but there was no specific enhancement.

Endoscopic retrograde cholangiographic findings in choledocholithiasis

Although ultrasonography replaced many invasive studies in biliary tract diseases, direct cholangiography does still play an important role in the diagnosis and management of choledocholithiasis. Endoscopoic retrograde cholangiography (ERC) is regarded as the best method in evaluation of exact extent of the disease and its frequent complication, cholangitis. Authors analysed 56 cases of choledocolithiasis diagnosed by ERC and compared these with ERC in 18 cases of normal, 22 cases of cholecystitis, 15 cases of clonorchiasis and 9 cases of parenchymal diseases of liver. The results are as follows; 1. ERC findings of choledocholithiasis are filling defects by stoneor stones, dilation of common hepatic as well as common bile ducts and findings of cholangitis. 2. ERC findings of cholangitis are dilatation of larger intrahepatic biliary radicles and acute peripheral tapering, decrease of arborization, increased or right angle branching pattern, straightening and rigidity as well as irregular narrowing of intrahepatic biliary trees. This findings are observed in majority of choledocholithiasis. 3. Over9mm in diameter at intraprancreatic portion of common bile duct was regarded as abnormal, with 95% sensitivity,85% specificity and 91% diagnostic accuracy by decision matrix analysis. 4. In the presence of dilatation of CBD and findings of cholangitis in ERC, one should consider choledocholithiasis in spite of absence of stone defect.