Can Anterior Junction Line be Used to Distinguish Right Middle from Right Upper Lobe on CT Scan?

PURPOSE: To evalvate the usefulness on a CT chest scan, of the anterior junction line as an anatomical landmark to distinguish the right middle and the right upper lobe MATERIALS AND METHODS: We found that the anterior junction line has a constant anatomical relationship with the right upper and middle lobe, and with this in mind, analysed connvcntional CT films of 86 patients with normal lung (group A) and 30 with architectural distortion (group B). On a series of slices, we compared the location of slice 1 with that of slice 2 (slice 1: the slice which includes the lowest portion of the anterior junction line, slice 2: the initial slice, in which the right middle lobe occupies the whole of the lung anterior to the right major fissure). RESULTS: In group A (n=86), the right upper lobe, as seen in the anteromedial zone of slice 1, was present in 83 cases (96.5%). The right upper lobe on slice 1 was absent in two cases (2.3%) in which a minor fissure was almost completely abent. In group B (n=30), the right upper lobe on slice 1 was absent in 19 cases (63.3%). CONCLUSION: We suggest that on a CT chest scan, the anterior junction line can be used as an anatomical landmark in the differentiation of the right middle from the right upper lobe, and as an indicator of the presence of architectural distortion.

CT Findings of the Chronic Sinonasal Inflammatory Disease

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.

A comparison of high resolution CT scan of temporal bone and operative findings in middle ear cholesteatoma

To evaluate the value of HRCT imaging in middle ear cholesteatoma, we prospectively analysed the CT images in 28 surgically proven cases with cholesteatomas regarding main site of lesion, ossicular change, facial nerve exposure and fistula formation . The most common main site of lesion was the epitympanum (92.8%). The results of sensitivity, positive predictability, and accuracy by CT imagings were as follows: for ossicular involvement, 94.1%, 88.8%, and 86.2% in malleus, 96.0%, 88.8%, and 85.7% in incus, 81.2%, 81.2%, and 78.5% in stapes; for facial verve exposure, 66.6%, 57.1%, and 81.2%; for fistula formation, 100%, 75.0%, and 96.4%, respectively. In conclusion, the temporal bone HRCT imaging is an accurate preoperative method in detecting main lesion site, ossicular involvement, fistula formation. Because of the low sensitivity and positive predictability in detecting facial nerve exposure, it is necessary to correlate the HRCT images with the clinical status.