Résumé
As part of the outreach program of the Welfare Federation of Agricultural Cooperatives in Kumamoto Prefecture, ultrasonographic examinations for abdominal diseases were carried out in rural communities from the beginning of April 1986 to the end of March 1994. A total of 119, 172 people went through the abdomen checkup during the period. In this study, we reviewed the results of the examinations with respect to the followings.<BR>The percentage of those examinees who were found to have some impairment increased from a range of 40% to upwards 50% during the period under review. Those who were told to receive followup examinations accounted for as high as 10% of the total initially, but the percentage dropped to 2. 9%. The percentage of those actually underwent followup examinations once fell to a range of 70%, but later rose to 85%. The rate of detection of malignancies went up steadily from 0. 08 to 0. 12% year by year.<BR>To decrease the percentage of the patients having to receive followup examinations and to increase the malignancy detection ratio, it was deemed necessary to improve echographers' skills, and establish a nost-examination care/guidance system.
Résumé
PURPOSE: To investigate the usefulness of dynamic MR imaging in the differential diagnosis of brain tumors. MATERIALS AND METHODS: Dynamic MR imaging was performed in 43 patients with histopathologically proved brain tumrs. Serial images were sequentially obtained every 30 seconds for 3--5 minutes with use of spin-echo technique(TR 200msec/TE 15msec) after rapid injection of Gd-DTPA in a dose of 0.1mmol/kg body weight. Dynamics of contrast enhancement of the brain tumors were analyzed visually and by the sequential contrast enhancement ratio(CER). RESULTS: On the dynamic MR imaging, contrast enhancement pattern of the gliomas showed gradual increase in signal intensity(SI) till 180 seconds and usually had a longer time to peak of the CER. The SI of metastatic brain tumors increased steeply till 30 seconds and then rapidly or gradually decreased and the tumors had a shorter time to peak of the CER. Meningiomas showed a rapid ascent in SI till 30 to 60 seconds and then made a plateau or slight descent of the CER. Lymphomas and germinomas showed relatively rapid increase of Sl till 30 seconds and usually had a longer time peak of the CER. CONCLUSION: Dynamic MR imaging with Gd-DTPA may lead to further information about the brain tumors as the sequential contrast enhancement pattern and CER parameters seem to be helpful in discriminating among the brain tumors.