The Usefulness of Helical CT in the Preoperative Staging of Gastric Carcinoma

PURPOSE: The Purpose of this study was to evaluate the usefulness of Helical CT in the preoperative staging of gastric carcinoma. MATERIALS AND METHODS: We performed Helical CT on 66 patients with pathologically proved gastric carcinoma. The findings were prospectively analyzed and correlated with surgical and histopathologic findings. RESULTS: The detection rate for gastric carcinoma was 88%(58/66). The rates of accuracy, understaging, and overstaging of Helical CT according to TNM staging in determining the depth of tumor invasion were 68%(45/66),23%(15/66), and 9%(6/66), respectively. In early and less advanced carcinomas(T1 & T2), the depth of tumor invasion was correctly determined in only 44%(11/25) of cases, whereas in more advanced carcinomas (T3 & T4), the corresponding figure was 83%(34/41). In lymph node staging, accuracy, understaging, and overstaging rates were 62%(41/66), 21%(14/66), and 17%(11/66), respectively. Helical CT showed a sensitivity of 48%, a specificity of97%, and an accuracy of 92% in assessing metastasis to lymph nodes. One of five cases of peritoneal carcinomatosis(20%) was correctly diagnosed by Helical CT. CONCLUSION: In the preoperative evaluation of gastriccarcinoma, Helical CT is useful in the detection of tumours and for determining the depth of tumor invasion, particularly in cases where there is serosal and adjacent organ invasion; for the evaluation of metastasis tolymph nodes and peritoneal carcinomatosis its usefulness is limited, however. Further resech will therefore be necessary.

Experimental Bacterial Meningitis in Rabbit : Evaluation with CT and MRI

PURPOSE: The purpose of this study was to evaluate the usefulness of computed tomography(CT) and magnetic resonance imaging(MRI) in experimental bacterial meningitis. MATERIALS AND METHODS: CT and MR images of experimental bacterial meningitis were obtained after inoculation of 1ml suspension of 106/ml Staphylococcusaureus directly into the supratentorial arachnoid space of 18 New Zealand white rabbits. Each animal was studied with both Pre-enhanced and post-enhanced CT and MRI at 12, 24, 48 hours and 1 week. Cerebrospinal fluid of all of18 rabbits were sampled and cultured for bacterial growth. RESULTS: All of 18 rabbits had the clinical symptoms such as neck stiffness and anorexia within 24 hours after the inoculation. Cerebrospinal fluid cultures werepositive for Staphylococcus sureus growth. Gd-enhanced MRI exhibited diffuse enhancement along the thickened supratentorial meninges earlier than CT. in Gd-enhanced MRI, the mean contrast enhancement ratio(CER) at supratentorial meninges increased to 1.93 at 12 hours and 2.99 at 24 hours from 1.06 at 0 hour. Histologic evaluation demonstrated inflammatory cell infiltration into the meninges. MRI also identified the complications of mening it is such as ependymitis and hydrocephalus more effectively than CT. CONCLUSION: These results indicatedthat Gd-enhanced MRI detected earlier the abnormal findings of bacterial meningitis and evaluated more effectively the complications of mening it is compared with CT. MRI was more useful than CT in evaluation of the bacterial meningitis.

MR Findings of Congenital Craniocerebral Anomaly: Correlation with Seizures and Developmental Delay

PURPOSE: To evaluate characteristic MR findings of craniocerebral anomaly and its relationship with neurologic manifestations. MATERIALS AND METHODS: We retrospectively reviewed MR images of 36 patients with craniocerebral anomaly diagnosed by MRI and clinical courses. We correlated the characteristic MR findings in 41 lesions with neurologic manifestastions focusing on seizures and developmental delay. RESULTS: Twenty-three patients with seizures consisted of 14 patients(60%) with neuronal migration disorders and seven(30%) with phakomatosis, among which 18 patients(78%) had generalized type of seizures. Locations of the lesions were the parietal lobes in 11 patients(52%) and the subependymal or periventricular regions in seven(33%). Two patients with tuberous sclerosis had the lesions in both parietal and subependymal areas. Nine patients had the signs of developmental delay that were seen in the four(44%) with schizencephaly, two (22%) with tuberous sclerosis, two(22%) with heterotopia, and one(ll %) with pachygyria. CONCLUSION: Neuronal migration anomaly was relatively common lesion that presented neurologic manifestations such as seizures and developmental delay. Generalized type of seizures was common. We were able to diagnose these anomalies using the MRI that helped establish therapeutic plans.

Helical CT Cholangiography with Multiplanar Reformation: Utility in Patients with Extrahepatic Biliary Obstruction

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.

Percutaneous Transluminal Angioplasty of Subclavian Artery: Case Report

Percutaneous transluminal angioplasty(PTA) were performed in three patients with atherosclerotic stenosis of subclavian arteries. The arteries were successfully dilated without complications during the procedure. All patients were asymptomatic during follow-up periods ranging from eight months to fifteen months after PTA.

Perianeurysmal Retroperitoneal Fibrosis Causing Obstructive Hydronephrosis: Case Report

Aortoiliac aneurysm is a rare cause of ureteral obstruction. We report a case of perianeurysmal fibrosis(PAF) associated with aortoiliac aneurysm resulting in hydronephrosis. CT and MRI findigns of PAF are presented. In patient with hydronephrosis of unknown cause, PAF should be included among the differential diagnosis. The diagnosis of PAF is easily made with CT and MRI findings.

Usefulness of Magnetic Resonance Angiography in Intracranial Arteriovenous Malformation

PURPOSE: To evaluate clinical usefulness of magnetic resonance angiography(MRA) as a diagnostic modality and for treatment planning of intracranial arteriovenous malformations(AVM). METHODS AND MATERIALS: In 14 patients with intracranial AVM which were confirmed by operations, radiologic studies and clinical evaluations, magnetic resonance imaging(MRI), MRA and conventional angiography(CA) were retrospectively reviewed with specific regards to nidus depiction, detectability of feeding arteries and draining veins, and number and anatomic consistency of these vessles. MRA was obtained by 3 D TOF, 2 D PC, and 3 D methods with adequate VENC selection. RESULTS: Nidus of AVM was well demonstrated in MRI and MRA, and no remarkable difference in detection and size estimation of nidus among MRI, MRA and CA except 2 cases of associated intracranial hemorrhage, in which 3 D PC MRA well depicted nidus that were not visualized on MRI because of subacute hemorrhage. Feeding arteries were well demonstrated on 3 D TOF and 3 D PC MRA. Dilated draining veins were well depicted on 3 D PC MRA by scannig with adequate VENC selection, and the results were no remarkable difference compared with the ones on CA. CONCLUSION: MRA of a consecutive scan after MRI is a excellent modality for evaluation and treatment planning of intracranial AVM, and possible substitutive method for CA except for radiotherapy or transarterial embolization.

Comparison of CO2 DSA and Conventional Angiography Using Non-ionic Contrast IVledia in Lower Extremity Angiography

PURPOSE: The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. MATERIALS AND METHODS: Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n:9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. RESULTS: In atherosclerosis;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occuring in 4 out of 16 patients. CONCLUSION: CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention reguiring large amount of contrast media CO2 could effectively replace nonionic contrast media.

Colonic wall abnormalities on enhanced CT:Differentiation between inflammatory and neoplastic diseases

The computed tomographic(CT) findings of fourteen patients with inflammatory disease and 28 with neoplasm who had an abnormal colonic wall thickening, were retrospectively studied to establish CT criteria for each disorder in differentiating inflammatory from neoplastic lesions. According to homogeneity, density and contour of mural thickening and pericolic inflammatory change in enhanced CT scans, we classified colonic wall abnormalities into 6 patterns: I) multilayering with inner and outer hyper- and middle hypodensities, II) homogeneously hyperdense with pericolic inflammatory change, III) heterogeneously hyperdense with pericolic inflammatory change, IV) homogeneously heperdense with lobulated contour, V) heterogeneously hypodense with lobulated contour and VI) heterogeneously mixed densities with irregular lobulated contour. Type I, II and III were distinctively identified in inflammatory disease, type IV, V in neoplasm, and type VI in boty diseases. We conclude that enhanced CT could be helpful in the initial diagnosis and/or suggestion of abnormal colonic wall disease and differentiation of inflammatory from neoplastic diseases.

Influence of tumor size on chemosensitivity of FSa II in combination of cyclophosphamide and radiation / 대한암학회지

No abstract available.

Left cervical aortic arch and persistent left superior vena cava in the SAME patient: case report

No abstract available.

The three-line sign of epiglottic enlargement on neck lateral radiograph

No abstract available.

Percutaneous transluminal angioplasty of atherosclerotic obstructive disease

No abstract available.

High resolution CT of cervical disk herniation: the value of intravenous contrast enhancement

No abstract available.

CT and angiographic findings in ruptured intracranial aneurysms

CT has become the most useful, non-invasive diagnostic method as the initial exmination in the diagnosis ofruptured intracranial aneurysm with intracranial hemorrhage(subarachnoid, intracerebral and intraventricularhemorrhage), hydrocephalus and infarction. Furthermore, high resolution CT can demonstrate aneurysm itself. Butangiography is the last and conclusive method as yet, for better evaluation of vascular anatomic structure ofaneurysm for surgery. Authors analyzed 40 cases of ruptured intracranial aneurysm confirmed by CT, angiographyand/or surgery at Chonnam National University Hospital from July, 83' to July, 85'. The results were as follows:1. The most prevalent age group was the 5th decade(35%), and female patient(57.5%) was more comon than male. 2.Angiographic findings were as follows: 1) Multiple aneurysm was found in 8 patients (20%): the one of thesepatients is tripple, the others are double. 2) The location of aneurysm, in order ot frequency, were : ACA andA-com aneurysm in 23 cases(47%). ICA and P-com aneurysm in 17 cases(35%), basilar tip aneurysm in 4 cases(8%), MCAaneurysm in 3 cases(6%) and PCA aneurysm in 1 case(2%). 3) Hydrocephalus was detected in 22 cases (55%): 21 cases(95%) of these cases were demonstarated within the first 3 weeks after attack. 4) Detection of aneurysm itseslfwas 20 cases(50%). 5) Cerebral infarction was 5 cases(12.5%). 6) Subarachnoid enhancement on post-contrast scanwas 8 cases(20%).

Two cases of emphysematous pyelonephritis

Emphysematous pyelonephritis is rare but freuently fatal complication of renal parenchymal infection, mostcommonly occurs in diabetic patients and is often associated with urinary obstruction, prior urologicalabnormality or infection. From 1898 to 1984 , about 50 cases of empysematous pyelonephritis have been reporteduniversally. The diaignosis of emphysematous pyelonephritis can be made only roentgenographically. In the last 2years, we have had two cases of emphysematous pyelonephritis at our hospital. It is our purpose to report twopatients who have survived wtih a brief review of the previous literature.

Percutaneous Antegrade Pyelography

Percutaneous antegrade pyelography guided by ultrasonography and fluoroscopy was attempted in 25 patients with supravesical obstructive hydronephrosis and suctessful in 23 patients to evaluate the site and nature of urinary obstruction. The etiology of the obstructive uropathies were urinary stricture in 11 cases,urinary Tbc. in 5 cases, urinary stone in 3 cases, uterine prolapse with cystocele, pyonephrosis, ureteral metastatic testicular carcinoma in 1 case respectively. No significant complication of the percutaneous antegrade pyelography was observed. Percutaneous antegrade pyelography provides significant diagnostic informations on the obstructive lesion and can be accomplished with ease and safe in patients with obstructiv hydronephnosis as a diagnostic procedure of choice in infants and children or as an alternative to a retrograde pyelography.

CT findings of epidemic encephalitis in acute stage

Although the incidence of epidemic encephalitis has decreased mardekly nowadays, sporadic cases are stillobserved in Korea. In this study, CT findings of 17 patients with clinically and serologically proven epidemicencephalitis were analized. In principle, CT scans were done at the acute and subacute stage, whithin 20 days fromonset. The results were follows; 1. Of all 17 patients with CT scan, normal scan were demonstrated in 3 cases andabnormal scans in 14 cases. 2. The abnormal CT findings were ; area of low density in 9 cases, brain edema in 7cases, nodular and gyral contrast enhancement in 3 cases, central brain atrophy in 3 cases and hemorrhagic highdensity in 2 cases in order of frequency. 3. The CT findings, according to date of CT scan from onset, were; brainedema and are of low density within 10 days from onset, normal or central brain atrophy between 11 days and 20days, are of hemorrhagic high density and contrast enhanced lesions at both stage. 4. The locational distributionswere; thalamus and cerebral white matter in 7 cases respectively, basal ganglia in 5 cases, cerebral cortex in 4cases and septum pellucidum in 1 case in order of frequency.