CT findings of bronchioloalveolar carcinoma: correlation with pathology

No abstract available in English.

Experimental atudy on pulmonary embolism caused by lipiodol and absolute ethanol

Pulmonary embolism of lipiodol or ethanol may occur inadvertently during the procedure of diagnostic or therapeutic embolization. We studied the nature of pulmonary damage, and its relation to the amount of lipiodol and ethanol embolized into the lung. Various doses of embolic agents(lipiodol 0.4cc/kg, 0.08cc/kg, absolute ethanol 0.4cc/kg, 0.03cc/kg and normal saline 0.4cc/kg)were injected intravenously through femoral vein in 50 rats(10 rats in each group). Pulmonary pathologic changes were analyzed on the 3rd and 28th days subsequent to injection. On the 3rd day, three of 10 lipiodol cases and all(10) ethanol cases showed multifocal pulmonary hemorrhages. Accompanying inflammatory cell infiltration was found only in lipiodol cases. On the 28th day, one of 10 lipiodol cases and four of 10 ethanol cases showed non-specific pneumopathy suggesting mild focal pulmonary fibrosis. The degree of pulmonary damage appeared to depend on the amount of injected embolic agents although their safety doses could not be clarified exactly. Therefore, we suggest careful injection of embolic agents, especially ethanol, during the embolization procedure to prevent possible pulmonary damage by inadvertent pulmonary embolism.

Radiologic findings of truncus arteriosus; incidence and associated anomalies

Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. Accordin to Collett and Edwards classification. Type I was encountered in 11cases(61%), type II in 4cases(22%), and type III in 3cases(17%), All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect(8cases), patent ductus arteriosus(3cases), coarctation of the aorta(2cases), isolation of the left subclavian artery(2 cases), and right aortic arch with an aberrant left subclavian artery(1case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.

Retained intrahepatic stones: percutaneous removal with a preshaped angulated catheter in 179 patients

Intrahepatic stones are frequently associated with recurrent pyogenic cholangiohepatitis and complete surgical removal of the stones is almost always difficult because of the large number of stones and associated bile duct strictures. One hundred and seventy-nine patients with retained intrahepatic stones underwent percuttaneous stone removal utilizing a preshaped angulated catheter and a Dormia basket under fluoroscopy with a combination of techniques including irrigation-suction. crushing of large stones. balloon dilatation of strictures and extracorporenal shock wave lithotripsy. The procedure was performed through a mature T-tube tract (177 patients) and a mature transhepatic tube tract (two patients). Stones were exclusively intrahepatic in 130 patients. whereas 49 patients also had stones in the common bile duct. In 91 (50.8%) of 179 patients. the stones were completely removed and in 36 (20.1%) patients most of the stones were removed. The overall success rate was 70.9% ngulation deformity. stricture of bile ducts and impacted stones were the factor most often responsible for failure, No significant complications were observed. Fluoroscopicalyy-guided percutaneous interventional procedures with a preshaped angulated catheter is an useful complementary procedure to surgery for patients with intrahepatic stones. the major benefits of an individually fitted angulated catheter are its safety and easy access to small peripheral bile ducts.

Enhancing mediastinal tumors: CT evaluation

CT scans of 21 patients(intrathoracic goiter=7. Castleman disease=6, pulmonary carcinoid tumor=3, parathyroid adenoma=1, thyroid carcinoma=1, paraganglioma=1, benign pleural mesothelioma=1, sclerosing hemangioma=1) with mediastinal tumors that are known to be enhanced with intravenous injection of contrast media, were studied retrospectively to investigate the enhancing capabilities f those tumors and to describe their CT findings. The degree of enhancement was estimated by visual inspection with a grading system. All but one case of cystic parathyroid adenoma showed enhancement on post-contrast scan. The degree of enhancement was not helpful in differentiating these tumors. Characteristic location and pattern of tumor extension were found in cases of intrathoracic goiter, parathyroid adenoma, thyroid carcinoma and paraganglioma. Calcifications were found in intrathoracic goiter(5/7). Castleman disease(2/6). Pulmonary carcinoid(1/3), thyroid carcinoma. Necrotic low-attenuation areas were in intrathoracic goiter(7/7), parathyroid adenoma, thyroid carcinoma and paraganglioma. In conclusion, mediastinal tumors that are known to be enhanced in the literature were enhanced with rare exception, and if we consider the predilection site of those tumors, the scope of differential diagnosis can reasonably be narrowed.