Anatomic Variation of the Deep Venous System and its Relationship with Deep Vein Thrombosis Found on the Lower Extremity Venograms that were Obtained after Artificial Joint Replacements

PURPOSE: We wanted to evaluate the anatomic variations, the number of valves and the presence of deep vein thrombosis (DVT) on the lower extremity venograms obtained after artificial joint replacements, and we also wanted to determine the correlation of the incidence of DVT with the above-mentioned factors and the operation sites. MATERIALS AND METHODS: From January to June 2004, conventional ascending contrast venographies of the lower extremities were performed in 119 patients at 7-10 days after artificial joint replacement, and all the patients were asymptomatic. Total knee replacement was done for 152 cases and total hip replacement was done for 34 cases. On all the venographic images of 186 limbs, the anatomic variations were classified and the presence of DVT was evaluated; the number of valves in the superficial femoral vein(SFV) and calf veins was counted. The sites of DVT were classified as calf, thigh and pelvis. Statistically, chi square tests and Fischer's exact tests were performed to determine the correlation of the incidence of DVT with the anatomic variations, the numbers of valves and the operation sites. RESULTS: Theoretically, there are 9 types of anatomical variation in the deep vein system of the lower extremity that can be classified, but only 7 types were observed in this study. The most frequent type was the normal single SFV type and this was noted in 117 cases (63%), and the others were all variations (69 cases, 37%). There was a 22.2% incidence of DVT (69 cases) in the normal single SFV type and 26.4% (17 cases) in the other variations. No significant difference was noted in the incidences of DVT between the two groups. In addition, no significant statistical differences were noted for the incidences of DVT between the single or variant multiple veins in the SFV and the popliteal vein (PV) respectively, between the different groups with small or large numbers of valves in the thigh and calf, respectively, and also between the different operation sites of the hip or knee artificial joint replacements. The total number of asymptomatic DVT cases was 43 (23.1%) and DVT was found in the calf in 39 of these cases. CONCLUSION: Post-operative venograms of the lower extremity showed 7 types of anatomic variation in the deep venous system. The incidence of silent post-operative DVT was not influenced by anatomic variations of the deep vein system, whether there were a small or large number of valves and the operation sites for artificial joint replacement. The most frequent site of DVT after artificial joint replacement was the calf.

The Study of Renal Perfusion Image in Rabbit by Harmonic Ultrasound with Microbble Contrast Agent in Comparison with 99mTc-DTPA: Focusing on US Scan Technique and Concentration of Contrast Agent

PURPOSE: To compare the results of harmonic ultrasound (US) renal perfusion imaging using 99mTc-DTPA as contrast agent with those obtained when a microbubble contrast medium was used. MATERIALS AND METHODS: Twenty rabbits underwent harmonic US renal perfusion imaging using 99mTc-DTPA as contrast agent, and the imaging procedure was then repeated using a microbubble contrast medium. Three different concentrations of contrast media (200, 300 and 400 mg/ml) and two different scanning techniques (intermittent and continuous) were used, and the images obtained were assessed using six different methods. By means of a computer program, the images were converted to a renal perfusion curve and Tpeak values were calculated. Images obtained after use of the two different contrast media were compared. RESULTS: Tpeak at renal perfusion imaging using 99mTc-DTPA was 6.3+/-0.9 sec, and where microbubble contrast agent was used, the findings were was as follows: 13.8+/-1.6 sec (method 1), 6.5+/-1.1 sec (method 2), 14.8+/-1.7 sec (method 3), 6.6+/-1.0 sec (method 4), 15.2+/-2.0 sec (method 5), 6.4+/-0.7 sec (method 6). Method 6 had the highest correlation coefficients. CONCLUSION: In conclusion, the harmonic ultrasound renal perfusion images acquired using 99mTc-DTPA were similar to those obtained using microbubble contrast agent. Continuous scanning techniques showed correlation.

A Case of Spontaneous Rupture of the Kidney with Acute Pyelonephritis / 대한신장학회잡지

Spontaneous rupture of the kidney, Wonderlich syndrome, is a rare event but potentially life-threatening condition. The most comman causes are clear cell carcinoma, benign angiomyolipoma and vascular disease. Among this event, acute pyelonephritis is a very unusual cause. A 67-year-old diabetic woman was admitted with high fever and left flank pain due to acute pyelonephritis. She had uterine prolapse for 10 years with both renal hydronephrosis before this event. Abdominal ultrasonography and CT scan showed fluid collection around left kidney with a rupture of renal parenchyme at lower pole. The renal angiography showed displaced capsular artery due to subcapsular hematoma and decreased blood flow at lower pole. The percutaneous needle aspiration revealed blood collection around left kidney, which confirmed spontaneous rupture of the kidney. We report this case with a review of the relevant literature.

Isolated Non-chylous Pleural Effusion in Two Neonates

Isolated pleural effusion, so called primary pleural effusion denotes a pleural effusion without documented etiology such as a cardiac, inflammatory, iatrogenic problem or fetal hydrops. Chromosomal anomaly such as Down syndrome may be associated with isolated pleural effusion. The content of the isolated pleural effusion is mostly chylous, and isolated non-chylous pleural effusion in neonate is rare. We experienced 2 cases of isolated non-chylous pleural effusion. They had neither cardiac problem nor other sign of hydrops fetalis. Imaging diagnosis was done by plain chest radiography and subsequent ultrasonogram. One of them was diagnosed to Down syndrome by karyotyping. They were fared well after diagnostic and therapeutic thoracentesis. We describe 2 cases of non-chylous pleural effusion and review a few English-language case reports of this entity.

Diagnostic Accuracy of Mammography and Ultrasonography in Detection of Early Breast Cancer

PURPOSE: To determine the value of mammography and ultrasonography in the detection of early breast cancer, and the usefulness of combining the two modalities for the diagnostic study of this condition. MATERIALS AND METHODS: The mammographic and ultrasonographic features of 47 female patients aged 23-68 (average, 46) years with pathologically proven early breast cancer were analyzed retrospectively. Mammography was performed in 46 patients and ultrasonography in 38, and 37 underwent both mammography and ultrasonography. Analysis of the mammographic and/or ultrasonographic features focused on mass, microcalcification, mass with microcalcification, multiple nodules, duct dilatation, and architectural distortion. RESULTS: Mammography revealed microcalcification in 29 (63%) patients, mass in 13 (28%) patients, mass with microcalcification in 8 (17%) patients, multiple nodules in 2 (4%) patients, architectural distortions in 1 (2%) patient, and negative finding in 9 (20%) patients. Ultrasonography revealed mass in 25 (66%) patients, microcalcifcation in 9 (24%) patients, mass with microcalcification in 8 (21%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and negative finding in 7 (18%) patients. On combined study of mammography and ultrasonography of the 37 patients, mammography or ultrasonography revealed mass in 25 (68%) patients, microcalcification in 20 (54%) patients, multiple nodules in 2 (5%) patients, duct dilatation in 3 (8%) patients, and architectural distortion in 1 (3%) patient. In one (3%) patient among them, both mammography and ultrasonography revealed negative findings. The false negative rate of mammography, ultrasonography or both was 20%, 18%, and 3%, respectively, which was statistically significant difference (p < 0.05). CONCLUSION: Combined study of mammography and ultrasonography is the most useful as a diagnostic study for early breast cancer. So, ultrasonography seems to be the important additional method for detection of early breast cancer.

Serial Brain MRI Findings in CNS Involvement of Familial Erythrophagocytic Lymphohistiocytosis: A Case Report

Familial erythrophagocytic lymphohistiocytosis is a fatal early childhood disorder characterized by multiorgan lymphohistiocytic infiltration and active hemophagocytosis. Involvement of the central nervous system (CNS) is not uncommon and is characterized by rapidly progressive tissue damage affecting both the gray and white matter. We encountered a case of familial erythrophagocytic lymphohistiocytosis with CNS involvement. Initial T2-weighted MRI of the brain demonstrated high signal intensity in the right thalamus, though after chemotherapy, which led to the relief of neurologic symptoms, this disappeared. After four months, however, the patient's neurologic symptoms recurred, and follow-up T2-weighted MR images showed high signal intensity in the thalami, basal ganglia, and cerebral and cerebellar white matter. Brain MRI is a useful imaging modality for the evaluation of CNS involvement and monitoring the response to treatment.

MR Findings of Bowel Ischemia with Mesenteric Vascular Occlusion: Comparison with Pathologic Findings in a Cat Model

PURPOSE: In order to determine the characteristic MR findings for the early diagnosis of bowel ischemia, we analysed the dynamic enhanced MR images of ischemic bowel induced by mesenteric vascular occlusion in a cat model, and compared the T1-and T2- weighted images (WI) of extracted bowel with the pathologic findings. MATERIALS AND METHODS: According to the ischemic period, twelve cats were assigned to either the normal control group (no ischemic period, n=2), the acute ischemic group (ligation of mesenteric vessels for 3 hours, n=6) or the subacute ischemic group (ligation of mesenteric vessels for 10 hours, n=4). Under general anes-thesia,laparotomy was performed. The ileal artery and vein were ligated, and a columnar surface coil was ap-plied to the expected bowel ischemia. Using a 4.7 T MR scanner, contrast-enhanced T1WI were obtained, after bolus injection of contrast media, at 10, 20, 30, 60, and 90minutes. After formalin fixation of the extracted bowel, T1- and T2WI were obtained, and the specimens were pathologically examined. MR signal intensity at each layer of the bowel wall was measured and compared with the histopathologic findings. RESULTS: On contrast enhanced MR images, the submucosal layer showed most intensive enhancement, fol-lowed-in decreasing order of signal intensity- by muscle and mucosa. Time to peak enhancement of bowel wall was 10-minutes in the normal control group, and 20 and 60minutes in the acute and subacute bowel is-chemia groups, respectively. On T1WI, no significant differences in signal intensity were observed between the ischemic group and the normal control group. On T2WI, the signal intensity of the submucosal layer of the acute ischemic group was significantly higher than that of the normal control or subacute ischemic group, and the signal intensity of the muscular layer of the ischemic group was significantly higher than that of the normal control group. CONCLUSION: Time to peak enhancement of bowel wall was a helpful criterion for assessment of the ischemic period. Analysis of the signal intensity of the bowel wall layer was useful for the early detection of bowel ischemia.

Virtual Bronchoscopy: An Experimental Study on Parameters Affecting Apparent Sizes of Simulated EndobronchialLesions

PURPOSE: To evaluate the scanning parameters affecting the apparent sizes of endoluminal lesions of thetracheobronchial tree, as seen on virtual bronchoscopy(VB), and to determine the optimal CT parameters fordemonstrating the real sizes of endobronchial lesions. MATERIALS AND METHODS: Spherical beads of 8 mm - 10 mmdiameter were randomly placed in the airways of fixed pig lung. CT scans were obtained with collimation and pitchof 3 mm/1, 3 mm/1.5, and 5mm/1, respec-tively. Volumetric data were reconstructed with 1mm-, 1.5 mm-, and2mm-collimation for each parameter. VBs were reconstructed with shaded-surface technique and soft tissuealgorithm. A 10mm-sized bead in the trachea and two 8 mm-sized beads in the left main bronchus were selected andtheir longest diameters were measured on VB at varying thresholds from -800 to -2 00HU. RESULTS: When themeasured diameters of beads on VB were recorded as the percentage of real sizes, they were 1) 78.9 %, 77.5%, and73.7% at collimations and pitches of 3 mm/1, 3mm/1.5, and 5 mm/1, respectively; 2) 77.9 %, 76.9 %, and 75.1 % at 1mm, 1.5 mm and 2 mm reconstructions, respectively; 3) 86.2 % / 83.4% / 80.4% / 77.0% / 74.8% / 70.2% / 64.5% atisosurface thresholds of -8 0 0 /-7 0 0 /-6 0 0 /-5 0 0 /-4 0 0 /-3 0 0 /-200HU, re-spectively; 4) 85.6 %, 75.0 %,69.3% at 23 mm, 17 mm and 11mm luminal diameters of lesion location, respectively. CONCLUSION: Overall, thediameters of endobronchial lesions are underestimated on VB. As the isosurface threshold values, collimations,pitches and reconstruction interuals decrease in size, the measured diameters approach to real diameter of thebeads. Beads in peripheral airways appear smaller than those in proximal airways.

Radiologic Findings of Pulmonary Sarcoidosis: Comparison Between Radiograph and HRCT

PURPOSE: To analyse the radiographic and HRCT findings of pulmonary sarcoidosis and to evaluate thediagnostic usefulness of HRCT MATERIALS AND METHODS: Initial chest radiographs (n=14) and HRCT scans (n=14), anda followup HRCT scan (n=1) from 14 patients (5 men and 9 women;median age, 38 Years) with biopsy proven pulmonarysarcoidosis were analyzed. RESULT: On initial chest radiographs, they showed pulmonary lesions were seenpredominantly in the middle, upper and lower lung zones in four, two and one patient, respectively. Patterns oflesions were reticulonodular opacities (n=4), air-space (n=2), honeycombing(n=1), macronodule(n=1), and cavitarynodule (n=1). In all patients, HRCT scans demonstrated both pulmonary lesions and intrathoracic lymphadenopathy.Pulmonary lesions were seen predominantly in the middle, lower and upper lung zones in nine, three and twopatients, and in the posterior and anterior lung zones in eight and four patients repectively. Lesions werepredominantly micronodules, with perilymphatic distribution (n=12), macronodules with air-bronchogram (n=1),cavitary macronodules (n=1), ground-glass opacity (n=5), consolidation (n=2), and irregular lines (n=8). CONCLUSION: Reticulonodular lesions in the middle lung zone were seen on radiograph, while the most common HRCTfinding was micronodular lesions with perilymhpatic distribution. HRCT is much more sensitive than chestradiograph for the detection of both pulmonary lesions and lymphadenopathy; this modality revealed micronoduleswhich were invisible on chest radiographs.

Skull-Base Foramina of the Middle Cranial Fossa: Assessment of Normal Variation with High-Resolution CT

PURPOSE: To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. MATERIALS AND METHODS: We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4|73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5 mm collimation at 1.5 mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. RESULTS: In 45 cases (27.6 %) the foramen ovale was 5-10 mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1 %). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8 %) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1 %). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22 %). The foramen spinosum was asymmetrical in 42 cases (25.8 %). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7 %). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5 %). In 74 cases (45.4 %), the foramen of Vesalius was absent ; it was present unilaterally and bilaterally in 55 (33.7 %) and 34 cases (20.9 %), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9 %) and was present bilaterally in three (1.8 %). CONCLUSION: HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images.

The Sonographic Measurement of the Length of Spleen in Normal Children

PURPOSE: The purpose of this study was to establish the guidelines for normal splenic length by sonographic measurement. MATERIALS AND METHODS: In 481 children (age range : 2-16years, M:F=1.5:1), abdominal sonography for the purpose of health screening was carried out, and the greatest length of spleen between the dome and tip was measured. Correlation and regression analysis was used to determine whether the relationship between splenic length and a patient's age, height, weight and body surface was statistically significant. RESULTS: The length of the spleen gradually increased according to age. Correlation and regression analysis showed significant positive correlation (p<0.0001) between splenic length and age (r=0.610) height (r=0.630), weight (r=0.598), and body surface (r=0.628). CONCLUSION: From the mean values of spleen length in children, an index useful for clinical application might be derived.

Color Doppler Ultrasound in Chronic Venous Insufficiency

PURPOSE: To analyse Doppler findings in patients with chronic venous insufficiency, and evaluate the usefulness of color Doppler ultrasonography. MATERIALS AND METHODS: Thirty-seven limbs in 29 patients were evaluated with color Doppler ultrasound for suspected chronic venous insufficiency. To determine luminal patency and valvular competence, the venous system was examined; more than 1 sec of reflux flow during Valsalva maneuver and after release of distal compression in the popliteal vein indicated incompetence. RESULTS: Venous insufficiency was seen in 30 cases (81%), and was Superficial in 14 (38%), deep in eight (21.5%), and combined in eight (21.5%). In seven limbs (19%), veins were normal. Six cases of insufficiency, four of which were deep, were combined with deep venous thrombosis. CONCLUSION: In cases of chronic venous insufficiency, color Doppler ultrasound is useful for defining the exact site of venous incompetence and evaluating venous luminal patency.

Treatment of Peripheral Artery Pseudoaneurysm: Three Case Reports

The pseudoaneurysms are resulted from complication of vascular catheterization, trauma, etc. and recently, the reports on pseudoaneurysms have been increasing. Successful treatment of pseudoaneurysms have been described usingdirect compression guided by color doppler ultrasound, instead of invasive surgical treatment. Authors experienced three cases of pseudoaneurysm ; two resulted from post-catheterization and one from trauma. We successfully treated two post-catheterization cases using C-clamp compression under the color doppler US-guidance. The traumatic case was treated by embolization instead of US-guided compression. We suggest that the compression of pseudoaneurysm using C-clamp under the US-guidance is more useful than hand or probe compression method.

MR Findings of Congenital Anorectal Malformation

PURPOSE: To assess the usefulness of MRI in preoperative diagnosis of congenital anorectal malformation MATERIALS AND METHODS: MR findings of 11 cases with surgically proved anorectal malformations were retrospectively reviewed and compared with operative findings, according to the level of atresia, the development of sphincter muscle, fistula and associated anomalies of other organs. RESULTS: Four of 11 cases were low type of anorectal atresia, 3 cases were intermediate type, and 3 cases were high type. There was one case of Currarino triad with low type of anorectal stenosis. MRI demonstrated the levels of atresia correctly in all cases and revealed fistulas in all high type of anomalies. Degrees of the development of the sphincter muscles were good in all cases of low types and fair in a case of intermediate type and an anorectal stenosis, whereas the development was poor in 2 cases of intermediate type and all 4 cases of high type. The associated anomalies in anorectal malformation were renal agenesis, congenital hip dysplasia and sacral defect with presacral teratoma in Currarino triad. CONCLUSION: MRI was a simple and useful study to confirm the level of atresia, fistula and associated anomalies in the diagnosis of the congenital anorectal malformation.

Clinical and MR Findings of Tethered Cord Syndrome

PURPOSE: Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit MATERIALS AND METHODS: To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings. RESULTS: Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI. CONCLUSION: MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.

Determination of main feeding artery with CT findings in cases of ruptured aneurysm of anterior communicating artery

Rupture of anterior communicating artery aneurysm is one of the most important casuses of subarachnoid hemorrhage. Subarachnoid hemorrhage due to ruptured anterior communicating artery aneurysm shows characteristic CT findings, such as forntal hematoma or septum pellucidum hematoma. In some patients with the ruptured aneurysm, direct carotid angiography may be needed. particularly when transfemoral approach is not possible. However, not much have been known about the puncture site selection between the two carotid arteries in relation to the location of hematoma in CT scans. To determine the ideal puncture site of the direct carotid angiography, seventy-five cases of anterior communicating artery aneurysm confirmed by operation from May 1988 to April 1992, were analyzed in terms of relationship between location of hematoma on CT, direction of aneurysm and A1 artery on angiograms. Frontal lobar hematoma was more prevalent than septal hematoma, and was more common on the right side. In cases of lobar hematoma, aneurysm was directed to the ipsilateral side of the hematoma (67%) and was most commonly fed by contralateral A1 artery(75%). Septal bematoma consisted 36% of the cases and among there, midline directed aneurysm was most common, frequently fed by left A1 artery. In conclusion, when performing direct carotid angiography in patients with anterior communicating artery aneurysm, if forntal hematoma is observed on CT, it may be beneficial to puncture contralateral carotid artery. Meanwhile, if hemorrhage of septum pellucidum is observed, it may be better to puncture left carotid artery.

Radiologic & histologic features of hyaline membrane disease of the newborn

This study represents the radiologic, histologic features & clinical analysis of hyaline mambrane disease in 47 newborn infants who were delivered in Ewha Womans Univ. Hospital & expired caused by repiratory distress & confirmed by autopsy , during Jan. 1981 to June, 1984. The results were as follows; 1. Classification ofradiolgraphic stage (by Wolfson's criteria); Stage III(34.1%) was the most frequent. 2. Male to female ratio was 2.4:1. 3. Method of delivery; Cesarean section (44.7%) was the highest frequency, compared with percent ofcesarean section to total delivery(29.0%). 4. Distribution of birth weight; 1.0-2.0 Kg(48.9%) was the mostfrequent. 5. Distribution of gestational period; 32-36 weeks (29.8%) was the most frequent. 6. Complication; Pulmonary hemorrhage(31.9%) was the most frequent, in order, subarachnoid hemorrhage & pneumothorax were followed.7. Final diagnosis of hyaline membrane disease was based on histo-pathologic diagnosis.

Congenital cystic adenomatoid malformation

The congenital cystic adenomatoid malformation of the lung is an unusual pulmonary entity, and usuallysymptomatic in infancy with sign of resiratory distress. This abnormality consists of enlarged, multicystic lobewith smooth-walled cysts of variable sized, which can communicate with major bronchi through malformed air passagethat usually lacks in cartilage. Roentgenographic findings are three types. First type is multicystic patternshowing various sized of cysts and causing mediastinal shift with pulmonary herniation. Second type is dominantcystic pattern underlying multicystic lesion, Third type is solid homogenous mass. Prompt surgical resection ischoice of treatment. We recently experienced a case of congenital cystic adenomatoid malformation of the lung of27 day female in fant and report with reviwe of literatures.

Evaluation of computed tomography of intraventricular hemorrhage

Prior to the introduction of CT, the clinical and radiological diagnosis of the intraventicular hemorrhage inliving patients was difficult. C.T. scanning is an invaluable investigation provding the rapid and noninvasivediagnosis of intracerebral and intraventricular hemorrhage. It reliably demonstrated the presence and distributionof fresh blood within the ventricular system. CT is also useful as a surgical guidance and in the evaluation offate of the hematoma by easily performable follow-up studies. We reviewed 3 cases of intraventricular hemorrhagein CT in the departement of radiology of Ewha Womans University hospital during the period from August, 1982 toAugust, 1983. The results were as follows: 1. The most patients were encountered in the 5th decade and the male tofemale ratio was 1.2:1. 2. Hypertension was the main cause of the intraventricular hemorrhage; 18 out of 31patients. Remaning 13 patients were caused by hypoxia, aneurysm, Moya Moya disease, coagulation defect, trauma andundetermined etiology. 3. 18 out of 31 patients showed hemorrhage in the lateral ventricles only and allventricles in 10 patients. 4. 28 out of 31 patients showed associated with intracranial hematoma: Those wereintracerebral hematomas in 16 patients, intracerebral hematoma with subarachnoid hemorrhage in 4 patients andextracerebral hematoma in 2 patients. 5. Outcome was assessed using the Glasgow scale. According to them the totalmortality rate was 54.8%, however, 32.2% of patients retured to normal or minor disablity. Patients, who hadhypertension and markded degree of hemorrhage in the ventricular systems had a poor outcome. Patients with onlyventricular hemorrhage had better outcome than associated intracranial hematoma. 6. 16 out of 31 patients weretreated by surgical methods and 15 out of 31 patients by conservative methods. 75% of patients were died inconservative treatment. 7. Conclusively, causes, degree of intraventricular hemorrhage and associatedintraventricular hematoma play an important role in outcome. And surgical treatment was beneficial in only a smallselective number of cases in intraventricular hemorrhage.

Computed tomography of malignant maxillary sinus tumors

CT was done 81 times on 63 proven malignant maxillary sinus tumors for 3 years from Feb.1979 to May 1982 atSeoul National University Hospital. Pre-treatment CT were 54 and post-treatment CT were 31 on 28 patient. Theresult were as follows; 1. The most frequent histopathologic diagnosis was 44 cases (69.8%) of squamous cellcarcinoma. Others were 5 cases (7.9%) of adenoid cystic carcinoma, 3 cases (4.8%) of olfactory neuroblastoma, 3cases (4.8%) of malignant lymphoma, 2 cases (3.2%) of melanoma, 2 cases (3.2%) of malignant fibrous histiocytoma,a rhabdomyosarcoma, a basal cell carcioma, a fibrosarcoma and a metastatic carcinoma from thyroid follicular adenocarcinoma. 2. The CT findings in 54 untreated malignant maxillary sinus tumors were sinus opacification, softtissue mass, and bone destruction in all cases. Other findings were fat plane obliteration (70%),osteosclerosis(59%), bone erosion and displacement (46%), low densities within soft tissue mass (27%), and airdensitis wiithin soft soft tissue mass (27%), and air densities within soft tissue mass(13%). 3. The value of pre-treatment CT in malignant maxillary sinus tumors were outlining the disease process especially soft tissuesuch as orbit, infratemporal fossa, pterygopalatine fossa, nasopharynx, pterygoid fossa and intracranialextension, and CT is the choice of diagnostic modality to determine the prognosis and the therapeutic planning insurgery and/or radiotherapy. 4. Post-treatment CT is also helpful to evalute the change in tumor size andpost-treatment complication.