The significance of the spleen-liver ratio in liver scanning

Increased splenic uptake of radiocolloid is a helpful sign in the scintigraphic diagnosis of diffuse hepatocellular diseases, but any attempt has been made to quantify this phsiologic phenomenon. The purpose of thestudy is to evaluate a simple computer quantitation of S/L ratio and to determine normal range and S/L ratios forvarious hepatic diseases. Authors analized S/L ratios of 194 cases of liver scintigraphy from July 1984 to May1985. The results are as follows; 1. The age distribution of normal and various heptic disases was most frequentin 30 to 40 decade. 2. The classification of studied groups were normal subjects (80 cases), hepatitis(30 cases),liver cirrhosis (59 cases), hepatoma(8 cases), metastasis(10 cases), and miscellaneous diseases(7 cases). 3. Thesimple computer quantitation method exhibits small interobserver variation.(r=0.92, p<0.001) 4. The mean S/L ratioin normal group was determined 0.34 (S.D=0.12) with a its range from 0.10 to 0.58 (0.34±2 S.D). The mean S/Lratios in various hepatic diseases were as follows; 0.52 (S.D=0.18) in hepatitis, 1.10 (S.D=0.43) in cirhhosis,0.77 (S.D=0.38) in hepatoma, 0.47 (S.D=0.21) in metastasis, and 0.43(S.D=0.17) in miscellaneous diseases. 5. Theelevated S/L ratios rather than normal values were found in hepatitis (30%), cirrhosis(51%), hepatoma(63%), and metastasis(20%). 6. The sensitivity of single scintigraphic diagnosis of liver cirrhosis was 63%, but thesensitivity was improved to 90% when combined with S/L ratio. 7. The simple computer quantitation of the S/L ratiois a valid and useful method in the interpreation of liver scintigraphy and also may increase the sensitivity inthe diagnosis of liver cirrhosis and hepatoma combined with cirrhosis.

A case of primary obstructive megaureter with CT demonstration

Megaureter is a relatively rare disease and its first description was done by Caulk in 1923. It is characterized by marked ureteral dilatation without obvious cause, and occurs in lower ureter especially. Authers report a case of primary obstructive megarureter with CT demonstration in 19 year-old female. To our knowledage,this is the first case report of primary obstructive megaureter in Korea.

Clinical values of CT and dynamic CT in brain infarction

With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.

Evaluation for ultrasonographic findings of hepatoma

Ultrasonographic findings in 34 cases of primary hepatoma, and 18 cases of secondary hepatoma, which had been proved histopathologically or suspected clinically and ultrasonographically, were reviewed. The results were summarized as follows. 1. Among 52 cases, 40 cases were male and 12 cases were female. The male predominent than the female with the ratio of 4:1. In 52 cases, 40 cases (77%) of the patients were between 41 years and 60 years.2. The most common ultrasonographic finding of hepatoma was discrete homogeneous hyperechoic mass. 3. Primaryhepatomas were usually solitary and relatively large, while secondary hepatomas were usually multiple andrelatively small. 4. Hepatitis, liver cirrhsis, and clonorchiasis were more common in primary hepatomas than secondary hepatomas.