Unruptured translabyrinthine meningocele without CSF otorrhea.

Labyrinthine meningocele can be classified into translabyrinthine and perilabyrinthine type. We describe a case of rare unruptured translabyrinthine meningocele (TLM). It is rare to encounter an unruptured TLM because it is usually diagnosed after rupture as a labyrinthine fistula, cerebral spinal fluid otorrhea, and subsequent meningitis. We provide for the first time an intraoperative photo and video of a case of an unruptured TLM that developed through an inner ear malformation in a single-side deaf child, which was preoperatively misdiagnosed as congenital cholesteatoma in preoperative temporal bone computed tomography. TLM without CSF otorrhea in an unruptured state merit attention because of its importance during the workup of congenital cholesteatoma or cochlear implantation in spite of its rarity of reports.

The Effects of 5-HTR1A Polymorphism on Cingulum Connectivity in Patients with Panic Disorder

OBJECTIVE: Serotonin-1A receptors (5-HTR1A) is suggested to be involved in the etiology of several psychiatric disorders including panic disorder (PD). A few imaging studies have suggested the alterations of the cingulum bundle in PD. The objective of this study is to examine the structural changes of cingulum related to the 5-HTR1A polymorphism rs6295 in the patients with PD. METHODS: Thirty-two right-handed patients with PD [11 men, 21 women; 40.34+/-13.17 (mean+/-SD) age] who met the diagnostic criteria in Structured Clinical Interview for DSM-IV were examined by means of MRI at 3 Tesla. We divided the patients with PD into CC genotype group and non CC genotype group (GG/CG genotype group) of the 5-HTR1A rs6295 polymorphism to compare the cingulum white matter connectivity. RESULTS: Tract-based spatial statistics showed significantly increased fractional anisotropy (FA) values in cingulate gyrus process of left cingulum in 5-HTR1A CC genotype compared to GG/CG genotype in PD. Significant positive correlations were shown between the Albany Panic and Phobia Questionnaire (APPQ) interoceptive fear subscale scores, the Anxiety Sensitivity Inventory-Revised fear of publicly observable anxiety reaction subscale scores and FA values of cingulate gyrus process of left cingulum in 5-HTR1A rs6295 GG/CG genotype group. In CC genotype group, APPQ total, APPQ agoraphobia subscale and APPQ social phobia subscale scores also showed significant positive correlations with FA values of hippocampal process of right cingulum. CONCLUSION: This preliminary study suggests that 5-HTR1A polymorphism may be associated with the cingulum white matter connectivity in PD.

Embolization of Cerebral Pial Arteriovenous Fistula Under Balloon-assisted Flow Control Using NBCA: a Case Report / 신경중재치료의학

Intracranial pial arteriovenous fistulas are rare vascular lesions of the brain. These lesions are composed of one or more direct arterial feeders with a single draining vein and usually have associated venous varix or giant venous aneurysms. Pial fistulas can be treated by endovascular occlusion or by microneurosurgery and endovascular treatment offers a simple and safe option. We report a case of pial fistulas treated with embolization using n-butyl cyanoacrylate (NBCA) and Lipiodol mixture in association with a balloon in the afferent artery to slow down the flow within the fistula.

Noninvasive Assessment of In-Stent Restenosis of the Coronary Artery with Using 16-Slice Computed Tomography

PURPOSE: We strove to evaluate in-stent restenosis of the coronary artery by measuring the in-stent CT attenuation with using 16-multislice CT. MATERIALS AND METHODS: We analyzed the coronary CT angiography, with using 16-slice CT, in 45 stents of 30 patients. The CT attenuation was measured in the lumen of the stented segments and in the lumen of the segment proximal to the stents, and this attenuation was compared with each other. The CT attenuation difference between them was analyzed in relation to the presence of significant in-stent restenosis. Conventional coronary angiography was used as a standard of reference for in-stent restenosis. RESULTS: 12 stents in 12 patients revealed significant restenosis on the conventional coronary angiography. In 6 (50%) of them, the CT attenuation value of the in-stent lumen was lower than that of the proximal segments (373.8 HU vs. 497.1 HU, respectively, p=0.77). In the other 6 stents, a small stent diameter (n=3) and adjacent severe calcification (n=2) accounted for the higher CT attenuation value of the in-stent lumen. In all the stents without significant restenosis, the CT attenuation values of the in-stent lumens were higher than those of their proximal segments. CONCLUSION: The measurement of CT attenuation with using 16-slice CT at the in-stent lumen as compared to the attenuation of the proximal segment provides an objective, confident method for the diagnosis of in-stent restenosis.

Variation of Attenuation Value of Pancreas at Dual Phase MDCT: Comparison of the Bolus-tracking Technique vs. the Fixed Scan Delay Protocol

PURPOSE: To clarify the difference between the bolus-tracking technique and a fixed scan delay protocol in the achievement of the optimal pancreatic phase of the pancreas with MDCT. MATERIALS AND METHODS: 526 patients underwent pancreatic and portal venous phase imaging of the pancreas using 16-channel MDCT. All the examinations were randomized into either scanning using a bolus-tracking technique with a scan delay of 20s after the aorta was enhanced > 100 HU (groups 1 and 2) or scanning with a scan delay of 38 s from the beginning of the injection (groups 3 and 4). A contrast material of 300 mgI/mL (groups 1 and 3) or 370 mgI/mL (groups 2 and 4) at an injection speed of 3 mL/sec was injected at 2 mL/kg body weight. The pancreatic CT attenuation values were compared. RESULTS: The scan delay times of the pancreatic phase in groups 1 and 2 were 38+/-3.8s and 37.4+/-3.4s, respectively. At the pancreatic phase, the pancreatic attenuation values of groups 1 and 2 were slightly higher than those of groups 3 and 4 (115.5+/-15.4 vs 111.7+/-15.1HU; p=0.093, 128.3+/-17.1 vs 119+/-17.1HU; p=0.003). There was no significant difference between groups at the portal venous phase. CONCLUSION: The use of a bolus-tracking technique in the optimal pancreatic phase of pancreatic CT does not significantly improve the pancreatic enhancement but does at higher iodine concentrations.