Effect of microbubble contrast agent during high intensity focused ultrasound ablation on rabbit liver in vivo.

OBJECTIVE: To evaluate the effect of a microbubble contrast agent (SonoVue) during HIFU ablation of a rabbit liver. MATERIALS AND METHODS: HIFU ablations (intensity of 400W/cm(2) for 4s, six times, with a 5s interval between exposures) were performed upon 16 in vivo rabbit livers before and after intravenous injection of a microbubble contrast agent (0.8ml). A Wilcoxon signed rank test was used to compare mean ablation volume and time required to tissue ablation on real-time US. Shape of ablation and pattern of coagulative necrosis were analyzed by Fisher's exact test. RESULTS: The volume of coagulative necrosis was significantly larger in the combination microbubble and HIFU group than in the HIFU alone group (P<0.05). Also, time to reach ablation was shorter in the combination microbubble and HIFU group than in the HIFU alone group (P<0.05). When analyzing the shape of tissue ablation, a pyramidal shape was more prevalently in the HIFU alone group compared to the combination microbubble and HIFU group (P<0.05). Following an analysis of the pattern of coagulative necrosis, non-cavitary necrosis was found in ten and cavitary necrosis in six of the samples in the combination microbubble and HIFU group. Conversely, non-cavitary necrosis occurred in all 16 samples in the HIFU alone group (P<0.05). CONCLUSION: HIFU of in vivo rabbit livers with a microbubble contrast agent produced larger zones of ablation and more cavitary tissue necrosis than without the use of a microbubble contrast agent. Microbubble contrast agents may be useful in tissue ablation by enhancing the treatment effect of HIFU.

Secondary omental infarction related to open and laparoscopic-assisted distal gastrectomy: report of two cases.

Omental infarction occurring after open and laparoscopic-assisted distal gastrectomy with partial omentectomy for gastric cancer was a very rare disease in the past, but its incidence has increased as more partial omentectomies are now being performed. But there are few case reports or radiologic studies on its increasing incidence. It is necessary to differentiate omental infarction from carcinomatosis peritonei, since both have similar imaging findings. In this report, we describe two cases of omental infarction; each occurred after open and laparoscopic-assisted distal gastrectomy in early gastric cancer patients. Partial omentectomy was performed in both cases. Omental infarction following distal gastrectomy with partial omentectomy can be discriminated from carcinomatosis peritonei by comparing with different initial and follow up CT findings.

High-intensity focused ultrasound treatment of abnormal vaginal bleeding secondary to uterine myoma.

We describe the use of high-intensity focused ultrasound for acute vaginal bleeding secondary to uterine myoma in 2 young female patients. Both patients had episodes of abnormal vaginal bleeding with severe dysmenorrhea that was not efficiently controlled by medical treatment. After high-intensity focused ultrasound ablation, both vaginal bleeding control and symptom relief were achieved without postinterventional complications. The patients remained free of symptoms during 2 months of follow-up and regained normal menstruation after high-intensity focused ultrasound therapy. High-intensity focused ultrasound treatment is one of the least invasive options for dysfunctional vaginal bleeding and may be an effective and safe alternative to other procedures in women of reproductive age with abnormal vaginal bleeding secondary to uterine myoma.

Metastatic gastric linitis plastica from bladder cancer mimicking a primary gastric carcinoma: a case report.

Primary gastric carcinoma is the most common cause of linitis plastica. Less frequently, metastatic gastric cancer from the breast, omental metastases and non-Hodgkin lymphoma involving the stomach have been reported to show similar radiographic findings as for linitis plastica. A metastatic gastric cancer from bladder cancer is extremely rare. We present an unusual case, the first to our knowledge, of gastric linitis plastica that resulted from a metastatic urothelial carcinoma of the bladder.

Imaging findings of central nervous system vasculitis associated with Goodpasture's Syndrome: a case report.

Glomerulonephritis and pulmonary hemorrhage are features of Goodpasture's syndrome. Goodpasture's syndrome accompanied with central nervous system (CNS) vasculitis is extremely rare. Herein, we report a rare case of CNS vasculitis associated with Goodpasture's syndrome in a 34-year-old man, who presented with a seizure and sudden onset of right sided weakness. He also had recurrent hemoptysis of one month's duration. Goodpasture's syndrome is histologically diagnosed by intense linear deposits of IgG along the glomerular basement membrane in both renal and lung tissues.

Infantile scrotal pyocele simulating missed testicular torsion on sonography.

We present the case of a neonate with idiopathic infantile pyocele. Scrotal sonography revealed a complex fluid collection within the left scrotal sac containing septations and a fluid-fluid level. The dependent region of the collection had moderate echogenicity, the slightly hypoechoic testis was not well defined, and the scrotal wall was thickened. Color Doppler sonography revealed mild hypervascularity in the thickened scrotal wall but no vascularity inside the testis. The sonographic findings suggested missed testicular torsion, but surgery revealed a pyocele, for which no source was identified. Radiologists should be aware that idiopathic infantile pyocele can mimic the Doppler sonographic findings in missed testicular torsion.