[Cystic vein: as a perfusion vein of hepatic portion-angiographical study].

In order to determine the hepatic portions by cystic vein, we carried out abdominal angiography in 153 patients. The cystic vein was recognized in eleven patients, but only in nine cystic venous flow could be measured. In this group of patients, in which the cystic venous flow was detected, hepatic angiography was performed through the right hepatic artery (RHA) in six patients, the anterior branch of RHA in one patient, and the cystic artery in two patients. Simultaneously, angiographical CT was performed in five patients. As the results, it is presumed that the cystic venous flow perfused segment 4 portal branch (P4) + segment 5 (S5) in four patients, P4 in two patients, segment 6 portal branch (P6), S5 + right portal vein (RPV) + right hepatic vein (RHV), and S5 + RHV in one patient, respectively, and we concluded that in 70% of cases cystic venous flow perfused either P4 or S5.

Torsion of the wandering spleen: CT and angiographic appearance.

OBJECTIVE: To seek CT and angiographic appearances that characterize torsion of the wandering spleen. MATERIALS AND METHODS: The CT and angiographic findings of two cases of preoperatively diagnosed torsion of the wandering spleen were reviewed, and the findings were closely compared with intraoperative and histopathological findings. RESULTS: Characteristic CT appearance seemed to be a whirled appearance formed at the medial side of the displaced spleen. The angiographic finding that was characteristic of the disease was a tapered and abruptly twisted distal splenic artery. CONCLUSION: These findings were useful in making the early and correct diagnosis of this rare but fulminant condition.

Occlusion of the posterior humeral circumflex artery: detection with MR angiography in healthy volunteers and in a patient with quadrilateral space syndrome.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of MR angiography in detecting occlusion of the posterior humeral circumflex artery and to determine if the finding is specific for the diagnosis of quadrilateral space syndrome. SUBJECTS AND METHODS: Two-dimensional fast low-angle shot MR angiography was used to image both shoulders of one symptomatic patient and six asymptomatic volunteers (10 posterior humeral circumflex arteries). RESULTS: With the arm in a neutral position, the posterior humeral circumflex arteries appeared normal on MR angiograms of all subjects. However, when the arm was in abduction, occlusion of the posterior humeral circumflex artery was seen both in the symptomatic patient and in 80% of the asymptomatic volunteers. CONCLUSION: Our data show that occlusion of the posterior humeral circumflex artery is common in asymptomatic volunteers. Thus, MR angiography has no value in the diagnosis of quadrilateral space syndrome.

[A case of Zollinger-Ellison syndrome successfully treated with an H+-K+ ATPase inhibitor].

A case of Zollinger-Ellison syndromes in a fifty year-old male that was successfully treated with a H+-K+ ATPase inhibitor (Omeprazol) is reported. The patient underwent a partial gastrectomy in 1984, but had been suffering from multiple refractory stomal and jejunal ulcers after the operation. In 1987, hypergastrinemia (760 pg/ml) was detected, and the presence of gastrinomas in the pancreatic head accompanied by a multiple liver metastasis was subsequently confirmed by CT-angiography and by the gastrin level detected in percutaneous, transhepatic, portal venous samples. A secretin provocation test proved to be negative, and the ulcers resisted the H2-receptor antagonists, but the patient was successfully cured shortly after the administration of an H+-K+ ATPase inhibitor.

Fundamental studies of breast tumor detection with narrow beam laser scanning (report 1).

Fundamental studies were performed in which halogen parallel lights and narrow beam He-Ne laser scanning were applied to the image diagnosis of breast lesions. The breast tissue was simulated by fresh milk as an opaque material. With halogen parallel lights, objects close to the light could not be detected, objects in the center were slightly detectable, and those close to the detector were visualized distinctly. Narrow beam scanning with He-Ne laser produced contrasting results: the closer the object was to the light, the better its detectability. However, as the diameter of the object decreased, detectability worsened. The results of the experiments indicated that small lesions in the opaque breast tissue may be detected by He-Ne laser with narrow beam scanning.

[Focal nodular hyperplasia-like lesion of the liver associated with thorotrast liver disease--report of a case].

A 66-year-old man with Thorotrast liver disease underwent a partial hepatectomy for a small tumor of the liver, which was demonstrated by digital subtraction angiography. The resected specimen was grossly a sharply circumscribed, gray-yellow nodule, 7.5 mm in diameter. Microscopically, the nodule was an ill-defined hepatic cell mass, which was divided by fine fibrous septa irregularly and incompletely. Central veins and Glisson's capsules were not observed inside the nodule. Bile duct proliferation and infiltration of lymphocytes were found in the fibrous septa. There were Thorotrast depositions within the fibrous tissues around the nodule. Because a typical fibrous boundary and central scar were not found, we have termed this condition a focal nodular hyperplasia-like lesion. A relationship between focal nodular, hyperplasia as a precancerous state and Thorotrast liver disease was suggested.

A case of congenital absence of the left internal carotid artery.

A case of congenital absence of the internal carotid artery was presented in a 37-year-old male with temporal lobe epilepsy. A dilated vascular channel, which is one of the characteristics associated with the congenital absence of the internal carotid artery, can be demonstrated in the conventional contrast-enhanced CT scans. Absence of the carotid canal can be delineated far more clearly in the CT scans of the skull base.

Direct coronal CT scanning for the body.

A direct coronal CT scanning technique for the trunk, named "Quasi-Coronal" CT, is presented and its usefulness demonstrated with clinical examples. Patients are placed in the lateral position on a wide plate laid on the scanner bed and instructed to assume various special postures. An important concept of this technique is to obtain the tomograms in which target organs with predominant longitudinal orientation are directly imaged in the coronal plane. An analysis of artifacts due to "Out of Field" objects is presented. When properly performed, "Quasi-Coronal" CT can provide useful additional information, despite having some limitations.

Paired anterior spinal arteries in a case of locked-in syndrome.

Paired anterior spinal arteries have rarely been demonstrated angiographically, although several anatomical studies have shown that they are not uncommonly observed. This report describes the angiographic and autopsy findings of such a variation, which was observed in a 65-year-old man with a locked-in syndrome. The paired trunks of the anterior spinal artery were visualized in a retrograde fashion through the left inferior thyroid artery and a radical branch at the 5th cervical level by left retrograde brachial angiography. The uppermost segments of either vertebral artery and the lower portion of the basilar artery were opacified through these channels. The autopsy confirmed the paired trunks of the anterior spinal artery, occlusion of the vertebral arteries just caudal to the origin of the main branches of the anterior spinal artery, and an old infarct involving the pontine tegmentum and cerebellum.