ABSTRACT
Thirty patients with intraductal papillary-mucinous tumor (IPMT) of the pancreas underwent multidetector-row CT (MD-CT) in addition to endoscopic retrograde pancreatography (ERP), and, in 27 cases magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS). The usefulness of MD-CT was investigated by comparing various imaging methods of the communication from the main pancreatic duct (MPD) to patulous/bulging papilla in addition to the indices for benign or malignant disease, the degree of dilation of the MPD, localization and size of cystic lesions, and presence or absence of neoplastic lesions, such as thickened walls and septa, intramural nodule, solid mass. With MD-CT, dilation of the MPD and localization and size of cystic lesions were accurately assessed, even in patients with obstruction of the main pancreatic duct in whom ERP was difficult to perform regardless of the presence or absence of massive amount of mucus. MD-CT with reconstructive imaging, such as MPR imaging and CPR imaging, allowed us to assess communication with the MPD and patulous/bulging papilla easier than MRCP. In our study, MD-CT was useful in the evaluation of thickened walls and septa that are predictive factors of malignancy in IPMT.
Subject(s)
Adenocarcinoma, Mucinous/diagnosis , Carcinoma, Pancreatic Ductal/diagnosis , Diagnostic Imaging/methods , Pancreatic Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Cholangiopancreatography, Magnetic Resonance , Endosonography , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Tomography, X-Ray ComputedABSTRACT
The 3-dimensional image was excellent as a result of the fast scanning and narrow collimation using multidetector computed tomography (CT); and the parallel escalation in the capabilities of the workstation allow the use of CT angiography/CT cholangiography image fusion. We demonstrated the feasibility of fusion images of the hepatobiliary system. We believe that fusion images are extremely valuable for applications such as preoperative planning for hepatic and bile duct resection.
Subject(s)
Angiography/methods , Biliary Tract Neoplasms/diagnostic imaging , Cholangiography/methods , Imaging, Three-Dimensional , Liver Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Female , Humans , Male , Middle Aged , Tomography, X-Ray Computed/methodsABSTRACT
A case of uterine lipoleiomyoma in a 72-year-old woman is presented. Although a series of imaging studies suggested a lipomatous tumor, diagnosis was difficult because the tumor appeared as a pedunculated mass extending from the uterine body. To distinguish the tumor from an ovarian lipomatous tumor, the "beak sign" in a magnetic resonance imaging study was diagnostic in this case. The purpose of this paper is to review lipomatous masses of the female pelvis, to discuss the differential diagnosis of the unusual imaging features, and to discuss imaging techniques to optimize pelvic mass characterization.
Subject(s)
Leiomyoma/diagnosis , Lipoma/diagnosis , Ovarian Cysts/diagnosis , Uterine Neoplasms/diagnosis , Aged , Diagnosis, Differential , Female , Humans , Leiomyoma/diagnostic imaging , Lipoma/diagnostic imaging , Magnetic Resonance Imaging , Ovarian Cysts/diagnostic imaging , Tomography, X-Ray Computed , Uterine Neoplasms/diagnostic imagingABSTRACT
OBJECTIVE: We evaluated the feasibility of creating 3D and multiphase fusion images of cholangiocarcinoma. The 3D rendering of the biliary tree provide valuable information for planning surgery, including the location of the obstruction and its relationship to the surrounding vessels. CONCLUSION: Our data emphasize that 3D and multiphase fusion images may be an accurate and routinely applicable tool for the diagnosis and therapeutic management of patients with biliary system abnormalities.
Subject(s)
Bile Duct Neoplasms/diagnostic imaging , Bile Ducts, Intrahepatic , Cholangiocarcinoma/diagnostic imaging , Cholangiography/methods , Imaging, Three-Dimensional , Tomography, X-Ray Computed/methods , Humans , Image Processing, Computer-AssistedABSTRACT
OBJECTIVE: To evaluate the usefulness of pancreatic enhancement using a high concentration of contrast material in CT. METHODS: We performed abdominal CT on 125 patients after dividing them at random into five groups with two different concentrations, two different injection rates and three different injection doses: group A: 100 ml, 300 mgI/mL, 3 mL/sec; group B: 2 mL/kg, 300 mgI/mL, 3 mL/sec; group C: 1.5 mL/kg, 370 mgI/mL, 3 mL/sec; group D: 2 mL/kg, 300 mgI/mL, 5 mL/ sec; and group E: 1.5 mL/kg, 370 mgI/mL, 5 mL/sec. Among these five groups, the two groups given a concentration of 370 mgI/mL received a dose of 1.5 mL/body weight. RESULTS: The peak enhancement value of the pancreas was significantly greater in group E than in groups A and B. However, no statistically significant differences were found among the other groups. CONCLUSION: The fast injection rate using the high concentration of contrast medium provided greater enhancement of the pancreas than the slow injection rate using the routine concentration of contrast medium, and pancreatic CT enhancement depended more on the dose of iodine per second than on that of total iodine.