Role of 3-D CT Reconstruction of Laryngeal IVlucosal Surface in Preoperative Staging of Laryngeal Cancer

PURPOSE: CT or MRT is performed in preoperative staging of laryngeal cancer. These methods are used in assessment of the deep tissues and cartilage of the larynx, but cannot compete with laryngoscopy in the evaluation of the laryngeal surface. The purpose of this study is to evaluate feasibilty and clinical value of the 3-D reconstruction of the mucosal surface in laryngeal cancer. METHODS AND MATERIALS: Twenty two patients with laryngeal cancer proved by means of surgical.exploration (pathologic) or clinical examinations including laryngoscope, imaging studies and biopsy underwent preoperative staging with computed tomography(G-P);and three dimensional(3D) CT reconstruction. The TNM classification of the American Joint Committee on Cancer was used to compare the imaging findings with pathologic or clinical staging. RESULTS: When the extension of primary tumor(T staging) was evaluated, the findings at only transaxial CT and those at pathologic or clinical examination were concordant in 8 of 14 cases(57.1%) of supraglottic tumor, and 3 of 6 cases(50%) of glottic tumor. The overall accuracy of CT with additional 3D-reconstruction was 85.7% for assessment of supraglottic tumor, and 66.6% for glottic tumor. CONCLUSION: 3D CT reconstruction after transaxial CT may improve outcome in preoperative staging of laryngeal cancer and has a potential value in guiding management decisions.

Computerized management of radiology department: Installation and use of local area network(LAN) by personal computers

There is increasing need for network connecting personal computers(PC) together. Thus Local Area Network(LAN) emerged, which was designed to allow multiple computers to access and share multiple files and programs and expensive peripheral devices and to communicate with each user. We built PC-LAN in our department that consisted of 1) hardware-9 sets of personal computers(IBM compatible 80386 DX, 1 set:80286 AT, 8sets) and cables and network interface cards (Ethernet compatible, 16bits) that connected PC and peripheral devices 2) software - network operating system and database management system. We managed this network for 6 months. The benefits of PC-LAN were 1) multiuser (share multiple files and programs, peripheral devices) 2) real time data processing 3) excellent expandibility and flexibility, compatibility, easy connectivity 4) single cable for networking ) rapid data transmission 6) simple and easy installation and management 7) using conventional PC's software running under DOS(Disk Operating System) without transformation 8) low networking cost. In conclusion, PC-LAN provides an easier and more effective way to manage multiuser database system needed at hospital departments instead of more expensive and complex network of minicomputer or mainframe.

MR imaging of intracranial tuberculosis: Emphasis on development of lesions and therapeutic effect

We retrospecively analyzed MRI findings of 14 patients with intracranial tuberculosis according to the disease process before anti-tuberculous medication. We also analyzed the correlativity between these findings and the clinical outcome after anti-tuberculous medication in 8 patients who had taken follow-up MR imaging. MR imaging was performed with either a 0.5T(1 patients) or 1.0T(13 patients) superconducting system with spinecho pulse sequences. Abnormalities on MRI were seen in 87%(12/14) of the patients. MRI findings consisted of meningeal enhancement(n=10), parenchymal tuberculoma(n=6), hydrocephalus(n=5), and infarction(n=5). Most of them were found within 3 months from symptom-onset. Parenchymal tuberculomas were found after 1 month of symptom-onset. All cases of hydrocephalus and infarction were associated with meningeal enhancement. On follow-up MRI after anti-tuberculous medication, changes of MR imaging did not correlate with clinical outocome in 4(50%) of 8 patients. Improvement of MRI findings were observed in patient treated for more than 3 weeks. In conclusion, MRI is a good modality in the diagnosis of intracranial tuberculosis, however, the MRI findings are not always correlated with clinical outcome after, anti-tuberculous medication.

Three-dimensional CT reconstruction of the surface of the sinonasal cavities, pharynx and larynx: Normal anatomy

Simulated three-dimensional (3D) imaging represents reformation of conventional sectional imaging data into a series of images that closely resemble the original studied structure. We tried to make 3D mucosal surface images of the sinonasal cavities, pharynx and larynx, and evaluated the feature of normal anatomy in 28 subjects. In the sinonasal cavities, 3D imaging was capable of demonstrating the inner wall of paranasal sinuses and its openings, and general status status of the nasal cavity. In the nasal cavity. In the nasopharynx, 3D imaging provided an easy concept of sectional images as 3D picture and displayed anatomic subsites and lesions comparable to that in fiberscope. In addition, 3D imaging had advantages in overcoming the technical limitations in fiberscope. In the larynx and hypopharynx, 3D imaging gave a 3D concept of the laryngeal structures and presented additive information not seen in axial iamges thus enabling access to regions beyond the scope of fiberscope. In conclusion, 3D imaging allows an easy conceptualization of transaxial CT images in complex anatomic areas and provides additional in formations undetectable in transaxial CT. We believe that the spaces of the sinonasal cavities, pharynx and larynx would be a new field of application of 3D image.

Three-dimensional CT reconstruction of the surface of the sinonasal cavities, pharynx and larynx: Normal anatomy

Simulated three-dimensional (3D) imaging represents reformation of conventional sectional imaging data into a series of images that closely resemble the original studied structure. We tried to make 3D mucosal surface images of the sinonasal cavities, pharynx and larynx, and evaluated the feature of normal anatomy in 28 subjects. In the sinonasal cavities, 3D imaging was capable of demonstrating the inner wall of paranasal sinuses and its openings, and general status status of the nasal cavity. In the nasal cavity. In the nasopharynx, 3D imaging provided an easy concept of sectional images as 3D picture and displayed anatomic subsites and lesions comparable to that in fiberscope. In addition, 3D imaging had advantages in overcoming the technical limitations in fiberscope. In the larynx and hypopharynx, 3D imaging gave a 3D concept of the laryngeal structures and presented additive information not seen in axial iamges thus enabling access to regions beyond the scope of fiberscope. In conclusion, 3D imaging allows an easy conceptualization of transaxial CT images in complex anatomic areas and provides additional in formations undetectable in transaxial CT. We believe that the spaces of the sinonasal cavities, pharynx and larynx would be a new field of application of 3D image.

MRI findings of cryptococcal infection of CNS: The long term follow-up: case report

Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.

MRI findings of cryptococcal infection of CNS: The long term follow-up: case report

Authors presented the serial changes of brain MRI findings in two cases of cryptococcal meningitis. The MRI findings of the first patient (53-year-old female) consisted of dilated Virchow-Robin spaces, leptomeningeal enhancement, cryptococcomas and hydrocephalus. Dilated Virchow-Robin spaces were noted on the first MR obtained 33 days after symptom onset. The size and number of dilated Virchow-Robin space gradually decreased since 119 days after symptom onset (62 days after treatment). Faint leptomeningeal enhancement was found at cerebellar region on the first MRI, which became more distinct and intense on the day 119, probably due to improper treatment. The leptomeningeal enhancement decreased on the day 156. Mild hydrocephalus was noted on MRI obtained 70 days after symptom onset, which markedly aggravated on the day 119. It decreased after steroid therapy alone. Enhancing crytococcomas of variable size were noted at the right temporal lobe and cerebellum on MRI of the day 119, which decreased in size and number on the day 156. On the day 295 MRI showed nearly disppearance of the dilated Virchow-Robin space, but faint leptomeningeal enhancement, cerebellar crytococcomas and hydrocephalus still remained. The MRI findings of the second patient (36-year-old female) showed the findings similar to those of the first patient. Initial MRI obtained 18 days after symptom onset showed no abnormal findings. Dilated Virchow-robin spaces were noted on the day 36 (13 days after treatment onset), which nearly disappeared on the day 109. Enhancing cryptococcomas in both basal ganglia and cerebral cortex and leptomeningeal enhancement were noted on MRI of the day 136. Both cryptococcomas and leptomeningeal enhancement decreased in size and enhancing degree on the day 157. Hydrocephalus was noted on the day 109.

Value of functional myelography with both lateral bending anterior-posterior views in lumbar radiculopathy

There are considerable discrepacies between clinical symptoms and imaging diagnosis in the localization of the responsible radiculopathy. The purposes of this study are to analyzed the dynamic alteration of contrast filling of the spinal nerve sleeves during positional changes and to determine how the abnormalities of nerve sleeves no lateral bending A-P views correlate with sciatica. The criteria indicationg the root abnormality in functional myelography were (1) bad filling of ipsilateral root to sciatica and (2) good filling of contralateral root compared with those in neutral A-P view. Of total 77 patients, 67 had radiculopathy and 10 had no radiculopathy. In 23 (34.3%) of 67 patients with radiculopathy and 6 (60%) of 10 patients with no radiculopathy, their clinical symptoms well correlated with conventional myelographic findings. However, in 35 (52.2%) of 67 patients with radiculopathy and 6(60%) of 10 patients with no radiculopathy, their symptoms well correlated with functional myelographic findings. This study suggests that the functional myelogaphy using both lateral bending A-P views can be used as a complementary tool in the evaluation of the radiculopathy.

MRI findinga of multiple sclerosis

Nine patients of clinically definite multiple sclerosis (MS) were examined by magnetic resonance imaging (MRI) at 1.0T. The MS plaques were seen in the brain and spinal cord in eight and three patients. respectively. The frequent sites of MS plaques were periventricular white matter, brain stem, and cervical cord. The shape of most brain MS plaques was round or finger-like configuration. The MS plaques showed high signal intensity on R2 weighted images and low or iso signal intensity on T1 weighted images in all nine cases. Contrast enhancement was seen in 4 cases. Mild brain atrophy was noted in 2 cases and mass effect in 1 case. The sites of cord MS plaques in three patients were C2-C4, C2-C5, and C4-C6 levels respectively. The cord MS plaques showed high signal intensity on T2 weighted image and contrast enhancement on Gd-DTPA enhanced T1 weighted images in all 3cases with mild cord expansion in 2 cases. In conclusion, MRI is a useful diagnostic tool in evaluationg the MS plaques involving central nervous system.

Evaluation of post-operative residual tumors using 67Ga scintigram 1. is the blood gallium redistributed into the surgical wound? / 대한핵의학회잡지

No abstract available.