MR Imaging of Gastric Carcinoma' Comparison with CT

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.

CT findings of abdominal actinomycosis

Actinomycosis still poses a problem for correct clinical and radiologic diagnosis. We retrospectively analyzed CT findings in 7 patients with pathologically proven abdominal actinomycosis. Involved areas were the pelvis (n=3), greater omentum (n=2), liver (n=1), and kidney (n=1). CT confirmed the infiltrative nature of the disease with a tendency to invade across tissue plane and boundary. Five of seven cases were predominantly solid mass (pseudotumor) with focal low-attenuation areas while two were predominantly cystic mass with thickened wall. Contrast-enhanced CT showed dense, inhomogeneous contrast enhancement in the wall and/ or solid components of the masses in five. Minimal lymphadenopathy was noted in one case. CT is useful in demonstrating the extent and characteristics of this disease. Despite nonspecific findings, actinomycosis should be included in the differential consideration when CT shows an infiltrative mass with unusual aggressiveness and dense inhomogeneous contrast enhancement in patients with fever, leukocytosis, or long-term use of intrauterine contraceptive devices.

Comparison of Tc-99m-HMPAO SPECT and MRI in cerebral infarction

Cerebral infarction is caused by decreased perfusion to the brain. In the evaluation of the infarction, CT has been widely used but MRI ans SPECT recently tend to increase in use. The purpose of this study is to compare the efficacy of MR imaging with that of 99mTc-hexamethylpropylene amine(HMPAO) single photon emission computed tomography(SPECT) in the patients with cerebral infarction in the points of (1) number of detected lesion, (2) size of the lesion, and (3) correlation with clinical neurologic deficits. Sixty-one patients with cerebral infarctions(acute: 23, subacute:30, chronic:8) were reviewed. In all patients, MRI and corresponding 99mTc-HMPAO SPECT examinations were performed within a reasonable time span. We analyzed the fiadings of (1) clinical neurologic examination, (2) MR and, (3) Tc-99m-HMPAO SPECT independently they were compared later on. The lesion of SPECT was larger than the seen on MRI in 9 of 23 acute cases, 13 of 30 subacute cases, and 3 of 8 chronic cases. The lesion on MRI was larger than that on SPECT in seven acute cases, six subacute, and only one case in chronic stage. In the remaining cases, the size of the lesion was similar to that on both SPECT and MRI. For the detection of lesion, MRI was superior to SPECT in 15 acute cases, 13 subacute cases, and four chronic cases, while SPECT was super or to MRI in four of 30 cases at subacute stage, and one of 8 cases at chronic stage. In conclusion, there was a tendency that the detection rate of the lesion was higher on MRI but the lesion was larger on SPECT. The lesions detected on both MRI and SPECT correlated well with clinical symptoms.

Impact of clinical history on film interpretation

We performed a study to determine whether clinical history gives a positive or negative influence on X-ray film interpretation. One hundred and nine patient's radiograms, consisting of 55 normal and 54 abnormal cases (136 abnormalities), were interpreted twice by three pairs of residents in radiology and a pair of qualified radiologists, without clinical history first and with clinical history next. The interpreters recorded diagnosis and confidence level of normal or abnormal findings on a six-point scale. Analysis of receiver operating characteristic (ROC) curves showed that knowledge of clinical history improved diagnostic accuracy. Residents, especially beginners, should be advised to obtain clinical history whenever they read radiograms.

Radiologic approach to the evaluation of congenital anorectal malformation

No abstract available.

Neonatal hydrometrocolpos: a case report

No abstract available.