Magnetic resonance imaging and computed tomography in the diagnoses of brain metastases of lung cancer.

We evaluated the usefulness of double-dose (0.2 mmol/kg of gadoteridol) contrast-enhanced magnetic resonance imaging (C-E MRI) in detecting brain metastases of lung cancer. We prospectively enrolled 134 patients with lung cancer who had no neurologic symptoms and who underwent a staging work-up. Patients were assigned to receive both contrast-enhanced computerized tomography (C-E CT) and double-dose C-E MRI. Double-dose C-E MRI detected brain metastases in 19 patients, while C-E CT detected brain metastasis in only 12 of the 19 (P = 0.02). The 3-month survival rate for patients in double-dose C-E MRI group was found to be 2.06 times that of patients in a C-E CT group (P = 0.029), although the survival rate fell to 1.45 (P = 0.387) at 6 months. The results imply that double-dose C-E MRI changed the clinical stage of lung cancer patients. We concluded that double-dose C-E MRI improves the rate of detection of brain metastases during the initial staging of lung cancer.

[Pulmonary alveolar proteinosis successfully treated by a modified lavage technique using high-frequency jet ventilation].

A 66-year-old woman presented with exertional dyspnea and productive cough. Chest radiography showed ground glass opacities and patchy infiltrates in both lungs. After confirmation of pulmonary alveolar proteinosis by bronchoalveolar lavage, she underwent conventional whole-lung lavage with slight improvement, with the aid of a partial extracorporeal circulation. After aggravation for one year, a modified lavage technique using high-frequency jet ventilation was used, and persistent improvement in oxygenation was achieved. We believe that this modified technique could be a useful method for pulmonary alveolar proteinosis.