[A Case Report of Uterine Metastasis Four Years after Breast Surgery for Breast Cancer].

We report a case of uterine metastasis of the breast cancer. The patient was diagnosed with invasive ductal carcinoma of the breast and underwent partial right mastectomy and sentinel lymph node biopsy. Tamoxifen was administered as adjuvant endocrine therapy. Four years after the surgery, she had irregular genital bleeding, and was referred to our hospital for cytological diagnosis of uterine cancer. Postoperative pathological diagnosis showed uterine metastasis of breast cancer, and it was decided to treat the recurrence of breast cancer with aromatase inhibitors and CDK4/6 inhibitors, a molecular targeted therapy. The patient has been progression-free for 5 months.

Improved detectability of thromboses of the lower limb using low kilovoltage computed tomography.

To determine the utility of low kilovoltage computed tomographic venography (CTV) for the detection of deep venous thrombus in the lower limbs.Twenty-one thrombi in 19 enrolled patients were investigated in this retrospective study. Patients were initially scanned using CTV at 100 kVp, at the femur level, followed by an immediate switch to 80 kVp. We assessed the CT values of thrombi and veins and performed subjective evaluation for detecting thrombi using a 5-point scoring system: 1, unable to evaluate due to noise or artifacts; 2, equivocal venous thrombus; 3, possible venous thrombus; 4, probable venous thrombus; and 5, definite venous thrombus.Venous density on 100-kVp images (mean ±â€ŠSD [standard deviation]: 122 ±â€Š23 HU, 95% confidence interval [CI]: 111-133 Hounsfield unit [HU]) was significantly lower than that on 80-kVp images (136 ±â€Š24 HU, 95% CI: 125-147 HU, P < .001). There was no significant difference in thrombi between 100-kVp images (55 ±â€Š14 HU, 95% CI: 49-61 HU) and 80-kVp images (57 ±â€Š16, 95% CI: 50-64 HU, P = .168). The thrombus to vein ratio on 100-kVp images (0.47 ±â€Š0.20, 95% CI: 0.39-0.56) was significantly higher than that on 80-kVp images (0.44 ±â€Š0.16, 95% CI: 0.37-0.51, P = .048). The mean 5-point score was significantly higher on the 80-kVp images (4.76) than on the 100-kVp images (4.45, P = .016).Lower kilovoltage CTV significantly improved thrombotic to venous contrasts in the lower limbs.

Usefulness of a glass-free medical three-dimensional autostereoscopic display in neurosurgery.

PURPOSE: Many stereoscopic displays require glasses that are awkward or inappropriate for use in a neurosurgical operating room. A glass-free three-dimensional autostereoscopic display (3DAD) monitor was developed and tested for neurosurgical applications. METHODS: Our 3DAD system uses images acquired from nine directions projected into the viewer's eyes through 1,280 lenticular lenses (1,280 x 720 pixels). The viewer interprets these as a single stereoscopic image. To evaluate the 3D visualization capabilities of the 3DAD system, 3D images of blood vessels created from brain magnetic resonance angiography were presented to 20 neurosurgeons on both a standard medical two-dimensional (2D) monitor and our 3DAD monitor. Discrimination of the positional relationships for each vessel was recorded. The observers were asked to identify blood vessels located in front of three pairs of points on each image. RESULTS: The neurosurgeon observers achieved significantly higher correct responses using the 3DAD monitor compared with the 2D monitor (91.7 vs. 56.7 %, p< 0.0001). There were no reports of problems such as eye fatigue or discomfort. CONCLUSION: Displaying 3D volume rendered multimodality images with a 3DAD monitor is useful for anatomical discrimination of 3D vessels in MR angiography. This technology may be useful for a wide variety of clinical applications such as rapid and precise diagnosis, surgical simulation, and medical education.

Acute rhabdomyolysis of the soleus muscle induced by a lightning strike: magnetic resonance and scintigraphic findings.

Among natural disasters, a lightning strike is a rare but potentially life-threatening phenomenon. If victims survive a cardiac arrest due to instantaneous passage of an exceptionally high voltage electric charge through the whole body, they may be afflicted with various complications such as muscle necrosis resulting in acute renal failure. In this article, we report a case of a 54-year-old man with acute rhabdomyolysis of the left soleus muscle associated with a lightning strike. T2-weighted and short-tau inversion recovery MR images showed a high signal intensity in the left soleus muscle. A whole-body bone scintigram showed abnormal uptakes in the left soleus muscle and the dorsal aspect of the left foot. MR and scintigraphic evaluations were very useful in depicting the site and extent of muscle damage. Since the patient showed a surprisingly high level of serum creatine kinase, the added information was very valuable for determining the patient's management.

Usefulness of a method for changing tube current during helical scanning in multislice CT.

PURPOSE: To determine whether employing a method for changing the tube current during helical scanning helps to adapt the image noise among various sections of the upper abdomen and chest in multislice computed tomography (CT). MATERIALS AND METHODS: One hundred CT examinations of the upper abdomen were assigned to one of two scanning protocols: standard scanning with a constant tube current and scanning with the changing method based on protocol 1. One hundred fifty CT examinations of the chest were assigned to one of three protocols: standard scanning with a constant tube current and scanning with the changing method based on protocols 1 and 2. In protocol 1, the tube current for each rotation was reduced in proportion to the water equivalent thickness based on the rotation showing the maximum value, while, in protocol 2, the tube current was increased in proportion to the water equivalent thickness based on the rotation showing the minimum value. The mean tube current, mean standard deviations (SDs) of the measured CT numbers, and dispersion of the SDs were compared between the different protocols. RESULTS: In the upper abdomen, the use of the changing method based on protocol 1 resulted in a significant reduction in the dispersion of the SDs of CT numbers, with no increase in mean tube current or mean SDs. In the chest, use of the changing method based on protocol 2 resulted in a significant reduction in the dispersion of the SDs of CT numbers, with a reduction in mean tube current and no increase in mean SDs. CONCLUSION: The method for changing tube current during helical scanning makes it possible to adapt the image noise among various sections of the upper abdomen and chest without increasing dose in multislice CT.