Bronchogenic cysts can arise either in the mediastinum or in the lung parenchyma. On both CT and T1 -weighted MR images, the cyst contents can show a variable signal characteristics. However, on T2-weighted MR images, the cyst show high signal intensity. Although unusual, the cyst may communicate with the tracheobronchial tree and demonstrate partial or complete air content. With hemorrhage, fluid-fluid levels can also be seen within the cyst. Pathologically, the diagnosis of bronchogenic cyst rests on demonstration of tissues normally found in the tracheobronchial tree within the cyst wall.
Adult* ; Bronchogenic Cyst* ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Mediastinum

PURPOSE: To analyze high-resolution CT findings(HRCT) of pulmonary lymphangitic carcinomtosis(PLC) and to correlated the HRCT findings with the results of pulmonary function test(PFT). MATERIALS AND METHODS: In Twenty eight patients with radiologically and clinically proved PLC, we retrospectively reviewed HRCT scans and PFT(N=12). PLC was classified by extent and distribution of metastatic nodules and interstitial thickenings on HRCT and the findings were correlated with the results of PFT and impairment of PFT according to the degree of FEVl(forced expiratory volume in one second). RESULTS: On the basis of distribution of PLC, HRCT findings showed 20 cases of peripheral type, 3 cases of central type, and 5 cases of mixed type. In the patients with PFT diffuse type was 10 cases and localized type was 2 cases. In diffuse types, the restrictive pattern occurred in 7 cases (p<0.05) and in localized types, restrictive pattern occurred in 2 cases. Marked impairment of vital capacity was shown as restrictive pattern in 7 cases all of which were diffuse type and were consisted of peripheral type in 4 cases and mixed type in 3 cases. CONCLUSION: HRCT findings of lymphangitic carcinomatosis correlated well the type and degree of impairment of PFT. Especially in diffuse type of lymphangitic carcinomatosis, the result of pulmonary function test were prominent restrictive patterns. Marked impairment of pulmonary function occurred in patients with diffuse type and types with peripheral interstitial thickening(periphral and mixed types).
Carcinoma* ; Humans ; Respiratory Function Tests* ; Retrospective Studies ; Vital Capacity

PURPOSE: PCNA has been widely used because it is highly accurate, relatively simple and safe to administer. Regardless of its high diagnostic rate, PCNA has the difficulty in excluding malignancy in the cases of, negative for malignancy" results in PCNA cytologic reports. So, we analysed PCNA cases to evaluate the clinical outcome of "negative for malignancy" results in PCNA cytologic reports. MATERIALS AND METHODS: PCNA in 170 cases were done between January, 1991 and December, 1993 and the diagnosis was malignancy in 86 cases, specific benign disease in 30 cases, "negative for malignancy" in 45 cases and inadequate sample in 9 cases. We analysed 36 cases among 45 cases of "negative for malignancy" results in cytologic examinations. The final diagnosis was made on the basis of histopathologic examinations, radiologic findings and clinical courses. we compared the final diagnosis to the radiologic diagnosis. RESULTS: Of the 36 cases with initial "negative for malignancy" results, the final diagnosis was benign in 30 cases and malignant in 6 cases(17%). In radiologic diagnosis of the malignancy, "positive predictive value" was 42%, "negative predictive value" was 96%, and accuracy was 78%. CONCLUSION: In the cases of PCNA results of "negative for malignancy", malignancy can not be excluded because 17% of the cases are proved to be malignant. And if malignancy is highly suggested at radiologic examination, the possibility of malignancy is 42%, and so intensive follow-up examination is needed.
Biopsy, Fine-Needle* ; Diagnosis ; Follow-Up Studies ; Proliferating Cell Nuclear Antigen ; Thorax*

PURPOSE: To evaluate CT findings of tuberculous pneumonia mainly presenting as parenchymal consolidation. MATERIALS & METHODS: CT scans of twenty patients with tuberculous pneumonia were retrospectively reviewed. Analyses included the location, extent, and homogeneity of consolidation, presence of volume loss of involved lung and air-bronchogram, associated lesions suggesting previous tuberculous infection and evidence of bronchogenic spread. RESULTS: The location of consolidation revealed relatively even distribution without any specific predilection site. The areas of consolidation were irregular in margin (95%), inhomogeneous in attenuation (75%) including focal areas of low attenuation and multiple cavities within it. Volume loss (70%) of the involved lobe was associated. There were lesions suggesting previous tuberculous infection (95%) in the surrounding area and evidences of bronchogenic spread (100%) such as poorly-defined nodules and Iobular consolidations in the remote site from main consolidation. CONCLUSION: In tuberculous pneumonia, the areas of consolidation are irregular in margin and inhomogeneous in attenuation on CT scan. The evidences of bronchogenic spread and lesions suggesting previous tuberculous infection are almost always associated in the surrounding or remote site from main consolidation.
Humans ; Lung ; Pneumonia* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To review MR findings of the posterior fossa hemangioblastomas and to evaluate diagnostic value of MRI correlated with CT and anglographic findings. MATERIALS AND METHODS: The MR findings in twelve patients with surgically proven posterior fossa hemangioblastomas including one case of von Hippel- Lindau disease were retrospectively analyzed and correlated with CT (7 patients) and anglographic findings (9 patients). RESULTS: On MRI, five hemangioblastomas were located in the cerebellar hemisphere and seven in the vermis. The masses appeared to be solid in 3 cases(25%), solid tumors with central cyst in 2 cases(17%), and cyst with mural nodules in 7 cases(58%). Abnormal tumor vessels represented by characteristic signal voids on MRI were observed in 9 cases(75%) and were not seen in 3 cases(25%) with mural nodule below 1.5cm in diameter. On pre-contrast CT, hemangioblastomas appeared poorly marginated slightly hyperdense masses in solid tumors, and hypodense cystic masses in cysts. After contrast enhancement, solid tumors were markedly enhanced, but it was difficult to differentiate hemangioblastomas from other tumors. In nine patients, anglograms demonstrated hypervascular blush corresponding to the solid component of the tumors. CONCLUSION: MRI was superior to CT in evaluating the characteristic of abnormal tumor vessels and mural nodules, delineation of tumor margin and tumor extent. Angiography was useful in the diagnosis of cystic hemangioblastomas which contain small mural nodule (less than 1.5cm in diameter) without definite vascular signal voids on MRI. MRI demonstrated solid or cystic tumor with small mural nodule and abnormal vascular signal voids in the posterior fossa should suggest hemangioblastoma.
Angiography ; Diagnosis ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; von Hippel-Lindau Disease

PURPOSE: CT and MR findings of cerebral fat embolism syndrome(CFES) have been rarely reported, because its diagnosis had been made on the basis of only clinical features in the majority of the cases. The purpose of this study is to describe the clinical, CT, and MR findings in six patients of CFES. MATERIALS AND METHODS: Brain CT and MR findings were retrospectively analyzed in six patients with CFES that was diagnosed on the basis of clinical and MRI findings. All six patients had long bone fractures and showed typical delayed clinical manifestations 2-3 days later. Both CT and MRI were examined in all of six patients. Initial CT scan was performed within 48 hours after trauma in all patients, andfollow-up CT scan was done in 2-11 days in two patients. MRI was done within 2-7 days after trauma in three patients, and 13 days, 18 days, and 45 days in other three patients. Follow-up MRI studies were performed in 2-60 weeks in four patients. Clinical and laboratory findings were analyzed retrospectively with medical records. CT and MRI findings were evaluated with regard to presence or absence of diffuse brain swelling and focal abnormalities of signal intensity(density). RESULTS: CT scans obtained within 2 days after trauma showed diffuse cerebral swelling in five patients and normal findng in one patient. On Tl-weighted MRI, diffuse cerebral swelling was shown in three cases and high signal spots suggesting cerebral petechial hemorrhage were noted in both caudate nuclei and thalami in two cases. On T2-weighted images, high signal spots which were shown on Tl-weighted image were not visible. In all of six cases, multiple lesions of high signal were observed mainly in the cerebral white matters, cerebellum and brain stem, probably representing ischemia/infarct or edema. On the follow-up MRI studies performed within a period from weeks to one month after trauma, the size and the number of the lesions were significantly decreased and these findings were well corresponded with clinical course. CONCLUSION: MR findings' of CFES include diffuse cerebral swelling, petechial hemorrhage and mi- croinfarcts, which characteristically improved in short period. In cases suspected of having CFES, MRI is more useful than CT for initial and follow-up studies because of its high detection rate of lesions and correspondence with clinical course.
Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Diagnosis ; Edema ; Embolism, Fat* ; Follow-Up Studies ; Fractures, Bone ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate the degree of contrast enhancement of intracranial tumors on delayed (6-8min.) MR imaging after administration of Gd-DTPA. MATERIALS AND METHODS: Both immediate and delayed post-contrast MR imagings were studied prospectively in 35 patients. with brain tumors (11 gliomas, 6 meningiomas, 4 neurinomas, 5 parencymal metastases, 5 hemangioblastoma, 4 others) at either 0.5 T or 2.0 T unit. After precontrast TI-, proton-density, and T2-weighted spin echo images were obtained, each patient underwent Tl-weighted imaging immediately following infusion of 0.1 mmol/Kg of Gd-DTPA. Subsequently, the second postcontrast Tl-weighted images were obtained with no additional injection of the contrast media. Time-interval between the postcontrast immediate and the delayed images was approximately 6-8 minutes. Degree of contrast enhancement of the lesions was assessed both visually and quantitatively. For quantitative study, contrast enhancement ratio(CER) of tumors was calculated in both immediate and delayed post-contrast images. RESULTS: There was stronger visual enhancement in 7 of 11 cases with gliomas and 3 of 5 cases with parenchymal metastasis on delayed images when compared with immediate images, whereas all 10 cases of extraaxial tumors(meningiomas and neurinomas) showed decreased enhancement on delayed images. Quantitatively, mean CERs of gliomas and metastases were higher on delayed study than on immediate study by 20. 5% and 49.2%, respectively. Extraaxial tumors showed decrease of CER on delayed study by 19.7% as compared with that of immediate study. Hemangioblastomas showed visually poor enhancement on delayed image in 4 cases and equal enhancement on both immediate and delayed images in remaining one case, and quantitatively demonstrated decrease of CER on delayed study by 15.4%. CONCLUSION: Since there was more conspicuous contrast enhancement in many intraaxial tumors such as gliomas and metastases on 6-8 minutes delayed post-contrast MR study, the delayed post-contrast study may be needed in some intraaxial tumors for their characterization, and may also be helpful for the differential diagnosis between intraaxial and extraaxial tumors.
Brain Neoplasms* ; Brain* ; Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA ; Glioma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma ; Prospective Studies

PURPOSE: The purpose is to evaluate the CT or MRI findings to help in the differentiation between benign and malignant meningiomas. MATERIAL AND METHODS: The CT and MRI findings of 8 patients with surgically proven malignant meningioma were reviewed. Four cases of 8 malignant meningiomas and 18 cases of 27 benign lesions were studied with a 1.5T or 0.5T MRI. Radiologic analysis was focused on the heterogeneity of tumor, grade of peritumoral edema, presence of cystic degeneration and calcification, tumoral enhancement pattern, dural enhancement, and tumoral border. RESULT: Histologic types of malignant meningioma were meningotheliomatous (n=4), papillary(n=1), fibroblastic(n=l), angioblastic(n=l), and sarcomatous(n=l). Tumoral Heterogeneity was seen in 8 of 8 malignant lesions(100%) and 8 of 27 benign ones(30%). (p<0.01) Marked peritumoral edema was seen in 8 of 8 malignant lesions(100%) and 2 of 27 benign ones. (7.3%)(p<0.01) Most of malignant lesions(6 of 8 cases, 75%) showed ill defined border. Calcification was not present in malignant lesions in contrast with benign ones (14 of 27 cases, 52%). (p<0.05) No statistical significance was noted in cystic degeneration, dural tail like enhancement or tumoral enhancement pattern between malignant and benign meningiomas. MRI signal intensity of malignant meningiomas was homogeneously or heterogeneously hypointense on T1WI, heterogeneously isointense or hypointense on T2WI and heterogeneous or mixed on Gd-DTPA enhancement study. CONCLUSION: The CT or MRI findings such as heterogeneity, ill defined tumoral border, marked peritumoral edema, and absence of calcification may suggest the possibility of malignancy in meningioma.
Edema ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Meningioma* ; Population Characteristics

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

PURPOSE: To evaluate the diagnostic value of radiologic studies in the Cushing's disease MATERIALS AND METHODS: We analyzed retrospectively the CT(n=19, dynamic CT was not perfomed), MR (n=23, dynamic MR in 2 cases), and the results of inferior petrosal sinus sampling(IPSS)(n=13) in 25 patients(19 women, 6men, age range 16-58, mean 32.2) with pathologically-confirmed ACTH secreting pituitary adenoma. We analyzed the radiologic findings and determined how accurately each method could detect and lateralize the lesion within the pituitary gland. The results were compared with the surgical findings and with each other. RESULTS: Seven patients(28%) out of 25 had macroadenomas and the lesions were detected and correctly diagnosed by CT and MR in all. Eighteen patients(72%) had microadenoma. In patients with microadenoma the sensitivity was 38.5%(5/13) in CT, 64.7%(11/17) in MR, 90.9%(10/11) in IPSS. In two patients with dynamic MR, in whom the conventional Gd-enhanced MR showed false negative results, the lesions were detected as low signal intensity mass and correctly lateralized. Considering the results of both MR and IPSS, the sensitivity increased up to 94.1%(17/18). CONCLUSION: Considering the invasiveness of IPSS, Gd-enhanced MR, preferably dynamic, seems to be an imaging modality of choice in Cushing's disease. Combined use of IPSS in selected patients further increases the accuracy of diagnosis and lateralization.
ACTH-Secreting Pituitary Adenoma ; Diagnosis ; Female ; Humans ; Pituitary Gland ; Retrospective Studies