PURPOSE: To evaluate the effect of respiration on the sizes of intrathoracic vasculature, and the trachea,and the main bronchus. MATERIALS AND METHODS: Seventeen volunteers (10males aged 20-39 years and 7 females aged20-39 years) underwent spiral CT, between the apex and lowest base of the lung, collimation was 10mm, pitch was 1,and images were obtained at breath hold forced end-inspiration and breath hold forced end-expiration. Crosssecional areas or diameters were measured in each respiration state at the aorta (ascending, descending, lowerthoracic) and great branches, the IVC (thoracic, abdominal), the SVC, pulmonary artery (right main, leftdescending) and the tracheobronchus (trachea, left upper bronchus). Changes in the size of vessels and airwaysbetween the respiration states were evaluated and compared between inspiration and expiration. RESULT: Duringbreath-hold forced end-inspiration CT, the ascending, descending, and lower thoracic aorta and itsbranches(brachiocephalic, left common carotid, left subclavian) as well as the thoracic IVC and SVC and the rightmain and left descending pulmonary arteries decreased in size: during breath-hold forced end-expiration CT, thesize of all these vessels increased. For the trachea, left upper lobe bronchus and abdominal IVC, the situationwas reversed. Statistically significant changes(p<0.05) were noted in the ascending aorta and descending aorta,the lower thoracic aorta, the thoracic and abdominal IVC, the SVC, the right main and left pulmonary arteries, andthe trachea. CONCLUSION: During respiration, changes in the size of the thoracic vasculature and airways isprobably due to changes in intrathoracic pressure. In the measurement and diagnosis of stenosis or dilatation inthe intrathoracic vesculature and airways, respiration states should therefore be considered.
Aorta ; Aorta, Thoracic ; Bronchi* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Female ; Humans ; Lung ; Pulmonary Artery ; Respiration* ; Tomography, Spiral Computed ; Trachea* ; Volunteers

PURPOSE: To analyse the radiographic and HRCT findings of pulmonary sarcoidosis and to evaluate thediagnostic usefulness of HRCT MATERIALS AND METHODS: Initial chest radiographs (n=14) and HRCT scans (n=14), anda followup HRCT scan (n=1) from 14 patients (5 men and 9 women;median age, 38 Years) with biopsy proven pulmonarysarcoidosis were analyzed. RESULT: On initial chest radiographs, they showed pulmonary lesions were seenpredominantly in the middle, upper and lower lung zones in four, two and one patient, respectively. Patterns oflesions were reticulonodular opacities (n=4), air-space (n=2), honeycombing(n=1), macronodule(n=1), and cavitarynodule (n=1). In all patients, HRCT scans demonstrated both pulmonary lesions and intrathoracic lymphadenopathy.Pulmonary lesions were seen predominantly in the middle, lower and upper lung zones in nine, three and twopatients, and in the posterior and anterior lung zones in eight and four patients repectively. Lesions werepredominantly micronodules, with perilymphatic distribution (n=12), macronodules with air-bronchogram (n=1),cavitary macronodules (n=1), ground-glass opacity (n=5), consolidation (n=2), and irregular lines (n=8). CONCLUSION: Reticulonodular lesions in the middle lung zone were seen on radiograph, while the most common HRCTfinding was micronodular lesions with perilymhpatic distribution. HRCT is much more sensitive than chestradiograph for the detection of both pulmonary lesions and lymphadenopathy; this modality revealed micronoduleswhich were invisible on chest radiographs.
Biopsy ; Follow-Up Studies ; Humans ; Lung ; Lymphatic Diseases ; Male ; Radiography, Thoracic ; Sarcoidosis ; Sarcoidosis, Pulmonary*

PURPOSE: To evaluate the usefulness of flexible covered stent in the treatment of acute colorectalobstruction secondary to colorectal carcinoma. MATERIALS AND METHODS: Flexible covered stents were placed in 11patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. Thepurposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment infour. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other wasrectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluatedaccording to the feasability and status of bowel preparation, as decided by the operator. Palliative treatment forthe relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. RESULT: Bowel preparation forthe purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colonpresented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this wasdue to recurrent stent obstruction by fecal materials after three months, and in two other patients there wasstent obstruction after two and five months, respectively. The stent in one of four patients who underwentpalliative treatment was removed because of stent migration three days after insertion;the stents in two patientswith fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in threepatients, anal bleeding in three and stent migration in one. CONCLUSION: The flexible covered stent was aneffective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. Itallowed for single-stage operation and covered the fistula. We believe however that for further evaluation of theusefulness of this type of stent in long-term palliative treatment, a larger-scale study is needed.
Abdomen ; Colon ; Colorectal Neoplasms ; Dilatation ; Fistula ; Hemorrhage ; Humans ; Jejunum ; Palliative Care ; Radiography ; Stents*

PURPOSE: To determine the effective embolic material and appropriate embolic site by comparing bowel changesafter arterial embolization in dogs in which the proximal or distal level of the superior mesenteric artery hadbeen occluded with gelfoam particles or a coil. MATERIAL AND METHODS: Using the coaxial catheter system,superselective arterial embolization was performed at sixteen sites in four dogs. In groups A and B, each site wasoccluded at the proximal or distal marginal artery, respectively, with gelfoam particles and in groups C and D, atthe proximal or distal artery, respectively, with a coi. All dogs were sacrifed one day after the procedure, andgross and microscopic histologic findings were evaluated. RESULT: In all dogs, the procedure was successful. Ingroup B, significant mucosal destruction, lymphocyte proliferation in submucosa and mucosa, and diffuse swellingin all layers of the intestine were found at all sites. The vessel in the submucosal layer was completelyobstructed by red blood cells and gelfoam.At three sites, the intestine showed diffuse ischemic change, and at oneother site, focal ischemic change was observed. In group D, exudation with destruction of mucosa and submucosalhemorrhage occurred at one site, but in groups A and C, intestinal layers were found to be normal. CONCLUSION: Using a coil, superselective arterial embolization was successful, even up to the distal level of the intestinalartery, and the intestine showed no ischemic change. Embolization with gelfoam must be performed carefully at theproximal level, and since it can cause severe intestinal necrosis, must be avoided at the distal level.
Animals ; Arteries ; Catheters ; Dogs ; Erythrocytes ; Gelatin Sponge, Absorbable* ; Intestines ; Lymphocytes ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Mucous Membrane ; Necrosis

Computed tomography revealed variable sized small areas of extremely low attenuation in the right orbit of a45-year-old woman who had fallen face down. The appearance and attenuation of the areas suggested air, but on widewindow-width images attenuation was seen to be higher than that of sinus air. We report a case involvingintraorbital wood foreign bodies which on CT mimicked the appearance of air and which were surgically removed.
Female ; Foreign Bodies* ; Humans ; Orbit ; Wood*

We report the imaging features of three cases of tuberculous otitis media. All three patients underwenttemporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissuedensity in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of themastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundantgranulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancementof the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another caseshowed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitismedia reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulationtissue and enhancement of the internal ear, tuberculous otitis media may be included in the differentialdiagnosis.
Acoustics ; Cochlea ; Ear Canal ; Ear, Inner ; Ear, Middle ; Facial Paralysis ; Humans ; Magnetic Resonance Imaging ; Mastoid ; Otitis Media* ; Otitis* ; Semicircular Canals ; Tomography, X-Ray Computed ; Tuberculosis ; Vestibulocochlear Nerve

PURPOSE: To evaluate the efficacy and safety of preoperative embolization of intrancranial meningioma. MATERIALS AND METHODS: We retrospectively reviewed intrancranial meningioma patients (n=37) who underwentpreoperative embolization. They were categorized into two groups, skull base lesions (n=22) and non-skull baselesions (n=15), according to tumor location. In addition, embolization results were classified by comparisonbetween pre- and post-embolization angiography as complete (residual tumor staining < 10 or 30 %) or incomplete(residual tumor staining >or= 10 or 30%). In each group, estimated blood loss (EBL) was estimated by amount ofintraoperative transfusion with pre- and post-operative hemoglobin level. Tumor resectability was evaluated byfollow-up computed tomography. New symptoms occurring within 24 hours of embolization were considered to be thoseassociated with embolization ; symptoms improved by conservative treatment were regarded as mild, while thoseresulting in new deficits were considered severe. RESULT: In the group with skull base lesions (n=22), completeembolization with the criteria of residual tumor staining of less than 30% was performed in 14 patients(EBL=1770ml;complete surgical removal in nine patients and incomplete removal four). Incomplete embolization wasperformed in eight patients (EBL=3210ml; complete and incomplete removal each in four patients). In the group withnon-skull base lesions, complete embolization with the criteria of residual tumor staining of less than 10% wasperformed in five patients (EBL=970ml) and incomplete embolization in ten (EBL=2260ml). Complete tumor removal waspossible in this group regardless of the completeness of preoperative tumor embolization. In a case ofintraventricular meningioma (3%), intratumoral hemorrage occurred on the day following embolization. Other mildpost-embolization complications occurred in three cases (8%). CONCLUSION: Preoperative embolization can be aneffective and safe procedure for meningioma and may reduce intraoperative blood loss. Its effectiveness may dependon tumor location and the degree of embolization, though the procedure seems to be helpful for lseions at theskull base.
Angiography ; Humans ; Meningioma* ; Neoplasm, Residual ; Retrospective Studies ; Skull Base

PURPOSE: To analyze the angiographic findings of cerebral aneurysms and to compare them with previousdomestic and foreign reports. MATERIAL AND METHODS: Three hundred and seventeen patients underwent DSA(digitalsubtraction angiography) and the results were retrospectively, reviewed. Among 278 patients, 356 cerebralaneurysms were detected. Patient's age and sex ratio were analysed, as well as the location, size and multiplicityof the aneurysms. RESULT: The most prevalent age group was 40 to 60 years (n=211, 76%), and the male to femaleratio was 1:1.5. Aneurysms were located in the anterior (n=324, 91%) or posterior circulation(n=32, 9%). In theformer, the most common locations were the anterior communicating artery (n=98, 28%), middle cerebral artery (MCA)bifurcation(n=65, 18%) and the posterior communicating artery (n=32, 9%), while in the pasterior circulation, themost common location was the basilar tip(n=11, 3%). One hundred and eighty-eight cerebral aneurysms(53%) were 3-6mm in size, and 75(21%) were 6-10mm. The size of nine aneurysms (3%) was more than 25mm. Multiple aneurysms(n=149)occurred in 65 patients(23%) ; the most common age group was 40 to 60 (74%) and the male to female ratio was 1:4.The most common number of multiple aneurysms were two (77%) and the common locations were the posteriorcommunicating artery (21%), MCA bifurcation (18%) and anterior communicating artery (13%). CONCLUSION: Weanalyzed a large series in a single center and therefore expect that our data will be helpful for the analysis ofaneurysms in the cerebral circulation and for comparison with domestic and foreign studies.
Aneurysm ; Arteries ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Middle Cerebral Artery ; Retrospective Studies ; Sex Ratio

PURPOSE: To demonstrate the usefulness of diffusion-weighted MR imaging(DWI) in patients with small acuteinfarction by comparing it with fast spin-echo T2-weighted MR imaging(FSE T2WI). MATERIAL AND METHOD: Weretrospectively analyzed the results of FSE T2WI in 26 consecutive patients who on DWI showed small discretehyperintensities of less than 1.5cm and whose final clinical diagnosis, within one week of clinical attack, wasacute inforction. Lacunar infarcts accounted for 24 cases and 2 small cortical infarcts for two. The onset ofsymptoms occurred within 12 hours (hyperacute stage) in two patients, within 24 hours in seven, within 3 days innine, and within one week in eight. Infarcts as seen on FSE T2WI were categorized as follows : (-) for cases ofimpossible localization with non-visualization ; (+/-) for cases of equivocal localization with faint visualizationand/or poor differentiation from combined chronic infarcts and chronic ischemic changes, or from subarachnoid CSFin cases of cortical infarction ; and (+) for cases of adequate localization with clear visualization andmoderately good differentiation from the associated brain changes, or from subarachnoid CSF in cases of corticalinfarction. These infarcts were analyzed according to the time of onset of symptoms. RESULT: For the localizationof small acute infarctions, DWI was markedly superior to the category(-), moderately superior to the category(+/-).With regard to the onset of symptoms, DWI was markedly or moderately superior to FSE T2WI in 2/2 (100%) ofhyperacute stage diagnosed within 12 hour of clinical attack, in 4/7(57%) diagnosed within 24 hours, in 5/9 (56%)diagnosed within 3 days, and in 1/8 (13%) diagnosed within 1 week(p<0.05). In 12/26 cases(46%), small acuteinfarcts were localized by DWI better than by FSE T2WI. CONCLUSION: Because the signal was unchanged or itsintensity was poor, small infarcts at the acute stage were frequently difficult to localize by FSE T2WI. Inaddition, differentiation of these from combined chronic infarcts and chronic ischemic change was poor. DWI canlocalize small acute infarcts even when the results of FSE T2WI are negative or inconclusive.
Brain ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Stroke, Lacunar

PURPOSE: The purpose of this study was to compare the clinical utility of diffusion-weighted images(DWI) withthat of apparent diffusion coefficient(ADC) maps for detecting early ishemic strokes. MATERIALS AND METHODS: In22 patients with infarct, lesion conspicuity as seen on T2-weighted images(T2WI), low diffusion-weightedimages(DWI ; b value 300 sec/mm2), high DWI(b value 1000 sec/mm2), and ADC maps was retrospectively compared. Theinfarct was hyperacute (< 6 hours) in six, acute (< 48 hours) in six, and subacute (< 2 weeks) in ten. All imageswere obtained using an echo-planar spin echo sequence; lesion conspicuity was graded from 0 to 2 by tworadiologists. Signal intensity was analysed in 17 patients[hyperacute (n=5); acute (n=4); and subacute (n=8)].Lesion-to-controlateral normal side signal intensity ratio(SIR) and contrast-to-noise ratio(CNR) were measured andcompared between four different types of images. RESULT: With regard to lesion conspicuity, high DWI wassuperior to the other images for detecting hyperacute strokes(Grade 2, 6/6). In such cases, an ADC map showedgrade 0 lesion conspicuity in one case, grade 1 in three, and grade 2 in two. There was no significant differencein lesion conspicuity in acute and subacute strokes between DWI(low & high) and T2WI(Grade 2, 16 in each). An ADCmap in acute and subacute stroke showed Grade 1 in four cases and Grade 2 in 12. Signal intensity analysis of SIRand CNR showed that high DWI was also superior to the other images for detecting hyperacute ischemic strokes(p <0.05, n=5), and superior to an ADC map in acute and subacute stroke(p < 0.05, n=12). CONCLUSION: Diffusion-weighted images with a high b value could be more useful than ADC maps and conventional T2-weightedimages, especially for the detection of hyperacute strokes.
Diffusion* ; Humans ; Retrospective Studies ; Stroke*