1.Is There Any Additional Benefit of Contrast-Enhanced CT as Part of Routine PET/CT Protocols for the Differentiation of Suspicious Incidental Gastrointestinal 2-Deoxy-18F-FDG Uptake?.
Cornelia Bettina BRENDLE ; Philip ASCHOFF ; Thomas KRATT ; Christina SCHRAML ; Matthias REIMOLD ; Claus Detlef CLAUSSEN ; Christina Anna PFANNENBERG
Korean Journal of Radiology 2013;14(6):951-959
OBJECTIVE: Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. MATERIALS AND METHODS: Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. RESULTS: Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. CONCLUSION: PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.
Adult
;
Aged
;
Aged, 80 and over
;
Contrast Media/diagnostic use/pharmacokinetics
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Female
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Fluorodeoxyglucose F18/*diagnostic use/pharmacokinetics
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Follow-Up Studies
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Gastrointestinal Diseases/*diagnosis/metabolism
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Gastrointestinal Tract/*metabolism/radiography/radionuclide imaging
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Humans
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Male
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Middle Aged
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Positron-Emission Tomography/*methods
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Reproducibility of Results
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Retrospective Studies
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Tomography, X-Ray Computed/*methods
2.A Case of an Idiopathic Massive Osteolysis with Skip Lesions.
Mustafa OZBAYRAK ; Mehmet Halit YILMAZ ; Fatih KANTARCI ; Harun OZER ; Kemal HARMANCI ; Muharrem BABACAN ; Sergulen DERVISOGLU
Korean Journal of Radiology 2013;14(6):946-950
A patient with a 2-year history of pain in the left arm, and decreased strengths unrelieved by non-steroidal anti-inflammatory therapy, was being referred for repeating radiography. The radiologic examinations have demonstrated a unique pattern of non-contiguous osteolysis in the left elbow, proximal and distal radius, ulna, wrist, carpal bones, proximal and distal metacarpals and phalanges. Multi-site biopsies were being performed and confirmed the diagnosis of massive osteolysis. To our knowledge, this is the first case in which multifocal, non-contiguous osteolysis with skip lesions without associated nephropathy and without a hereditary pattern is being described in one extremity.
Adult
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Biopsy, Fine-Needle
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Diagnosis, Differential
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Humans
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Magnetic Resonance Imaging
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Male
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Osteolysis, Essential/*diagnosis
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Tomography, X-Ray Computed/*methods
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Ulna/*pathology/radiography
3.Correlation of Histological Examination of Meniscus with MR Images: Focused on High Signal Intensity of the Meniscus Not Caused by Definite Meniscal Tear and Impact on MR Diagnosis of Tears.
Chun Ai LI ; Min Ki KIM ; In Hwan KIM ; Ju Hong LEE ; Kyu Yun JANG ; Sang Yong LEE
Korean Journal of Radiology 2013;14(6):935-945
OBJECTIVE: To document the causes of high signal intensity of the meniscus which is not caused by definite meniscal tears on MR imaging, through correlation with histological examination. MATERIALS AND METHODS: For the correlation between the MR image and histology, we obtained prospectively 31 meniscal specimens from 21 patients. Proton density-weighted turbo spin-echo MR images were used. Minimal tear, thinning of the lamellar layer, degeneration of the central layer, and radial tie fibers were detected upon histological examination, and were correlated with the corresponding MR images. RESULTS: Minimal tear of the lamellar layer was seen in 60 zones out of 100 slides. On MR images, 29 (48.3%) of these 60 zones had high signal intensity. Thinning of the lamellar layer was seen in 24 zones, with 7 (29.2%) having high signal intensity. 57 central zones showed degenerative change in the central layer and high signal intensity on all corresponding MR images. Radial tie fibers in the central layer appeared as high signal intensity areas. CONCLUSION: Minimal tear and thinning of the lamellar layer, degeneration and radial tie fibers of the central layer of the meniscus cause high signal intensity on MR images.
Aged
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Aged, 80 and over
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Diagnosis, Differential
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Female
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Follow-Up Studies
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Humans
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Knee Injuries/*diagnosis
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Magnetic Resonance Imaging/*methods
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Male
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Menisci, Tibial/*injuries/*pathology
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Middle Aged
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Prospective Studies
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Rupture
4.Endovascular Treatment of Aneurysm of Splenic Artery Arising from Splenomesentric Trunk Using Stent Graft.
Chinmay Bhimaji KULKARNI ; Srikanth MOORTHY ; Sreekumar Karumathil PULLARA ; Rajesh Ramaih KANNAN
Korean Journal of Radiology 2013;14(6):931-934
We report a rare case of aneurysm of splenic artery arising anomalously from the superior mesenteric artery (SMA). The aneurysm was treated successfully by coil embolization of the splenic artery distal to aneurysm and then deploying a stent graft in the SMA. A combination of stent graft and coil embolization for the treatment of aberrant splenic artery aneurysm has been reported only once. We describe the imaging findings and the endovascular procedure in this patient.
Adult
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Aneurysm/radiography/*surgery
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Angiography/*methods
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*Blood Vessel Prosthesis
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Endovascular Procedures/*methods
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Humans
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Male
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Mesenteric Artery, Superior/radiography/*surgery
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*Splenic Artery
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*Stents
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Tomography, X-Ray Computed/*methods
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Treatment Outcome
5.Rat Model of Hindlimb Ischemia Induced via Embolization with Polyvinyl Alcohol and N-Butyl Cyanoacrylate.
Cheong Il SHIN ; Hyo Cheol KIM ; Yong Sub SONG ; Hye Rim CHO ; Kyoung Bun LEE ; Whal LEE ; Hwan Jun JAE ; Jin Wook CHUNG
Korean Journal of Radiology 2013;14(6):923-930
OBJECTIVE: To investigate the feasibility of a rat model on hindlimb ischemia induced by embolization from the administration of polyvinyl alcohol (PVA) particles or N-butyl cyanoacrylate (NBCA). MATERIALS AND METHODS: Unilateral hindlimb ischemia was induced by embolization with NBCA (n = 4), PVA (n = 4) or surgical excision (n = 4) in a total of 12 Sprague-Dawley rats. On days 0, 7 and 14, the time-of-flight magnetic resonance angiography (TOF-MRA) and enhanced MRI were obtained as scheduled by using a 3T-MR scanner. The clinical ischemic index, volume change and degree of muscle necrosis observed on the enhanced MRI in the ischemic hindlimb were being compared among three groups using the analysis of variance. Vascular patency on TOF-MRA was evaluated and correlated with angiographic findings when using an inter-rater agreement test. RESULTS: There was a technical success rate of 100% for both the embolization and surgery groups. The clinical ischemic index did not significantly differ. On day 7, the ratios of the muscular infarctions were 0.436, 0.173 and 0 at thigh levels and 0.503, 0.337 and 0 at calf levels for the NBCA, PVA and surgery groups, respectively. In addition, the embolization group presented increased volume and then decreased volume on days 7 and 14, respectively. The surgery group presented a gradual volume decrease. Good correlation was shown between the TOF-MRA and angiographic findings (kappa value of 0.795). CONCLUSION: The examined hindlimb ischemia model using embolization with NBCA and PVA particles in rats is a feasible model for further research, and muscle necrosis was evident as compared with the surgical model.
Animals
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*Disease Models, Animal
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Embolization, Therapeutic/*adverse effects
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Enbucrilate/administration & dosage/*toxicity
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Feasibility Studies
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Hindlimb/*blood supply
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Injections, Intra-Arterial
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Ischemia/*chemically induced/diagnosis
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Magnetic Resonance Angiography/*methods
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Male
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Polyvinyl Alcohol/administration & dosage/*toxicity
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Rats
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Rats, Sprague-Dawley
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Tissue Adhesives/administration & dosage/toxicity
6.MR Imaging Findings of Extraovarian Endocervical Mucinous Borderline Tumors Arising from Pelvic Endometriosis.
Dong Myung YEO ; Sung Eun RHA ; Jae Young BYUN ; Ahwon LEE ; Mee Ran KIM
Korean Journal of Radiology 2013;14(6):918-922
We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.
Adult
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Cystadenoma, Mucinous/*diagnosis/etiology
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Diagnosis, Differential
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Endometriosis/complications/*diagnosis
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Female
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Follow-Up Studies
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Humans
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Magnetic Resonance Imaging/*methods
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Ovarian Neoplasms/*diagnosis/etiology
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Pelvis
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Precancerous Conditions/*diagnosis/etiology
7.Biliary Peritonitis after Radiofrequency Ablation Diagnosed by Gadoxetic Acid-Enhanced MR Imaging.
Akihiro FURUTA ; Hiroyoshi ISODA ; Takashi KOYAMA ; Giro TODO ; Yukio OSAKI ; Kaori TOGASHI
Korean Journal of Radiology 2013;14(6):914-917
This study describes the first case of biliary peritonitis after radiofrequency ablation diagnosed by magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), a hepatocyte-specific MR imaging contrast agent. The image acquired 300 minutes after the administration of Gd-EOB-DTPA was useful to make a definite diagnosis and to identify the pathway of bile leakage. It is important to decide on the acquisition timing with consideration of the predicted location of bile duct injury.
Aged, 80 and over
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Bile Duct Diseases/*diagnosis/etiology
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Carcinoma, Hepatocellular/diagnosis/surgery
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Catheter Ablation/*adverse effects
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Contrast Media/diagnostic use
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Diagnosis, Differential
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Follow-Up Studies
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Gadolinium DTPA/*diagnostic use
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Hepatectomy/adverse effects/methods
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Humans
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Liver Neoplasms/diagnosis/*surgery
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Magnetic Resonance Imaging/*methods
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Male
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Peritonitis/*diagnosis/etiology
8.Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography.
Aysel TURKVATAN ; Ayse ERDEN ; Mehmet Akif TURKOGLU ; Ozlem YENER
Korean Journal of Radiology 2013;14(6):905-913
Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography.
Cholangiopancreatography, Magnetic Resonance/*methods
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Humans
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Multidetector Computed Tomography/*methods
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Pancreas/abnormalities
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Pancreatic Diseases/congenital/pathology/radiography
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Pancreatic Ducts/*abnormalities
9.Chronic gastric volvulus.
Journal of the Korean Surgical Society 1991;40(1):121-125
No abstract available.
Stomach Volvulus*
10.Carcinosarcoma of the stomach.
Bong Bai KIM ; Won Jin CHOI ; Hye Rim PARK
Journal of the Korean Surgical Society 1991;40(1):113-120
No abstract available.
Carcinosarcoma*
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Stomach*