PURPOSE: To investigate the efficacy of SPIO (superparamagnetic iron oxide) enhanced MR imaging for the detection of colorectal liver metastasis, compared to the intraoperative ultrasound (IOUS). MATERIALS AND METHODS: Thirteen patients who underwent IOUS during surgery for colorectal liver metastasis as well as a liver MR before and after administration of SPIO. The mean patient age was 57 years (age range: 43-77). Two observers reviewed the SPIO-enhanced MR via a double blind test. We evaluated the efficacy of the SPIO-enhanced MR compared to the results of IOUS. RESULTS: Following IOUS, 55 lesions were found, including 32 metastases, 20 cysts, 2 calcifications, and 1 coagulation necrosis. The interobserver correlation of the SPIO-enhanced MR is significant, with a kappa index of 0.839. Radiologist 1 and 2 missed three lesions in three patients. Two of the patients had multiple liver lesions (six and eight, respectively), whereas the other patient had tumor recurrence following hepatic surgery for liver metastasis. In the other nine patients, MR detected all lesions. The sensitivity and positive predictive value of the SPIO-enhanced MR was 94.5%, and 100%, respectively. CONCLUSION: The SPIO-enhanced liver MR shows a good correlation to IOUS, especially in the case of patients who had fewer than three lesions. Therefore, the SPIO-enhanced MR may help to plan a surgical resection of colorectal liver metastasis.
Contrast Media ; Humans ; Iron ; Liver ; Liver Neoplasms ; Necrosis ; Neoplasm Metastasis ; Recurrence

Peritoneal calcifying fibrous tumor is a rare tumor in the peritoneal cavity. In this case, plain radiography showed multiple conglomerated calcifications and several separate calcifications scattered in the lower abdomen and pelvic cavity. CT showed several well-circumscribed masses with a group of conglomerated nodular calcifications in their centers, and these were surrounded by three bands with different attenuation. Ultrasonography showed a well-circumscribed mass with strong posterior shadowing from its anterior surface and hyperechoic calcifications in its center. The histopathological diagnosis was calcifying fibrous tumor. The mass was well circumscribed and non-encapsulated and it was mainly composed of hyalinized fibrosclerotic tissue and dystrophic calcification with no inflammatory cells. We report here on a case of peritoneal calcifying fibrous tumor, along with a review of the relevant literature.
Abdomen ; Hyalin ; Peritoneal Cavity ; Peritoneum ; Shadowing (Histology) ; Tomography, X-Ray Computed

Angular pregnancy is rare, in which the embryo in the lateral angle of uterine cavity and located medial to the utero-tubal junction. Angular pregnancy is differentiated from interstitial pregnancy. There is no report about term angular pregnancy in Republic of Korea, a few reports in other countries. Angular pregnancy has different clinical characteristics according to the trimester. We diagnosed angular pregnancy by ultrasonography and computed tomography (CT). The CT is a useful diagnostic method. We report a case of term angular pregnancy with placenta accreta and review the diagnostic process and complications.
Embryonic Structures ; Placenta ; Placenta Accreta ; Pregnancy ; Republic of Korea

Spontaneous rupture of intrahepatic cholangiocarcinoma is rare due to its abundant fibrous stroma. We report our experience in a case of spontaneous rupture of intrahepatic cholangiocarcinoma in a pregnant patient. In our case, multiple hepatic masses with intratumoral hemorrhage were noted on post-delivery computed tomography and magnetic resonance imaging and they caused hemoperitoneum. A right hemi-hepatectomy was carried out to control the bleeding and the diagnosis of intrahepatic cholangiocarcinoma with metastasis was performed.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Diagnosis ; Hemoperitoneum ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pregnancy ; Rupture ; Rupture, Spontaneous*

Perineal involvement by metastatic renal cell carcinoma (RCC) is very rare, and there are only few reports on its radiological findings in the literature. Here, we present a case of a 76-year old female who presented with perineal pain caused by metastatic clear cell RCC. We discuss the radiological changes of the tumor before and after targeted therapy.

An acardiac twin is one of the very rare anomalies that occurs in monochorionic twins and the incidence of this is about one out of 35,000 births. We present the serial prenatal ultrasound findings, along with the postnatal histologic correlation, of an acardiac twin that manifested as a single lower extremity.
Fetus ; Humans ; Incidence ; Lower Extremity ; Parturition ; Ultrasonography, Prenatal

PURPOSE: The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role. MATERIALS AND METHODS: We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID; n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups. RESULTS: We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women; HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed. CONCLUSION: The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems.
Abdomen ; Abscess ; Adipose Tissue ; Diagnosis, Differential ; Fallopian Tubes ; Female ; Humans ; Pelvic Inflammatory Disease ; Pelvic Pain ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Rupture

PURPOSE: To determine the associated diseases causing hepatic capsular enhancement and analyze the relationship of the capsular enhancement patterns as a function of the associated diseases. MATERIALS AND METHODS: We retrospectively reviewed 797 patients having undergone arterial phase abdominal CT scans. Among these images, 47 patients showed hepatic capsular enhancement (13 men and 34 women; mean age: 53.1; age range: 5-91 years). We investigated if there was a correlation between the pattern of hepatic capsular enhancement and cause of disease. When the hepatic capsular enhancement was found to persist until the portal phase, the symptom duration was evaluated. RESULTS: Hepatic capsular enhancements were presented in 5.9% (47/797) of the arterial phase abdominal CT scans. Six patients (12.8%) were diagnosed with Fitz-Hugh-Curtis syndrome. The other causes of hepatic capsular enhancement included 20 cases of inflammation, 13 cases of malignancy, and 8 cases of other diseases. The extent of the hepatic capsular enhancement was not significantly different among the causes of disease. In thirty two of 47 patients (68.1%), hepatic capsular enhancement persisted until the portal phase images. CONCLUSION: Hepatic capsular enhancement on an arterial phase is a nonspecific imaging finding observed in the Fitz-Hugh-Curtis syndrome as well as a variety of other diseases. A CT is useful in finding the hepatic capsular enhancement and determining the accompanying disease.
Chlamydia Infections ; Female ; Hepatitis ; Humans ; Inflammation ; Liver ; Male ; Multidetector Computed Tomography ; Pelvic Inflammatory Disease ; Peritonitis ; Retrospective Studies

Sparganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid tapeworms belonging to the genus Spirometra, as first described by Manson in 1882. The infection is transmitted by ingestion of contaminated water, frogs, and snakes, and contact between a second intermediate host and an open wound or mucus membranes. Humans are accidental hosts in the life cycle, but dogs, cats, and other mammals are definitive hosts. Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. We misdiagnosed vulva sparganosis as a Bartholin's gland abscess. The patient was a green consumer, so she may have been infected by consuming health foods. Sparganosis should be considered as a cause of soft tissue masses especially among patients who have ingested health foods.
Abscess ; Animals ; Cats ; Cestoda ; Dogs ; Eating ; Food, Organic ; Humans ; Life Cycle Stages ; Mammals ; Membranes ; Mucus ; Snakes ; Sparganosis ; Sparganum ; Spirometra ; Vulva

We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vena cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology.
Adenocarcinoma ; Biopsy ; Colonoscopy ; Colorectal Neoplasms ; Female ; Humans ; Iliac Vein ; Leg ; Lymphoscintigraphy ; Middle Aged ; Pelvis ; Phlebography ; Rectal Neoplasms ; Thrombosis ; Tomography, X-Ray Computed ; Vena Cava, Inferior