PURPOSE: We evaluated the role of conventional CT for preoperative staging of gastric carcinoma. MATERIALS AND METHODS: Conventional CT was prospectively performed in 95 patients with gastric adenocarcinoma proved by means of endoscopic biopsy, and findings were compared with those of surgery or pathology. RESULTS: In the evaluation of pancreatic invasion of the primary tumor, the sensitivity, specificity, and diagnostic accuracy of CT were 71%(5/7), 95%(84/88), and 94%(89/95), respectively. CT depicted transverse mesocolon invasion in only one of the 4 cases(25%). In the evaluation of lymph node metastasis, the sensitivity, specificity, and diagnostic accuracy were 33%(24/72), 99%(867/878), and 94%(891/950), respectively. In lymph node staging, 49 patients(52%) were correctly staged, 39(41%) were understaged, and 7(7%) were overstaged with CT. CT failed to demdnstrate peritoneal carcinomatosis in all 10 patients. CONCLUSION: The role of conventional CT in the preoperative evaluation of gastric adenocarcinoma is limited due to poor sensitivity despite of good specificity and accuracy.
Adenocarcinoma ; Biopsy ; Carcinoma ; Humans ; Lymph Nodes ; Mesocolon ; Neoplasm Metastasis ; Pathology ; Prospective Studies* ; Sensitivity and Specificity

Recently data about performances in radiology department tend to increase rapidly and appropriate use of computer system is needed to monitor variuos jobs including scheduling of the patient, reporting of radiologic examination and film library management. The authors describe experiences in computerizing several jobs of radiology departement using Aplle II personal computer during last uear, and our experiences suggest that with appropriate soft ware and peripheral devices, personal computer can handle relatively large amount of informations about a certain functions in radiology department. The authors also put emphasis on the point that meticulous characterization and cocumentation of data is mandatory for effective use of computer system and should be done by radiologist who use or want to use computer system.
Computer Systems ; Humans ; Microcomputers

PURPOSE: To evaluate the relative value of arterial, portal venous and delayed phase images of spiral CT in the detection of metastatic tumor of the liver. MATERIALS AND METHODS: Forty-three metastatic tumors in twelve patients were underwent tri-phasic spiral CT examination with injection of 120 ml ionic contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial, portal venous and delayed phase CT images were obtained 35, 65, and 360 seconds after the start of contrast injection, respectively. RESULTS: Arterial phase images detected 35(81%), portal venous phase images 43(100%), and delayed phase images 34(79%) lesions, respectively(p<0.05). All masses larger than 2cm(n=23) were detected in all three phases, whereas 60%, 100%, 55%of the masses smaller than 2cm(n=20) were detected in arterial, portal venous and delayed phase CT, respectively. The best contrast between masses and the hepatic parenchyma was in portal venous phase followed by arterial and delayed phase(p<0.01). In two hypervascular masses, the contrast was better in arterial phase. CONCLUSION: Portal venous phase of spiral CT is optimal in the detection of metastatic tumor of the liver. Arterial phase may be helpful for the detection of hypervascular metastasis. Delayed phase should be used restrictively.
Humans ; Liver* ; Neoplasm Metastasis ; Tomography, Spiral Computed*

Three cases of orbital rhabomyosarcoma are reported here. Histological studies comfirmed the lesion 1:0 be the alveolar type in all cases. This tumor is a rare disease entity in Orient than Europe and America and accordingly, rarely encountered in our ophthalmologic practice, although it is the commonest primary malignant orbital tumor in children. Of the three cases reported here one occurred in adu1t and the other two in children. Case I. This 15 month old male showed a swelling of the left upper lid toward the medial side for 2 months and visited to our hospital on March 10, '69 with complaints of progressive swelling on the region with ptosis. The eye ball was slightly displaced toward the lower temporal side and ocular movement is limitted to upward. On palpation, the childthumb sized tumor was palpable in the upper nasal portion of the orbit. On excision of the tumor, the mass was found to be originated from the superior oblique muscle. The mass round measuring 2.5 X 2.5 X 1.5 cm in size. Histological diagnosis was alveolar rhabdomyosarcoma without cross-striation. No follow-up could be done. Case II. This patient of 15 month old male showed a swelling on the right lower lid existed 6 months and visited to our hospital on September 8, '69. The physical examination revealed that the left eye and the other routine examinations were within normal limits. The right eye showed the swelling of the lower lid, congestion of the palpebral conjunctiva, limitted movement of the eye ball toward the lower side and a palpable bean-sized mass on the region. The excision of tumor was performed under the general anesthesia. This mass was attached with the inferior oblique muscle with no other recognizable adhesion seemingly originating from that muscle. The mass was round and oval in shape, measuring 2 X 2 X 1 cm in size, diagnosis was alveolar rhabdomyosarcoma. The post-operative follow-up studies were unavailable. Case III. This case in one of adult alveolar rhabdomyosarcoma. At the age of 25 years, this man showed a proptosis of the right eye associated with migrain like headache, ocular pain and visual disturbance. This symptoms existed 6 months and gradually increased in intensity. On the physical examination, the left eye was found to be normal. The skull and orbit x-ray and c.b.c. were with in normal limits. The right eye revealed about 5mm proptosis compared with left eye and the adult thumb sized tumor was palpated on the inner side of the lower orbital rim. The visual acuity was in zero. The right optic disc was edematous and elevated about 4.0 D. The pupil showed marked dilatation and the light reflex was abscent and ocular movement was markedly limitted and eye ball is deviated toward the upper side. Under the general anesthesia, the exenteration of the orbit associated with the removal of tumor was carried out with no untoward complications. Origin of the mass was the inferior oblique muscle penetrating to the deeper part of the optic foraman and optic nerve was surrounded by the tumor completely Histology confirmed alveolar rhabdomyosarcoma. Follow-up study was impossible.
Adult ; Americas ; Anesthesia, General ; Child ; Conjunctiva ; Diagnosis ; Dilatation ; Estrogens, Conjugated (USP) ; Europe ; Exophthalmos ; Headache ; Humans ; Infant ; Male ; Optic Nerve ; Orbit* ; Palpation ; Physical Examination ; Pupil ; Rare Diseases ; Reflex ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Alveolar ; Skull ; Thumb ; Visual Acuity

No abstract available.
Meningitis, Cryptococcal*

Billiary cystadenoma and cystadenocarcinoma are rare neoplasms of the biliary ductal system. The authorspresent 2 cases of biliary cystadenoma and 3 cases of cystadenocarcinoma. The typical sonographic apearance ofthese tumors is a large intrahepatic gloular or ovoid thickwalled cystic mass which often containes multipleseptations with papillary growth and solid portion. Low-level internal echoes may be seen within the cystic mass.The characteristic CT findings of these tumors are multiloculated cystic mass, thick sepatations with papillaryprojection sand solid portion within the cystic mass. Angiographical characteristics of these tumors arehypovascular mass with frequent abnormal clusters of tumor vessels within the walls on arterial phase andaccumulation of contrast material along the wall or internal septation on delayed film.
Angiography ; Cystadenocarcinoma ; Cystadenoma ; Ultrasonography

Mirizzi syndrom is a rare disorder characterized by obstruction of common hepatic duct due to impacted gallbladder neck or dystic duct stone and is an uncommon cause of obstructive jaundice. Authors experienced one case of Mirizzi syndrome mimicked lobulated intraductal tumor.
Gallbladder ; Hepatic Duct, Common ; Jaundice, Obstructive ; Mirizzi Syndrome ; Neck

Staging of carcinoma of the urinary bladder is important for the choice of therapy and also has prognostic implications. Hitherto the staging has been based upon cystoscopy with bio psy, transurethral resection , and palpation with complementary radiographic examlnations such as cystography, urography, lymphangiography, ultrasound and angiography. However, with all these methods, the staging of bladder carcinomas still uncertain and inferior to CT. Authors analyzed CT staging of bladder cancers and compared with pathologic staging of laparotomy results. The results are as follows: 1. Overall accuracy of CT staging in bladder carcinoma was 72 percent. 2. Overstaging was 20 percent (5/25) and understaging was 8 percent (2/25). 3. All of CT stage B cancers were proven to be stage B, pathologlcally. 4. In 6 cases of CT stagec cancers,only one was correct,3 were overstaged and 2 were understaged. 5. In 7 cases of CT stage D cancers, 5 were correct and 2 were overstaged. 6. CT detected only 2 cases of pelvic Iymph node involvement in 4 of pathologically proven Iymphadenopathy.
Angiography ; Cystoscopy ; Laparotomy ; Lymphography ; Palpation ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder ; Urography

To differentiate amebic and pyogenic liver abscesses, sonography(US) and CT findings of 21 amebic and 22 pyogenic liver abscesses were reviewed retrospectively. US was performed in all cases and CT in 15 cases of each group. Eleven cases of amebic abscesses had well defined margin which was observed in 10 cases of pyogenic abscessed. Amebic abscesses showed hyperechoic wall in 7 cases and calcification in 4 cases. Ten cases of pyogenic abscesses had mearby intrahepatic duct dilatation which was observed in 2 cases of amebic abscesses. Pneumobilia was seen in 6 cases of pyogenic abscesses. US findings of clear margin and hyperechoic wall, and CT findings of intrahepatic duct dilatation, pneumobilia, and calcification were helpful in differentation of amebic pyogenic liver abscesses.
Abscess ; Amebiasis ; Dilatation ; Liver Abscess, Pyogenic* ; Retrospective Studies

PURPOSE: To evaluate the efficacy of the arterial phase of dynamic spiral CT in the detection of pancreatic adenocarcinoma compared with the late phase. MATERIALS AND METHODS: Two phase spiral CT images of seventeen patients with pathologically proven pancreatic ductal adenocarcinomas were compared retrospectively. CT scans were performed with 5mm collimation at 1:1 pitch table speed. Images of arterial and late phases were obtained at 35 seconds and 180 seconds after initiation of administration of 100mL of contrast material(3mL/sec), respectively. Images of the arterial phase were compared with those of the late phase. RESULTS: Images of the arterial phase showed sufficient contrast between the tumor and adjacent pancreatic parenchyma in 12 cases, insufficient in four cases, and no significant contrast in one case. Images of the late phase showed sufficient contrast in five cases, insufficient in five cases, and no significant contrast in seven cases. Images of the arterial phase was superior to that of the late phase in 12 patients(70.6%). In six of the 12 patients, only the images of the arterial phase showed contrast between the tumor and the adjacent parenchyma. The images of late phase showed only one case of three metastasis detected on the images of the arterial phase. CONCLUSION: The arterial phase of spiral CT is superior to the late phase that is comparable with conventional CT in the detection of pancreatic adenocarcinoma.
Adenocarcinoma* ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed