PURPOSE: Transthoracic fine needle aspiration biopsy is a widely practiced technique in the investigation of the lung and mediastinal masses because of its safety, reliability and accuracy. We report the diagnostic accuracy of the transthoracic fine needle aspiration biopsy and the frequency of its complications which required treatment. MATERIALS AND METHODS: We analyzed 1000 transthoracic needle aspiration biopsies whcih were performed in 986 patients with 993 chest lesions. Aspiration biopsies were obtained with Westcott needles (20G or 22G) under the fluoroscopic guidance. Final diagnosis was made with operation, bronchoscopy, sputum study, biopsy of other sites and the clinical course of the patient. We analyzed diagnostic yields of aspiration biopsy and the frequency of the complication requiring treatment. RESULTS: The sensitivity was 87.6% in benign diseases and 95.8% in malignant diseases. Pneumothorax was the most frequent complication, which required pig-tail catheter insertion in 36 cases or thoracostomy in six cases. In 36 cases, minimal hemoptysis developed which did not require treatments. CONCLUSION: We obtained relatively high sensitivities of malignant and benign lesions using transthoracic fine needle aspiration biopsy and the frequency of the complications requiring treatment was very low. Transthoracic fine needle aspiration biopsy is a valuable diagnostic method in the thoracic lesions.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Bronchoscopy ; Catheters ; Diagnosis ; Hemoptysis ; Humans ; Lung ; Needles ; Pneumothorax ; Sputum ; Thoracostomy ; Thorax

PURPOSE: Authors studied the injection method of contrast medium in routine chest spiral CT scan to obtain the best image in the mediastinum. MATERIALS AND METHODS: Dynamic static scan had been performed in 5 normal volunteers as a pilot study. In consideration of the result of pilot study, Chest spiral CT was performed in 217 patients by three different methods. We used 100cc nonionic contrast medium. Average attenuation of great vessels in the mediastinum were assessed in various injection methods. Image quality was graded with three levels of score by two radiologists. RESULTS: Peak enhancement time of the great vessels on pilot at dynamic static scan were as follows :52 sec at ascending aorta, 45 sec at pulmonary artery, and 40 sec at SVC. In the study of spiral CT, the highest attenMarion in the great vessels was obtained after injection of 100cc of contrast medium(2cc/sec, with 35-40 second scan delay), althrough artifact from highly enhancing SVC was most common in this method. Image quality were highest in the scans obtained with other methods(3-2-1cc/sec for 10-15-40 seconds, with 40 second scan delay). CONCLUSION: For chest spiral CT, authors recommend that scans should be obtained after infusion of 70--80cc of contrast medium during 35--40sec to obtain maximal vascular enhacement of mediastinum.
Aorta ; Artifacts ; Healthy Volunteers ; Humans ; Mediastinum ; Pilot Projects ; Pulmonary Artery ; Thorax* ; Tomography, Spiral Computed*

PURPOSE: Ultrasound(US) findings of hyperechoic renal medulla in gouty nephropathy were compared with clinical features such as serum uric acid level to evaluate its usefulness in determination of the treatment and prognosis. MATERIALS AND METHODS: A retrospective review of US of 36 cases of gouty arthritis was classified into four groups according to the medullary echogenicity (O:normal, grade 1 :renal medulla as isoechoic as renal cortex, grade 2'heterogeneous increased echogenicity of renal medulla than that of renal cortex, grade 3 :the echogenicity of all renal medulla higher than that of renal cortex with renal contour deformity) which were compared with the serum urate level and associated conditions. Nephrocalcinosis and nephrolithiasis were analyzed through the KUB and the RGP. RESULTS: The degree of hyperechoic renal medulla was related to the level of serum uric acid, and in group IV, six cases of obstructive uropathy (nephrocalcinosis and nephrolithiasis) showed deformed renal contour. Associated conditions such as hypertension, alcoholism, diabetes mellitus and drug abuse were distributed in relation to the degree of hyperechoic renal medullas. CONCLUSION: US findings of hyperechoic renal medulla was related with uric acid level in gouty nephropathy and thus could be valuable for treatment decision and prediction of prognosis.
Alcoholism ; Arthritis, Gouty ; Diabetes Mellitus ; Hypertension ; Nephrocalcinosis ; Nephrolithiasis ; Prognosis ; Retrospective Studies ; Substance-Related Disorders ; Ultrasonography* ; Uric Acid