Follow-up sonographic studies of three infants, whose initial sonograms showed findings suggestive of choledochal cyst, demonstrated disappearance of cystic dilatation of the common bile ducts. The phenomena could be accounted for by acute common bile duct obstruction secondary to bile sludge. Bile plug syndrome should also be included in the differencial diagnosis. When a cystic or fusiform dilatation of the common bile duct is seen on sonogram. Conservative management must be the choice of approach unless the finding is proven to unchanged over a period of time and irreversible.
Bile ; Choledochal Cyst ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Follow-Up Studies ; Humans ; Infant* ; Sewage ; Ultrasonography

No abstract available.

The obliteration of a fat plane between the gastric carcinoma and the pancreas is a major criterion on CT scan for pancreatic invasion of gastric carcinoma. However, this sign is not always a reliable indicator of invasion, as the patients with gastric carcinoma are often emaciated. Producing a false positive CT findings. The purpose of our study is to improve the diagnostic accuracy of pancreatic invasion of gastric carcinoma in cases which the fat plane between the gastric carcinoma and the pancreas is obliterated in conventional CT scan. The authors performed lateral decubitus as well as supine CT scans and upper gastrointestinal series(UGIS) in 49 pathologically proven cases in which the fat plane was obliterated between the gastric carcinoma and the pancreas on conventional supine CT scan. Pancreatic invasion was suggested when the fat plane was obliterated persistently in the lateral decubitus view as well as the supine CT images and the involved gastric wall and adjacent pancreas maintained constant approximation despite postural change(CT+), and when the gastric tumor moved downward on the erect view of the UGIS no more than 1.5 time the height of the first lumbar vertevral body(UGIS+). Among 49 cases in which the fat plane between the gastric carcinoma and the pancreas was obliterated on supine CT scan, pancreatic invasion was confirmed pathologically in 11 cases(22.4%). Eight of 11 cases proven as pancreatic invasion were correctly diagnosed as pancreatic invasion by this combined analysis (CT+/UGIS+, 72.7%). Twenty seven of 38 cases proven as no pancreatic invasion were correctly diagnosed as no pancreatic invasion(CT-/UGIS-, 71.1%). Twelve cases showed CT +/UGIS-or CT-/UGIS+, so it was inconclusive whether there was invasion or not. The overall diagnostic accuracy was 71.4%. In conclusion, combined analysis with supine and lateral decubitus CT and UGIS is useful for improving diagnostic accuracy for pancreatic invasion by gastric carcinoma in patients of which the fat plane between the gastric carcinoma and the pancreas is obliterated on conventional supine CT.
Humans ; Pancreas ; Tomography, X-Ray Computed

PURPOSE: To assess the value of MR imaging compared to CT for the staging of gastric carcinoma when body-wrap-around surface coil, intravenous glucagon, motion suppression technique and effervescent granules are used. MATERIAL AND METHOD: CT and MRI were performed for thirty-five patients with gastric carcinoma. Postcontrast CT scan was performed immediately after oral effervescent granules and Buscopan were given. Before MR imaging, BWA surface coil was wrapped around the upper abdomen. T1 coronal, sagittal and axial SE images (TRITE=400/15 msec) were obtained immediately after oral effervescent granules and glucagon were given. Respiratory compensation and presaturation techniques were used for each imaging. Three radiologists evaluated independently for randomly mixed 70 sets of CT and MR images. The signal intensity of gastric mass and enlarged lymph nodes were compared to the signal intensity of the adjacent pancreas, liver and spleen to evaluate any discriminating features between them. RESULTS: The accuracy in the diagnosis of pancreatic invasion was 83.8% on MRI and 74.3% on CT (p < 0.05). The accuracy of MRI and CT was 77.1% and 72.4% in detecting of gastric tumor respectively (p > 0.05), 73.3% and 68.6% in gastric serosal invasion (p> 0.05), 50.5% and 42.9% in lymph node metastasis (p > 0.05). The gastric mass and enlarged lymph nodes were hypointense to the intensity of pancreas and liver in more than 78% of cases. CONCLUSION: MRI was comparable to CT scan for the staging of gastric carcinoma. Therefore, MRI could be used as an alternative or adjunctive diagnostic modality in the staging of gastric carcinoma.
Abdomen ; Butylscopolammonium Bromide ; Compensation and Redress ; Diagnosis ; Glucagon ; Humans ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pancreas ; Spleen ; Tomography, X-Ray Computed

It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.
Brain Edema ; Brain Neoplasms ; Brain ; Choriocarcinoma ; Craniotomy ; Female ; Mass Screening ; Neoplasm Metastasis ; Neurologic Manifestations ; Occipital Lobe ; Pregnancy ; Rabeprazole ; Stroke

A 7-year-old boy presented with productive cough and mild dyspnea. He had a history of intlermittant attacksof broanchopneumonia, but otherwise he was healthy. He had a small right lung on chest roentgenogram. Thediagnosis of developmental hypoplasia of the right lung due to congenital absence of the right pulmonary arterywas made by radionuclide angiocardiography and subsequently confirmed by cardiac catheterization and angiography.
Angiocardiography ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Cough ; Diagnosis ; Dyspnea ; Humans ; Lung ; Male ; Thorax

Amyloidosis is a rare systemic disease caused by extracellular deposition of insoluble protein. Systemic amyloidosis is subclassified into idiopathic primary and secondary form. The cause of secondary amyloidosis includes tuberculosis, familial Mediterranean fever, rheumatoid arthritis and multiple myeloma. We report a case of tuberculosis-related, secondary systemic amyloidosis which involved liver, spleen, kidneys, stomach, urinary bladder and lymph nodes.
Amyloidosis* ; Arthritis, Rheumatoid ; Familial Mediterranean Fever ; Kidney ; Liver ; Lymph Nodes ; Multiple Myeloma ; Spleen ; Stomach ; Tuberculosis* ; Urinary Bladder

The cranial CT is a new radiological technique with which, for the first time, minimal differences anattenuation by intracranial soft tissue can be measured exactly. Th basic physical principles of CT have beenextensively presented by Hounsfield (1973). It is well established that the attenuation of extravasated blood measures between 35 and 45 houns field units. Therefore no difficulty should be encoutered in the recognition anddiagnosis of extra-axial hematoma and cerebral contusion since the density of the brain parenchyma never measures more than 25 units. As the constant increase in high velocity accidents and violence, the problem of acute headinjury is one of the matters of great importance in today's medical practice. Therfore it is very important to figure out the method that would allow us to diagnose easily and precisely the effects of trauma upon the brain inorder to institute the proper treatment at the earliest possible moment . CT allows us to make a diagnosis quickly and in a non-invasive manner. The CT scan was carried out on 310 head trauma cases in the department of radiology, St. Mary's and Kang Nam St. Mary's Hospital, Catholic Medical College, for 16 months from June 1979 to Oct. 1980.All the scans were obtained with the Hitachi CT-H2 scanner and the scans were repeated following intravenous injection of high dose of contrast media(roughly 1.8cc per kg body weight of 60% Conray). We have reviewed the CTscans of 310 patients got acute head injury in order to assess the location of brain lesions, the relationshipbetween the CT scans of 310 patients got acute head injury in order to assess the location of brain lesions, the relationship between the CT densities of hematomas and their stage, the shape mass effect of the extra-axialhematomas, and the effect of contrast enhancement. The resuls were as follows; 1. Of all 310 cases of the headinjuries, epidural hematoma was 13.5%, subdural hematoma was 8.7%, subdural hygroma was 10%, cerebral contusion was 39%. hydrocephalus and atrophy was 3.9% and negative finding was 24.9%. 2. The extra-axial hematoma waslocated on the right side in 49.3% and the left side in 39.1% and bilaterally in 11.6%. Therfore unilateral lesion was much more than bilateral one. 3. The extra-axial hematoma was getting decreased in density as time gone by. 4. The shape of epidural hematoma was biconvex in 88.1% and planoconvex in 11.9%. 5. The shape of subdural hematoma was crescent in 88.9% and biconvex in 11.9% in chronic stage. 6. The mass effect of extra-axial hematoma was getting slowly decreased as time gone by. 7. The extra-axial hematoma was enhanced by the contrast media in allacute, subacute and chronic stages as well as in the cerebral contusion, but there was a tedency that the contrast enhancement of hematoma was getting increased as time gone by.
Atrophy ; Body Weight ; Brain ; Contrast Media ; Contusions ; Craniocerebral Trauma ; Diagnosis ; Hematoma ; Hematoma, Subdural ; Humans ; Hydrocephalus ; Injections, Intravenous ; Methods ; Subdural Effusion ; Tomography, X-Ray Computed ; Violence

Radiological demonstration of lymph vessels and lymph nodes may be achieved only by direct lymphography, whichis perfomred by injecting contrast material directly into the lymph vessels. lymph nodes, or occasionally intolymph cysts. Clinical lymphography is performed essentially according to the direct technique of Kinmonth(1952 &1954). Lymphography has become a routine procedure in patients with carcinoma of the uterine cervix. Thoroughassessment of the extent of carcinoma of the uterine cervix is necessary to the intellignet management of anypatient with uterine carcinoma. This presentation is to outline the technique of lymphangio-adenography(lymphography), lymphographic finding and diagnostic criteria of the cervical carcinoma, and evaluation of theaccuracy of lymphographic diagnosis in cervical carcinoma. A retrospective reivew of the lymphograms of 145patients with carcinoma of the uterine cercix was undertaken. All lymphograms were performed at Kang Nam St.Mary's and St. Mary's Hospitals, Catholic Medical College form 1975 to 1982. Of thse patients 87 were got radicalhysterectomy and lymphographic diagnosis was compared with tissue pathology of the nodes removed, and determinedthe diagnostic accuracy of lymphography. Lymphography can make a significant contribution in the pretreatmentassessment of patients with carcinoma of the uterine cervix. Strict adherence to rigid criteria will yieldexcellent pathologic correlation in the event of a positive radiographic diagnosis of metastatic carcinoma. Once apositive diagnosis is made, it should influence the management of the cancer patients. The results were as follow;1. The accuracy of lymphography in diagnosing lymph node metastasis of carcinoma of the uterine cervix was 85.1%,82.4% in sensitivity and 86.8% in specificity. 2. Metastic lymph nodes were moderately to markedly enlarged andirregular in shape and shown motheaten marginal filling defects in 92.7%. Theses ranged from 3mm to 20mm in thegreatest diameter. 3. Metastatic lymph nodes showed a tendency to get increased in size, inproportion to the sizeof marginal filling defect. 4. The size of filling defect of metastatic lymph nodes was not correlated to theclinical stage of carcinoma of the uterine cervix. 5. Lymph node metastasis was confirmed in 6 patients of 10patients who were got lymphography in 2 to 5 years after radical hysterectomy. 6. Many collateral lymphatics andlymphatic cysts were found out in the lymphography after radical hysterectomy in carcioma of the uterine cerix.
Cervix Uteri ; Diagnosis ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Lymphography ; Neoplasm Metastasis ; Pathology ; Retrospective Studies ; Sensitivity and Specificity

The ability of CT sanning of the mediasinum to distinguish specific tissue densitie and to display in a transverse plane often provides unique diagnsotic information unobtainable with conventional radiographic methods. We retrospectively analyzed the CT findings of 20 cases of proven mediastinal masses at the Departement of Radiology, St. Mary's Hospital, Catholic Medical College from Feb. 1982 to June 1984. CT scans were performed witha Siemens Somatom 2 scanner. The technical factors involved were tube voltage 125 kVp, exposure time 5 seconds,230 mAs, 256x256 matrices, and pixel size 1.3mm. 8mm slices were obtained at 1cm interval or magnifying scans were obtained. After pre-contrast scans, contrast scans were routinely taken with rapid drip-infusion of contrast media(60% Conray, 150cc). The results obtained were as follows; 1. Among 20 cases, 11 were tumors, 4 infectious masses and 5 aneurysms of great vessels, tortuous brachicephalic artery and pericardial fat pad. In each case CT showed accurate location, extent, and nature of the masses. 2. Solid tumors were thymic hyperplasias, thymoma,thymus carcinoid, neurilemmoma and germ cell tumors(seminoma, embryonal cell carcinoma). Internal architecture was homogeneous in thymoma, thymus carcinomoid, neurilemmoma, seminoma but inhomogeneous in thymic hyperplasias andembryonal cell carcinoma. CT number ranged from 16 to 49 HU and were variably enhanced. 3. Cystic tumors consistedof teratomas, cystic hygroma, and neurilemmoma. Teratomas contained calcium and fat, inhomogeneous mass withstrongly enhancing wall. Cystic hygroma was nonenhancing mass with HU of 20. 4. All of germ cell tumors (2 teratomas and one each of seminoma and embryonal cell carcinoma) and one of 2 thymic hyperplasias had calciumdeposit. 5. Tuberculous lymphadenopapthies presented as a mass in the retrocaval pretracheal space and hilarregion with HU ranging from 34 to 64 and enhancement was variable. Mediastinal abscess was alsmost not enhancing,presenting as an inhomogeneous mass of 21 HU with mottled air densities. 6. Aneurysm of great vessels, tortuouobrachiocephalic artery and pericardial fat pad which were often misinterpretted as mediastinal tumor on the conventional radiographic study could be easily distinguishable on CT scan.
Abscess ; Adipose Tissue ; Aneurysm ; Arteries ; Calcium ; Carcinoid Tumor ; Germ Cells ; Lymphangioma, Cystic ; Neoplasms, Germ Cell and Embryonal ; Neurilemmoma ; Retrospective Studies ; Seminoma ; Teratoma ; Thymoma ; Thymus Gland ; Thymus Hyperplasia ; Tomography, X-Ray Computed