PURPOSE: Most hepatic metastases are hypovascular, and CT scanning during peak hepatic enhancement is thusimportant for the detection of hepatic lesions. The purpose of this study was to determine whether images obtainedby bolus tracking show greater hepatic enhancement. MATERIALS AND METHODS: We prospectively evaluated 101 patientswho underwent helical CT of the abdomen, using either a fixed 60-sec delay(n=50) or bolus tracking (n=51). For thelatter, we used a hepatic enhancement threshold of 50HU over baseline on monitor phase to determine a 6-sec delaybetween the monitor and diagnostic scanning phase. For all patients, three region-of-interest measurements wererecorded, one at each of the upper, middle, and lower levels of the liver; the measurements were averaged andsubtracted from the baseline density that measured CT values in three different hepatic segments at the mid-levelof the liver. We compared mean enhancement above the baseline of the liver between fixed 60-sec delay and bolustracking. RESULTS: A statistically significant difference in the enhancement level of the liver (upper, p=.001;middle, p=.001; lower, p=.003) was noted between fixed 60-sec delay (upper, 65.3+/-16HU; middle, 67.4+/-16.5HU;lower, 68.5(19.4HU) and bolus tracking (upper, 75.2+/-15.5HU; middle, 74.4+/-13.7HU;lower, 75.6+/-13.6HU). With fixeddelay, 86% of patients reached 50HU of enhancement, but with bolus tracking, 98% reached this level. For onenhancement value of 60HU, the corresponding figures were 64% and 86%. Mean delay for the transition betweenmonitoring scans and diagnostic scan initiation was 63.8+/-7.9(range, 48-79)secs. For two patients in whom theenhancement curve did not reach threshold (50HU), the default time was 70 sec; one subsequently failed to reachthis same threshold. CONCLUSION: Using the same amounts of contrast material, bolus tracking provides a greaterlevel of hepatic enhancement than a fixed 60-ses delay, and is thus helpful for the detection of hypovascularmasses such as metastatic lesions.
Abdomen ; Humans ; Liver ; Neoplasm Metastasis ; Prospective Studies ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

No abstract available.
Moyamoya Disease*

Removal of blunt esophageal foreign bodies using Foley catheter under a fluoroscopic guidance is a well-recognized procedure. However, since this procedure is rather cumbersome and uncomfortable to the patient, the authors tried to find an easier and more convenient modified technique. For 10 patients with esophageal foreign body, we tried the method to the patients who is lying in the right lateral decubitus position and 3 assistants hold head. arms, trunk and legs of the patients without tilting the table and without using immobilizer. Foley catheter is inserted through nostril, nasal cavity and pharynx to esophagus. In order to identify the Foley catheter in esophagus, 0.025 inch short wire was inserted in the Foley catheter. The balloon of a Foley catheter was inflated by 10cc of air, and the syringe was kept attached to the Foley catheter during the procedure. After passage of the foreign body through the upper esophageal sphincter, the balloon was deflated immediately and the foreign body was removed through the mouth. We successfully removed in removing all the blunt esophageal foreign body with ease. This modified method is also fast, safe and efficient.
Arm ; Catheters* ; Deception ; Esophageal Sphincter, Upper ; Esophagus ; Foreign Bodies* ; Head ; Humans ; Leg ; Methods* ; Mouth ; Nasal Cavity ; Pharynx ; Syringes

In the Republic of Korea, medical insurance coverage for ultrasounds began on October 1, 2013 for four major categories of illness: cancer, heart disease, cerebrovascular disorders, and rare and incurable diseases. However, several problems associated with this ultrasound insurance coverage have arisen: broad classification of ultrasound examination procedures, small and distorted insurance fees, and inappropriate insurance fee calculation methods. In order to prevent the deterioration of medical quality as well as confusion in the medical field, it is necessary that the Ministry of Health and Welfare, the Korean Medical Association, and other ultrasound-related academic societies cooperate to subdivide the classification of ultrasound examination procedures, modify the insurance fee, and properly calculate the ultrasound insurance fee.
Cerebrovascular Disorders ; Classification ; Fees and Charges ; Heart Neoplasms ; Insurance Coverage ; Insurance* ; Republic of Korea ; Ultrasonography*

No abstract available.
Abscess* ; Drainage*

No abstract available.
Tuberculosis, Renal*

PURPOSE: Computed tomographic(CT), ultrasonographic(US) findings of solid and papillary epithelial neoplasm of the pancreas were correlated with pathologic findings for the better understanding of this disease entity. METHODS AND MATERIALS: A retrospective review of CT and US of 14 cases of solid and papillary epithelial neoplasm of the pancreas was carried out in terms of the margin, internal architecture, caicification and septation, and this was correlated with gross pathologic findings. RESULTS: CT and US findings were well defined round masses consisting of both solid and cystic components. Five cases were cystic, four cases were solid and five cases were mixed. Cystic portion of the tumor represented variable degree of hemorrhagic necrosis. Six cases contained foci of calcification, which were linear, marginal and amorphous. Marginal calcification interfered US examination of the mass in three cases. Internal septurn was demonstrated in four cases on CT, one case on US and three cases on gross specimen. CONCLUSIONS: Our results indicate that calcification and internal septurn were considered as a part of radiologic findings in solid and papillary epithelial neoplasm of the pancreas.
Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Retrospective Studies

Primary paraganglioma of the liver is a very rare disorder, and radiologic findings have not yet been described. We report a case of this entity in which the US, CT, MRI and 131I-MIBG scan findings are described.
Liver* ; Magnetic Resonance Imaging ; Paraganglioma*

PURPOSE: The aim of this study was to determine the role of the CT scan in blunt hepatic injury and the significance of CT degree of hepatic injury in the decision making of treatment plan. MATERIALS AND METHODS: We retrospectively analysed the CT findings of 22 patients with hepatic injury. We graded hepatic injury on CT scan into five according to the severity. Clinical records, type of management and clinical outcome of the patients were also reviewed. RESULTS: Of the 22 patients, 17 had conservative treatment and five had surgery. The numbers of patients treated conservatively were 0, 4, 11, 2 and 0 in the grade 1, 2, 3, 4 and 5, respectively and the numbers of surgically treated cases were 0, 0, 3, 2 and 0 respectively. There was no significant statistical difference between surgically and conservatively treated groups(p-value > 0.05). All patients with conservatively treated group were hemodynamically stable and had no complication during hospitalization. Hemoperitoneum was observed in 11 of 22 patients. CONCLUSION: In blunt hepatic injury, CT plays an important role in the demonstration of location and extent of the hepatic injury, size of hemoperitoneum and the post operative course. However, we believe that physiologic status of the patients may be more important than the extent of CT based hepatic injury for determining a mode of treatment.
Decision Making ; Hemoperitoneum ; Hospitalization ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography