No abstract available.
Hyperplasia* ; Islets of Langerhans* ; Nesidioblastosis*

Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.
Angiography ; Artifacts ; Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Diagnostic Imaging ; Image Processing, Computer-Assisted ; Prospective Studies ; Retrospective Studies ; Saphenous Vein ; Sensitivity and Specificity ; Surgical Instruments ; Tomography, X-Ray Computed* ; Transplants ; Vascular Diseases

About one tenth of all CNS neoplasms involves the brain. Due to their location in the ventricles they often present similar nonspecific clinical manifestation. Localization and differential diagnosis are dependent on radiological investigation. For the identification of specific CT characteristics of the intraventricular tumors and the differental diagnosis, we retrospectively analyzed 22 pathologically proved cases seen on CT. Important differential features included age and sex of the patient, the location within the ventricle, and the morpholgic appearance of the mass and density on CT before and after intravenous administration of contrast material. Meningiomas (4 cases) and a germinoma showed increased density on the precontrast CT scans, and demonstrated dense uniform enhancement of the postenhanced scan. Choroid plexus papillomas (3 cases) showed dense uniform contrast enhancement. Intraventricular neurocytomas (3 cases) demonstrated characteristic attachment to the septum pellucidum, confinement of the lateral and third ventricle, and calcification within the mass Colloid cysts (2 cases) showed characteristic location of anterosuperior aspect of the third ventricle. In conclusion, CT findings of intraventricular tumors are usually nonspecific. The location of the mass and the patient's age are the most helpful information in the differential diagnosis.
Administration, Intravenous ; Brain ; Colloid Cysts ; Diagnosis ; Diagnosis, Differential ; Germinoma ; Humans ; Meningioma ; Neurocytoma ; Papilloma, Choroid Plexus ; Retrospective Studies ; Septum Pellucidum ; Third Ventricle ; Tomography, X-Ray Computed

PURPOSE: This study was performed to detect the diseases of congenital hypothyroidism by the neonatal mass screening test early and to demonstrate the possible role of topical iodinated antiseptics(povidone-iodine, PVP-I) on transient hyperthyrotropinemia in newborn infants. METHODS: We performed neonatal screening tests for inborn errors of metabolism since 1985 by Guthrie test for PKU, maple syrup urine disease, histidinemia, and homocystinuria and enzyme-linked immunosorbent test for TSH. And for our prospective study, 366 newborns with a appropriate gestational age (between 37 and 42 weeks) were submitted to TSH screening test. We divided the study subjects into 4 groups; the group used PVP-I for mother and alcohol for cord care was categorized as Group A, the group used PVP-I for both mother and cord care as Group B, the group used triple dye for mother and PVP-I for cord care as Group C, and the group used triple dye for mother and alcohol for cord as Group D. RESULTS: 1) By neonatal screening test for inborn errors of metabolism during the last 10 years, we detected one case of phenylketonuria (PKU), one case of histidinemia and 28 cases of congenital hypothyroidism. The incidence of congenital hypothyroidism was 1 in 3,918 live births. 2) The mean TSH levels were 6.25+/-5.09 microU/ml(male 5.85+/-4.77 and female 6.6+/-5.41 microU/ml) in Group A, 8.30+/-7.68 microU/ml(male 6.30+/-7.15 and female 9.98+/-7.77U/ml) in Group B, 7.42+/-5.35 microU/ml(male 7.40+/-6.11 and female 7.44+/-4.63 microU/ml) in Group C, and 6.33+/-1.95 microU/ml(male 6.19+/-1.90 and female 6.42+/-2.03 microU/ml) in Group D, There were statistically significance between Group A and Group B, and Group D, but there was no statistically significance between gender. 3) The number of the newborns showed high levels of TSH over 15 muU/ml were 4.2%, 26.7% and 7.7% in Group A, B, and C, respectively. But nobody showed high TSH level over 15 microU/ml in Group D without use of PVP-I. CONCLUSIONS: In conclusion, we might be concerned for neonatal mass screening test on a national scale to prevent mental retardation and it is necessary to switch the povidone-iodine to other preparations as a perinatal antiseptics because of the possibility of the effect on neonatal screening test for congenital hypothyroidism.
Anti-Infective Agents, Local ; Congenital Hypothyroidism* ; Female ; Gestational Age ; Homocystinuria ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Iodine* ; Live Birth ; Maple Syrup Urine Disease ; Mass Screening* ; Metabolism, Inborn Errors ; Mothers ; Neonatal Screening ; Phenylketonurias ; Povidone-Iodine ; Prospective Studies ; Umbilical Cord

PURPOSE: Mesenteric and omental cysts are uncommon lesions found all age groups. They elicit interest because of their unclear pathogenesis and confusing terminology. MATERIALS AND METHODS: CT findings of 12 case with mesenteric and omental cysts were described and compared with surgical and pathologic findings. RESULTS: In mesenteric and omental cyst, the histologic diagnoses were lymphangioma(7 cases), nonpancreatic pseudocyst(3 cases), mesothelial cyst(2 cases). Lymphangiomas were usually multiloculated with enhancing wall, located in the small bowel mesentery. And these cystic lesions were frequently attached to bowel and required resection of a bowel segment. In three cases of pseudocyst, thick and enhancing wall was shown in unilocular cyst. Two cases of mesothlial cyst were located in greater omenturn, showed very thin wall in unilocuation. CONCLUSION: The CT features of the mesenteric and omental cysts are fairly characteristic. Identification of lymphangioma, which shows a multilocuation and enhancing wall, is important due to frequent bowel resection in operative field.
Diagnosis ; Humans ; Lymphangioma ; Mesentery

PUYPOSE: The purpose of this study was to determine whether the magnetization transfer ratio(MTR) differs between malignant and benign cervical lymphadenopathy. MATERIALS AND METHODS: Magnetization transfer ratios were obtained from 104 lymph nodes of 43 patients. Fifty-five nodes were malignant and 49 were benign. Biopsy or cervical lymph node dissection was performed in 83 nodes, while the remaining 21 were diagnosed clinically or by follow-up imaging studies. Among the 55 malignant nodes, squamous cell carcinomas accounted for 29 cases, lymphomas for 15, undifferentiated carcinomas for four, acute myelogenous leukemia for four, and melanomas for three. The 49 benign nodes comprised 21 cases of reactive hyperplasia, 12 of Kikuchi's disease, nine of acute lymphadenitis, and seven of tuberculous lymphadenitis. All scans were performed using a 1.5T Magnetom Vision(Siemens, Erlangen, Germany) with phased-array or Helmholtz-type neck coil. Scanning was performed with and without magnetization transfer pulse(MT pulse : 11.2 T, 250 Hz band-width, off-set 2.0 KHz) using FLASH 2D sequencing. The region of interest(ROI) for signal intensity(SI) measurements was sampled at the same nodes by keeping the position, shape and size of the ROI constant for the scans before and after the MT pulse was applied. SI measurements were repeated more than three times in each node and the mean value was used to calculate MTR. In this study, however, corrected MTRs(CoMTRs) were used for correction of the effect of background noise produced by magnetic field inhomogeneity. RESULTS: Mean CoMTRs of malignant and benign nodes were 0.33(SD: +/- 0.04) and 0.28(SD: +/- 0.05), respectively. This difference was statistically significant. At CoMTR 0.31, the sensitivity and specificity of malignant nodes were 83% and 75%, respectively. CONCLUSION: A CoMTR of above 0.31 suggests malignant lymphadenopathy. CoMTR is one of the MR criteria which can serve to differentiate between malignant and benign lymphadenopathy.
Biopsy ; Carcinoma ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Head* ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Hyperplasia ; Leukemia, Myeloid, Acute ; Lymph Node Excision ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Lymphoma ; Magnetic Fields ; Melanoma ; Neck* ; Noise ; Sensitivity and Specificity ; Tuberculosis, Lymph Node

No abstract available.
Catheters* ; Epidural Space*

No abstract available.
Catheters* ; Epidural Space*

PURPOSE: To compare the usefulness of test bolus examination in three-dimensional contrast enhanced MR angiography of the carotid artery with that of the fixed delay time method. MATERIALS AND METHODS: Sixty consecutive patients (mean age, 60.1 years) in whom carotid arterial disease was suspected and who were examined during a 17-month period were divided into two equal groups. For group A, a fixed delay time of 5 secs was used, while for group B, the delay time of the test bolus examination was calculated from the signal intensity versus time curve of the carotid artery, obtained after the test injection of 1 ml contrast material into the right brachal vein. Overall image quality, discrimination between the arterial and the venous phase, and the contrast-to-noise ratio(CNR) of the carotid artery were compared between the two groups. Overall image quality was classified as excellent, good, moderate or poor, and discrimination between the two phases was graded IV-I according to the degree of jugular venous enhancement. RESULTS: In group A, overall image quality of the carotid artery was classified as excellent or good in 13 (43.3%)and 9 (30.0%) cases, respectively, while in group B the corresponding figures were 23 (76.7%) and 5 (16.7%). The differences between the two groups were statistically significant (p<0.05). In terms of discrimination between the arterial and venous phase, 20 (66.7%) of the 30 cases in group A were assigned grade IV or III, while 28 (93.3%) of the 30 in group B were assigned these same grades (p<0.05). The CNR of the carotid artery was higher in group B(67.1 +/-16.1) than in group A(27.3 +/-17.8), with statistical significance(p<0.05). CONCLUSION: For examination of the carotid artery, contrast enhanced MR angiography using a test bolus is su-perior to the fixed delay time method.
Angiography* ; Carotid Arteries* ; Carotid Artery Diseases ; Discrimination (Psychology) ; Humans ; Veins

PURPOSE: Plasma fibrin D-dimer (D-dimer) has been suggested as a potential screening marker of acute aortic syndrome (AAS) in the emergency department (ED). However, the appropriate thresholds of D-dimer for AAS have not yet been defined. Moreover, studies reporting determinants of D-dimer concentrations in AAS are scarce. METHODS: Data were collected retrospectively on patientsfor whom a D-dimer assay and enhanced computed tomography (CT) had been performed for differential diagnosis in the ED. The D-dimer assay used during the study was the quantitative latex agglutination assay. The study was conducted in a university ED with an annual census of 67,500 between March 2004 and February 2006. A receiver operating characteristics curve was used to find the optimal cutoff of the D-dimer to predict AAS in the ED. A multivariable linear regression analysis was used to identify factors associated with increased D-dimer concentrations in AAS. RESULTS: The enrolled patients (n=105) were divided into 2 groups according to enhanced CT findings: an AAS group (n=65) and a non-AAS group (n=40). The mean D-dimer level was higher in the AAS group (10.7+/-12.8 ug/mL) than in the non-AAS group (0.6+/-0.3 ug/mL)(p<0.001). The Ddimer test showed a 92.3% sensitivity, an 85.0% specificity, a 90.9% positive predictive value, an 87.2% negative predictive value, and a 90.5% accuracy for detection of AAS at a discriminate level of 1.0 ug/mL. Stratified age, smoking, extent of AAS, complications associated with AAS, and the time interval from symptoms to D-dimer testing were independently associated with D-dimer concentrations in AAS. CONCLUSION: At a discriminate level of 1.0 ug/mL, the Ddimer assay is a sensitive and specific test for the detection of AAS in the ED. D-dimer concentrations in AAS were significantly associated with stratified age, smoking, extent of AAS, complications associated with AAS, and the time interval from symptom onset to testing.
Agglutination ; Aorta ; Censuses ; Diagnosis, Differential ; Emergencies* ; Emergency Service, Hospital* ; Fibrin* ; Humans ; Latex ; Linear Models ; Mass Screening ; Plasma* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Smoke ; Smoking ; Universities