PURPOSE: The author presents imaging findings of patients that underwent partial resection of the breast followed by absorbable mesh implantation. MATERIALS AND METHODS: Ultrasonographic (n=18) and mammographic (n=11) images of patients that had undergone absorbable mesh implantation after breast partial resection were reviewed retrospectively. Sequential changes of the lesions were analyzed in follow-up ultrasonographic examinations, focusing on the change of the size and pattern of the lesion. The presence of a mass, asymmetry, focal asymmetry, architectural distortion, and calcification were evaluated by mammography. Pathologic findings of the implanted mesh in available cases were analyzed. RESULTS: Ultrasonograms revealed a well-encapsulated anechoic lesion with (pattern 1, n=11) or without (pattern 2, n=5) internal isoechoic nodular portion, and a hyperechoic mass-like lesion without anechoic portion (pattern 3, n=2). The mean length of the longest diameter decreased gradually as determined in follow-up examinations (3 months, 6.12 +/- 2.599cm; 6 months, 5.08 +/- 2.105cm; 12 months, 3.26 +/- 2.206cm). In mammograms, a mass (n=4) was noted at the surgical site and focal asymmetry, overlapping with the postoperative change, was seen in the remaining seven cases. Pathologic findings of two cases revealed foreign body reaction. CONCLUSION: Ultrasonography of the patients that underwent breast partial resection followed by absorbable mesh implantation showed a well-encapsulated cyst at the surgical site that gradually decreased in follow-up examinations. Adjunctive ultrasonography combined with mammography would be recommended in postoperative follow-up examinations.
Absorption ; Adult ; Biocompatible Materials/*metabolism ; Breast/*cytology/metabolism/*surgery ; *Breast Implants ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Retrospective Studies ; *Surgical Mesh ; Ultrasonography, Mammary

Primary small cell carcinoma of the prostate is a rare malignancy of unknown origin and with poor prognosis. We report a case occurring in a 74-year-old man. Radiologic findings showed that the prostate was markedly enlarged, with a lobulated contour and unclearly defined internal architecture. It was therefore impossible to distinguish it from prostatic adenocarcinoma, but the huge mass and normal range of serum tumor markers (prostate-specific antigen and prostate acid phosphatase) suggested small cell carcinoma of the prostate.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Humans ; Prognosis ; Prostate* ; Reference Values ; Biomarkers, Tumor

PURPOSE: We performed this study to describe the findings of MR Myelography(MRM) of herniated disc disease, spinal stenosis and spinal tumor and to evaluate the usefulness of the MRM in comparison to MRI. MATERIALS AND METHODS: MRI and MRM were performed in 31 patients with herniated disc disease(12 patients), spinal stenosis(11 patients) and spinal tumor(8 patients). MRI and MRM were done with 1.5-T Signa MR, using fat suppressed heavily T2-weighted fast spin echo technique. We retrospectively analyzed MRM images about the thecal sac indentation, compression or displacement of the nerve root, extent and degree of narrowing of spinal canal, relationship between spinal tumor and spinal cord. MRM findings were compared with MRI in all cases. RESULTS: In 18 herniated disc cases of 12 patients, focal filling defect with cutoff or displacement of the nerve root in eight cases of paracentral herniated disc was seen. Cutoff and displacement of the nerve root were more clearly delineated on MRM than rvlRI. In the patients of spinal stenosis(11 cases), hourglass deformity of the thecal sac or complete spinal block of the subarachnoid space was clearly demonstrated. The extent and severity of spinal stenosis were more accurately evaluated on MRM than MRI. MRM finding of intramedullary tumor(3 cases) was enlargement of spinal cord. Five cases of intradural extramedullary tumor showed intradural filling defect, which caused contralateral displacement of the spinal cord with meniscus sign on inferior margin of the mass. CONCLUSION: MRM shows characteristic findings of herniated disc disease, spinal stenosis and spinal tumor. MRM yields excellent definition of the thecal sac, nerve roots and nerve root sleeves in relation to herniated disc and may be more accurate in evaluation of the degree and extent of spinal stenosis than MRI.
Congenital Abnormalities ; Constriction, Pathologic ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Myelography* ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Diseases ; Spinal Stenosis ; Subarachnoid Space

PURPOSE: The purpose of this study is to describe the patterns of enhancement of the herniated lumbar disc with Gd-DTPA enhanced MR imaging. MATERIALS AND METHODS: Out of 65 patients, 103 lumbar discs diagnosed to be herniated by MR image were retrospectively analyzed. The MR imaging was performed with 1.5 T MR unit, using T1- and T2- weighted sagittal and axial spin echo techniques. Contrast- enhanced T1 weighted sagittal and axial images were performed after intravenous injection of Gadopentetate-dimeglumine(Magnevist, Shering) (0.1 mmol/kg). RESULTS: Contrast enhancement was seen in 66 cases(64%). Thirteen cases of bulging disc were not enhanced. Twenty-eight cases of protruded disc showed intraannular enhancement in 23 cases, peripheral linear and irregular enhancement in each of one case, and nonenhancement in three cases. Fifty-seven cases of extruded disc showed irregular enhancement in 14 cases, peripheral linear enhancement in 12 cases, peripheral ring enhancement in five cases and intraannular enhancement in five cases. All five cases of sequestered disc showed peripheral ring enhancement. CONCLUSION: Protruded discs show intraannular enhancement frequently and sequestered discs usually show peripheral ring enhancement. Enhanced MR imaging may be helpful to evaluate the type of herniated lumbar disc and relationship among disc material, nerve root and thecal sac.
Gadolinium DTPA ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: To assess the usefulness of MRI in preoperative diagnosis of congenital anorectal malformation MATERIALS AND METHODS: MR findings of 11 cases with surgically proved anorectal malformations were retrospectively reviewed and compared with operative findings, according to the level of atresia, the development of sphincter muscle, fistula and associated anomalies of other organs. RESULTS: Four of 11 cases were low type of anorectal atresia, 3 cases were intermediate type, and 3 cases were high type. There was one case of Currarino triad with low type of anorectal stenosis. MRI demonstrated the levels of atresia correctly in all cases and revealed fistulas in all high type of anomalies. Degrees of the development of the sphincter muscles were good in all cases of low types and fair in a case of intermediate type and an anorectal stenosis, whereas the development was poor in 2 cases of intermediate type and all 4 cases of high type. The associated anomalies in anorectal malformation were renal agenesis, congenital hip dysplasia and sacral defect with presacral teratoma in Currarino triad. CONCLUSION: MRI was a simple and useful study to confirm the level of atresia, fistula and associated anomalies in the diagnosis of the congenital anorectal malformation.
Constriction, Pathologic ; Diagnosis ; Fistula ; Hip Dislocation, Congenital ; Magnetic Resonance Imaging ; Muscles ; Retrospective Studies ; Teratoma

PURPOSE: To determine the role of the use of a US-guided vacuum-assisted biopsy for the removal of sonographic evidence (excisional mammotome) for low- and high-risk benign and malignant breast lesions. MATERIALS AND METHODS: We retrospectively reviewed the pathological results of 678 excisional mammotomes (611 low- and 46 high-risk benign and 21 malignant lesions). We compared the pathological results of the excisional mammotomes and the corresponding subsequent surgery of 27 high-risk benign (7/46 cases) and malignant (20/21 cases) lesions. We also reviewed the follow-up US findings of low- (306/611 cases) and high-risk benign lesions (33/39 cases). RESULTS: Fifteen of 27 (55.6%) surgical cases revealed a residual lesion on the excisional mammotome. There was no case of upgrade pathology seen for a surgical specimen. Follow-up sonography of 306 low-risk benign lesions showed a negative finding for 231 (75.2%) cases, post-biopsy changes in 56 (17.8%) cases, and residual lesions in 19 (5.7%) cases. None of the lesion was palpable. Follow-up sonography of 33 high-risk benign lesions revealed a negative finding in 28 (85%) cases, a post-biopsy scar in 4 (12%) cases, and a local recurrence in 1 (3%) case; none of the cases showed a residual lesion. CONCLUSION: We suggest that an excisional mammotome can replace surgical excision for low-risk cases and may avoid the immediate surgery for high-risk benign lesions; however, surgery is crucial for a malignancy.
Biopsy* ; Breast* ; Cicatrix ; Follow-Up Studies ; Pathology ; Recurrence ; Retrospective Studies ; Ultrasonography*

PURPOSE: The matrix metalloproteinases (MMPs) are a family of enzymes whose main function is the degradation of the extracellular matrix. Several studies have revealed that MMPs and TIMPs are related to the wound healing process and in photoaging caused by ultraviolet irradiation. However, the expressions of MMP and TIMP after irradiation have not, to the best of our knowledge, been studied. This study investigates the expressions of MMP-2 and TIMP-2 in rat intestinal mucosa following irradiation. Material and Methods:The entire abdomen of Sprague-Dawley rats was irradiated using a single dose method. The rats were sacrificed on day 1, 2, 3, 5, 7 and 14 following irradiation. Histopathological observations were made using hematoxilin & eosin staining. The expressions of MMP-2 and TIMP-2 were examined using immunohistochemistry, immunoblotting and ELISA. RESULTS: Radiation induced damage, associated with atrophic villi, and infiltration of inflammatory cells was observed from the first postirradiation day, and severe tissue damage was observed on the second and the third postirradiation days. An increase in mitosis and the number of regenerating crypts, as evidence of regeneration, were most noticeable on the fifth postirradiation day. From the immunohistochemistry, the MMP-2 expression was observed from the first postirradiation day, but was most conspicuous on the third and the fifth postirradiation days. The TIMP-2 expression was most conspicuous on the fifth postirradiation day. From the immunoblotting, the MMP-2 expression was strongly positive on the third postirradiation day, and that of TIMP-2 showed a strong positive response on the fifth postirradiation day. In ELISA tests, the expressions of MMP-2 and TIMP-2 were increased in the postirradiation groups compared to those of the normal controls, and showed a maximum increase on the fifth postirradiation day. These results were statistically significant. CONCLUSION: The expressions of MMP-2 and TIMP-2 were increased in the intestinal mucosa of the rats following irradiation, and these results correlated with the histopathological findings, such as tissue damage and regeneration. Therefore, this study suggests that MMP-2 and TIMP-2 play roles in the mechanisms of radiation-induced damage and regeneration of intestinal mucosa of rats.
Abdomen ; Animals ; Enzyme-Linked Immunosorbent Assay ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Humans ; Immunoblotting ; Immunohistochemistry ; Intestinal Mucosa* ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Mitosis ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Tissue Inhibitor of Metalloproteinase-2* ; Wound Healing

PURPOSE: To present the ultrasonographic findings of an implanted absorbable mesh in patients who underwent breast partial resection. MATERIALS AND METHODS: We retrospectively analyzed the ultrasonographic findings of 18 patients who underwent breast partial resection with an absorbable mesh implant to minimize the breast deformity. Sonography was performed approximately 3 months after surgery (mean interval, 92 days). The presence of a capsule and cyst at the surgical site, the size of the cyst, internal content of the cyst, vascularity of the lesion, and presence of complications were analyzed. RESULTS: An ultrasound examination revealed a well-encapsulated cyst with regular capsule in 16 of the 18 patients. The longest diameter of the cyst varied from 3 cm to 10 cm. Among 16 cases that showed a well-encapsulated cyst, 11 cases showed an isoechoic nodular pattern in the cyst and in the remaining five cases, the internal nodular pattern was not seen. In two of the18 cases, an isoechoic nodular pattern without fluid content was seen for the lesions. A Doppler study revealed no vascularity in any of the lesions. CONCLUSION: Ultrasonographic findings of an implanted absorbable mesh, inserted in the surgical site to minimize breast deformity in patients that underwent breast partial resection, showed the presence of a well-encapsulated cyst with an internal isoechoic nodular pattern in the majority of the cases.
Absorbable Implants ; Breast* ; Congenital Abnormalities ; Humans ; Retrospective Studies ; Surgical Mesh ; Ultrasonography

PURPOSE: To compare the contrast-enhanced dynamic MR findings of solid breast masses with their histopathologic tumor angiogenesis. MATERIALS AND METHODS: Thirty-two cases of pathologically proved breast lesions (8 benign and 24 malignant lesions) examined with contrast-enhanced MRI were retrospectively reviewed, focusing on the tumor size, the maximum amount of contrast enhancement (% Signal Intensity Change, SIC), the time to peak (early or late peak) and the type of time-signal intensity curve (TSC). We compared the characteristic MR findings of breast cancer with the microscopic maximum microvessel density (MVD). RESULTS: Among the total of 11 small lesions (< or = 2 cm, 9 malignant and 2 benign), 8 cases of malignant lesions showed high MVD (> or = 20). On the other hand, among the 21 large lesions (> 2 cm, 15 malignant and 6 benign), only two cases of malignant and five cases of benign lesions showed high MVD. More than 100% SIC was observed in a total of 11 malignant and two benign lesions, but 8 of these 11 malignant lesions showed low MVD (< 20), whereas the two benign lesions showed high MVD. Early time to peak (< or = 3 min) was observed in 18 (17 malignant and 1 benign) lesions, and 11 of these 17 malignant lesions showed low MVD. An early high peak and early or slow wash-out pattern, which is typical of the malignant type, was seen in 18 (17 malignant and 1 benign) lesions, but 12 of these 17 malignant lesions showed low MVD. There is no statistically significant correlation between the characteristic MR findings of breast cancer and the MVD. CONCLUSION: Although high MVD indicated malignancy in the case of the small lesions, the histopathologic MVD was not significantly correlated with either the increased amount of enhancement, early time-to peak or the malignant pattern of the TSC.
Breast Neoplasms ; Breast* ; Hand ; Magnetic Resonance Imaging ; Microvessels* ; Retrospective Studies

PURPOSE: We wanted to know the results and the usefulness of placing a marker clip (a surgical titanium clip) after ultrasound (US)-guided excisional mammotome biopsy for breast lesion. MATERIALS AND METHODS: We have placed marker clips at the biopsy sites after performing US-guided excisional mammotome biopsies in 24 cases (mean age; 46 years, mean size of the 12.6 mm, pathologic results; benign in 19 cases, malignant in 5 cases) from Nov. 2003 to Jun. 2004. We designed the needle that we used. Twenty-five cases of follow-up sonography (at 1-month follow-up; 13 cases, at 6-months follow-up; 12 cases) were performed for 18 cases of clip placement. We retrospectively reviewed the success rate and the complications for 24 cases of clip placement, and we analyzed the visibility, conspicuity and location of the clips on 25 cases of follow-up sonography for 18 cases of clip placement. RESULTS: The marker clip is successfully placed in all 24 cases (100%). None of the patients complained of pain or infection, except for 1 case of a large hematoma (3.5 cm). On the follow-up sonography, the titanium clip was well visualized as a short echogenic line on the interval follow-up (for the 1-month follow-up; 85%, for the 6 month follow-up; 84%) and parenchymal composition of the breast was well observed at the location of the clip (intraparenchymal; 80%, parenchyma-fat interface; 90%). The clips were easily found when there was hematoma (85%) or scar (89%). Marker clips were found within the hematoma, scar or the distorted region of tissue in all cases (100%), and there was no evidence of migration on the post-biopsy findings. CONCLUSION: Marker clip placement after US-guided excisional mammotome biopsy is a simple, inexpensive and successful (100%) procedure without any significant complications. Because the maker clips were easily found and well visualized within the biopsy site on follow-up sonography, clip placement was useful as a post-biopsy marker.
Biopsy ; Breast* ; Cicatrix ; Follow-Up Studies ; Hematoma ; Humans ; Needles ; Retrospective Studies ; Titanium ; Ultrasonography