A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behcet's disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.
Adult ; Aneurysm, Ruptured/*radiography/*surgery ; Behcet Syndrome/*complications ; Humans ; Iopamidol/analogs & derivatives/diagnostic use ; Male ; *Pulmonary Artery ; Radiography, Thoracic ; *Septal Occluder Device ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to evaluate the CT findings of epithelial origin ovarian carcinoma according to the degree of histologic differentiation. MATERIALS AND METHODS: This study enrolled 124 patients with 31 well differentiated, 44 moderately differentiated and 95 poorly differentiated carcinomas with epithelial origin. The CT images were retrospectively evaluated with regard to bilateral ovarian involvement, the tumor's nature, lymphadenopathy, adjacent organ invasion, peritoneal tumor seeding, a large amount of ascites and distant metastasis. In cystic, predominantly cystic and mixed tumors, the tumor wall, septa, papillary projection and necrosis in the solid portion were assessed. RESULTS: Bilateral ovarian involvement was more common in the poorly (48%) and moderately (42%) differentiated carcinomas than in the well differentiated carcinomas (7%) (p < 0.05). The frequency of a predominantly solid or solid nature was greater in the moderately and poorly differentiated carcinomas than in the well differentiated carcinomas (p < 0.0001). In the 87 tumors with a cystic, predominantly cystic or mixed nature, septa greater than 3 mm, papillary projection and necrosis in the solid portion were more common in the poorly differentiated carcinoma (91%, 91% and 77%, respectively) than in the moderately (64%, 68% and 34%, respectively) and well differentiated carcinomas (63%, 47% and 27%, respectively) (p < 0.05). Lymphadenopathy, organ invasion, tumor seeding and a large amount of ascites were more common in the poorly differentiated carcinomas (38%, 27%, 73% and 69%, respectively) than in the moderately (13%, 10%, 48% and 45%, respectively) and well differentiated carcinomas (3%, 0%, 10% and 17%, respectively) (p < 0.05). CONCLUSION: Epithelial origin ovarian carcinoma shows different CT findings according to the degree of histologic differentiation.
Ascites/radiography ; Carcinoma/*pathology/*radiography ; Contrast Media ; Female ; Humans ; Iohexol/analogs & derivatives ; Iopamidol ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Invasiveness ; Ovarian Neoplasms/*pathology/*radiography ; Retrospective Studies ; Tomography, Spiral Computed/*methods

Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.
Anaphylaxis/chemically induced/diagnosis/immunology ; Contrast Media/*adverse effects ; Cross Reactions/immunology ; Dermatitis, Contact/*diagnosis/*immunology ; Drug Hypersensitivity/diagnosis ; Female ; Humans ; Iodides/*immunology ; Iohexol/analogs & derivatives ; Iopamidol/analogs & derivatives ; Male ; Middle Aged ; Republic of Korea ; Skin Tests/*methods ; Triiodobenzoic Acids ; Urticaria/diagnosis/immunology

OBJECTIVE: We aimed to describe the imaging findings of multidetector CT coronary angiography (MDCTA) in cases of vasospastic angina (VA) and to determine the accuracy of MDCTA in the identification of VA as compared with invasive coronary angiography with an ergonovine provocation test (CAG with an EG test). MATERIALS AND METHODS: Fifty-three patients with clinically suspected VA were enrolled in this study. Two radiologists analyzed the stenosis degree, presence or absence of plaque, plaque composition, and a remodeling index of the related-segment in CAG with an EG test, which were used as a gold standard. We evaluated the diagnostic performances of MDCTA by comparing the MDCTA findings with those of CAG with an EG test. RESULTS: Among the 25 patients with positive CAG with an EG test, all 12 patients with significant stenosis showed no definite plaque with the negative arterial remodeling. Of the six patients with insignificant stenosis, three (50%) had non-calcified plaque (NCP), two (33%) had mixed plaque, and one (17%) had calcified plaque. When the criteria for significant stenosis with negative remodeling but no definite evidence of plaque as a characteristic finding of MDCTA were used, results showed sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of 48%, 100%, 100%, and 68%, respectively. CONCLUSION: Significant stenosis with negative remodeling, but no definite evidence of plaque, is the characteristic finding on MDCTA of VA. Cardiac MDCTA shows good diagnostic performance with high specificity and PPV as compared with CAG with an EG test.
Angina Pectoris/*radiography ; Chi-Square Distribution ; Comorbidity ; Contrast Media/diagnostic use ; Coronary Angiography/*methods ; Electrocardiography ; Ergonovine/diagnostic use ; Female ; Humans ; Iopamidol/analogs & derivatives/diagnostic use ; Male ; Middle Aged ; Oxytocics/diagnostic use ; Predictive Value of Tests ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods

OBJECTIVETo assess the value of dynamic enhanced CT scanning in diagnosis of pulmonary nodules.

METHODSSixty-nine patients with pulmonary nodules underwent examination with dynamic enhanced CT scanning. Of these patients, 53 with definite diagnoses confirmed by histological or clinical data were divided into three groups according to the nature of the nodules, namely the malignant group (n=34), benign group (n=13) and active inflammatory group (n=6). The time-density curve (T-DC) and the corresponding parameters of these patients were compared.

RESULTSSignificant differences in the net enhancement and S/A ratio were found among the 3 groups (P<0.001). The active inflammatory nodules showed the highest enhancement, followed by malignant nodules and then by benign nodules, with significant differences between any of the two groups (P<0.05). At the diagnostic threshold of net enhancement by 25 Hu or S/A ratio by 10% for malignant nodules, a higher negative predictive value and accuracy were obtained. The difference in the wash-out value among the 3 groups was statistically significant (P<0.05). When diagnostic criteria for malignancy was defined by a wash-in value of 25 Hu or higher and wash-out value of 0-35 Hu, the false-positive rate was decreased from 57.89% to 47.37%.

CONCLUSIONThe application of 16-slice spiral CT and its CT perfusion software allows convenient dynamic enhancement study of pulmonary nodules and can be helpful in their differential diagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Contrast Media ; administration & dosage ; Diagnosis, Differential ; Female ; Humans ; Iopamidol ; administration & dosage ; analogs & derivatives ; Lung Diseases ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Radiographic Image Enhancement ; Solitary Pulmonary Nodule ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Young Adult