PURPOSE: This study was designed to evaluate usefulness of intravenous digital subtraction angiography (IV-DSA) in detection of peripheral arterial obstructive disease(PAOD) and in follow-up of percutaneous transluminal angioplasty(PTA). MATERIALS AND METHODS: 35 Patients who had clinical symptoms and signs of compromised lower extremity perfusion, was screened with IV-DSA and then performed confirmative conventional angiography. We obtained sensitivity, specificity and accuracy of IV-DSA by comparing the findings of IV-DSA with those of conventional angiography. 21 patients who had been performed successful PTA, were foliowed-up with IV-DSA in 3, 6, 12months. We studied patency rate and factors that influenced restenosis. RESULTS: The sensitivity, specificity and accuracy of IV-DSA were 100%, 97%, 97% in lilac artery, 92%, 96%, 93% in femoropopliteal artery, 85%, 75%, 70% in proximal tibioperoneal artery retrospectively. IV-DSA follow up after PTA showed patency rate of 67% in first 3month, 67% in 2nd 3month, 60% in next 6month. Longer length and more irregular surface of the stenotic site, and higher incidence of run-off of vessel and of residual stenosis in the patients with restenosis were noted. CONCLUSION: High sensitivity, specificity and accuracy of IV-DSA in evaluating PAOD suggest that IV-DSA is useful in screening, planning therapy and following up after PTA.
Angiography ; Angiography, Digital Subtraction ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity

Vibrio vulnificus infection is a fatal disease occurring after the consumption of seafood in patients with underlying liver disease. Inflammation of the skin, subcutanous fat and fascia disseminates from the lower extremity to the trunk and upper extremity Infectious myositis caused by vibrio vulnificus is rare, and its MR imaging findings have not been reported. We report these in a case of infectious myositis caused by vibrio vulnificus involving both lower extremities.
Fascia ; Humans ; Inflammation ; Liver Diseases ; Lower Extremity ; Magnetic Resonance Imaging ; Myositis* ; Seafood ; Skin ; Upper Extremity ; Vibrio vulnificus* ; Vibrio*

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.
Hemorrhage ; Magnetic Resonance Imaging* ; Neurilemmoma* ; Pathology ; Retrospective Studies

Recently there has been a progressive increase of thoracolumbar fractures with neurologic symptoms. It has been thought that laminectomy increased instability and was therefore considered a contraindication. Currently, with the development of instrument for posterior stabilization, it is possible to perform posterior fusion and instrumentation, both with and without laminectomy. To compare the effect of neurologic recovery with and without laminectomy, we analyzed the clinical records of 38 patients with neurologic symptoms who were evaluated with plain radiographs and CT before and after surgery from 1989 to 1996 in Gyeong-Sang National University Hospital. We divided our cases into two groups, one group consisted open reduction with laminectomy and instrumentation with posterior fusion. The other group consisted of open reduction without laminectomy and instrumentation with posterior fusion. Twenty three of 38 were operated with open reduction and internal fixation with laminectomy and others were operated without laminectomy. The results were that both groups had improvement of neurologic symptoms after surgery and at follow-up. There was no significant statistical difference between the two groups. Depending on the time interval between injury and surgery, patients who were underwent emergency surgery had an marked improvement of neurologic symptoms. Except cases of complete paraplegia, incomplete paraplegic patients who were operated within 24 hours with laminectomy group had greater improvement than those without laminectomy. The improvement was statistically significant(P<0.05).
Emergencies ; Follow-Up Studies ; Humans ; Laminectomy* ; Neurologic Manifestations* ; Paraplegia

Metaphyseal cysts are common findings in Legg-Calv Perthes(LCP) disease, though usually disappear within 6-12 months. Several studies have described the MR imaging findings of these cysts, though serial MRI findings have not been documented. In this report, therefore, we report the serial MRI results of metaphyseal cyst in LCP patients.
Humans ; Magnetic Resonance Imaging

Myositis ossificans is an ossifying inflammatory lesion occurring within skeletal muscle. Myositis ossificans usually arises in the large muscles of the extremities and this lesion is characterized by progression of mineralization from periphery to center. In the early phase, myositis ossificans simulates malignant soft tissue tumor without dense mineralization. Traumatic myositis ossificans in rectus abdominis muscle has been reported worldwide. The radiologic findings of early active myositis ossificans in rectus abdominis muscle are ill defined heterogenous hypoechoic mass on US, hemorrhage, early strong enhancement and early peripheral mineralization on CT and MR.
Extremities ; Hemorrhage ; Muscle, Skeletal ; Muscles ; Myositis Ossificans* ; Myositis* ; Rectus Abdominis*

Percutaneous transhepatico-biliary duodenal drainage(PTBDD) (n=2) and percutaneous transhepatic duodenaldrainage(PTDD) (n=1) were performed as palliative treatment of obstructed afferent loop in patients in whomobstructive jaundice had occurred after surgery for malignant tumors. All three patients experienced septic shockafter PTBDD or PTDD. We describe these cases and review the literature.
Duodenum ; Humans ; Jaundice ; Jaundice, Obstructive* ; Palliative Care ; Sepsis ; Shock, Septic*

BACKGROUND: We assessed the accuracy of staging in evaluation of bronchial invasion thus found the role of CT in patients who underwent resective surgery in primary lung cancer. Materials and METHODS: Authors retrospectively analized the preoperative CT scans of 156 patients receiving pneumonectomy(n=95) and lobectomy(n=61). Among lobectomy patients 7 patients subsequently performed pneumonectomy because of positive resection margin of bronchus in frozen biopsy. We also retrospect lively analized CT scans of non-operated 60 patients who Performed sufficient bronchoscopic biopsy. Bronchial wall thickness more than 3mm, irregular wall thickening find reduction of diameter by CT were defined as bronchial invasion. The pathologic examination of resection margin were positive in 20, stump recurrence occurred in 6 of the operated group, and the pathologic examination of biopsy of bronchial wall were positive in 34 of the non operated group, and these were all regarded as bronchial invasion. RESULTS: The CT assessment of bronchial invasion revealed low sensitivity (11.5%), low positive predictability(38%), but high specificity(96%) and relatively high accuracy (84%) in the operated group and higher sensitivity (62%), higher positive predictability(95%) in non-operated group. CONCLUSION: In lung cancer patients who underwent operation CT showed very low sensitivity and positive predictability In evaluation of bronchial invasion Because the usefulness of CT in evaluation of bronchial invasion is limited, therefore aggressive fiberoptic bronchoscopic biopsy is thought to be necessary before surgical attempt.
Biopsy ; Bronchi ; Humans ; Lung Neoplasms* ; Lung* ; Pneumonectomy ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed

We tested the hypothesis that the extent of necrosis at the initial MRI predicts the subsequent risk of collapse of the femoral head in a randomized clinical trial conducted to compare the core decompression to the conservative treatment. After the initial clinical evaluation including plain roentgenography and MRI, 37 hips of early-stage osteonecrosis (ON) in 33 patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation including plain roentgenography and MRI at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal aod sagittal MR images. The angle of necrotic portion in mid-coronal image (A) and that in mid-sagittal image (B) were used to quantify the extent of necrotic portion by the formula; (A/180) x (B/180) x 100%. A strong association was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion, which might be useful as a predictive index for the fate of early-stage ON.
Classification* ; Decompression ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Radiography ; Risk Factors ; Weight-Bearing