PURPOSE: To identify the four layers based on intranodular vascular nature visible in multiphase incremental bolus dynamic CT and to determine any differential points according to various factors of liver abscess with this vascular nature or not. MATERIALS AND METHODS: We categonized 29 cases of confirmed liver abscess into three different groups according to presence of four layers visible in early phase(arterial phase) of CT. Three groups were compared in regard to the results of antiamebic antibody test and bacteriologic study and presense of cholangitic abscess and internal septation. RESULTS: We could separate four layers, innermost hypodense central cavitary lesion, hyperdense granular tissue, hypodense abscess wall and outermost hyperdense compensatory hypervascular zone in 18 cases(62%), only two layers, cavity and wall in six cases(21%), and characteristically we could find three layers without innermost cavitary lesion in five cases(17%). But we couldn't find significant correlations between various clinical factors of liver abscess and our vascular groups. CONCLUSION: Our method of CT could represent four layers based on vascularity in 62% of cases. And also could find the unusual inflammatory mass containing three layer which must be differentiated from other malignant solid mass. But we couldn't find differential point between various clinical factor of liver abscess and imaging diagnosis. We think that with the improvement of hardware such as spiral CT, identification of four layers will be earier and will be very helpful in early detection and proper treatment planning of liver abscess.
Abscess* ; Diagnosis ; Liver Abscess* ; Liver* ; Tomography, Spiral Computed

We compared 87 portographic filling defects detected by portal CT in 64 patients were compared with those obtained by indirect portography. The indirect portography could visualize portogram only in anterior-posterior view. But the portal portal CT could visualize both portogram and hepatogram. We examined the portal CT and indirect portography and compared the accuracy of the both methods to evaluate the limitation and significance of the indirect protography. The mass shape lesions were seen on the portal CT which means portal flow defects of the mass lesions only could not depict totally in indirect portography (0%, 0/41). And the larger defects than real mass lesion were seen in portal CT means mass with associated portal flow defect and find portal vein invasion around the mass in 52% (24/46) of the indirect portography. Among them, only 66% of mass were detected correctly in the indirect portography comparing with mass lesion in portal CT. In summary, indirect portogram could not detect small filling defects which detected in portal CT and could not depict the extent of large filling defects. It also could not visualize correctly the protal flow in non-lesion side of the liver parenchyma.
Humans ; Liver ; Portal Vein ; Portography*

Authors performed angio-CT(portal &/or arterial CT) in 35 patients with various hepatic masses. We obtained portal CT in 32 and arterial CT in 13 patients. The contrast material was injected into superior mesenteric artery for portal CT and into hepatic artery for arterial CT after transfemoral cathetrization of these arteries. We concluded that portal CT was superior to other imaging modalities highly sensitive in detecting hepatic masses, especially, early hepatocellular carcinomas, daughter nodules, and subclinical metastatic hepatic malignancy, With this method, detection rate of early hepatocelluar carcinomas improved 62% in number of patients and 90% in number of masses. Detection rate of subclinical hepatic metastases improve 60% each in number of patients and in number of masses. It was also useful for the detection of portal vein invasion. Arterial CT was useful in differential of masses and in defining the characteristics of entire or part of the masses because this method revealed hemodynamic patterns more definitely.
Arteries ; Carcinoma, Hepatocellular ; Hemodynamics ; Hepatic Artery ; Humans ; Mesenteric Artery, Superior ; Methods ; Neoplasm Metastasis ; Nuclear Family ; Portal Vein

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. It; incidence ranges between 0.1 and 5%. This anomaly is usually diagnosed incidentally during bronchoscopy, bronchography or computed tomography. Occasionally, it represents the underlying etiology for chronic pulmonary disease, especially if it involves the right upper lobe and reflects an abnorrnal pulmonary clearing mechanism. The tracheal bronchus may be associated with other bronchopulmonary anomalies, tracheal stenosis, or Down's syndrome. Asymptornatic tracheal bronchus does not require any treatment. In case of tracheal bronchus associated recurrent right upper lobe diseases, tracheal bronchus therapy should include resection of the aberrant bronchus as well as the lob it supplies. (J Korgan Pediatr Soc 2000;43:1501-1504)
Bronchi* ; Bronchography ; Bronchoscopy* ; Down Syndrome ; Equipment and Supplies ; Incidence ; Lung Diseases ; Tracheal Diseases ; Tracheal Stenosis

An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.
Abdominal Pain ; Barium ; Child ; Diagnosis ; Diarrhea ; Early Diagnosis ; Enema ; Failure to Thrive ; Humans ; Incidence ; Intestinal Volvulus ; Meals ; Pancreas ; Retrospective Studies ; Vomiting

In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
Animals ; Arterial Pressure ; Atrial Pressure ; Autopsy ; Catheters ; Dogs* ; Gases ; Heart Atria ; Heart Rate ; Hemodynamics ; Hydrogen-Ion Concentration ; Jugular Veins ; Leukocytes ; Models, Theoretical ; Mortality ; Pancuronium ; Pentobarbital ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism* ; Pulmonary Wedge Pressure ; Thermodilution ; Transducers

DCRV is a rare cause of right ventricular outflow obstruction by anomalous muscle bundle at the level of sinus portion. The symptoms due to DCRV itself were mild inspite of significant pressure gradient over 90mmHg between proximal and distal chamber, and became severe by associated complication of bacterial endocarditis or aortic regurgitation in ventricular septal defect. In 12 cases(40%), right ventricular hypertrophy configuration in electrocardiogram was characteristic. Although R wave in V1 was tall, S wave in V6 and R wave in aVR were indistinctive. Those were very useful findings for diagnosis of DCRV which was thought to be possible only invasively. With operation prior to overt right ventricular faliure, the prognosis was good with only minor complication.
Adolescent* ; Adult* ; Aortic Valve Insufficiency ; Diagnosis ; Electrocardiography ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Hypertrophy, Right Ventricular ; Prognosis ; Ventricular Outflow Obstruction

Sparganosis is a parasitic infectious disease by sparganum which is a plerocercoid larva of spirometra, a kind of cestode. We experienced a case of intramural sparganosis of cecum presenting as chronic intermittent abdominal pain. A 39 year old man was hospitalized due to intermittent abdominal pain for 6 months and the operation was done under the impreesion of the intestinal tuberculosis or submucosal tumor of cecum after diagnostic work-up. Resected cecum revealed diffuse wall thickening and luminal narrowing. The microscopic findings showed a degenerated larva in the muscle layer with typical tissue reaction which was basically noncaseating cavitary granulomatous inflammation and many calcareous corpuscles which were pathognomonic features of cestode were prominent within the degenerated worm.
Abdominal Pain ; Adult ; Cecum ; Cestoda ; Communicable Diseases ; Humans ; Inflammation ; Intestinal Obstruction* ; Intestines ; Larva ; Phenobarbital ; Sparganosis* ; Sparganum ; Spirometra ; Tuberculosis