Computed body tomography has become useful in the diagnosis of pancreatic disease. It was found to be are liable, often specific, and noninvasive method for detecting pancreatitis and extra-pancreatic extension of the pathology. Of eight hundred and seventy-two cases studied for abdominal pathology with EMI-CT 5005 whole body scanner form Oct. 1977 to August 1980, 21 cases were confirmed to be pancreatitis clinically or operatively. The authors reviewed the CT findings of the above cases and the results were as follows; 1. Among twenty-one cases, the acute pancreatitis was 12 cases and the chronic pancreatitis was 9 cases. The sex ratio as 17 males to females. 2. In acute pancreatitis, diffuse enlargement of pancreas (11/12), focal enlargement (1/12), loss of peripancreatic fat plane (9/12), thickening of anterior of pararenal fascia (6/12), and smooth margin ofpancreas (5/12) were observed. 3. In chronic pancreatitis, parenchymal atrophy (7/9), normal size (2/9), loss of peripancreatic fat plane (3/9), thickening of anterior pararenal fascia (1/9), calcification (1/9), smooth margin (2/9), and serrated margin (6/9) were observed. 4. The complications were associated with 7 cases of acute pancreatitis and 1 case of chronic pancreatitis; pseudocyst (6), abscess (2), and fat necrosis (3), The sites of the pseudocyst were lesser sac (2), anterior pararenal space (2), posterior pararenal space (1), subhepatic region (1), greater omentum (1), and intrapancreatic region (2). All of them were associated with acute pancreatitis except one in chronic pancreatitis.
Abscess ; Atrophy ; Diagnosis ; Fascia ; Fat Necrosis ; Female ; Humans ; Male ; Methods ; Omentum ; Pancreas ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Pathology ; Peritoneal Cavity ; Sex Ratio

Tetrodotoxin is a neurotoxin, so gastrointestinal symptoms are very rare ; these described in the literature are merely nausea and vomiting. Severe complications in the gastrointestinal tract caused by tetrodotoxin have not been radiologically reported. US and CT show thickening of the gastric wall and contraction of the lumen, andupper gastrointestinal series show shortening, lobulation and irregularity of the lesser and greater curevature ofthe body and antrum similar to the findings of corrosive gastritis.
Barium ; Eggs* ; Gastritis* ; Gastrointestinal Tract ; Nausea ; Ovum* ; Tetraodontiformes* ; Tetrodotoxin ; Vomiting

PURPOSE: To evaluate the radiologic findings of gastric MALToma, and to correlate these with its pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the pathologic slides of gastrectomy and gastroscopic biopsy specimens obtained between 1982 and 1996 and collected nine cases of gastric MALToma. Eight of these had been surgically confirmed, and one had been diagnosed by gastroscopic biopsy. A gastrointestinal series comprised eight cases ; five involved sonography and five, CT. RESULTS: The lesions were located at the body in five cases, at the antrum in one, and at the body and antrum in three cases. Pathologic diagnosis was low grade MALToma in four cases, and mixed high and low grade MALToma in five cases. Initial radiologic diagnosis was gastric lymphoma in four cases, early gastric carcinoma in three, and advanced gastric carcinoma in two cases. On retrospective analysis, radiologic diagnosis was changed to lymphoma in both cases initially diagnosed as advanced gastric carcinomas. One case showed marked thickening of the gastric wall, with poor enhancement on CT, and the other case showed a very small and shallow ulcer in comparison to diffuse infiltration of tumor in the upper gastrointestinal series. The final radiologic diagnosis was gastric lymphoma in six cases, and early gastric carcinoma in three. Radiologic findings of gastric MALToma were EGC II c-like lesion in three cases, marked gastric wall thickening in two, multiple discrete lesions in two, hyperugosity of gastric folds with discrete lesions in one, and diffuse infiltrative lesion with small ulcer in one case. The pathologic diagnosis of gastric MALToma was made by the presence of lymphoepithelial lesions, centrocyte-like cells, reactive follicles, plasma cell infiltration, and follicular colonization. There were no significant correlations between radiologic findings and pathologic results such as depth of tumor invasion, low grade MALToma or mixed high and low grade MALToma. CONCLUSION: There are no specific radiologic characteristics of gastric MALToma, but a gastric MALToma might show the radiologic findings of gastric lymphoma. Further radiologic evaluations of many cases of gastric MALTomas are needed in the future.
Biopsy ; Colon ; Diagnosis ; Gastrectomy ; Lymphoma ; Plasma Cells ; Retrospective Studies ; Ulcer

PURPOSE: The purpose of this study is to assess the efficacy of axial CT imaging and 3D imaging by spiral CTin the detection and evaluation of gastric lesion. MATERIALS AND METHODS: Seventy-seven patients with pathologically-proven gastric lesions underwent axial CT and 3D imaging by spiral CT. There were 49 cases of advanced gastric carcinoma(AGC), 21 of early gastric carcinoma (EGC), three of benign ulcers, three of leiomyomas, and one case of lymphoma. Spiral CT was performed with 3-mm collimation, 4.5 mm/sec table feed, and 1-1.5-mmreconstruction interval after the ingestion of gas. 3D imaging was obtained using the SSD technique, and on analysis a grade was given(excellent, good, poor). Axial CT scan was performed with 5-mm collimation, 7mm/sectable feed, and 5-mm reconstruction interval after the ingestion of water. RESULTS: Among 49 cases of AGC, excellent 3D images were obtained in seven patients (14.3%), good 3D images in 30(61.2%), and poor 3D images in12(24.5%). Among the 12 patients with poor images, the cancers were located at the pyloric antrum in eight cases, were AGC Borrmann type 4 in three cases, and EGC-mimicking lesion in one case. Using axial CT scan alone, Borrmann's classification based tumor morphology were accurately identified in 67.3% of cases, but using 3D imaging, the corresponding figure was 85.7%. In 33 cases receiving surgery, good correlation between axial CT scanand pathology occurred in 72.7% of T class, and 69.7% of N class. Among 21 cases of EGC, excellent 3D images were obtained in three patients (14.3%), good 3D images in 14 (66.7%), and poor 3D images in two (9.5%). The other twocases of EGC were not detected. By axial CT scan, no tumor was detected in four cases, and there were two doubtful cases. 3D images of three benign ulcers were excellent in one case and good in two. 3D images of three leiomyomas and one lymphoma were excellent. CONCLUSION: Combined axial CT imaging and 3D imaging by spiral CT has the potential to accurately diagnose gastric lesions other than AGC Borrmann type 4 or tumors located at the pyloricantrum.
Classification ; Eating ; Humans ; Lymphoma ; Pathology ; Pyloric Antrum ; Silver Sulfadiazine ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Ulcer ; Water

PURPOSE: To determine the preferred method of drinking water before spiral CT scanning of a gastric lesion. MATERIALS AND METHODS: Spiral CT scans of 92 patients with gastric lesion were obtained and evaluated. Patients drank tap water as oral contrast material and were scanned in the prone position; they were divided into two groups according to the method by which water was ingested. Group 1 patients drank 500ml 60 minutes before scanning; 500mL, 30 minutes before scanning; and 500mL just before scanning, while those in group 2 drank 800-1000mL just before scanning. In all cases, precontrast images were obtained, and an additional 300mL of water was given if the stomach was not adequately distended. Postcontrast images were obtained at 35 seconds, 80 seconds and 3 minutes after the start of infusion of contrast material. For 35- and 80-second scans, spiral CT was performed with 5-mm collimation, 7mm/sec table feed, and 5-mm reconstruction interval; for precontrast and 3-minute scans, 10-mm collimation, 10mm/sec table feed, and 10-mm reconstruction interval were used. There were 40 patients in group 1, and 52 in group 2. The images of the two groups were evaluated according to three criteria: gastric distension, mucosal enhancement, and tumor distinction. For each criterion, the images were evaluated by grading; an 'excellent' image scored 3, 'good' 2, 'ordinary' 1, and 'poor' 0. The differences in imaging quality between the two groups were statistically evaluated. Images obtained at 35 and 80 seconds, and at 3 minutes after the start of infusion of contrast material were compared, and the detectability of 18 confirmed cases of early gastric cancer was evaluated. RESULTS: For gastric distension, the mean score was 1.65 in group 1, and 1.81 in group 2 (P=0.33); the corresponding figures for mucosal enhancement were 1.45 and 1.65 (P=0.11), and for tumor distinction, 1.30 and 1.52 (P=0.09). Between the two groups, there was therefore no statistical difference in image quality. With regard to postcontrast images, those obtained after a delay of 35 seconds were best; those obtained at 80 seconds were better than those obtained at 3 minutes. Fifteen of 18 case of early gastric cancer were detected on spiral CT, and the detection rate was 83.8%. CONCLUSION: No statistically significant difference was seen between the two groups, and a single drink of water-just before scanning- is thus preferable to several drinks. Two scans, with images delayed for 35 and 80 seconds after contrast enhancement, are adequate. The use of these methods may improve the image quality of gastric lesions and the detection rate of early gastric cancer.
Drinking Water ; Eating* ; Humans ; Prone Position ; Stomach ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Water*

No abstract available.
Hemorrhagic Fever with Renal Syndrome*

CT has an important role in the evaluation of gastric adenocarcinoma. It clearly demonstrates the primary tumor itself and reveals the spread of cancer to adjacent or distant structures. It is therefore useful in the staging of gastric carcinoma, and has proved valuable in the differential diagnosis of this and other gastrictumors. Recent advances in technology such as spiral CT with water ingestion, improve the value of CT. This report describes the characteristic findings of gastric adenocarcinomas by spiral CT, and elucidates its role in the staging of gastric carcinoma.
Adenocarcinoma* ; Diagnosis, Differential ; Eating ; Tomography, Spiral Computed* ; Water

The authors evaluated ultlrasonographic findings of surgically or pathologically proven anterior abdominalwall lesion in 17 cases. The results were follows; 1. Ultrasonography is an accurate, convenient and noninvasive method to detect and determine the extent of anterior abdominal wall lesion. 2. Peritoneal fascia interface is animportant landmark in differenciation between intraperitoneal and abdominal wall lesion. 3. Sonographic differenciation of abscess and hematoma from tumor was impossible.
Abdominal Wall ; Abscess ; Fascia ; Hematoma ; Methods ; Ultrasonography

PURPOSE: To correlate the preoperative staging of gastric adenocarcinoma using two-phase spiral CT withpathologic staging. MATERIALS AND METHODS: One hundred and eighty patients with gastric cancers confirmed duringsurgery underwent two-phase spiral CT, and were evaluated retrospectively. CT scans were obtained in the proneposition after ingestion of water. Scans were performed 35 and 80 seconds after the start of infusion of 120mL ofnon-ionic contrast material with the speed of 3mL/sec. Five mm collimation, 7mm/sec table feed and 5mmreconstruction interval were used. T- and N-stage were determined using spiral CT images, without knowledge of thepathologic results. Pathologic staging was later compared with CT staging. RESULTS: Pathologic T-stage was T1 in70 cases(38.9%), T2 in 33 (18.3%), T3 in 73 (40.6%), and T4 in 4 (2.2%). Type-I or IIa elevated lesions accountedfor 10 of 70 T1 cases(14.3%) and flat or depressed lesions(type IIb, IIc, or III) for 60 (85.7%). PathologicN-stage was N0 in 85 cases(47.2%), N1 in 42 (23.3%), N2 in 31 (17.2%), and N3 in 22 (12.2%). The detection rate ofearly gastric cancer using two-phase spiral CT was 100.0%(10 of 10 cases) among elevated lesions and 78.3%(47 of60 cases) among flat or depressed lesions. With regard to T-stage, there was good correlation between CT image andpathology in 86 of 180 cases (47.8%). Overstaging occurred in 23.3%(42 of 180 cases) and understaging in 28.9%(52of 180 cases). With regard to N-stage, good correlation between CT image and pathology was noted in 94 of 180cases (52.2%). The rate of understaging(31.7%, 57 of 180 cases) was higher than that of overstaging(16.1%, 29 of180 cases)(p<0.001). CONCLUSION: The detection rate of early gastric cancer using two-phase spiral CT was 81.4%,and there was no significant difference in detectability between elevated and depressed lesions. Two-phase spiralCT for determing the T- and N-stage of gastric cancer was not effective ; it was accurate in abont 50% of casesunderstaging tended to occur.
Adenocarcinoma* ; Eating ; Humans ; Pathology ; Retrospective Studies ; Stomach Neoplasms ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Water

PURPOSE: To evaluate the degree of mucosal coating on double contrast barium enema (DCBE) using barium suspension made with distilled water or normal saline. MATERIALS AND METHODS: Between June 1 and July 30, 1996, fifty-four patients prospectively underwent DCBE using 83% w/v(weight-to-volme) of barium suspension (room temperature, 24 degrees), which was made with 1,200 mL of distilled water (Group 1 ; 29 cases) and normal saline (Group 2 ; 25 cases) per 1 Kg of Solotopr (Taejoon Pharmacy, Seoul, Korea). Bowel preparation and examination methods were the same in both groups, and four projections (erect view, supine view, both decubitus views) were taken. The mucosal coating was graded as excellent, good, ordinary, or poor by three radiologists working independently, and scored from 3 to 0. Significance was analyzed by t-test. RESULTS: Mean grading scores 2.33+/-0.70 in group 1 and1.56+/-0.99 in group 2 (P < 0.003). CONCLUSION: When barium suspension made with distilled water was used, the degree of mucosal coating on DCBE was better than when the suspension was made with normal saline.
Barium* ; Enema* ; Humans ; Pharmacy ; Prospective Studies ; Seoul ; Water*