PURPOSE: To evaluate whether or not previously known CT criteria for differentiating malignant and benign pleural diseases are useful in the differentiation of diffuse malignant pleural diseases and tuberculosis. MATERIALS AND METHODS: We retrospectively analyzed CT scans of 42 patients comprising 20 cases of malignant pleural diseases and 22 cases of tuberculous pleural diseases, according to previously known CT criteria for differentiating malignant and benign pleural diseases. RESULTS: The most common shape of pleural effusion was crescentic in malignant pleural diseases and loculated in tuberculosis. The aggressive nature of pleural effusion, pleural rind, and pleura thickenign was 1.5 times more frequently observed in malignant pleural diseases than in tuberculosis. Smooth thickening or smooth nodular pleural thickening and extrapleural deposition of fat were 1.5 times more frequently found in tuberculous than in malignant pleural diseases. Interruption of pleural thickening was found twice as frequently in malignant pleural diseases as in tuberculosis. Decreased lung volume was found twice as frequently in tuberculous as in malignant pleural diseases. Anatomical mediastinal pleural involvement was three times, and irregular nodular pleural thickening nine times more frequent in malignant pleural diseases than in tuberculosis. The sensitivity and specificity of CT findings above 70%, and thus suggesting malignant pleural diseases, were as follows: 1) aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung (51.5%, 75%); 2) involvement of anatomical mediastinal pleura (69.2%,73.7%); 3) irregular nodular pleural thickening (87.5%, 69%). CONCLUSION: Although there in overlap between previously known CT criteria for the differentiation of benign and malignant pleural diseases, the aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung, the involvement of anatomical mediastinal pleura and irregular nodular pleural thickening may suggest malignant pleural diseases.
Humans ; Lung ; Pleura ; Pleural Diseases* ; Pleural Effusion ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tongue ; Tuberculosis*

No abstract available.
Adenocarcinoma* ; Myxoma*

BACKGROUND: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI). METHODS: We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men. RESULTS: Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI<25kg/m2. But in BMI)25kg/m2, men had higher(P<0.01) triglyceride at WHR>_0.9. Women had higher(P<0.05) triglyceride, systolic and diastolic blood pressure at WHR>_0.8. CONCLUSIONS: We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI>_225kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.
Adipose Tissue* ; Blood Glucose ; Blood Pressure* ; Body Mass Index* ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diabetes Mellitus ; Fasting ; Female ; Glucose* ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Medical Records ; Obesity ; Risk Factors ; Triglycerides ; Waist-Hip Ratio*

PURPOSE: To compare power and conventional color Doppler sonography for depiction of the vasculature of solidbreast lesions, and to evaluate the usefulness of power Doppler sonography for differential diagnosis of malignantbreast lesions. MATERIALS AND METHODS: In order to detect vascularity, 82 cases of solid breast lesions wereevaluated by power and color Doppler sonography. Fifty-eight pathologically proven cases (37 benign and 21malignant lesions) were analyzed for the amount and patterns of Doppler signals, morphology of vessels, and thediagnostic accuracy. RESULTS: In 45 of 82 cases, power Doppler sonography depicted flow better than did colorDoppler sonography, while in 37 cases, depiction was equal. On power Doppler sonography, the incidence of markedblood flow in malignant lesions was three times higher than in benign lesions. The pattern of vasculature was morepredominantly central (85.5 %) and penetrating (61.9 %) in malignant lesions than in benign lesions. Branching(57.1 %) and disordered vessels (33.3 %) were more frequent in malignant lesions than in benign. For the diagnosisof malignancy, sensitivity for power Doppler sonography was 65 %, specificity was 79 % and diagnostic accuracy was74.1 % ; for color Doppler sonography, the corresponding figures were 76.9 %, 75.6 % and 75.9 %. CONCLUSION: Power Doppler sonography was more sensitive than color Doppler sonography for the detection of flow in solidbreast lesions. For the differentiation of benign from malignant lesions, however, there was no difference indiagnostic accuracy between the two modalities. findings of central and penetrating distribution patterns ofDoppler signals, and branching and disordered shapes of vessels, along with other sonographic criteria, arehelpful for predicting malignancy.
Breast* ; Diagnosis, Differential ; Incidence ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: To evaluate the usefulness and the application of three dimensional digital rotational imaging (3D DRI) by the evaluation of fractures. MATERIALS AND METHODS: Sixteen patients with clinically diagnosed or suspicious fracture were involved in this study. The lesion or suspicious sites of all 16 cases were spines (n=7), pelvis (n=3) and so on (n=6; knee, elbow, ankle, wrist and foot). In all cases, conventional radiography, multiplanar 2D (slice thickness/pitch=3 or 5 mm/1:1)and volume rendering 3D reconstructed single detector helical CT (HiSpeed Advantage, GE Medical Systems, Milwaukee, WIS) scans and 3D DRI (Integris V-5000,Philips Medical Systems, The Netherlands) with multiplanar intersection and gray scaling as postprocessing technique were performed. 3D DRI was evaluated and compared with conventional radiography, multiplanar 2D CT and volume rendering 3D CT. RESULTS: 3D DRI provided more detail and additional information in 14 cases (88%), comparing with 2D and 3D CT scans. Two fractures were revealed only on 3D DRI other than conventional radiography and CT scans and one case was revealed on 2D CT and 3D DRI. In all cases, we could acquired more detail and additional information from 3D DRI than from 3D CT in the acquisition of 3D imaging. 3D DRI didn't change the classification of fracture in 12 of 13 cases (92%),which revealed the fracture on the conventional radiography or CT. CONCLUSION: 3D DRI can diagnose and evaluate the fracture rapidly and easily with anatomical and spatial resolution by acquisition of 3D imaging with postprocessing using DRI.
Ankle ; Classification ; Elbow ; Humans ; Imaging, Three-Dimensional ; Knee ; Pelvis ; Radiography ; Spine ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Wrist

PURPOSE: To assess the usefulness of STIR (short tau inversion recovery) imaging in breast MRI (magnetic resonance imaging). MATERIALS AND METHODS: We retrospectively reviewed T1- and T2-weighted (T1WI, T2WI), STIR, and dynamically enhanced images of 44 pathologically confirmed breast lesions (benign, 13; malignant, 31) in 36 patients. We selected the dynamically image which best depicted a particular lesion, and then made hard copy of the corresponding T1WI, T2WI, and STIR images. Using the dynamically enhanced image as a standard, we analysed these in terms of parenchymal pattern, lesion detectability, differentiation between benign and malignant lesions, extent, multifocality, and the ductal system. The results were statistically analyzed. RESULTS: In 33 of 44 cases (75%), detectability was greater at STIR imaging than at T1- and T2WI, especially in fibrofatty or fatty breast (14/14 cases, p<0.05). STIR images did not always differentiate between benign and malignant lesions, and extent (50%) and multifocality (46%) were commonly exaggerated compared with T1- and T2WI. In 18 of 44 cases (41%), STIR images suggested the presence of ductal structures. CONCLUSION: For the detection of lesions, STIR imaging was more useful than T1- and T2WI, though STIR did not differentiate between benign and malignant lesions. The extent and multifocality of a lesion were exaggerated on STIR images, compared with T1- and T2WI.
Breast* ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. MATERIALS AND METHODS: We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists: enlarged appendix (> 6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, (appendiceal) intraluminal air extraluminal air, periappendiceal fat stranding, extraluminal fluid, phlegmon, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening. RESULTS: The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters: 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p < 0.05). CONCLUSION: On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were clearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis.
Abscess ; Appendicitis* ; Appendix ; Cellulitis ; Colon ; Diagnosis ; Humans ; Lymphatic Diseases ; Retrospective Studies ; Sensitivity and Specificity* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed*

Bile duct adenomas are discovered incidentally during surgery or at autopsy. Especially, the occurrence of an adenoma in a choledochal cyst is very rare. Biliary carcinomas are known to be related to choledochal cysts. The association of an adenoma in a choledochal cyst with the carcinoma is not definite. We have experienced a case of a tubular adenoma arising in a choledochal cyst. Recently, a 24-year-old female was admitted with complaints of right upper quadrant abdominal pain and indigestion. Abdominal ultrasonography and ERCP showed a fusiform dilation of the common bile duct. During the operation, a tiny polyp was discovered in the cyst. We performed a cyst excision and a Roux-en-Y hepaticojejunostomy. On microscopic examination, the polyp was diagnosed as a tubular adenoma.
Abdominal Pain ; Adenoma* ; Adenoma, Bile Duct ; Autopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Dyspepsia ; Female ; Humans ; Polyps ; Ultrasonography ; Young Adult

PURPOSE: The sensitivity encoding (SENSE) technique is increasingly being used with clinical MRI scanners. The object of this study is to compare the normative human data and image quality of the diffusion tensor imaging (DTI) with sensitivity encoding (SENSE) and standard single-shot EPI techniques. MATERIALS AND METHODS: 16 normal volunteers underwent single-shot echo-planar DTI with both standard and SENSE sequences using a 1.5 T Philips Intera MR scanner (TR/TE=6755/74 or 5871/66 ms, echo train length 127 or 67, NEX=3, matrix=128x128, FOV=220x220 mm, slice thickness=4 mm, b value=600 s/mm2, six orthogonal diffusion gradients). The diffusion tensor-encoded MR images were transferred to a PC workstation and analyzed using in-house software. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were calculated. The presence of artifacts (ghost susceptibility, eddy current) was graded with a two- or three-point scale. The ADC and FA values were measured in the major white matter tract and gray matter nuclei. The signal-to-noise ratio was also measured. Fisher's exact test and the Mann-Whitney test were used for the statistical analysis. RESULTS: With SENSE, the acquisition time was reduced from 2 min 57 sec to 1 min 22 sec for DTI. Susceptibility artifacts (around the brain stem and temporal base) and eddy current artifacts were significantly reduced on the SENSE DTI as compared with those on the standard DTI (p<0.05). No ghost artifacts were observed on the SENSE DTI, whereas such artifacts were observed in 14 cases (87.5%) on the standard DTI. The ADC value was not significantly different between the SENSE DTI and the standard DTI, whereas the FA values in the cerebral cortex and white matter were significantly higher on the SENSE DTI than on the standard DTI (p<0.05). The signal-to-noise ratio was 8.44 on the standard DTI and 11.40 on the standard DTI. CONCLUSION: The use of SENSE DTI significantly reduces the geometric distortion caused by artifacts, shortens the acquisition time, and allows a relatively high SNR to be maintained, but tends to erroneously increase the FA value of the tissue. Therefore, DTI with SENSE may provide better white matter fiber tracking and diffusivity indices when the imaging parameters for SENSE are optimized.
Anisotropy ; Artifacts ; Brain Stem ; Brain* ; Cerebral Cortex ; Diffusion Tensor Imaging* ; Diffusion* ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Signal-To-Noise Ratio

In 2010, symptoms of leaf and stem rot were observed on potted plants (Peperomia quadrangularis) in a greenhouse in Yongin, Korea. The causative pathogen was identified as Myrothecium roridum based on morphological data, internal transcribed spacer sequence analysis, and pathogenicity test. To our knowledge, this is the first report of M. roridum causing leaf and stem rot disease on P. quadrangularis in Korea and elsewhere worldwide.
Gyeonggi-do ; Korea ; Peperomia* ; Sequence Analysis ; Virulence