PURPOSE: To determine the incidence of flow artifact and vascular compression, phenomena that mimic biliary stone disease at magnetic resonance cholangio pancreatography (MRCP). MATERIALS AND METHODS: In 160 patients who underwent MRCP, the prescence and location of flow artifact were determined. The signal intensity of flow artifacts was chassifieded as either higher than renal cortical density (group I), the same as renal cortical density (group II), the same as hepatic density (group III), or the same as vascular density (group IV). Correlation between flow artifact and the largest diameter of the extrahepatic duct (EHD) was statistically evaluated, and the location of vascular compression in the biliary system and causative vessels was also determined. RESULTS: At MRCP, flow artifacts were observed in 81 patients (76.4%). Forty-five (42.5%) were classified as group I, 15 (14.2%) as group II, 18 (17.0%) as group III, and three (2.8%) as group IV. They were located in the common bile duct (78.3%), common hepatic duct (70.0%), or intrahepatic duct (29.2%) or at the cystic duct insertion site (7.5%). In patients in whom a flow artifact was not apparent, the diameter of the EHD was 7.1mm; in those with an artifact, this diameter was 11.3 mm. The mean diameter of the EHD was greater in groups II, III and IV (11.4 mm) than in group I (9.8 mm). Vascular compression was demonstrated in 21 patients (19.8%), occurring in the common hepatic duct in 8.5%, the left intrahepatic duct in 8.5%, the common bile duct in 1.9%, and the right intrahepatic duct in 0.9%. Causative vessels were the right hepatic artery (12.5%), left hepatic artery (5.7%), and branches of the gastroduodenal artery (1.9%). CONCLUSION: As the extrahepatic duct is wide, a flow artifact appears and signal intensity decreases. In particular, flow artifacts with a signal intensity of grade III or IV, occuring in 19.8% of patients, mimicked biliary stones at MRCP. The presence of a flow artifact and vascular compression, which mimic biliary stone, therefore be carefully interpreted.
Arteries ; Artifacts ; Biliary Tract ; Common Bile Duct ; Cystic Duct ; Diagnosis* ; Hepatic Artery ; Hepatic Duct, Common ; Humans ; Incidence

PURPOSE: To compare the CT findings of tuberculous pneumonia (TBPN) with those of bacterial pneumonia (BAPN) in diabetic patients and to evaluate the usefulness of CT in the differential diagnosis of these two diseases. MATERIALS AND METHODS: The chest CT scans of 23 diabetic patients with TBPN (M:F=21:2; mean age, 59 yrs.) and of 37 diabetic patients with BAPN (M:F=21:16; mean age, 63 yrs.) were evaluated by two radiologists with regard to low attenuation areas in regions of consolidation, cavities, air bronchogram, volume changes, ground-glass attenuation, findings of bronchogenic spread, and other associated findings. The involvement of each segment was recorded in all patients. RESULTS:The frequencies of multiple small low-attenuation areas in regions of consolidation (52%, 0%), multiple cavities (35%, 3%), loss of volume (70%, 30%) and findings of bronchogenic spread (96%, 30%) were significantly higher in TBPN than in BAPN (p<.05). Low-attenuation masses and bizarre-shaped cavities were noted only in TBPN. Large areas of ground-glass attenuation (4%, 38%) and bilateral pleural effusions (0%, 19%) were more common in BAPN, while air-bronchogram was common in both groups (96%, 86%). The involvement of the superior segment was significantly more common in TBPN (p<.05). CONCLUSION: In the diabetic patients with pulmonary consolidation, CT findings of multiple small low-attenuation areas, multiple cavities, bizarre-shaped cavities, low attenuation masses in cavities, volume loss, and findings of bronchogenic spread are more suggestive of TBPN, while large areas of ground-glass attenuation and bilateral pleural effusions are more suggestive of BAPN. CT may be useful in the differential diagnosis between TBPN and BAPN.
Aminopropionitrile ; Diabetes Mellitus ; Diagnosis, Differential ; Humans ; Pleural Effusion ; Pneumonia* ; Pneumonia, Bacterial* ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Increased intima-media thickness (IMT) and pulse wave velocity (PWV) are noninvasive markers of early arterial wall alteration and are more widely used in adult clinical research. We investigated whether IMT and PWV are useful predictors of cardiovascular risk in hypertensive adolescents. Fifteen hypertensive adolescents (13-18 yr old, systolic BP > or = 140 mmHg, diastolic BP > or = 90 mmHg) and seventeen normotensive subjects were included. Height, weight, obesity index, body mass index (BMI), and fat distribution were obtained from each group. Serum lipid, insulin, vitamine B12, folate, renin, aldosterone, angiotensin-converting enzyme (ACE), and homocysteine levels were compared. The carotid IMT and PWV were measured. Arterial wall compliance and distensibility were calculated with the equation. High systolic blood pressure significantly correlated with height, weight, BMI, obesity index, arm circumference, fat mass, and fat distribution. Hypertensive adolescents had significantly greater cIMT (carotid intima-media thickness) and lower elastic properties such as cross-sectional compliance and distensibility of the carotid artery. The carotid IMT significantly correlated with brachial-ankle PWV. In conclusion, the measurement of carotid IMT and brachial-ankle PWV might be useful to predict the development of atherosclerosis in hypertensive adolescents.
Adolescent ; Arteries/*pathology/physiopathology ; Body Mass Index ; Elasticity ; Female ; Humans ; Hypertension/*pathology/physiopathology ; Male ; Tunica Intima/*pathology/physiopathology ; Tunica Media/*pathology/physiopathology

PURPOSE: The purpose of this experiment is to investigate the image quality of CT coronary angiography using a 16-slice multi-detector row CT and to determine the optimal image reconstruction window. MATERIALS AND METHODS: CT coronary angiography was obtained in 36 nonsymptomatic volunteers using a 16-slice multi-detector row CT (SOMATOM Sensation, Siemens Medical System). The mean heart rates were 70 beats per minute (bpm) or less in 18 persons and more than 70 bpm in 18 persons. Eleven data sets were obtained for each patient (reconstructed at 30-80% of the cardiac cycle with an increment of 5%). Image quality of the eight coronary segments [left main coronary artery (LM), proximal and middle segments of left anterior descending artery (p-LAD, m-LAD) and left circumflex coronary artery (p-LCx, m-LCx) and proximal, middle and distal segments of right coronary artery (p-RCA, m-RCA, d-RCA)] was assessed. RESULTS: The optimal reconstruction windows in the cardiac cycle for the best image quality were 60-70% for the segments of the LM, LAD, and LC arteries in two groups (bpm<70, bpm>70) and 55-65% (bpm<70) or 30-40% and 65-70% (bpm>70) for the segments of the RCA. On the best dataset for each coronary segment, the following diagnostic image quality was achieved in the two groups: LM: 100%, 83%; p-LAD: 100%, 88%; m-LAD: 100%, 72%; p-LCx: 100%, 72%; m-LCx: 100%, 72%; p-RCA: 94%, 72%; m-RCA: 61%, 50%; d-RCA: 100%, 88%. CONCLUSION: The 16 slice multi-detector row CT scan provided visualization of the coronary arteries with high resolution. Especially in the group with a mean heart rate of 70 bpm or less, all the coronary segments except the RCA showed diagnostic image quality. Optimal image quality was achieved with a 60-70% trigger delay for all coronary arterial segments, but the best images of RCA were achieved in the earlier cardiac phase in the patients with a mean heart rate of more than 70 bpm.
Arteries ; Coronary Angiography* ; Coronary Vessels ; Dataset ; Heart Rate ; Humans ; Image Processing, Computer-Assisted* ; Sensation ; Tomography, X-Ray Computed ; Volunteers

We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition.
Diagnosis, Differential ; Female ; Fibrin/metabolism ; Humans ; Mediastinum ; Middle Aged ; Pleura/*pathology/surgery ; Pleural Neoplasms/diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVES: These days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study is to determined the efficiency of transcartilaginous (TC) approah as compared with CT approach for unilateral vocal fold paralysis patients, especially for previously neck treated patients. METHODS: From March 2005 to February 2008, 137 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 G 4 cm long needles through the cricothyroid membrane or directly through the thyroid cartilage. Of the 137 patients, 124 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 3 months after the injection. RESULTS: In the 124 patients, the CT and TC approaches were used in 94 and 30 patients, respectively. Acoustic and perceptual parameters (GRBAS, MPT, jitter, shimmer), voice handicap index, and grades of mucosal waves and glottic closure were significantly improved after the injection in both the CT and TC groups (P<0.05). Only two patients (6.6%) had penetration difficulties, because of ossification of the thyroid cartilage. The overall success rates of the CT and TC approaches were 86.2%, 93.3%, respectively. However, the success rate of the TC approach in patients who had previously undergone neck treatments was significantly higher than that of the CT approach (100% vs. 65% P<0.05). CONCLUSION: Based on the preliminary results of this trial, injection laryngoplasty using a TC approach was an effective alternative to the CT approach, especially in patients who had previously undergone neck surgeries.
Acoustics ; Anesthesia, Local ; Humans ; Laryngeal Muscles ; Laryngoplasty ; Membranes ; Neck ; Neck Dissection ; Needles ; Paralysis ; Thyroid Cartilage ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords ; Voice

OBJECTIVE: We aimed at evaluating the prevalence and CT characteristics of occult coronary artery disease (CAD) in young Korean adults under 40 years of age by performing coronary CT angiography (CCTA). MATERIALS AND METHODS: We retrospectively enrolled 112 consecutive asymptomatic subjects (90 men, mean age: 35.6 +/- 3.7 years) who underwent CCTA as part of a general health evaluation. We classified the subjects into three National Cholesterol Education Program risk categories and we assessed the plaque characteristics on CCTA according to the number of involved vessels, the location and type of plaques and vascular remodeling. RESULTS: Twelve individuals had CAD (11%, 11 men). The prevalence of CAD was significantly higher in the subgroups with moderate (22%) or high (25%) risk than that in the low risk subgroup (5%) (p < 0.05). Nine patients had single-vessel disease and three patients had two-vessel disease. The most common location for plaque was the proximal left anterior descending coronary artery (60%). All the patients had non-significant stenosis and plaque, including the non-calcified (27%), mixed (47%) and calcified (27%) types. Positive vascular remodeling was identified in all the patients with non-calcified or mixed plaques. CONCLUSION: The prevalence of occult CAD was not negligible in the asymptomatic young adults with moderate to high risk, and this suggests the importance of management and risk factor modification in this population. All the patients had non-significant stenosis, and one fourth of the plaques did not show calcification.
Adult ; Chi-Square Distribution ; Contrast Media ; *Coronary Angiography ; Coronary Disease/*epidemiology/*radiography ; Female ; Humans ; Korea/epidemiology ; Male ; Prevalence ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

A wide variety of pulmonary disorders related to hemodialysis or pre-existing renal disease occurs in hemodialysis patients. The disorders may be classified as 1) pulmonary abnormalities associated with chronic renal failures; 2) pulmonary complications arising during hemodialysis; 3) pulmonary infection; or 4) pulmonary-renal syndrome. An awareness of the various possible pulmonary disorders arising in hemodialysis patients may be helpful for the proper and timely management of such patients. We describe and illustrate various radiographic and CT findings of variable pulmonary disorders in hemodialysis patients.
Humans ; Renal Dialysis* ; Renal Insufficiency ; Vasculitis

Decompression sickness is a self contained underwater breath apparatus (SCUBA)-related injury with various symptoms and is considered an extreme emergency condition. This is a case of pulmonary involvement in decompression sickness in a 26-year-old SCUBA diver. Although pulmonary involvement in decompression sickness is a potentially severe condition that requires immediate treatment, this condition can be under- or misdiagnosed, and evaluation of this disease by imaging findings is not clearly understood. We experienced a case of pulmonary involvement in decompression sickness and herein present the chest computed tomography and simple radiograph findings associated with this condition.
Decompression ; Decompression Sickness ; Dyspnea ; Emergencies ; Thorax