To find any specific radiologic findings of skeletal metastases from hepatocellular carcinoma, we analyzed plain radiographs(n=25), CT(n=16) and MRI(n=5)of 25 patients with metastatic bony lesions from hepatocellular carcinoma. Vertebrae(17/25) and rids(16/25)were most frequently involved and 16 cases showed multiple metastases. The size of the lesions was larger than 5cm in 17 cases. Plain radiographs showed osteolytic destruction(2/25). CT(n=16) showed osteolytic destruction with an isodense expansile mass in all cases. Focal low attenuations suggesting necrosis were found in 2 cases. Calcification within the mass was not detected. MRI(n=5) showed a slight hyperintense area on T1WI and a defimte hyperintense mass on T2WI. After gadopentetate dimeglumine enhancement. The mass showed irregular enhancement. We concluded that skeletal metastatic lesions from hepatocellular carcinoma showed relatively large osteolytic destruction accompanying soft tissue mass and minimum central necrosis.
Carcinoma, Hepatocellular* ; Gadolinium DTPA ; Humans ; Necrosis ; Neoplasm Metastasis*

We present our technique for reconstruction of the posterior cruciate ligament (PCL) using the quadrupled hamstring tendons with EndoButton(Acufex Microsurgical, Mansfield, MA). This paper describes the surgical technique of the procedures and reports the preliminary results in 10 patients with a more than 12 months follow-up. There were 8 males and 2 females ranging in age from 17 to 37 years (average 25 years). The average time from injury to operation was 3 weeks (range; 2 weeks to 4 weeks). Of ten patients, 6 were classified as an isolated tear, 2 were associated with lateral collateral ligament tears. A torn meniscus was present in 2 cases. We used one-incision technique. The results of these PCL reconstructions with a minimum follow-up of 12 months are as follows. Patients were evaluated preand postoperatively using the Lysholm, and Hospital for Special Surgery Knee ligament rating scales. Average knee ligament evaluation scores were Lysholm preoperative 48, postoperative 87.6; and Hospital for Special Surgery preoperatively 33.5, postoperative 88.8. We chose the semitendinosus and gracilis tendons with EndoButton fixation for PCL reconstruction for specific reasons: (1) No injury to the extensor mechanism and (2) Easy passage of the graft through the tibial tunnel. (3) The problem about the screw and patellar bone-tendon-bone can be resolved. (4) It preserves intact meniscofemoral ligament, some intact fibers of PCL bundle. (5) When rupture of the PCL is associated with ACL tear, each ligament should be reconstructed. In such a case, we preserve patellar tendon for reconstruction of the ACL, The technique presented here is not applicable to all individuals requiring PCL reconstruction but does provide significant advantages to those patients for whom it is utilized. Although the clinical results are very promising at this length of follow up, long-term study is required to evaluate our PCL reconstruction procedure more precisely.
Female ; Follow-Up Studies ; Humans ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Patellar Ligament ; Posterior Cruciate Ligament* ; Rupture ; Tendons ; Transplants* ; Weights and Measures

Detection and evaluation of early soft tissue changes are important in rheumatoid arthritis or other jointdiseases. The most important factors for radiologic demonstration of soft tissue changes are resolving power andthe optimization of contrast differences between structures representing skin and subcutaneous tissue densities.Phantom study was done by using combination of immersion technique and mammography to get the most reliable methodfor improvement of soft tissue contrast without deterioration of resolution. Clinical application was also done in5 normal volunteers and 5 rheumatoid patients. The results indicate that soft tissue contrast, especially betwenskin and subcutaneous tissues can be significantly imporved with combination of immersion technique andmammography with 50% ethanol in both phantom and clinical study.
Arthritis, Rheumatoid ; Clinical Study ; Ethanol ; Healthy Volunteers ; Humans ; Immersion ; Mammography ; Radiography ; Skin ; Subcutaneous Tissue

Particulate wear debris(polyethylene, polymethylmethacrylate and metal particles, or combination of these) can initiate aseptic loosening. To eliminate polyethylene debris and reduce the total amount of wear, metal on metal bearings(Metasul) which were made of a wrought Co-28Cr-6Mo-0.2C alloy, were introduced. From May 1994 total hip replacements using a Metasul metal on metal articulation were performed by the authors. 34 patients with 40 hips with minimum follow-ups during 24 months were analysed in this study. The mean follow up period was 31 months(ranging from 24 to 47 months). We used Armor cups and standard cups as acetabular comporients and SL stems, CLS stems and cone stems as femoral components. Preoperative average Harris hip score of 48 points became postoperatively 93(from minimum 81 to maximum 100). And there were slight and occasional thigh pains in 2 cases(5%). There were no revisions for the early aseptic loosening of femoral stems or stem failures. Radiologic evaluation which revealed mild calcar atrophy was developed in 33 cases(82.5%), revealing cortical hypertrophy in 10 cases(25%). Osteolysis was not noted around the prosthetic stem nor around the cup. Radiolucent lines were found in 9 cases of femoral components(22.5%) and in 1 case of acetabular component(2.5%) and subsidence of more than 3mm in 1 case of femoral components(2.5%) were also found. There was 1 case of definitive loosening of acetabular component(2.5%). These also showed that endosteal bone formation adjacent to femoral prosthesis was developed in 22 cases(55%) but no distal pedestal and stem shift occurred. The short-term but satisfactory results of the contemporary metal on metal articulation investigated in this study were encouraging and warrant continued study.
Acetabulum ; Alloys ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Atrophy ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Osteolysis ; Polyethylene ; Polymethyl Methacrylate ; Prostheses and Implants ; Thigh

PURPOSE: To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. MATERIALS AND METHODS: Sixteen patients with avascular necrosis of femoral head were examined with MRI. Tl-weighted and T2-weighted images and contrast-enhanced Tl-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. RESULTS: Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the portions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. CONCLUSION: Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.
Head* ; Humans ; Joints ; Magnetic Resonance Imaging* ; Necrosis* ; Synovial Membrane

PURPOSE: To assess the role of blood vessels in the formation of peritumoral abnormal signal intensity which exaggerates the size of malignant tumor on MR images. MATERIALS AND METHODS: We performed MR-microangiographic-pathologic correlation using implanted VX-2 carcinoma in 16 rabbit thighs 1-28 days after tumor implantation. The shape and distribution of abnormal vessels were analyzed on microangiography and on histologic examination in correlation with peritumoral abnormal signal intensity on MR images. RESULTS: Dilated peritumoral blood vessels gave rise to irregular, tortuous tumor vessels penetrated into the tumor. With the tumor growth, hypervascular tumor vessels in peritumoral area and central avascular areas were increased. These hypervascular areas on microangiography were corresponded with abnormal signal intensity on MR images. CONCLUSION: Hypervascularity could be a cause of peritumoral abnormal signal intensity which exaggerates the size of experimentally induced malignant musculoskeletal tumors on MR images.
Blood Vessels* ; Thigh

Sarcoidosis can affect two or more members of the same family, and the reported occurrence of such familial sarcoidosis is variable from 0.5 to 14%. Recently we have experienced familial sarcoidosis affected mother and daughter, for the first time in Korea. Mother was diagnosed as Stage II sarcoidosis 4 years ago by transbronchial lung biopsy and cervical lymph node biopsy with compatible BAL finding in our hospital. This time, the daughter was admitted with bilateral hilar enlargement and anterior uveitis. Even though she had positive tuberculin skin test and atypical BAL finding(lymphocyte: 61%, CD4/CD8: 1.22). Transbronchial lung biopsy and mediastinal lymph node biopsy revealed noncaseating epithelioid granulorna without AFB. Slit lamp examination of the eyes showed severe anterior uveitis. Systemic steroid therapy was started due to progressive uveitis with antituberculous medication.
Biopsy ; Humans ; Korea* ; Lung ; Lymph Nodes ; Mothers ; Nuclear Family ; Sarcoidosis* ; Skin Tests ; Tuberculin ; Uveitis ; Uveitis, Anterior

PURPOSE: To assess the spinal canal and neural foraminal stenosis associated with spondylolisthesis on MR imaging. MATERIALS AND METHODS: We retrospectively analysed MR findings of 63 cases of spondylolisthesis(degenerative type:23 cases, isthmic type:40 cases) regarding the type and grade of spondylolisthesis, prensence or absence of associated spinal canal stenosis, and the severity of associated neural foraminal stenosis. RESULTS: Central canal stenosis were more frequent in degenerative type(91%) than isthmic type(33%), and more frequent in grade II spondylolisthesis of degenerative type(100%) and isthmic type(89%) than in grade spondylolisthesis of degenerative type(45%) and isthmic type(20%). There was positive correlation between the severity of neural foraminal stenosis and the grade of spondylolisthesis, whereas there was no significant difference between degenerative and isthmic types. CONCLUSION: Degenerative spondylolisthesis were frequently associated with central canal stenosis more than isthmic type. When the grade of spondylolisthesis was higher, it was more frequently associated with central canal stenosis and severe neural foraminal stenosis.
Constriction, Pathologic* ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spondylolisthesis*

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis

This study was designed to evaluate the potential applicability of magnetic resonance imaging (MRI) for the diagnosis of acute renal vein thrombosis. Renal vein thrombosis was experimentally induced by surgical ligation of the left renal vein in a total of 21 rabbits. MRI was performed with a 0.5 Tesla superconductive magnetic system. Spin echo technique was used with varying TR and TE parameters. Spin echo images of the rabbit kidney were analysed for morphology and signal intensity. T1 and T2 relaxation times of the renal cortex and medulla were calculated from the images. After venous ligation, kidneys became enlarged. Low signal band along the outer medulla in T2 weighted images were characteristically shown from 1 hour to 3 days after ligation, Changes of cortex to medullar contrast (CMC) values were significant (p<0.05) in T1 - and T2- weighted images of the ligated side. T1 and T2 relaxation times were significantly prolonged (p<0.05) on the ligated side, both in the cortex and medulla from 1 hour to 2 weeks after the ligation, while T2 relaxation time on the contralateral side was significantly prolonged both in the cortex and medulla 2 weeks after venous ligation. The most useful MRI criteria for the diagnosis of renal vein thrombosis were enlarged renal size, and the low signal band along the outer medulla of ligated kidney. The relative intensity difference between cortex and medulla (CMC) in T1-and T2-weighted images, and T1 and T2 relaxation times were suggested to be the useful MR parameters for the diagnosis of acute renal vein thrombosis.
Diagnosis ; Kidney* ; Ligation* ; Magnetic Resonance Imaging* ; Rabbits ; Relaxation ; Renal Veins* ; Thrombosis