No abstract available.
Balloon Valvuloplasty* ; Constriction, Pathologic*

PURPOSE: Bilateral high signal intensity in basal ganglia on Tl-weighted images is unusual. the purpose of this study is to describe the pattern of high signal intensity and underlying disease. METHODS AND MATERIALS: During the last three years, 8 patients showed bilateral high signal intensity in basal ganglia on Tl-weighted image, as compared with cerebral white matter. Authors analized the images and underlying causes retrospectively. Of 8 patients, 5 were male and 3 were female. The age ranged from 15 days to 79 years. All patient were examined by a 0.5T superconductive MRI. Images were obtained by spin echo multislice technique. RESULTS: Underlying causes were 4 cases of hepatopathy, 2 cases of calcium metabolism disorder, and one case each of neurofibromatosis and hypoxic brain injury. These process were bilateral in all cases and usually symmetric. In all cases the hyperintense areas were generally homogenous without mass effect or edema, although somewhat nodular appearence was seen in neurofibromatosis. Lesions were located in the globus pallidus and internal capsule in hepatopathy and neurofibromatosis, head of the caudate nucleus in disorder of calcum metabolism, and the globus pallidus in hypoxic brain injury. CONCLUSION: Although this study is limited by its patient population, bilateral hyperintense basal ganglia is associated with various disease entities. On analysis of hyperintense basal ganglia lesion, the knowledge of clinical information improved diagnostic accuracy.
Basal Ganglia* ; Brain ; Brain Injuries ; Calcium Metabolism Disorders ; Caudate Nucleus ; Edema ; Female ; Ganglia ; Globus Pallidus ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Male ; Metabolism ; Neurofibromatoses ; Retrospective Studies

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

The authors analyzed the radiographs(brain CT and cerebral angiograms) and medical & surgical records of 54 cases of ruptured anterior communicating artery aneurysms resulted in operations at our hospital from January 1991 to December 1995. The results were summarized as follows: 1) The rate of incidence was found to be highest in sixth decade and the ratio of male to female was 1:1. 2) On the preoperative brain CT, ventricular or cerebral hemorrhage combined cases had high Hunt-Hess and Fisher grades. 3) Of 54 cases, hypertension was observed in 20 cases(37%). Hypertension had no effect on the admission Hunt-Hess and Fisher grades. 4) Classification of the anterior communicating artery aneurysms according to its directions were as follows; anterior direction in 57.4%, superior direction in 18.5%, posterior direction in 13%, inferior direction in 11.1%. 5) The afferent artery of anterior communicating artery aneurysms were as follows; left A1 in 38 cases(70.4%), right A1 in 12 cases(22,2%), bilateral A1 in 4 cases(7.4%). 6) The ranges of diameters of the aneurysm was as follows;6-10mm in 57.4%, below 5mm in 22.2%. 7) The posteriorly directing aneurysms showed less favorable preoperative state, and preoperative hydrocephalus was most common on the posteriorly directing aneurysms. 8) There was no significant relationship between direction of aneurysm and prognosis. However, better Hunt-Hess grades seem to correlate better prognosis. 9) The operation was performed by pterional approach in all cases, the approach side was selected for the presence of dominant feeding artery in 50 cases(92.6%). 10) Overall mortality rate was 1.8%, the patients who died are of the older age group and the cause of death was medical complication in 6 cases.
Aneurysm ; Arteries ; Brain ; Cause of Death ; Cerebral Hemorrhage ; Classification ; Female ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Prognosis

Bilateral hypoplasia of the internal carotid arteries is a rare condition. The authors experienced two cases of bilateral hypoplasia of the internal carotid arteries. In one case, a 46-year-old female patient, presented with subarachnoid hemorrhage. Internal carotid angiograms showed right hypoplastic internal carotid artery and left agenetic internal carotid artery. An aneurysm, believed to be the source of the subarachnoid hemorrhage, took origin from the trunk of the basilar artery. In another case, a 48-year-old male, presented with semicomatous mentality. Brain CT demonstrated intracranial hemorrhage on the parasylvian area, and high density on the basal cistern, quadrigerminal cistern and temporal horn of left lateral ventricle. Initially, aortic arch injection did not visualized the origin of the common carotid arteries. It revealed only the vertebral arteries and both external carotid artery originating from each vertebral artery. A selective left vetebral artery study demonstrated a communication between the hypertrophied basilar artery and the posterior cerebral arteries. The anterior and middle cerebral vessels, in turn, were opacified through the circle of Willis, via the posterior communicating arteries. In addition, an aneurysm, believed to be the sourse of the subarachnoid hemorrhage, took origin from the posterior cerebral artery. The cases of the bilateral hypoplasia of internal carotid artery with intracranial aneurysm are reported as above, together with literature review.
Aneurysm ; Animals ; Aorta, Thoracic ; Arteries ; Basilar Artery ; Brain ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal* ; Circle of Willis ; Collateral Circulation ; Female ; Horns ; Humans ; Intracranial Aneurysm* ; Intracranial Hemorrhages ; Lateral Ventricles ; Male ; Middle Aged ; Posterior Cerebral Artery ; Subarachnoid Hemorrhage ; Vertebral Artery

The authors devdeloped a computer program for automatic coding of ACR (American College of Radiology) code. The automatic coding of the ACR code is essential for computerization of the data in the department of radiology. This program was written in FoxBASE language and has been used for automatic coding of diagnosis in the Deparment of Radiology, Wallace Memorial Baptist Hospital since May 1992. The ACR dictionary files consisted of 11 files, one for the organ code and the others for the pathology code. The organ code was obtained by typing organ name or code number itself among the upper and lower level codes of the selected one that were simultaneously displayed on the screen. According to the first number of the selected organ code. the corresponding pathology code file was chosen augomatically. By the similar fashion of organ code selection, the proper pathologic dode was obtained. An example of obtained ACR code is "131.3661". This procedure was reproducible regardless of the number of fields of data. Bacause this program was written in "User's Defined Function" from, decoding of the stored ACR code was achieved by this same program and incoporation of this program into another data processing program was possible. This program had merits of simple operation, accurate and detail coding, and easy adjustment for another program. Therefore, this program can be used for automation of routine work in the department of radiology.
Automation ; Clinical Coding* ; Diagnosis ; Methods* ; Pathology ; Protestantism

PURPOSE: Retrospective studies were carried out to evaluate the usufulness of CT in differentiating benign or malignant intrahepatic duct(IHD) dilatation due to extrahepatic duct(EHD) obstruction. MATERIALS AND METHODS: Among 75 cases of IHD dilatation, 35 cases(47%) which did not show causative lesion on CT were classified into central or peripheral type according to the extent of the dilatation and into pruned or beaded form according to its pattern. We considered central type or pruned form as a benign feature while peripheral type or beaded from as a malignant feature. Predictions of benignancy or malignancy were made according to the pattern and the extent of IHD dilatation. In all 75 cases, maximum caliber of IHD at portal vein bifurcation were examined. RESULTS: In regard to the classification of the extent, 80% (28 out of the 35 cases:11 of 15 cases of benignancy and 17 of 20 cases of malignancy) of our prediction was correct. As to the classification of the pattern, similar results(82% correct prediction) were obtained(14 out of 17 cases):ln 15 cases of benignancy, we observed six cases of pruning and 1 case of beading. Among the 20 cases of malignancy, two cases of pruning and eight cases of beading of IHD dilatation were observed. Mean diameters of IHD at portal vein bifurcation were 10.1ram in benignancy and 15.1mm in malignancy.(Diameters less than 11mm was suggestive of benignancy(alpha =0.05). CONCLUSION: Evaluation of the extent, the pattern, and the degree of IHD dilatation is necessary in differential diagnosis of benignancy and malignancy of EHD obstruction. We conclude that CT is a useful tool for this purpose of differential diagnosis of the benignancy and the malignancy of extrahepatic biliary obstruction.
Classification ; Diagnosis, Differential ; Dilatation* ; Portal Vein ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.
Brain ; Cysticercosis ; Hemianopsia ; Humans ; Optic Chiasm* ; Pituitary Apoplexy ; Prevalence ; Retrospective Studies ; Visual Fields