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Confident Diagnosis of Bronchobiliary Fistula Using Contrast-Enhanced Magnetic Resonance Cholangiography.

Nevzat KARABULUT ; Vefa CAKMAK ; Goksel KITER

Korean Journal of Radiology.2010;11(4):493-496. doi:10.3348/kjr.2010.11.4.493

We report the utility of contrast-enhanced magnetic resonance cholangiography (MRC) using gadoxetic acid (Gd-EOB-DTPA) in the diagnosis of bronchobiliary fistula associated with liver hydatid cyst. Contrast-enhanced MRC clearly delineated the leakage of contrast agent from the biliary duct and its communication with the bronchial tree. Providing functional information about physiologic or pathologic biliary flow in addition to the display of biliary anatomy, contrast-enhanced MRC stands as a robust technique in confidently detecting bronchobiliary fistula and bile leaks.
Biliary Fistula/*diagnosis/pathology/surgery ; Bronchial Fistula/*diagnosis/pathology/surgery ; *Cholangiopancreatography, Magnetic Resonance ; Contrast Media/diagnostic use ; Decompression, Surgical ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Middle Aged ; Stents ; Tomography, X-Ray Computed

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Clear Cell Hidradenoma of the Axilla: a Case Report with Literature Review.

Kyung Eun CHO ; Eun Ju SON ; Jeong Ah KIM ; Ji Hyun YOUK ; Eun Kyung KIM ; Jin Young KWAK ; Joon JEONG

Korean Journal of Radiology.2010;11(4):490-492. doi:10.3348/kjr.2010.11.4.490

Clear cell hidradenoma is an uncommon benign skin appendageal tumor that typically involves the dermal layer of the head, face, and extremities. The breast is a rare site for this lesion, with only two documented cases, which were determined based on mammogram and sonogram findings. We present a case of clear cell hidradenoma of the axillary tail with radiological findings and a literature review.
Adenoma, Sweat Gland/pathology/*radiography/*ultrasonography ; *Axilla ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Sweat Gland Neoplasms/pathology/*radiography/*ultrasonography ; Ultrasonography, Doppler

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Pulmonary Artery Embolotherapy in a Patient with Type I Hepatopulmonary Syndrome after Liver Transplantation.

Hae Won LEE ; Kyung Suk SUH ; Joohyun KIM ; Woo Young SHIN ; Nam Joon YI ; Hwan Jun JAE ; Jin Wook CHUNG ; So Won OH ; Keon Wook KANG ; Kuhn Uk LEE

Korean Journal of Radiology.2010;11(4):485-489. doi:10.3348/kjr.2010.11.4.485

Although liver transplantation (LT) is the only effective treatment option for hepatopulmonary syndrome (HPS), the post-LT morbidity and mortality have been high for patients with severe HPS. We performed post-LT embolotherapy in a 10-year-old boy who had severe type I HPS preoperatively, but he failed to recover early from his hypoxemic symptoms after an LT. Multiple embolizations were then successfully performed on the major branches that formed the abnormal vascular structures. After the embolotherapy, the patient had symptomatic improvement and he was discharged without complications.
Child ; Combined Modality Therapy ; Echocardiography ; Embolization, Therapeutic/*methods ; Hepatopulmonary Syndrome/diagnosis/*therapy ; Humans ; *Liver Transplantation ; Male ; Oximetry ; Positron-Emission Tomography ; *Pulmonary Artery ; Tomography, X-Ray Computed

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Imaging Features of Pediatric Pentastomiasis Infection: a Case Report.

Can LAI ; Xi Qun WANG ; Long LIN ; De Chun GAO ; Hong Xi ZHANG ; Yi Ying ZHANG ; Yin Bao ZHOU

Korean Journal of Radiology.2010;11(4):480-484. doi:10.3348/kjr.2010.11.4.480

We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection.
Abdomen, Acute/*parasitology ; Animals ; Biopsy ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Parasitic Diseases/*diagnosis ; *Pentastomida ; Tomography, X-Ray Computed/methods

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MRI Appearance of Florid Cystic Endosalpingiosis of the Uterus: a Case Report.

Sangeeta TANEJA ; Ramandeep SIDHU ; Anuj KHURANA ; R SEKHON ; Anurag MEHTA ; Amarnath JENA

Korean Journal of Radiology.2010;11(4):476-479. doi:10.3348/kjr.2010.11.4.476

Endosalpingiosis is a non-neoplastic proliferation of ectopic tubal epithelium. It may be found incidentally or the patients may present with chronic pelvic pain. It may resemble a gynecologic malignancy on imaging findings and clinicians and radiologists should be aware of this benign entity to render a correct diagnosis and to avoid over-treatment. We report here the MR imaging appearance of a case of florid cystic endosalpingiosis.
Adult ; Diagnosis, Differential ; Endometriosis/*diagnosis/pathology/surgery ; Fallopian Tube Diseases/*diagnosis/pathology/surgery ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Uterine Diseases/*diagnosis/pathology/surgery

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Primary Yolk Sac Tumor Arising in the Pancreas with Hepatic Metastasis: a Case Report.

Bo ZHANG ; Shunliang GAO ; Ying CHEN ; Yulian WU

Korean Journal of Radiology.2010;11(4):472-475. doi:10.3348/kjr.2010.11.4.472

Extragonadal yolk sac tumor (YST) is a relatively rare entity. We describe here the case of an extragonadal YST that occurred in the pancreas with hepatic metastasis in an adult woman. The contrast enhanced CT images of the abdomen revealed a heterogeneous, solitary mass occupying the pancreatic neck and body with slightly inhomogeneous contrast enhancement. Two low-density lesions in the liver were also displayed on the CT images. The patient underwent surgery and the diagnosis of YST was pathologically verified.
Contrast Media ; Endodermal Sinus Tumor/pathology/*radiography/surgery ; Female ; Humans ; Liver Neoplasms/*radiography/secondary/surgery ; Middle Aged ; Pancreatic Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed/*methods

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Recanalization of an Occluded Intrahepatic Portosystemic Covered Stent via the Percutaneous Transhepatic Approach.

Chih Yang CHAN ; Po Chin LIANG

Korean Journal of Radiology.2010;11(4):469-471. doi:10.3348/kjr.2010.11.4.469

A 41-year-old woman with liver cirrhosis had recurrent portal hypertension and bleeding from esophageal varices due to complete occlusion of a previously inserted transjugular intrahepatic portosystemic shunt stent. Because recanalization of the stent by the transjugular approach was unsuccessful, ultrasound-guided entry to the splenic vein and portal vein was used. After catheter-directed intrathrombus thrombolysis, successful opening of the stent was achieved and a stent was placed. We herein report a rare case in which thrombolysis and recanalization of a TIPS stent were performed via a percutaneous transhepatic approach.
Adult ; Esophageal and Gastric Varices/etiology/*surgery ; Female ; Humans ; Hypertension, Portal/etiology/*surgery ; Liver Cirrhosis/complications ; Portasystemic Shunt, Transjugular Intrahepatic/*adverse effects ; Reoperation ; Stents/*adverse effects ; Vascular Patency

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Cystic Lesions of the Gastrointestinal Tract: Multimodality Imaging with Pathologic Correlations.

Jongmee LEE ; Cheol Min PARK ; Kyeong Ah KIM ; Chang Hee LEE ; Jae Woong CHOI ; Bong Kyung SHIN ; Soon Jin LEE ; Dongil CHOI ; Kee Taek JANG

Korean Journal of Radiology.2010;11(4):457-468. doi:10.3348/kjr.2010.11.4.457

The cystic lesions of the gastrointestinal (GI) tract demonstrate the various pathologic findings. Some lesions may present a diagnostic challenge because of non-specific imaging features; however, other lesions are easily diagnosed using characteristic radiologic features and anatomic locations. Cystic masses from the GI tract can be divided into several categories: congenital lesions, neoplastic lesions (cystic neoplasms, cystic degeneration of solid neoplasms), and other miscellaneous lesions. In this pictorial review, we describe the pathologic findings of various cystic lesions of the GI tract as well as the radiologic features of GI cystic lesions from several imaging modalities including a barium study, transabdominal ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging.
Contrast Media ; Cysts/*diagnosis/pathology ; *Diagnostic Imaging ; Gastrointestinal Diseases/*diagnosis/pathology ; Humans

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Visualization of Tumor Angiogenesis Using MR Imaging Contrast Agent Gd-DTPA-anti-VEGF Receptor 2 Antibody Conjugate in a Mouse Tumor Model.

Hong Young JUN ; Hong Hua YIN ; Sun Hee KIM ; Seong Hoon PARK ; Hun Soo KIM ; Kwon Ha YOON

Korean Journal of Radiology.2010;11(4):449-456. doi:10.3348/kjr.2010.11.4.449

OBJECTIVE: To visualize tumor angiogenesis using the MRI contrast agent, Gd-DTPA-anti-VEGF receptor 2 antibody conjugate, with a 4.7-Tesla MRI instrument in a mouse model. MATERIALS AND METHODS: We designed a tumor angiogenesis-targeting T1 contrast agent that was prepared by the bioconjugation of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) and an anti-vascular endothelial growth factor receptor-2 (VEGFR2) antibody. The specific binding of the agent complex to cells that express VEGFR2 was examined in cultured murine endothelial cells (MS-1 cells) with a 4.7-Tesla magnetic resonance imaging scanner. Angiogenesis-specific T1 enhancement was imaged with the Gd-DTPA-anti-VEGFR2 antibody conjugate using a CT-26 adenocarcinoma tumor model in eight mice. As a control, the use of the Gd-DTPA-anti-rat immunoglobulin G (Gd-DTPA-anti-rat IgG) was imaged with a tumor model in eight mice. Statistical significance was assessed using the Mann-Whitney test. Tumor tissue was examined by immunohistochemical analysis. RESULTS: The Gd-DTPA-anti-VEGFR2 antibody conjugate showed predominant binding to cultured endothelial cells that expressed a high level of VEGFR2. Signal enhancement was approximately three-fold for in vivo T1-weighted MR imaging with the use of the Gd-DTPA-anti-VEGFR2 antibody conjugate as compared with the Gd-DTPA-rat IgG in the mouse tumor model (p < 0.05). VEGFR2 expression in CT-26 tumor vessels was demonstrated using immunohistochemical staining. CONCLUSION: MR imaging using the Gd-DTPA-anti-VEGFR2 antibody conjugate as a contrast agent is useful in visualizing noninvasively tumor angiogenesis in a murine tumor model.
Adenocarcinoma/*pathology ; Animals ; Colonic Neoplasms/*pathology ; Contrast Media/chemistry/*diagnostic use ; Gadolinium DTPA/chemistry/*diagnostic use ; Immunoenzyme Techniques ; Magnetic Resonance Imaging/*methods ; Mice ; Mice, Nude ; Neovascularization, Pathologic/*diagnosis ; Rats ; Statistics, Nonparametric ; Tumor Cells, Cultured ; Vascular Endothelial Growth Factor Receptor-2/*antagonists & inhibitors/chemistry

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An Effective Guidewire Looping Technique for the Recanalization of Occlusive Segments of Infrapopliteal Vessels.

Jian bo WANG ; Jun gong ZHAO ; Ming hua LI ; Yue qi ZHU ; Jue WANG ; Pei lei ZHANG

Korean Journal of Radiology.2010;11(4):441-448. doi:10.3348/kjr.2010.11.4.441

OBJECTIVE: To determine the efficacy, safety and primary follow-up results of a guidewire looping technique for the treatment of infrapopliteal arteries. MATERIALS AND METHODS: From October 2006 to May 2008, an intraluminal angioplasty of the infrapopliteal arteries was attempted in 200 consecutive patients. Altogether, 417 infrapopliteal lesions, with lengths varying from 2 cm to 32 cm, were treated as part of this study, including 305 lesions in the anterior tibial arteries, 89 in the posterior tibial arteries, and 23 in the peroneal arteries. The 'U'-shaped guidewire technique was attempted in 393 lesions from 361 limbs. The tip of a hydrophilic 0.035-inch guidewire was formed into a 'U' shape with the aid of a 4-Fr catheter and collateral branch vessel to recanalize the completely occluded long segment lesions. RESULTS: A successful angioplasty with at least one artery recanalized directly to the malleolar or dorsal foot was achieved in 322 limbs (89%). The looping technique had a success rate of 90% (352 of 393 lesions). After the procedure, the rest pain was relieved in 58 of 69 patients, while 207 of 245 limbs (85%) showed improvement for intermittent claudication. Complete wound healing was noted in 21 of 54 patients, while 20 of 54 patients showed an improvement in the wound size or depth. A total of 38 major immediate procedure-related complications were noted, including retroperitoneal hematoma, distal emboli, and vessel rupture. CONCLUSION: The results of this study suggests that the guidewire looping technique is a safe and effective method for the recanalization of the occluded lesions in infrapopliteal vessels.
Aged ; Aged, 80 and over ; Angioplasty/*methods ; Ankle Brachial Index ; Arterial Occlusive Diseases/*surgery ; Female ; Follow-Up Studies ; Foot/blood supply/surgery ; Humans ; *Magnetic Resonance Angiography ; Male ; Middle Aged ; *Popliteal Artery ; Postoperative Complications ; Treatment Outcome

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