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Primary squamous cell carcinoma of the stomach is a rare epithelial tumor with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers (1). To date, only 80 cases have been reported in the English literature (2). Moreover, the multidetector CT (MDCT) findings associated with primary squamous cell carcinoma of the stomach have not yet been reported. We report a case of primary squamous cell carcinoma of the stomach, which was manifested as a large unlcerofungating mass by a MDCT.

Purpose: The purpose of this study is to analyze the most discriminative MR findings for making the differential diagnosis of tuberculous and pyogenic spondylitis. Materials and Methods: Sixty MR scans of 18 pyogenic spondylitis patients and 42 tuberculous spondylitis patients were retrospectively reviewed. The statistical analysis was performed using stepwise discriminant analysis and Student’s T-test. Results: The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings as follows (p

Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting.

Intracranial dermoid cyst is a rare congenital benign disease, representing less than 0.5% of primary brain tumors. Nevertheless, if ruptured spontaneously or during surgery, it has a poor prognosis due to chemical meningitis. Therefore, it is essential to perform accurate diagnosis and proper treatment. We report an intracranial subdural dermoid cyst that may be misdiagnosed as extracranial or epidural lesion because of extension into the right foramen ovale, and describe the CT and MR imaging findings.

We report a case of gastric inflammatory myofibroblastic tumor in a 25-month-old boy. The condition is very rare and is of unknown pathogenesis. Because it is large and invades adjacent organs, imaging procedure do not provide easy differentiaion between an inflammatory myofibroblastic tumor and malignacy, and it should thus be inclued in the differential diagnosis of an infiltrative upper abdominal mass occurring in children.

Extramedullary plasmacytoma involves organs outside the bone marrow, but involvement of the pancreas is very rare. We present the imaging findings of extramedullary plasmacytoma of the pancreas in a patient with multiple myeloma. Mixed echogenecity was noted at US, and marked enhancement at CT and MR.

Purpose: To describe the spiral CT findings of CRCC and to correlate these with the pathologic features, nuclear grading, tumor staging, and prognosis. Materials and Methods: We encountered eleven cases of CRCC among 167 cases of histopathologically proven RCC, retrospectively evaluating the spiral CT findings of CRCC including tumor size, internal texture, attenuation, margin, and the involvement of veins or lymph nodes. In addition, the CT findings were correlated with the pathologic features, Fuhrman's nuclear grade, Robson’s staging, and the prognosis. Between 27 and 80 (mean, 49.6) months later, the follow-up CT scans of tea patients were examined for tumor recurrence. Results: All tumors, which ranged in size from 2.5 to 15 (mean, 7.7) cm, were solid and well demarcated from renal parenchyma. Pre-contrast CT scans showed that their attenuation was equal to (n=1) or slightly lower (n=10) than that of renal parenchyma, and on early and delayed phase post-contrast enhanced scans, attenuation was low in all cases. In three, focal areas in which attenuation was lower than in the rest of the tumor were observed; histopathologically, these represented hyalinization. There was neither venous nor lymph node involvement, and no distant metastasis. Histopathologic examination demonstrated cystic change (n=1), hemorrhage or necrosis (n=5), complete encapsulation (n=3) and perirenal fat infiltration (n=3). Nuclear grading was II (n=6) or III (n=5), and tumor staging was I (n=8) or II (n=3). Among the five cases in which the nuclear grade was III, three were stage I and two were stage II. Follow-up scans showed no evidence of tumor recurrence, and all patients survived. Conclusion: Pre-, early- and late-phase post-contrast enhonced spiral CT scans showed that the attenuation of a CRCC was lower than that of renal parenchyma. Even where the nuclear grade was higher, a well-demarcated soild mass was observed, the tumor stage was lower and the prognosis better.

Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p

Purpose: To determine changes in the square index of the liver segments of liver cirrhosis(LC) patients, as seen on CT, and the value of this indicator during follow-up. Materials and Methods: Twenty-three patients with LC were included in this study. Abdominal CT scans were performed twice in each patient and the mean follow-up period was 15 (6-36) months. We measured the square index of the right lobe, the caudate lobe, and the medial and lateral segment of the left lobe of the liver, as seen on initial and follow-up CT images, and compared the results. The square index was obtained by deter-mining the product of the transverse and longitudinal diameters. According to the Child-Pugh classification, the condition was classified as either progressive or non-progressive, and the square index was compared between the two groups. Results: The square index of the left lobe medial segment showed a significant decrease in both the progression group(n=13) and non-progression group(n=10), while that of the right lobe was significantly lower only in the progression group. There was no significant change in the square index of the caudate lobe or the lateral segment of the left lobe. Conclusion: For predicting the progression of LC, the square index of the medial segment of the left lobe is a more sensitive index than the Child-Pugh classification. For ascertaining the progression of the condition, the square index of the right lobe is a valuable deferminant.

Purpose: To evaluate the intrahepatic anatomy of the hepatic vein and right portal venous system, as seen on 3-D CTAP, and to assess the avascular zone between the anterior and posterior segments of the right lobe in relation to the right hepatic vein. Materials and Methods: Fifteen patients in whom nodular hepatocellular was suspected underwent spiral C-TAP. 3-D images of the portal and hepatic vein were obtained using the maximal intensity projection technique. We examined the portal venous branching pattern and the draining pattern of the hepatic venous system to the inferior vena cava, as well as variation of the right hepatic vein and the avascular zone between the anterior and posterior segments of the right lobe. Results: In 13 patients, three hepatic veins were clearly visualized, and in ten, the middle and left hepatic veins conjoined before draining to the IVC. In three patients, three hepatic veins drained separately into the IVC. Two right hepatic veins were seen in three patients. The right portal venous system was clearly visualized in 13 patients a classical branching pattern in 11, trifurcation in one, and four simultaneous branching patterns in one. Lateral projection showed that the angle of the avascular zone declined posteriorly by 26- 64( 47.5) in relation to the right hepatic vein. Conclusion: We observed the drainage pattern of the hepatic vein and variation of the right portal venous system on 3-D image, and confirmed that since the avascular zone declined posteriorly, the right hepatic vein is an inappropriate landmark for right hepatic segmentation.

Purpose : To distinguish the spiral CT findings of Borrmann type IV adenocarcinoma from those of gastric lymphoma with diffuse gastric wall thickening. Materials and Methods : We retrospectively reviewed the spiral CT scans of 30 patients with Borrmann type IV adenocarcinoma and nine with gastric lymphoma with diffuse gastric wall thickening. In all patients the respective condition was pathologically confirmed by gastrectomy. CT scanning was performed after peroral administration of 500-700ml of water. A total of 120-140ml bolus of nonionic contrast material was administered intravenously at a flow rate of 3ml/sec and two-phase images were obtained at 35-45 sec(early phase) and 180 sec(delayed phase) after the start of bolus injection. Spiral CT was performed with 10mm collimation, 10mm/sec table feed and 10mm reconstruction. We evaluated the degree and homogeneity of enhancement of thickened entire gastric wall, and the enhancement pattern of gastric inner layer, as seen on earlyphase CT scans. On early and delayed views, the thickness of gastric wall and the presence of perigastric fat infiltration were determined. The enhancement patterns of gastric inner layer were classified as either continuous or discontinuous thick enhancement, thin enhancement, or nonenhancement. Results : The thickness of gastric wall was 1.2-3.5cm(mean 2.2cm) in cases of adenocarcinoma and 1.2-7.6c m (mean 4cm) in lymphoma. Perigastric fat infiltration was seen in 24 patients with adenocarcinoma(80 %) and four with lymphoma(44%). In those with adenocarcinoma, the degree of enhancement of entire gastric wall was hyperdense in fifteen patients(50%) and isointense in eleven (37 %). Seven patients with lymphoma(78 % ) showed hypodensity. In those with adenocarcinoma, continuous thick enhancement of gastric inner layer was seen in 18 patients(60 %) and discontinuous thick enhancement in nine(30%). In lymphoma cases, no thick enhancement was observed. Thin enhancement of gastric inner layer was demonstrated in three patients with adenocarcinoma( 10 %) and two with lymphoma(22 %). In seven patients with lymphoma(78 %), there was no enhancement. Conclusion : The following early-phase findings are highly suggestive of gastric lymphoma: a gastric wall thickness of more than 3 cm; no or minimal perigastric fat infiltration, hypodense enhancement of thickened entire gastric wall; and no or thin enhancement of gastric inner layer.

Purpose : To determine which contrast media are both efficient and safe for the imaging of airways.Materials and Methods : We evaluated five contrast media (barium, gastrografin, iotrolan, ioxaglate, iopentol) in terms of image quality and their effects on the lungs of 25 white rabbits. For bronchography 0.5ml of contrast media was used. In each contrast group, HRCT scans were obtained immediately (n=5), 12 hours (n=4),1 day (n=3), 2 days (n=2), and 1 week (n=1) after bronchography. Histopathologic specimens were obtained immediately, 12 hours, 1 day, 2 days, and 1 week later. Bronchograms were evaluated for image quality by three radiologists working independently, and were scored as 1(poor), 2(moderate), or 3(good) in terms of contrast quality and bronchial coating. HRCT was evaluated by two radiologists who reached a concensus; they determined the presence of contrast media, and then the pattern and extent of pulmonary opacity, and any related changes. Histopatholgic specimens were evaluated by two pathologists who sought consensus as to the extent of inflammation, pulmonary edema, and hemorrhage, and any changes in these aspects.Results : Bronchography indicated that the sum of scores for contrast quality was 45 for barium, 33 for gastrografin, 28 for iotrolan, 30 for ioxaglate, and 28 for iopentol, while for each of these media, the sum of scores for bronchial coating was 39, 19, 25, 23, and 21, respectively. Barium showed the best image quality. In all rabbits,HRCT demonstrated the variable extent of ground-glass attenuation and/or consolidation. Lesions were most extensive at 1-2 days and then regressed at 1 week; these HRCT findings correlated well with histologic findings. In histologic studies of all five contrast media groups, variable severe inflammatory reactions were observed, with or without necrosis, congestion, edema, and hemorrhage. It was noted that ioxaglate appeared to cause least tissue reaction.Conclusions : The imaging results of this experimental study indicate that for bronchography, barium is the best available contrast media, On the basis of the histologic and HRCT results, however, ioxaglate is the best.