Search

Thirty-three patients with suspected biliary obstruction were prospectively evaluated with multislice CT cholangiography using thin-slab minimum intensity projection (MinIP) and multiplanar reformation (MPR) to determine its usefulness and to compare with the comparative studies of endoscopic retrograde cholangiography (ERC), magnetic resonance cholangiography (MRC), or percutaneous transhepatic cholangiography (PTC). CT cholangiography made correct diagnoses in all biliary obstructions except in two patients with common bile duct stones. The correspondence with the comparative study was 93.9%. Multislice CT cholangiography may be favorable in noninvasive evaluation of biliary obstructions.

Abdominal CTs of 57 patients with bowel perforation after blunt abdominal trauma were retrospectively analyzed to determine: the diagnostic accuracy of the perforation site, and the differential findings according to the elapsed time from the trauma. Diagnostic accuracy of the perforation site was as follows: duodenum (100%), jejunum (81%), jejunoileal junction (100%), ileum (93%), and colon (20%). Extraluminal air was the only significant differential findings according to the elapsed time, and was seen more commonly on late stage of bowel perforation (P

Thirty-three patients with suspected biliary obstruction were prospectively evaluated with multislice CT cholangiography using thin-slab minimum intensity projection (MinIP) and multiplanar reformation (MPR) to determine its usefulness and to compare with the comparative studies of endoscopic retrograde cholangiography (ERC), magnetic resonance cholangiography (MRC), or percutaneous transhepatic cholangiography (PTC). CT cholangiography made correct diagnoses in all biliary obstructions except in two patients with common bile duct stones. The correspondence with the comparative study was 93.9%. Multislice CT cholangiography may be favorable in noninvasive evaluation of biliary obstructions.

Carcinoid tumor of the pancreas is rare. Moreover, obstructive pancreatitis secondary to a pancreatic carcinoid tumor is extremely rare. We report a case of pancreatic carcinoid tumor in a 50-year-old male who presented with pancreatitis. On multislice helical computed tomography, the main pancreatic duct was obstructed by a small round tumor, and the main pancreatic duct proximal to the tumor was dilated. The correlation between the main pancreatic duct and the tumor was well depicted on minimum intensity projection image. This is the first report of multislice helical computed tomorgraphic and minimum intensity projection image findings of a pancreatic carcinoid tumor presenting with pancreatitis.

The recent development of multidetector computed tomography (MDCT) and the parallel escalation in the capabilities of the workstation allow the use of high-quality multiplanar and three-dimensional reconstruction images. As a noninvasive technique, MDCT dedicated to the biliary tract represents an alternative to magnetic resonance cholangiography. The usefulness of three-dimensional reconstructed images using MDCT in evaluating biliary tract abnormality is illustrated.

Abdominal CTs of 57 patients with bowel perforation after blunt abdominal trauma were retrospectively analyzed to determine: the diagnostic accuracy of the perforation site, and the differential findings according to the elapsed time from the trauma. Diagnostic accuracy of the perforation site was as follows: duodenum (100%), jejunum (81%), jejunoileal junction (100%), ileum (93%), and colon (20%). Extraluminal air was the only significant differential findings according to the elapsed time, and was seen more commonly on late stage of bowel perforation (P.05).

대하여 알아보고자 하였다. Purpose: To evaluate the incidence of sternal fracture due to trauma, the CT features of sternal fractures, and the hospitalization period. Materials and Methods: The medical records and CT images of 755 patients who suffered trauma from January 2012 to August 2013 were analyzed retrospectively. We compared the incidence of sternal fracture due to various traumatic causes. We evaluated the location and shape of the sternal fracture on CT scans and the relationship between a sternal fracture and the hospitalization period. Results: The incidence of sternal fracture was 9.27% (70/755) in all patients; 11.7% (53/453) due to a traffic accident (TA), and 5.63% (17/302) due to other causes. TA was the most frequent cause (75.71%) of a sternal fracture, fracture incidences after a TA differed by traumatic cause (p < 0.05). Among sternal fractures, the body was the most commonly involved (68.57%), one wall was limited (32.85%), and anteroposterior length increased (7.14%). Body fractures involving two or more segments included 33.33% of the cases. The hospitalization period was not related with sternal fracture (p = 0.30). Conclusion: Sternal fracture was more frequent after a TA than due to other causes. Fracture incidences after a TA depended on the traumatic causes. Involvement of two or more segments and one wall-limitation were common among sternal fractures. Sternal fractures occurred even in slightly injured patients. Index terms Sternum Fracture Trauma Incidence Computed Tomography

Copyrights © 2012 The Korean Society of Radiology Purpose: The purpose of this study was to evaluate the significance of the presence of adjacent rib involvement in osteoporotic compression fractures. Materials and Methods: All the patients with acute osteoporotic compression fractures of the thoracic spine on thoracic spine MRI that presented to our clinic between September 2003 and January 2010 were retrospectively reviewed. All the vertebrae were divided into two groups: those that showed signal-intensity change in the rib adjacent to the compression fracture and those that did not. We compared the results between the two groups to determine if there were differences in the degree of osteoporosis, the compression fracture level and the age of patients between the two groups. We calculated the degree of correlation between the MRI and the bone scan images of these patients. We also reviewed whether percutaneous vertebroplasty relieved symptoms or not. Results: Signal-intensity changes were found in the adjacent rib(s) in 12 of the 60 patients and in 14 of the 94 levels (the total number of levels). The MRI and bone scan showed significant correlation (p < 0.001). There was a statistically significant difference in the incidence of pain at the one-month outpatient follow-up between the two groups (p = 0.0215). Conclusion: The radiologist should comment on the presence or absence of adjacent rib involvement when reporting on the thoracic spine MRI of patients suffering from osteoporotic compression fractures in order to more accurately determine prognosis. Index terms Osteoporosis Compression Fracture Vertebroplasty MRI Thoracic Spine Rib Involvement The Clinical Significance of Adjacent Rib Involvement on MRI in Patients with Acute Osteoporotic Compression Fractures of the Thoracic Spine 급성 골다공증성 흉추압박골절 환자에서 동반된 늑골 침범의 임상적 의의

We present a series of 61 traumatic subdural hygromas, and discuss the pathogenic mechanisms and natural history of this condition. It commonly occurred in patients over 50 years of age and before 5 years of age. Fifty-two cases (85.2%) were diagnosed 3 days after head injury. Glasgow Coma Score (GCS) on admission was 3-8 in 24 (39.3%), 9-12 in 15 (24.6%) and 13-15 in 22 patients (36.1%). Although three patients (4.9%) showed slow deterioration, most hygromas were clinically 'silent'. Thirty-eight patients (62.3%) were managed conservatively and 23 patients (37.7%) underwent surgery. Only five patients (21.7%) showed gross improvement after surgery, even though surgery was performed only for enlarged hygromas shown by serial computed tomography. In five patients (8.2%), a chronic subdural haematoma subsequently developed from a hygroma. A favourable outcome (good recovery or moderate disability) occurred in 59%, an unfavourable outcome (severe disability and vegetative state) in 28%, and death resulted in 13%. Outcome was closely related to the severity of primary head injury.

Purpose: To evaluate the characteristics of tracheal and main bronchial diverticula in relation with emphysema. Materials and Methods: A total of 967 CT images were reconstructed with 1.25 mm axial images over 2 months. The incidence, size, number, and location of the tracheal and main bronchial diverticula were analyzed using 3D medical software (Seoul, Korea). The incidence of emphysema and the relationship between emphysema and the size of the diverticula were analyzed. Results: In total, 50 patients (5.1%) showed tracheal diverticula in the right posterolateral wall. In addition, 51 patients (5.2%) showed 89 (9.4%) main bronchial diverticula in the inferior wall, while 68 (72%) showed diverticula in the left posterolateral wall. Tracheal diverticula (6.4 5.0 mm, 1.0 0.2) were larger and fewer than the main bronchial diverticula (2.1 2.0 mm, 1.8 1.6) (p 7.4 mm) with emphysema in 13 patients (26%), were larger than those without emphysema (5.1 3.0 mm) (p

Isolation of the left innominate artery is a rare anomaly and is usually combined with a right side aortic arch. Most patients are neonates or children with congenital heart disease. We report the MDCT findings of a right aortic arch and isolation of the left innominate artery in a 76-year-old man without congenital heart disease.

Thin-section CT scans were performed in 40 patients to demonstrate the normal appearance of the lingular division (LD) bronchus and its segmental and subsegmental bronchi and to search out the possible anatomical landmark dividing the anterior segment and LD of the left upper lobe. The LD bronchus was identified in all patients. The complete branching pattern of the lingular segmental and subsegmental bronchi could be traced in 19 (47.5%) patients. Since the lower branch of the draining vein of the anterior segment of the left upper lobe (V3b) runs horizontally between the anterior segment and the LD of the left upper lobe, it is a good landmark dividing the anterior segment and LD of the left upper lobe. Familiarity with thin-section CT anatomy of the lingular segmental and subsegmental bronchi and surrounding vascular structures is helpful in identifying the lingular bronchial tree precisely and localizing a lesion in the left upper lobe correctly.

Thoracic duct cysts are uncommon lesions that most commonly occur in the abdominal and thoracic portion of the thoracic duct: the cervical portion is the rarest location. The main causes of thoracic duct cyst are surgical injuries such as neck dissection and blunt trauma. We report here on a rare case of spontaneous cervical thoracic duct cyst that was noted on ultrasonography and CT. The thoracic duct cyst was confirmed by fine needle aspiration and it was treated by sclerotherapy.

Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease.

Purpose: To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. Materials and Methods: Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. Results: Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n= 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7), closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. Conclusion: The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction.

Subperiosteal hematoma of the orbit is a rare disease and most of the cases occur in young adult males as a result of direct facial or orbital trauma. In the absence of direct facial or orbital trauma, nontranmatic subperiosteal orbital hematoma has rarely been reported in association with a sudden elevation of cranial venous pressure or venous congestion, systemic diseases associated with a bleeding diathesis and paranasal sinusitis. We report here on a rare case of subperiosteal orbital hematoma associated with ethmoid sinusitis, as was seen on CT imaging.

Most giant sacral schwannomas are associated with moderate to massive bone destruction before they extend into the presacral space. These lesions can, on rare occasions, manifest as a giant tumor in the presacral space without bone destruction. We report here on the image findings of a presacral giant schwannoma in a 65-year-old man. On ultrasound and CT, the tumor appeared as an inhomogenous, well-demarcated mass that demonstrated some cystic changes and peripheral calcifications without sacral bone destruction. On the MR imaging, the tumor showed as an inhomogeneous, encapsulating mass with low signal intensity on both the T1 and T2-weighted images, except for some areas that showed cystic change.

Kallmann's syndrome is defined as the combination of hypogonadotropic hypogonadism and anosmia/hyposmia. The syndrome is a result of defect in the embryonic migratory pathway of gonadotropin-releasing hormone, which synthesizes neurons and olfactory axons. The hypogonadotropic hypogonadism results due to absence of or incomplete pubertal development and may be associated with anosmia, hyposmia, midline defect (color blindness, cleft-lip, cleft-palate, unilateral renal agenesis, sensorineural deafness), cryptorchidism and skeletal anomaly. Till date in Korea, few cases of Kallmann's syndrome have been reported but there are no available reports on cases of Kallmann's syndrome with unilateral renal aplasia and diabetes mellitus. We handled a case of Kallmann's syndrome associated with unilateral renal agenesis and diabetes mellitus. In the current work, we present a peculiar case as afore mentioned with the review of related literature (J Kor Soc Endocrinol 20:96～102, 2005).

Purpose: To evaluate the frequency of a paratracheal cyst on CT in an adult, and to compare the degree of loculation and the patient's age with the longest diameter of the air cysts. Materials and Methods: Of 1520 patients, who underwent a CT scan, 41 patients with paratracheal cysts were enrolled in this study. There were 26-males and 15 females, whose ranged from 24 to 82 years (mean, 59.8). The CT findings were evaluated to determine the relationship between the degree of loculation and the longest diameter of the air cysts. Another tracheal diverticula or an air cyst, as well as the tracheal communication were also evaluated. Results: The longest diameter of the paratracheal air cysts was 1 cm (p=0.043). The paratracheal air cysts 2 cm were multilocular. Four patients had another small tracheal diverticula, and one patient had another small paratracheal air cyst. Tracheal communication was observed in 7 patients (17%). Conclusion: The frequency of paratracheal air cysts in adults undergoing a CT scan was 2.7%. The longest diameter of the paratracheal air cysts was associated with the patient's age. The shape of air cysts became more multilocular as the longest diameter of the paratracheal air cysts increased. Another small tracheal diverticula or air cysts were observed in 12% of patients.

Acute appendicitis is the most common cause of surgical abdomen in children. Because of the various locations where you can find the appendix and the different presentation for the symptoms of appendicitis, the clinical diagnosis of appendicitis is often difficult in children, and radiologic diagnosis is becoming increasingly important. Being familiar with the findings of acute appendicitis on the MDCT axial image and the multiplanar reformation images may aid the physician in reaching an early diagnosis and so prevent complications and reduce negative appendectomy rates.

Purpose: To determine the long-term follow-up CT findings of paraquat-induced lung injury. Materials and Methods: Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years, and more than above 7 years after poisoning were analyzed. Results: We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. Conclusion: The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed.

Giant cell tumors of the bone commonly occur in the epiphyseal scar of a long tubular bone, representing about 5% of all primary bone tumors. A short tubular bone, such as one in the hand or foot, is the site of less than 5% of all giant cell bone tumors. The authors report two cases in which giant cell tumors arose in the short tubular bone, and describe the clinical manifestations and radiologic findings.

Annular pancreas is a rare congenital abnormality characterized by a ring of pancreatic tissue encircling the second portion of the duodenum, and it is definitively diagnosed by endoscopic retrograde cholangiopancreatography. We present here a case of annular pancreas that was diagnosed by the minimum intensity projection technique of multidetector row CT. On the CT scan, the annular pancreas was demonstrated as the pancreatic tissue with an aberrant pancreatic duct encircling the duodenum.

Although hepatic hemangioma is the most common benign tumor of the liver, it is rarely associated with calcifications. We report on the case of an asymptomatic 58-year-old man in whom multiple hepatic masses containing calcifications were discovered incidentally at ultrasonography. The radiologic features mimicked those of multiple hepatic metastases.

Transmesenteric hernia occurs usually in adult patients who had history of an abdominal surgery or blunt abdominal trauma. Congenital mesenteric defect is a relatively common cause of internal hernia in children. However, the report of CT findings of congenital transmesenteric hernia is relatively rare. Thus, we report a case of congenital transmesenteric hernia occurring in a 13-year-old girl with intestinal obstructive symptoms, and include the CT findings.

Peliosis hepatis is a rare disease characterized by cystic hepatic sinusoidal dilatation and the presence of multiple blood-filled spaces in the hepatic parenchyma. In most cases, multiple lesions and individual cysts not exceeding 1cm in diameter occur. We report a case in which the condition occurred in a 33-year-old woman who presented with general weakness and in whom a 3.5 cm-sized single hepatic mass was discovered incidentally at ultrasonography. The radiologic features mimicked those of a signle hepatic mass.

We recently experienced an omental teratoma in a 34-year-old woman. Ultrasonography (US) revealed a large mass of mixed echogenicity, occupying the entire lower abdomen. Computed tomography showed an inhomogeneous solid and cystic mass in the abdominal cavity containing fat and calcification.

Purpose : To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness, Materials and Methods: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at S mm invervals in 50consectutiwe subjects.Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CT scans were analyzed .ResuIts : Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its media 1 end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10subiects (20%). Completely absent minor fissure was noted in four subjects (8%) . The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. The minor and major fissure intersected each other in only 27 subjects (54%). The highest point of intersection was variable.Conclusion : There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin -section CT scans .