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Periurethral bulking agent injection (or transurethral submucosal injection) is a comparatively less invasive procedure for the treatment of stress urinary incontinence in patients who develop incontinence after radical prostatectomy, and who are more frequently being treated with transurethral submucosal injection. However, as the radiologic findings of bulking agents are not very well known, they can be mistaken for local recurrence in prostate cancer patients who have undergone prostatectomy. Unlike some of the literatures, in which the radiologic features of collagen injections have been reported, the radiologic findings of silicone injections are yet to be determined. Thus, it is our intention to report this case along with the literature review as the authors have experienced an actual case of a silicone injection mistaken as local recurrence.

Sonographic evaluation of the gastrointestinal (GI) tract may be difficult because of overlying intraluminal bowel gas and gas-related artifacts. However, in the absence of these factors and with the development of high-resolution scanners and the technical experience of radiologists, sonography can become a powerful tool for GI tract assessment. This pictorial essay focuses on sonographic findings of GI tract lesions compared with endoscopic, computed tomographic, and magnetic resonance imaging findings. Neoplastic and non-neoplastic diseases and postoperative complications are illustrated, and the distinctive sonographic characteristics of these entities are highlighted.

Sonography is usually regarded as a first-line imaging modality for masses and masslike lesions in the abdominal wall. A dynamic study focusing on a painful area or palpable mass and the possibility of ultrasound-guided aspiration or biopsy are the major advantages of sonography. On the other hand, cross-sectional imaging clearly shows anatomy of the abdominal wall; thereby, it is valuable for diagnosing and evaluating the extent of diseases. Cross-sectional imaging can help differentiate neoplastic lesions from non-neoplastic lesions. This pictorial essay focuses on sonographic findings of abdominal wall lesions compared with computed tomographic and magnetic resonance imaging findings.

OBJECTIVES To evaluate characteristic sonographic findings for mumps orchitis with epididymal involvement. METHODS This study included 18 patients (aged 12-18 years) with mumps orchitis. We assessed the volume, echogenicity, and vascularity of the testes and the transverse diameter, echogenicity, and vascularity of the epididymal head, body, and tail. We classified 4 types of epididymal involvement: 1A, focal swelling of the epididymal head with hypervascularity only on the swollen head; 1B, focal swelling of the epididymal head with hypervascularity on the entire epididymis; 1C, diffuse swelling of the entire epididymis with hypervascularity; and 2, no epididymal involvement. The Student t test was used to evaluate the significance of the size of each part of the epididymis and the epididymal head-to-tail diameter ratio. RESULTS Orchitis was unilateral in 13 patients and bilateral in 5. Of 23 affected hemiscrotums, 7 (30.4%) were type 1A, 4 (17.4%) type 1B, 2 (8.7%) type 1C, and 10 (43.5%) type 2. In 11 patients with unilateral epididymal involvement, the mean diameters ± SDs of the epididymal heads on the affected and contralateral sides were 1.11 ± 0.19 (range, 0.7-1.7) and 0.65 ± 0.14 (0.3-0.9) cm (significantly different, P

Gastric gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors of the stomach, which may be asymptomatic or cause symptoms such as pain, gastrointestinal bleeding, and obstruction. Hemoperitoneum due to spontaneous rupture of the tumor is an extremely rare complication. We described a case of a 52-year-old man with a large pedunculated GIST causing loculated hematoma within the gastrocolic ligament. The patient visited our hospital due to a 3 week history of epigastric pain. A computed tomography scan revealed a 10.3 × 7.5 × 9.4 cm sized mass that was growing exophytically from the greater curvature of the stomach and was surrounded by loculated hematoma within the gastrocolic ligament. Laparotomy revealed a large stalked gastric mass surrounded by loculated hematoma within the gastrocolic ligament and blood fluid in the peritoneal cavity. Pathologic examination confirmed a GIST, of the high risk group.

The purpose of the study was to assess the value of initial sonography in the diagnosis of right-sided colonic diverticulitis in comparison with supplementary CT. A total of 183 consecutive adult patients with right lower quadrant pain (73 diverticulitis, and 110 non-diverticulitis) who underwent both initial sonography and subsequent CT within 24 h were enrolled in this study. Two reviewers retrospectively assessed imaging findings of diverticula, colonic wall thickening, inflammatory pericolic fat, and pericolic abscess for each sonography and CT and then classified each case as non-diverticulitis, simple diverticulitis or complicated diverticulitis. Sonography and CT were independently reviewed at 2-week intervals. The value of initial sonography was assessed through head-to-head comparison with CT results. Sensitivity, specificity and accuracy for diagnosing diverticulitis were not significantly different between the two modalities (p = 0.366, 0.605 and 0.259, respectively). In addition, the net sensitivity (97.26%) of both sonography and CT was not significantly different from the sensitivity (89.04%) of sonography alone (p = 0.101). Agreement between sonography and CT for the classification of diverticulitis and the four imaging findings was excellent (all κ > 0.8). Initial sonography can be as effective as CT for the diagnosis of right-sided colonic diverticulitis. Supplementary CT is only needed when sonography is inconclusive.

In a computed tomography (CT) scan, fat deposition in the urinary bladder wall is seen as a linear hypoattenuating band surrounded by soft tissue density. It is uncommon, but is often seen in normal cases. However, there is no report of fat deposition in the urinary bladder wall in Korea. The authors encountered a 62-year-old male patient who showed an incidental hypoattenuating band in the urinary bladder wall on abdominal CT. The patient showed no clinical signs related to fat deposition in the urinary bladder wall. When the patient's previous abdominal CT was retrospectively reviewed, the same CT finding was seen. This linear hypoattenuating band within the urinary bladder wall should be considered as a normal CT finding, although it is uncommon.

Intravenous lobular capillary hemangiomas are extremely uncommon and mostly occur in the veins of the neck and upper extremities. Here, we report the clinical and sonographic features of an intravenous lobular capillary hemangioma localized in the right cephalic vein, and we discuss its pathologic findings and differential diagnoses.

Purpose The aims of the study were to evaluate the usefulness of low-dose (LD) nonenhanced CT (NECT) with coronal reformation in diagnosing acute appendicitis and to compare LD NECT with standard-dose (SD) NECT and SD contrast-enhanced CT (CECT). Methods A total of 452 patients suspected of having acute appendicitis underwent CT using a scan 1 (SD NECT and SD CECT1, n = 182) or a scan 2 protocol (LD NECT and SD CECT2, n = 270). The diagnostic performance and interobserver agreement for diagnosing acute appendicitis were compared. Results Although the area under the curves of both reviewers of LD NECT were lower than those of SD CECT2, area under the curves of both reviewers for SD NECT were not significantly different for SD CECT1 and LD NECT (all P > 0.05). The interobserver agreements within each scan were excellent (all κ > 0.8). Conclusions Low-dose NECT with coronal reformation showed high diagnostic performance and can be used as the first-line imaging tool in the work-up of patients with suspected acute appendicitis.

A suprapubic cartilaginous cyst from the symphysis pubis is a rare lesion, which may be asymptomatic or cause symptoms such as urinary retention and pelvic pain. It is thought to be secondary to degenerative changes in the symphysis pubis and usually occurs in multiparous women. We report the case of a suprapubic cartilaginous cyst in a 76-year-old asymptomatic woman, which mimicked a bladder mass on ultrasonography.

Diagnostic errors remain an inevitable occurrence during abdominopelvic CT (APCT) interpretation, despite advances in imaging technology. The main cause of error is failure to identify a lesion (i.e. perceptual error) and failure to recognize a finding's significance (i.e. interpretive or cognitive error). Awareness and understanding of the causes of errors can reduce their occurrence and may lead to a reduction in morbidity and mortality. This pictorial essay highlights various causes of error in interpreting APCT scans and briefly discusses possible solutions for minimizing these errors.

To investigate the relationship between the increased signal intensity (SI) of proximal lateral collateral ligament (LCL) at femoral attachment site on fat-suppressed (FS) proton density-weighted (PDW) MR imaging and the corresponding histological features on cadaveric knees.MRI was obtained from 11 cadaveric knees. Two musculoskeletal radiologists evaluated SI of LCL at femoral attachment site and the remaining caudal portion on FS PDW imaging. The SI was classified into three types; I = low, II = intermediate to slightly high, III = high SI or intraligamentous discontinuity of fibre. In addition, 100 control subjects were reviewed for normal LCL SI.All proximal LCLs at femoral attachment site showed increased SI (nine cases of Type II and two cases of Type III). The remaining caudal portion presented Type I in all cases. Histological examination of proximal LCL at femoral attachment site revealed loose distribution of fine collagen fibres, intervened with fat and vessels, whereas the remaining caudal portion was composed of parallel distribution of compact collagen bundles. There were no signs of degeneration or tear of the LCL in all our cadaveric knee samples, even for the two cases that presented as Type III. Clinical study identified increased SI of proximal LCL at femoral attachment site in 94% (94/100) of control subjects.Increased SI of proximal LCL at femoral attachment site on FS PDW imaging is due to histological characteristics, not degeneration or tear.Increased SI of proximal LCL at femoral attachment site on FS PDW MR imaging is a common, normal finding that its clinical significance can be neglected.

Congenital intrahepatic inferior vena cava (IVC) interruption with azygos/hemiazygos continuation is a rare congenital anomaly (1, 2) and hemiazygos vein continuation draining into the right atrium via a persistent left superior vena cava (SVC) is even rarer (3). Furthermore, a single coronary artery (SCA) ostium, in the absence of other cardiac disease, is an extremely rare coronary artery anomaly (4). We presented a very rare case of incidentally found interrupted IVC with hemiazygos vein continuation combined with a left SCA diagnosed by multi-detector computed tomography (MDCT). The dilated hemiazygos vein drained directly into the persistent left SVC.

Granular cell tumors (GCTs) are extremely rare mesenchymal neoplasms of Schwann cell origin. Malignant GCTs (MGCTs) comprise 0.5–2% of all GCTs. In the present report, we describe a case of a 66-year-old man with MGCT of the abdominal wall. The patient visited our hospital due to a recently growing palpable soft tissue mass in the abdominal wall. Computed tomography scan revealed a 4.3 × 4.1 × 2.9 cm sized mass arising from the left abdominal wall, which was contemplated as a desmoid tumor before surgical excision. Histopathological examination confirmed MGCT.

Diabetes mellitus (DM) can accompany many musculoskeletal (MSK) diseases. It is difficult to distinguish the DM-related MSK diseases based on clinical symptoms alone. Sonography is frequently used as a first imaging study for these MSK symptoms and is helpful to differentiate the various DM-related MSK diseases. This pictorial essay focuses on sonographic findings of various MSK diseases that can occur in diabetic patients.