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The objective of this study was to evaluate susceptibility changes caused by iron accumulation in cognitive normal (CN) elderly, those with amnestic mild cognitive impairment (aMCI), and those with early state AD, and to compare the findings with gray matter volume (GMV) changes caused by neuronal loss. The participants included 19 elderly CN, 19 aMCI, and 19 AD subjects. The voxel-based quantitative susceptibility map (QSM) and GMV in the brain were calculated and the differences of those insides were compared among the three groups. The differences of the QSM data and GMVs among the three groups were investigated by voxel-based and region of interest (ROI)-based comparisons using a one-way analysis of covariance (ANCOVA) test with the gender and age as covariates. Finally, a receiver-operating-characteristic (ROC) curve analysis was performed. The voxel-based results showed that QSM demonstrated more areas with significant difference between the CN and AD groups compared to GMV. GMVs were decreased, but QSM values were increased in aMCI and AD groups compared with the CN group. QSM better differentiated aMCI from CN than GMV in the precuneus and allocortex regions. In the accumulation regions of iron and amyloid β, QSM can be used to differentiate between CN and aMCI groups, indicating a useful an auxiliary imaging for early diagnosis of AD., Highlights • The susceptibility difference was more sensitive than GMV change in known regions of iron and the amyloid β accumulations. • QSM values were increased in patients compared with normal elderly and better differentiated aMCI from CN than GMV values. • The QSM technology can be used as an auxiliary imaging for early diagnosis of AD.

PURPOSE To analyze the malignancy rate of ultrasound-guided core needle biopsy (US-CNB) for screen-detected breast lesions and to evaluate the results according to the mode of detection of the target lesions. METHODS This is a retrospective review of 703 consecutive women who underwent US-CNB for screen-detected breast lesions at a single tertiary hospital. Breast Imaging Reporting and Data System (BI-RADS) categories and histopathological results of the target lesions were assessed. The cases were divided into two groups: the mammography-based detected lesions (M-group) and the US-based detected lesions (U-group). The biopsy performances of the two groups were compared using the χ2 test. RESULTS The malignancy rate in the entire population was 22.0%: 0.8%, 12.3%, 65.2%, 89.3%, and 94.6% in BI-RADS categories 3, 4A, 4B, 4C, and 5, respectively. The malignancy rate was significantly higher in the M-group (54.1% [79/146]) than in the U-group (13.6% [76/557]) (p < 0.001). BI-RADS category 3 was the most common assessment overall that led to a US-CNB (362/703, 51.5%) and the rate of BI-RADS category 3 diagnoses that led to US-CNB was significantly higher in the U-group (p < 0.001). CONCLUSIONS The malignancy rate associated with US-CNB for screen-detected breast lesions was 22.0%. The breast lesions detected by mammography have a higher malignancy rate than those detected by US. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:261-266, 2017.

Objective: To compare the diagnostic performance of breast MRI with abbreviated protocol (AB-MRI) and full ddiagnostic protocol (FDP-MRI) for surveillance of females with a personal history of breast cancer Methods: In this retrospective study, we analyzed the outcomes of total 1312 post-operative screening breast MRI matched from 1045 AB-MRI and 677 FDP-MRI, which had histologic confirmation for suspicious MRI findings or 1 year negative follow-up images. This study was approved by the institutional review board and informed patient consent was waved. AB-MRI consists of T2 weighted scanning and dynamic contrast-enhanced imaging including one pre-contrast and two post-contrast scans. We compared the diagnostic performance for recurrent breast cancer in terms of sensitivity, specificity, positive-predictive value, negative-predictive value, and accuracy and area under the curve between the screening AB-MRI and FDP-MRI. Results: Overall, 13 recurrent tumors among 1312 post-operative cases screened with breast MRI (1.0%) were detected including 8 invasive cancer, 2 cases of in situ cancer, and 3 cases of metastatic lymph nodes. The sensitivity and negative predictive value were 70 vs 100 and 99.5% vs 100% in AB-MRI and FDP-MRI. Specificity, positive predictive value, accuracy, and area under the curve of AB-MRI and FDP-MRI were 98.0% vs 96.9%, 35.0% vs 23.1%, 97.6% vs 97.0%, and 0.840 vs 0.985, respectively. Conclusion: The performance of AB-MRI was comparable to that of FDP-MRI in detecting recurrent breast cancer and decreased false positive cases. Advances in knowledge: AB-MRI provides a reliable alternative with similar diagnostic performance and shorter MRI acquisition time.

Objective The purpose of this study was to estimate the T2* relaxation time in breast cancer, and to evaluate the association between the T2* value with clinical-imaging-pathological features of breast cancer. Materials and methods Between January 2011 and July 2013, 107 consecutive women with 107 breast cancers underwent multi-echo T2*-weighted imaging on a 3T clinical magnetic resonance imaging system. The Student's t test and one-way analysis of variance were used to compare the T2* values of cancer for different groups, based on the clinical-imaging-pathological features. In addition, multiple linear regression analysis was performed to find independent predictive factors associated with the T2* values. Results Of the 107 breast cancers, 92 were invasive and 15 were ductal carcinoma in situ (DCIS). The mean T2* value of invasive cancers was significantly longer than that of DCIS (p = 0.029). Signal intensity on T2-weighted imaging (T2WI) and histologic grade of invasive breast cancers showed significant correlation with T2* relaxation time in univariate and multivariate analysis. Breast cancer groups with higher signal intensity on T2WI showed longer T2* relaxation time (p = 0.005). Cancer groups with higher histologic grade showed longer T2* relaxation time (p = 0.017). Conclusion The T2* value is significantly longer in invasive cancer than in DCIS. In invasive cancers, T2* relaxation time is significantly longer in higher histologic grades and high signal intensity on T2WI. Based on these preliminary data, quantitative T2* mapping has the potential to be useful in the characterization of breast cancer.

OBJECTIVES This study aimed to evaluate the usefulness of Acoustic Structure Quantification (ASQ; Toshiba Medical Systems Corporation, Nasushiobara, Japan) values in the diagnosis of Hashimoto thyroiditis using B-mode sonography and to identify a cutoff ASQ level that differentiates Hashimoto thyroiditis from normal thyroid tissue. METHODS A total of 186 thyroid lobes with Hashimoto thyroiditis and normal thyroid glands underwent sonography with ASQ imaging. The quantitative results were reported in an echo amplitude analysis (Cm(2)) histogram with average, mode, ratio, standard deviation, blue mode, and blue average values. Receiver operating characteristic curve analysis was performed to assess the diagnostic ability of the ASQ values in differentiating Hashimoto thyroiditis from normal thyroid tissue. Intraclass correlation coefficients of the ASQ values were obtained between 2 observers. RESULTS Of the 186 thyroid lobes, 103 (55%) had Hashimoto thyroiditis, and 83 (45%) were normal. There was a significant difference between the ASQ values of Hashimoto thyroiditis glands and those of normal glands (P < .001). The ASQ values in patients with Hashimoto thyroiditis were significantly greater than those in patients with normal thyroid glands. The areas under the receiver operating characteristic curves for the ratio, blue average, average, blue mode, mode, and standard deviation were: 0.936, 0.902, 0.893, 0.855, 0.846, and 0.842, respectively. The ratio cutoff value of 0.27 offered the best diagnostic performance, with sensitivity of 87.38% and specificity of 95.18%. The intraclass correlation coefficients ranged from 0.86 to 0.94, which indicated substantial agreement between the observers. CONCLUSIONS Acoustic Structure Quantification is a useful and promising sonographic method for diagnosing Hashimoto thyroiditis. Not only could it be a helpful tool for quantifying thyroid echogenicity, but it also would be useful for diagnosis of Hashimoto thyroiditis.

PURPOSE This study aimed to evaluate the relationship between the degree of perihepatitis and the severity of pelvic inflammatory disease (PID) on multidetector computed tomography (MDCT). METHODS A total of 177 women with PID who underwent biphasic abdominal computed tomography (CT) scans were enrolled. Two reviewers retrospectively reviewed the CT scans with consensus and subjectively categorized the severity of PID into 4 grades (normal, mild, moderate, and severe). Another reviewer independently assigned the extent (grades 0 to 4) and the depth (grades 0 to 4) of hepatic surface enhancement in terms of the degree of perihepatitis. Relationships between the degree of perihepatitis and the CT severity as well as each CT manifestation of PID were evaluated using the χ test or a cumulative logistic regression analysis. RESULTS Of the 177 patients, 99 (55.9%) showed hepatic surface enhancement. The severity of PID on MDCT was significantly related with the degree of perihepatitis (all P < 0.001). Salpingitis, oophoritis, pelvic fat haziness, complicated ascites, and omental/mesenteric fat infiltration were significantly related with the degree of perihepatitis (all P < 0.05). Among these variables, omental/mesenteric fat infiltration (odds ratio = 10.9) and salpingitis (odds ratio = 6.0) were the CT manifestations that were most associated with the presence of perihepatitis in PID. CONCLUSIONS The degree of perihepatitis seems to show a relationship with the severity of PID on MDCT. Omental/mesenteric fat infiltration and salpingitis can be strongly related with perihepatitis in PID.

We evaluated the benefit of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) compared to FFDM alone for breast cancer detection, focusing on cancer characteristics. We searched electronic databases and relevant references for published studies comparing DBT plus FFDM to FFDM alone for breast cancer screening. Pooled risk ratios (RRs) for various pathologic findings were determined using random effects models. Eleven eligible studies were included. Pooled RRs showed a greater cancer detection for DBT plus FFDM than for FFDM alone for invasive cancer (1.327; 95% CI, 1.168–1.508), stage T1 (1.388; 95% CI, 1.137–1.695), nodal-negative (1.451; 95% CI, 1.209–1.742), all histologic grades (grade I, 1.812; grade II/III, 1.403), and histologic types of invasive cancer (ductal, 1.437; lobular, 1.901). However, adding DBT did not increase for detection of carcinoma in situ (1.198; 95% CI, 0.942–1.524), stage ≥T2 (1.391; 95% CI, 0.895–2.163), or nodal-positive cancer (1.336; 95% CI, 0.921–1.938). Heterogeneity among studies was not significant in any subset analysis. Adding DBT to FFDM enabled detection of early invasive breast cancer that might have been missed with FFDM alone. Knowing which cancer characteristic DBT detects may allow it to play a complementary role in predicting long-term patient outcomes and facilitate treatment planning.

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.

Nodular fasciitis of the breast is a rare, benign, proliferative disease characterized by sudden onset and rapid growth. It can clinically and radiologically mimic breast cancer. We present imaging findings from two cases of nodular fasciitis that initially manifested as palpable masses. Sonographically, they appeared as irregular, not-circumscribed hypoechoic nodules. The diagnosis of nodular fasciitis was made by US-guided core needle biopsies. US-guided vacuum-assisted excision was subsequently performed in the first case, while the second resolved via spontaneous regression.

Background IDEAL technique is a robust fat-water separation method which is potentially useful in cartilage imaging with significant improvement in the cartilage signal-to-noise ratio (SNR). Purpose To identify whether iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) improved diagnostic performance for IDEAL 2D fast spin echo (FSE) and 3D spoiled gradient-recalled echo (SPGR) versus fat-saturated (FS) protocols at 1.5 and 3.0 T in the evaluation of patella-femoral cartilage lesions. Material and Methods Forty-six artificial cartilage lesions were created in femoro-patellar articular cartilages of 11 porcine knees. All knees underwent MR examination at 1.5 and 3.0 T with MR protocol consisting of sagittal FS 2D FSE and 3D SPGR and IDEAL 2D FSE and IDEAL 3D SPGR, respectively. Qualitative assessment was performed to compare the diagnostic performance between 1.5- and 3.0-T protocols and between IDEAL and FS protocols. Results IDEAL 3D SPGR had a significantly higher accuracy for detecting partial thickness cartilage lesions ( P Conclusion Compared with conventional FS SPGR imaging, IDEAL 3D SPGR provided a better diagnostic performance for evaluation of porcine knee articular cartilage lesions in the knee joints at 1.5 and 3.0 T. IDEAL 3D SPGR may therefore be useful for detecting partial-thickness cartilage lesions in patients with degenerative osteoarthritis.

To analyze the malignancy rate of ultrasound-guided core needle biopsy (US-CNB) for screen-detected breast lesions and to evaluate the results according to the mode of detection of the target lesions.This is a retrospective review of 703 consecutive women who underwent US-CNB for screen-detected breast lesions at a single tertiary hospital. Breast Imaging Reporting and Data System (BI-RADS) categories and histopathological results of the target lesions were assessed. The cases were divided into two groups: the mammography-based detected lesions (M-group) and the US-based detected lesions (U-group). The biopsy performances of the two groups were compared using the χThe malignancy rate in the entire population was 22.0%: 0.8%, 12.3%, 65.2%, 89.3%, and 94.6% in BI-RADS categories 3, 4A, 4B, 4C, and 5, respectively. The malignancy rate was significantly higher in the M-group (54.1% [79/146]) than in the U-group (13.6% [76/557]) (p0.001). BI-RADS category 3 was the most common assessment overall that led to a US-CNB (362/703, 51.5%) and the rate of BI-RADS category 3 diagnoses that led to US-CNB was significantly higher in the U-group (p0.001).The malignancy rate associated with US-CNB for screen-detected breast lesions was 22.0%. The breast lesions detected by mammography have a higher malignancy rate than those detected by US. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:261-266, 2017.

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.

Fibrovascular polyps are rare, pedunculated, tumor-like lesions that are usually found in the esophagus; occurrence in the stomach is very rare. To our knowledge, sonographic and CT findings of a fibrovascular polyp in the stomach have never been reported. Here, we report a case of a fibrovascular polyp that was identified in the gastric antrum and prolapsed into the duodenal bulb. Sonography revealed a hyperechoic polypoid mass in the gastric antrum, which prolapsed into the duodenal bulb upon a change in the patient’s position. CT also revealed a pedunculated polypoid mass with an inner fatty component.

The purpose of this study was to compare the characteristics of quantitative perfusion parameters obtained from dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI) in patients with mammographically occult (MO) breast cancers and those with mammographically visible (MV) breast cancers. Quantitative parameters (AUC, Ktrans,kep,ve,vp, and wi) from 13 MO breast cancers and 16 MV breast cancers were mapped after the DCE‐MRI data were acquired. Various prognostic factors, including axillary nodal status, estrogen receptor (ER), progesterone receptor (PR), Ki‐67, p53, E‐cadherin, and human epidermal growth factor receptor 2 (HER2) were obtained in each group. Fisher's exact test was used to compare any differences of the various prognostic factors between the two groups. The Mann‐Whitney U test was applied to compare the quantitative parameters between these two groups. Finally, Spearman's correlation was used to investigate the relationships between perfusion indices and four factors — age, tumor size, Ki‐67, and p53 — for each group. Although age, tumor size, and the prognostic factors were not statistically different between the two groups, the mean values of the quantitative parameters, except wi in the MV group, were higher than those in the MO group without statistical significance (p=0.219). The kep value was significantly different between the two groups (p=0.048), but the other parameters were not. In the MO group, vp with size, ve with p53, and Ktrans and vp with Ki‐67 had significant correlations (p

We evaluated the sonographic features of superficial-type nodular fasciitis in 9 pathologically proven cases.Review of the radiology and pathology databases yielded 14 cases of histologically proven superficial-type nodular fasciitis, which was defined as nodular fasciitis located in the subcutaneous fat layer or outer muscle fascia between the subcutaneous fat layer and muscle. Sonograms were available in 9 patients. Two musculoskeletal radiologists retrospectively reviewed all cases in consensus. Imaging features evaluated included the fasciitis location in the body, size, relationship with the fascia, echogenicity, vascularity, and location of the center.There were 4 male and 5 female patients. The mean age was 35 years (range, 8-49 years). The masses ranged in size from 0.8 to 2 cm, with 90% measuring less than 1.8 cm. Five masses developed in the forearm (4 cases) or elbow (1 case). Six masses were located in the subcutaneous fat layer, and 3 masses were in the fascia. Seven masses were in direct contact with the outer muscle fascia, whereas 2 masses were indistinctly in contact with the fascia. These masses showed a hypoechoic background with echogenic foci or peripheral hyperechoic nodules. In all 3 of the masses within the fascia, the findings were similar to those of neurogenic tumors. The vascularity of the masses was variable, but most (7 of 9 cases) showed no substantial vascularity. All masses had centers of less than half the thickness of the subcutaneous fat layer.Superficial-type nodular fasciitis is often located in the deep subcutaneous fat near the muscle fascia, has a hypoechoic appearance with echogenic foci or peripheral hyperechoic nodules, and quite often does not show internal vascular flow. If a superficial soft tissue mass has the above findings, superficial-type nodular fasciitis should be included in the differential diagnosis.

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that can be benign or malignant. SFTs have been most often documented in the pleura. Recently, involvement of extrapleural sites such as the abdomen, musculoskeletal soft tissue, upper respiratory tract, mediastinum, and head and neck were reported. Less than 15 cases of SFT of the breast have been reported. Here, we report a case of a pathologically proven SFT of the breast and review the literature on the radiologic findings. US imaging showed an oval, well-circumscribed, hypoechoic solid mass. A solitary fibrous tumor of the breast is a very rare lesion.

We report on a 41-year-old woman with a chest wall desmoid tumour who was successfully treated with a computed tomography (CT)-guided steroid injection. She presented with a palpable mass in the right upper chest wall and was treated by surgical excision and postoperative radiation therapy due to recurrence of the mass at the surgical site. At 20 months after the second operation, a recurrent mass was again detected in the anterosuperior portion of the previous surgical site on CT. We performed a CT-guided steroid injection weekly for 4 weeks by applying a mixture of 3 mL of triamcinolone acetonide (40 mg/mL) and 3 mL of 1% Lidocaine, administering 4-6 mL of the mixture, to the lesion. Six months later, CT showed a marked decrease in the size of the mass.

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.

A variety of medical devices are used to monitor or treat abdominal and pelvic diseases. They are routinely recognized on abdominal radiographs and computed tomography (CT), and complications associated with their use are not uncommon. The complications associated with the use of the medical devices are migration, malposition and fracture, which can be easily recognized on abdominal radiographs. Additional potential complications include bleeding, obstruction, infection and organ injury, which may be detected on CT. Therefore, awareness of these complications and familiarity with their imaging findings are important aspects of the management of patients with medical devices. The aim of this pictorial review is to demonstrate the abdominal radiography and CT features of potential complications associated with the use of medical devices.

Quantitative measurement of relaxation parameters in MRI refers to MR relaxometry which implies the measurement of biophysical parameters through decoupling the different contrast mechanisms contributing to the overall MR signal. MR relaxation mapping is important to evaluate the tissue structure and function. Among the quantitative MRI parameters reflecting the local tissue environment, the relaxation times T1, T2, and T2* are the fundamental components (1, 2). The longitudinal (or spin-lattice) relaxation time T1 is the decay constant for the recovery of the z component of INTRODUCTION �Received; February 24, 2014�Revised; March 12, 2014 �Accepted; March 12, 2014 This work was supported by a grant from the Kyung Hee University in 2012 (KHU-20120762). Corresponding author : Geon-Ho Jahng, Ph.D. Department of Radiology, Kyung Hee University Hospital at Gandong, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea. Tel. 82-2-440-6187, Fax. 82-2-440-6932, E-mail : ghjahng@gmail.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Estimation of T2* Relaxation Times for the Glandular Tissue and Fat of Breast at 3T MRI System

Purpose: We investigated the relationship between BRCA mutations, pathological findings, and magnetic resonance imaging (MRI) features in patients with breast cancer at risk for the mutation. Methods: Genetic testing for BRCA mutations was performed in 275 breast cancer patients with at least one risk factor for the mutation. Using the breast imaging reporting and data system MR lexicon, morphological and kinetic features were reviewed on MRI scans of 230 tumors in 209 patients. The relationship between BRCA mutations, pathologic findings, and MRI data was examined, and disease recurrence was estimated. Results: BRCA mutations were detected in 48 patients (23.0%), of which 21 (10.0%) were in BRCA1, and 25 (12.0%) in BRCA2. Additionally, two patients (1.0%) had mutations in both genes. Cancers in patients with BRCA1 mutations more frequently showed a higher nuclear grade (p= 0.0041), and triple-negative (TN) phenotype (p< 0.0001). On MRI scans, the cancers were seen as mass-type in 182 out of 230 lesions (79.1%), and nonmass type in 48 cases (20.9%). Among the features indentified by MRI, rim enhancement was significantly associated with mo lecular subtypes based on immunohistochemistry (p< 0.0001), and nuclear grade (p= 0.0387) in multiple logistic regression analysis. Rim enhancement on MRI, along with advanced pathologic N stage, was associated with increased disease recurrence (p= 0.0023) based on multivariate analysis. However, the proportion of mass and nonmass tumors, and the distribution of morphological shape, margin, internal enhancement, and kinetic features assessed by MRI were not different according to BRCA mutation status. Conclusion: BRCA1 mutations were associated with aggressive pathological characteristics, and the TN phenotype. Rim enhancement was frequently seen on MRI scans of high-grade cancers and in the TN phenotype. And it was a significant predictor of disease recurrence. However, a direct asso ciation with BRCA mutations was not observed.

Purpose : We performed this study to investigate the characteristic imaging and clinicopathologic features of invasive micropapillary carcinoma of the breast. Materials and Methods: Among the 47 women with surgically confirmed invasive micropapillary carcinoma between 2005 and 2009, 32 patients (mean age, 50 years; range, 37-69 years) had all preoperative mammography, ultrasound (US) and MR images. Two radiologists retrospectively assessed the imaging findings, clinical presentation and histological results of the patients. Results: On mammography, 29 of 32 patients had suspicious findings. Among them, a mass (or focal asymmetry) with calcifications was the most common findings (15/32, 65%). The calcifications were noted in 20 patients (63%) and the shape of calcifications was frequently amorphous or punctate (n = 12, 60%). On US and MR imaging, all lesions had suspicious findings. The most common US findings were single (n = 20) or multiple (n = 10) irregular hypoechoic mass (es). The mass was frequently hypoechoic (n = 29, 97%). On MR imaging, the type of lesions was a mass or masses in 23 (72%), a mass combined with non-mass in six patients, and non-mass lesions in three patients. Histologically, axillary lymph nodes metastasis were very common (25/32, 78%). Asymptomatic clinical presentation was not usual (9/32, 28%). Conclusion: The imaging features of invasive micropapillary carcinomas strongly suggest malignancy. Microcalcifications on mammography, marked hypoechogenicity on US and an irregular mass, often combined with non-mass on MR are common. Axillary lymph node metastasis is commonly associated. Index words : Breast∙Carcinoma∙Invasive micropapillary carcinoma∙MR imaging∙Sonography

Purpose: To evaluate the imaging findings of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. Materials and Methods: From March 2003 to December 2008, five patients with uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis were evaluated as part of this study. We retrospectively reviewed the CT, ultrasound, and MRI findings as well as the medical records of each patient. Results: The patients initially underwent an imaging study for abdominal pain (n=3), recurrent vaginal bleeding (n=1), and prenatal evaluation (n=1). Of the five patients that underwent US, four had hematocolpos and two of them had hematometra. Moreover, three patients underwent a CT examination. The MR examination of four patients revealed hematocolpos (n=3), hematometra (n=1), and a tubular structure resembling an ectopic ureter (n=2). The gynecologic examination of a patient without hematocolpos revealed a pinpoint hole in the vaginal septum. Two of four patients with hematocolpos underwent a vaginal septectomy, which resulted in an improvement of the symptoms. Conclusion: The most common finding of patients with uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is vaginal fluid collection. Hematometra is not a consistent finding and can be transient according to the menstrual cycle. MR is the most useful imaging modality for the diagnosis of an ectopic ureter.

We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vena cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology.