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Purpose To evaluate the computed tomography findings of intersigmoid hernias. Methods Between April 2010 and March 2018, seven patients who were surgically diagnosed with intersigmoid hernia from three institutions were enrolled in this study. Two radiologists evaluated imaging findings for the herniated small bowel, the distance between the occlusion point and bifurcation of the left common iliac artery, and its relationships with the surrounding structures. Results All patients were male ,and their mean age (standard deviation, range) was 61.0 (13.5, 36–85) years. The mean size of the bowel loops was 5.19 (1.34, 4.0-8.3) cm in the caudal direction, 3.59 (0.79, 2.5–5.1) cm in the lateral, and 3.43 (0.64, 2.5–4.7) cm in the anterior-posterior direction, 37.88 (27.79, 15.6–103.0) cm3 calculated by the length. The obstruction point was located 3.57 (0.59, 2.84–4.70) cm inferior to the bifurcation of the left common iliac artery. In all cases, the small bowel ran under the point that the inferior mesenteric vessels bifurcated to the superior rectal vessels and the sigmoid vessels and formed a sac-like appearance between the left psoas muscle and the sigmoid colon. The ureter ran dorsal to the point of the bowel stenosis, and the left gonadal vein outside the small bowel loops. Conclusion In all cases, the small bowel ran under the position of the inferior mesenteric vessel's bifurcation and became strangulated at the anterior of the left ureter, showing a sac-like appearance medial to the left gonadal vein. These findings may be characteristic of the intersigmoid hernia.

This study investigated retrospectively the diagnostic yield and complication rate of transthoracic needle biopsies for posterior thoracic pulmonary lesions using C-arm cone-beam computed tomography （CBCT）. The risk factors for pulmonary hemorrhage were evaluated. Our study included 113 patients with 113 posterior pulmonary lesions （mean longest diameter: 30.6mm, and mean depth: 4.7mm） through the erector spinal muscles using a 19/20-gauge coaxial system. The diagnostic performances of procedures for malignant lesions and the incidence of complications after biopsies were also assessed. The patient-related and procedure-related variables were investigated. Risk factors for pulmonary hemorrhage were analyzed with a multivariate logistic regression analysis. Findings revealed 99 malignant, 13 benign, and one intermediate lesion. Sensitivity, specificity, and diagnostic accuracy rates were 100％ （99/99）, 92.3％ （12/13）, and 99.1％ （111/112）, respectively. Air embolization, hemothorax, hemoptysis, pneumothorax, and pulmonary hemorrhage, occurred in 0, 2, 12, 48, and 70 procedures. The averaged spinous process-pleura depth and the traversed lung parenchyma depth achieved by the introducer needles were 54.2mm and 27.4mm, respectively. The needle position at the pleural puncture site within the intercostal space was in middle （31％） and inferior （69％） areas. The incidence of pulmonary hemorrhage was significantly higher in smaller lesions （p＝0.001）. Manual evacuation was performed in five procedures for patients with pneumothorax. The chest tube placement （trocar＞8 Fr） was performed in two procedures in patients with hemothorax and pneumothorax. In conclusion, the biopsy method with a posterior intercostal approach for posterior thoracic pulmonary lesions yielded high diagnostic accuracy and few major complications.

We examined whether the superior margin of the left main bronchus is the best landmark for the starting position of computed tomography coronary angiography（CTCA）. We retrospectively evaluated 693 consecutive CTCAs. From the scout scanogram, the superior margin of the left main bronchus was noted. The relationships among and distance between the superior margin of the left main bronchus and the left coronary system were analyzed. The superior margin of the left main bronchus extended caudally to the superior margin of the left coronary system in 13 patients（1.9％）. The addition of 1cm to the superior margin of the left main bronchus kept it caudal to the superior margin of the left coronary system in only one patient（0.1％）. On the scout scanogram, 1cm above the superior margin of the left main bronchus is the most appropriate starting position for CTCA.

The relationship between the clinicopathological features and the grade of cellular dysplasia of the neoplastic glands in mass-forming gallbladder cancer was investigated. In this retrospective study, 41 mass-forming （≧1cm） gallbladder cancer specimens from 83 resected cases were examined. Tumors were classified into three groups: Group A had intraluminal masses consisting of neoplastic glands with only low-grade dysplasia; Group B had mixed low- and high-grade dysplasia, and Group C had only high-grade dysplasia. Of the 41 tumors, 13 were classified as Group A, 11 as Group B, and 17 as Group C. For Group A, B, and C, respectively, the mean tumor diameter was 1.6, 3.7 and 3.4cm; macroscopic type （pedunculated/semi-pedunculated/sessile） was 7/5/1, 4/6/1 and 0/10/7; frequency of an invasive component inside the mass was 0％, 9％ and 82％; and cell lineage （biliary/metaplastic/mixed） was 2/1/10, 8/1/2 and 14/1/2. In addition, invasion depth （Tis＋T1/T2/T3） was 13/0/0, 7/4/0 and 3/10/4; lymph node metastases were present in 0％, 9％ and 24％ of patients; 3-year survival rate was 100％, 100％ and 82％; and 5-year survival rate was 100％, 100％ and 69％, for A, B and C, respectively. Significant intergroup differences were seen for positive lymph node metastasis rate and 5-year survival rate. The present study indicates that the clinicopathological features of mass-forming gallbladder cancer are different depending on the grade of cellular dysplasia of the mass lesion. The tumors in Groups A and B were of lower malignancy than those in Group C and the prognosis of patients in the former groups was excellent. Group A and B tumors may be intracholecystic papillary-tubular neoplasms, a recently proposed new disease concept.

Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: Becuase CT is an important technique for the detection of hepatic metastases [1], screening and follow-up CT examinations are usually performed to determine the clinical stagein patients with digestive malignancy, including...

Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: With the introduction of multidetector computed tomography (MDCT), CT angiography (CTA) is widely accepted for assessment of the cervical and intracranial vessels. In particular, CTA has a highly diagnostic accuracy in detection for cerebral...

Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: Introduction The advent of Multidetector row Computed Tomography (MDCT) resulted in increased radiation-dose exposure of patients undergoing CT urography (CTU), including the excretory phase (EP) images. Most patients with transitional cell...

Right pleural effusion was diagnosed in a 36-year-old woman with right upper quadrant pain and fever. Enhanced pelvic computed tomography performed because of irregular genital bleeding revealed the pelvic inflammatory disease. Upon further questioning, the patient confirmed that she had recently undergone therapy for Chlamydia trachomatis infection. Therefore she was given an injection of tetracycline because we suspected Fitz-Hugh-Curtis syndrome (FHCS), a pelvic inflammatory disease characterized by perihepatitis associated with chlamydial infection. A remarkable clinical response to antibiotics was noted. The right upper quadrant pain was due to perihepatitis, and the final diagnosis was FHCS. Right pleural effusion may be caused by inflammation of the diaphragm associated with perihepatitis. Once chlamydial infection reaches the subphrenic liver, conditions in the closed space between the liver and diaphragm due to inflammatory adhesion may be conductive to chlamydial proliferation. The possibility of FHCS should be considered in patients and carefully distinguished from other abdominal diseases.