Search

Aim. To evaluate the feasibility of a newly developed prototype MRI projection mapping (PM) system for localization of invasive breast cancer before breast-conserving surgery. Methods. This prospective study enrolled 10 women with invasive breast cancer. MRI was performed in both prone and supine positions. The tumor location was drawn on the breast skin using palpation and sonography while referring to the prone MRI (i.e., a conventional method). A maximum intensity projection image generated from the supine MRI was projected using our PM system, and the tumor location was drawn. The PM system consisted of a projector and a camera and was used to measure the shape of the breast surface using the structured light method. Breast-conserving surgery was performed based on the conventional method. We compared the tumor size and location between the PM and conventional methods or pathology. Results. There were no significant differences in the maximum diameters of invasive cancers between the PM system and the conventional method or pathology. The maximum discrepancy in tumor location between the PM and conventional method was 3–8 mm. Conclusions. This PM system may support breast-conserving surgery by showing the tumor size and location on the breast surface.

In patients with well-differentiated papillary thyroid carcinoma (PTC), late recurrence is very rare. It is unusual that 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (PET/CT) shows hypermetabolic lesions in patients with well-differentiated PTC metastases. We demonstrate an exceptional case exhibiting a first relapse 37 years after hemithyroidectomy to treat PTC. Recurrent metastasis of a PTC should be considered as a differential diagnosis even if the elapsed time from the initial treatment is great. A left cervical lymphadenopathy, which exceptionally exhibited a hypermetabolic lesion on PET/CT, should be considered a metastatically well-differentiated PTC.

Background Previous methods for the quantification of brain tissue properties by magnetic resonance imaging were mainly based on two-dimensional acquisitions and were thus limited to a relatively low resolution in the slice direction compared to three-dimensional (3D) acquisitions. The 3D-quantification using an interleaved Look–Locker acquisition sequence with a T2 preparation pulse (3D-QALAS) sequence may allow for simultaneous acquisition of relaxometry parameters in high spatial resolution. Purpose To evaluate bias, linearity, and day-to-day repeatability of relaxometry parameters, as well as tissue fraction maps, acquired with 3D-QALAS. Materials and methods Scan–rescan test of the 3D-QALAS sequence was performed on a 1.5-T scanner with the International Society for Magnetic Resonance in Medicine/National institute of Standards and Technology system phantom and 10 healthy volunteers (7 male, 3 female; mean age, 23.2 ± 3.6 years). Simple linear regression analysis, Bland–Altman plots, and intrasubject coefficients of variation (CV) were used to assess the reliability of 3D-QALAS sequence-derived parameters. The T1, T2, proton density (PD), and myelin volume fraction (MVF) of in vivo brain regions were compared with values obtained using the multidynamic multi-echo sequence. Results In the phantom study, the T1, T2, and PD values measured by 3D-QALAS showed strong linearity with the reference values (R2 = 0.998, 0.998, and 0.960 for T1, T2, and PD, respectively) and high repeatability (mean CV of 1.2%, 2.8%, and 2.9% for T1, T2, and PD, respectively). The T1, T2, PD, and MVF values of in vivo brain regions obtained with 3D-QALAS were highly consistent within subjects, with mean intrasubject CVs of 0.5%, 0.5%, 0.4%, and 1.6% for the T1, T2, PD, and MVF values, respectively. Conclusion 3D-QALAS enables reliable measurement of T1, T2, PD, and MVF values of the whole brain in high spatial resolution across a clinically-relevant dynamic range.

BackgroundThe predictive factors of coronavirus disease 2019 (COVID-19) pneumonia, including clinical parameters with symptoms, vital signs, and laboratory data, have not been compared directly between cases with and without complicated pneumonia. AimsWe aimed to identify predictive factors for COVID-19 patients with complicated pneumonia, and determine which COVID-19 patients should undergo computed tomography (CT). MethodsThis retrospective cross-sectional survey was conducted at the Juntendo University Nerima Hospital in Tokyo, Japan. We recruited patients diagnosed with COVID-19 between 1 January and 31 December 2020 and all patients underwent blood tests and CT. Clinical information, including vital signs, symptoms, laboratory results, and CT findings, were extracted from medical charts. Factors potentially predicting COVID-19 pneumonia were analysed using Student’s t -test or the chi-squared test, and variables with a p- value of < 0.05 in the bi-variate analysis were entered into multivariate logistic regression models. ResultsAmong 221 included patients (119 males [53.8%]; mean age, 54.59 ± 18.61 years), 160 (72.4%) had pneumonia. The significant factors in the multi-variate analysis were the lactate dehydrogenase (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.47–7.95; p < 0.01) and C-reactive protein (OR, 3.94; 95% CI, 1.05–14.80; p = 0.04) levels. No significant differences were observed in vital signs and the symptoms. ConclusionLDH and CRP level of > 220 IU/L and > 3.0 mg/dL, respectively, are independent risk factors for COVID-19 pneumonia. The present results are extremely useful for deciding whether to perform CT among COVID-19 patients.

Statins and exercise reduce cardiovascular disease incidence. We investigated whether endurance exercise in mice induces mitochondrial adaptation in skeletal muscle and muscle injury during administration of atorvastatin, a member of the statin medication class. Male C57BL mice were assigned to one of three groups: control (Con), statin (Statin), or statin and exercise (Statin + Ex). Atorvastatin was administered, and exercise performed on a treadmill for 8 weeks. The levels of mitochondria-associated proteins, PGC-1α, and respiratory chain complex, (COX) I–V, in the quadriceps femoris, and serum creatine kinase, a muscle injury marker, were measured. PGC-1α and COX I–V were upregulated in the Statin + Ex group compared to those in the Statin and Con groups; serum creatine kinase levels were similar. Endurance training in mice induced mitochondrial adaptation in skeletal muscle without causing muscle injury, during atorvastatin administration.

Purpose The aim of this study was to elucidate the distribution of estimated glomerular filtration rate (eGFR) values in patients who underwent gadolinium-based contrast agent (GBCA)-enhanced magnetic resonance imaging (MRI) at different types of hospitals. Materials and methods We retrospectively studied 2,550 patients who underwent MRI at five institutions. We recorded the date and value of each patient’s eGFR test. The distribution of eGFR values was compared with that in the general Japanese population. Results A total of 84.3% of patients had their eGFRs evaluated before GBCA-enhanced MRI. Of these, 84.7% were evaluated within 3 months before the GBCAenhanced MRI, and 1.3% were evaluated on the day of the GBCA-enhanced MRI. A total of 87.2% of patients tested had an eGFR of C60 ml/min/1.73 m 2 ; 12.8% had an eGFR of \60 and C30 ml/min/1.73 m 2 , and no patients had an eGFR of \30 ml/min/1.73 m 2 . Conclusion The rate of renal function evaluation differed among hospitals. The prevalence of low eGFR values was greater in Juntendo Tokyo Koto Geriatric Medical Center than in the other hospitals, and the prevalence of low eGFR values was greater in patients who underwent GBCAenhanced MRI than in the general Japanese population.

Primary cervical neuroblastoma (NB) in neonates is extremely rare. We treated a 1-day-old male neonate who presented with stridor and feeding difficulty and was subsequently diagnosed with NB of the retropharynx. The tumor was excised in toto transorally, and no metastatic lesions were confirmed. Histopathology and molecular genetic analysis showed poorly differentiated NB with no N-myc amplification, stage I NB. He has had no signs of recurrence or adverse sequelae during 18 months of follow-up. We report our experience and review the literature.

A 45-year-old male was admitted with difficulty in walking due to leg pain. At the time of the first visit, a reduced serum phosphorus concentration and an increased serum alkaline phosphatase concentration of unknown etiology were observed. Either a whole body bone scintigraphy or CT of the neck, chest and abdominal region did not reveal any underlying disease. However both the whole body 201Tl scintigraphy and 99mTc MIBI SPECT showed accumulation in the right knee region, and a small tumor was detected by MRI examination. After a diagnosis of oncogenic osteomalacia due to this tumor was determined the tumor was surgically removed, and turned out to be a hemangiopericytoma. By removal of the tumor, either the symptoms or the laboratory data were improved significantly. In this case, both 201Tl scintigraphy and 99mTc scintigraphy MIBI were useful in identifying the location of the tumor which caused oncogenic osteomalacia.

To evaluate the reasons for misdiagnosis of gastric carcinoma at upper gastrointestinal radiography.Upper gastrointestinal radiographs obtained within 3 years prior to diagnosis of gastric carcinoma in 336 patients were selected. Two radiologists who were initially blinded and then unblinded to the diagnosis reviewed the radiographs. Decisions were made by means of consensus. The reason for misdiagnosis was classified as perceptual error when the lesion was identified correctly at the blinded review, as possible perceptual error when the lesion was identified only at the unblinded review, and as technical error when the lesion could not be identified at either review and technical deficiencies were thought to be the cause.Twenty-four patients underwent upper gastrointestinal radiography within 3 years prior to diagnosis of 27 carcinomas. The reason for misdiagnosis was classified as perceptual error in 11, as possible perceptual error in four, and as technical error in five lesions. In the remaining seven lesions, the lesion could not be identified at either review, and technical deficiencies were not thought to be the cause. The most common overlooked finding was depression (10 of 15), and the most common presumed technical error was incomplete compression study (seven of 11).Careful attention should be paid to detect limited barium pooling during double-contrast studies to avoid overlooking depressions.

General features are described and examples are provided of the radiological manifestations of postbulbar duodenal lesions, particularly the findings on hypotonic duodenograms. Hypotonic duodenography does not always reveal the characteristic findings of postbulbar duodenal lesions, but it helps to evaluate luminal stenosis and diagnose disease entities even in lesions that show non-specific findings. Radiologists should be familiar with the radiological findings of postbulbar duodenal lesions and know which kinds of lesions can affect the postbulbar duodenum. This is important in making a differential diagnosis and in preventing delays in diagnosis.

A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

Bellini duct carcinoma is a rare variant of renal cell carcinoma and usually has a poor prognosis. In this article, we report the Gallium-67 citrate (Ga-67) uptake in Bellini duct carcinoma. To our knowledge, this is the second reported case of Bellini duct carcinoma in which Ga-67 uptake was positive. We suggest that Ga-67 scintigraphy has potential utility in detecting Bellini duct carcinoma of the kidney. And if a hypovascular tumor of the kidney shows Ga-67 uptake, Bellini duct carcinoma should be included in the differential diagnosis.

To accurately quantify liver function using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MR imaging.A total of 105 patients with suspicion of a hepatic tumor (Child–Pugh scores: 5 in 56, 6 in 26, 7 in 20, and 8 in 3) who underwent Gd-EOB-DTPA-enhanced MR imaging and an indocyanine green retention rate at 15 min (ICG-R15) evaluation were retrospectively analyzed. The hepatobiliary images were taken at 20 min after Gd-EOB-DTPA injection. The quantitative liver–spleen contrast ratio (Q-LSC) was measured by calculating the signal intensity of the spleen and 12 intrahepatic points consisting of each central zone (near the porta hepatis) and peripheral zone (near the subcapsular zone) in the two main liver lobes.Each averaged Q-LSC of six points in the central zone or right lobe was significantly higher than that in the peripheral zone or left lobe regardless of hepatic function. The mean Q-LSC of the 12 points was significantly correlated with the ICG-R15 and significantly decreased with elevation of the Child–Pugh score.The hepatic enhancement by Gd-EOB-DTPA is influenced by zonal and lobar differences. This method with consideration of regional differences is valid for estimation of liver function by Gd-EOB-DTPA-enhanced MR imaging.

Several kinds of fused cyclic compounds were obtained by tandem Michael-Claisen condensation of ethyl 2-[bis(ethylthio)methyl]benzoate and ethyl 2-[1, 3]dithiolan-2-yl-benzoate with α, β-unsaturated carbonyl compounds. Treatment of the annulated products with mercury(II)perchlorate trihydrate or N-chlorosuccinimide gave naphthoquinones, naphthalenes, and anthracenes.

A new procedure using lithium chloride in hexamethylphosphoramide was found to be useful for the synthesis of Michael-type adducts and cyclic enones. Selectivity for the two products could be controlled by altering the reaction temperature employed. The urea-type solvents were also examined instead of hexamethylphosphoramide.

Primary small cell carcinoma of the breast is a rare breast cancer. We report two cases of this entity showing a non-mass-like pattern on multimodality images and histopathology. Both women presented with a breast mass, and one had axillary lymphadenopathy. Both cases revealed fine calcification on mammography (MMG) and an irregularly shaped, hypoechoic lesion on ultrasonography. Computed tomography (CT) and magnetic resonance imaging (MRI) showed non-mass-like enhancement in both cases. Dynamic MRI showed medium initial enhancement followed by persistent delayed enhancement in one patient, whereas rapid initial enhancement with plateau delayed enhancement was observed in the other. The breast lesions showed very high signal intensity on diffusion-weighted MRI. Positron emission tomography showed moderate accumulation of 2-fluoro-2-deoxyglucose in the breast tumor and lymph node metastasis. The non-mass-like enhancement on CT and MRI and the segmental fine calcification on MMG indicate the abundance of components of ductal carcinoma in situ and the breast origin of the small cell carcinoma.

We report a case of intestinal angiosarcomatosis manifesting as jejuno-jejunal intussusception.

1, 2-Benzenediols were synthesized via 1, 1-bis(ethylthio)-3-cyclohexen-2-one derivatives, which were prepared by condensation of 1, 1-bis(ethylthio)-2-propanone with Mannich bases. Regioselective preparation of their monoethers was also achieved.

Cyclic enones were obtained from the reactions of β-keto esters with acyclic α,β-unsaturated ketones by using lithium chloride in hexamethylphosphoramide. The products were brought about via the Michael addition, decarboxylation, and the aldol condensation.

A new procedure using lithium chloride in hexamethylphosphoramide was found to be useful for the synthesis of Michael-type adducts and cyclic enones. Selectivity for the two products could be controlled by altering the reaction temperature employed. The urea-type solvents were also examined instead of hexamethylphosphoramide.

Several kinds of fused cyclic compounds were obtained by tandem Michael-Claisen condensation of ethyl 2-[bis(ethylthio)methyl]benzoate and ethyl 2-[1, 3]dithiolan-2-yl-benzoate with α, β-unsaturated carbonyl compounds. Treatment of the annulated products with mercury(II)perchlorate trihydrate or N-chlorosuccinimide gave naphthoquinones, naphthalenes, and anthracenes.

Several kinds of 2-substituted 5-hydroxyindoles were prepared by the procedure starting from the condensation of 1,4-cyclohexanedione with N-protected α-amino aldehydes in the presence of lithium chloride. The substitutent on 2-position of the indole ring system depends on that of the α-amino acid which was converted to the aldehyde.

The purpose of this study was to evaluate the effective dose during abdominal three-dimensional (3D) imaging on phantoms and estimate the dose-area product (DAP) for effective dose conversion factors for three types of angiographic units. Three-dimensional imaging was performed for three sizes (small, medium, large) of human-shaped phantoms using three types of angiographic units (Allura Xper FD20/10, INNOVA 4100, AXIOM Artis dTA). We calculated 25 organ doses and effective doses using Monte Carlo technique for the three phantoms with a program for a personal computer. As benchmark studies to back up the results by Monte Carlo technique, we measured the organ doses directly on the small phantom using radiophotoluminescent glass dosimeters. The DAP value increased as the phantom size increased. The organ doses and the effective doses during the 3D imaging increased as the phantom size increased. The effective doses for the small phantom by Monte Carlo technique were 1.9, 2.2, and 2.1 mSv for the Allura Xper FD20/10, INNOVA 4100, and AXIOM Artis dTA, respectively, while those by direct measurement were 1.6, 2.0, and 2.6 mSv. The effective doses to DAP ratios by Monte Carlo technique were 0.37-0.45, 0.26-0.32, and 0.13-0.15 (mSv Gy⁻¹ cm⁻²) for the Allura Xper FD20/10, INNOVA 4100, and AXIOM Artis dTA, respectively. In conclusion, the effective doses during 3D imaging and the dose-to-DAP ratios differ among angiographic units, and the effective dose can be estimated using a proper conversion factor for each angiographic unit.

Clinical usefulness of67Ga-citrate scintigraphy for the diagnosis of colorectal carcinoma was reappraised at the standpoint of clinicopathological diagnosis. Fifty-eight patients with colonic carcinoma were subjected to this study. They underwent67Ga scintigraphy before surgery. Colorectal carcinomas were detected in 38 patients, 65.5% by this procedure. Surgical specimens from thirty-seven patients underwent postoperative scanning. The scanning of the surgical specimen revealed accumulation of67Ga-citrate in all 37 patients, suggesting that67Ga-citrate accumulated in the carcinoma of the colon. The results suggested that detectability of carcinoma of the colon by67Ga scintigraphy in this series was better than generally considered. 67Ga scintigraphy was considered to provide useful information in cases of severe stenosis and dolichocolon which were difficult to diagnose with a Barium enema and fiberscope. The problem is that abnormal accumulation is sometimes hard to distinguish from physiological excretion in the stools. However we believe that images should be carefully evaluated, keeping in mind the fact that67Ga-citrate could accumulate in a colorectal carcinoma, and also believe that we radiologists should actively promote Ba-enema examination in positive cases rather than to devote time to the differentiation between physiological excretion of67Ga in the stools and accumulation in a colorectal carcinoma.

1, 2-Benzenediols were synthesized via 1, 1-bis(ethylthio)-3-cyclohexen-2-one derivatives, which were prepared by condensation of 1, 1-bis(ethylthio)-2-propanone with Mannich bases. Regioselective preparation of their monoethers was also achieved.

Recently, emphysematous pyelonephritis (EPN) has been classified into two subtypes based on CT findings. We recently experienced a patient whose CT image changed from type I (extensive destruction of the renal parenchyma with a large amount of air density without any fluid collection) to type II (containing a large amount of fluid) during the course of conservative treatment. We believe that some patients with type I EPN can change to type II EPN.

The purpose of this prospective study was to perform quantitative multidetector computed tomography (MDCT) analysis of pulmonary solid nodules using three parameters (long-short ratio, compactness, and intranodular CT number) and to evaluate the usefulness of each parameter in the differentiation of the nodules. Seventy solitary pulmonary nodules with a long axis length of 5–30 mm were examined using one multidetector CT (MDCT) system and one three-dimensional (3D) system, and the findings regarding the three parameters were statistically analyzed among five diseases (hamartoma, organizing pneumonia, adenocarcinoma, squamous cell carcinoma, and metastasis). The long-short ratio of the pulmonary nodule showed no significant differences among five diseases. The compactness showed significant differences (P < 0.05) in five pairs of diseases. Intranodular CT number showed significant differences (P < 0.05) in three pairs of diseases. Our results are insufficient for the complete differentiation of pulmonary solid nodules. However, among the three parameters, compactness and intranodular CT number contribute somewhat to the differentiation of pulmonary nodules.

A 5-year-old boy who had pneumonia was treated in a neighboring hospital. Ceftriaxone was administrated 2 g/day divided into two equal intravenous doses. After 1 week of ceftriaxone therapy, the patient developed abdominal pain. In our hospital, an abdominal sonogram showed a hyperechoic band with postacoustic shadow within the collapsed gallbladder. He was diagnosed with ceftriaxone-associated biliary pseudolithiasis, and ceftriaxone therapy was ceased. On the 8th our hospital day, he again complained of right abdominal pain after supper. A sonogram revealed high-amplitude echoes within the gallbladder neck and common bile duct. Furthermore, bile duct dilatation was observed. He was managed conservatively, after which the symptoms were resolved. On the 11th day, a sonogram showed only sludge within the gallbladder, and on the 13th day, he was discharged from our hospital. It is important for sonographers to recognize the possible occurrence of biliary pseudolithiasis in ceftriaxone-treated patients, especially when a high dose is used in children.

Intracranial arterial wall calcifications are frequently observed on routine head computed tomography (CT) images. The purpose of this study was to evaluate whether calcification of the intracranial carotid artery on CT images could predict atheromatous plaque and luminal stenosis.A total of 259 patients were examined using three-dimensional CT angiography using high-resolution 64 detector scanners. We examined patients from the petrous portion to the top of the internal carotid arteries. We evaluated the existence of calcification and atheromatous plaque based on our criteria retrospectively. The thickness of calcification was measured in each vessel, and the shape of calcification was classified into three types.There was low correlation between the thickness of the calcification and luminal stenosis, but the shape of the calcification corresponded well to the stenosis. The population of patients with50% stenosis of the intracranial carotid artery differed statistically significantly for each calcification shape. There was a high negative predictive value (97.7%) in the correlation between the existence of calcification and atheromatous plaque on the multidetector CT images.Calcification of the intracranial carotid artery on CT images shows a high negative predictive value for the existence of atheromatous plaque in the same artery. The thickness of the calcification did not correlate well with luminal stenosis, but its shape seemed to predict luminal stenosis.

M eckel’s diverticulum results from persistence of the omphalomesenteric (vitelline) duct. which is an embryonic connection between the mid gut and the umbilical cord. Meckel’s diverticulum is the most common anomaly of the gastrointestinal tract and usually produces no symptoms. although common clinical manifestations can indude small-bowel obstruction, diverticulitis, and rectal bleeding. Sometimes the diverticulum can invert, and it may then become the lead point for intussusception. To our knowledge, the angiographic appearance of an inverted Meckel’s diverticulum has not been previously reported. Here we describe its radiologic appearance, particularly on superior mesenteric arteriography. when the vitelline artery is visualized in the ileal lumen.

A 68-year-old female presented with the disturbance of brainstem function. Brain T2 weighted and FLAIR (fluid-attenuated inversion recovery) magnetic resonance imaging revealed the hyperintensity signal of the medulla oblongata, which led to diagnosis of brainstem infarction. Diagnostic cerebral angiography showed the dural arteriovenous fistula (DAVF) developed on the left transverse sinus (TS). Venous drainage route was consisted of retrograde leptomeningieal venous reflux of the cerebrum and spinal perimedullary vein via superior petrosal sinus. Venous hypertension of the brainstem was relieved by transvenous platinum coil selective embolization of superior petrosal sinus. The correct analysis of venous drainage pattern is essential for the curative endovascular surgery.

To determine the frequency and sonographic features of focal sparing of fatty liver at segment 2.The sonographic database was searched over the preceding three years. The criteria for sonographic diagnosis of focal sparing of fatty liver was an area of liver parenchyma of relatively low echogenicity with lack of mass effect.Six (0.9%) of 686 patients with diffuse fatty liver showed focal sparing at segment 2. The areas showed spherical or ovoid hypoechoic mass-like lesions measuring 2 to 6 cm in longest diameter (average, 3.8 cm). These all abutted on the posterior surface of segment 2 adjacent to the ligamentum venosum. These were segmental in two cases and subsegmental in four.In diffuse fatty liver, segment 2 is infrequently spared, and this may be a helpful adjunct sign of fatty liver.

A 57-year-old man was admitted to our hospital because of high fever and generalized tonic seizure. Brain magnetic resonance imaging (MRI) delineated multiple abnormal intensity areas. Thallium-201 (201Tl) scintigraphy revealed abnormal uptake in the brain. The imaging findings did not allow definitive exclusion of brain tumor, even though brain abscess was the more strongly suspected diagnosis. As the patient improved, the multiple abnormal intensity areas in the brain on MRI and the abnormal areas of accumulation on 201Tl scintigraphy were reduced, and eventually completely disappeared. A final diagnosis of brain abscess was therefore made. Since relatively few studies have reported 201Tl accumulation in cases of brain abscess, we report here our patient in whom the changes in the accumulation of 201Tl in a brain abscess were observed over time.

We performed MR imaging of the small bowel (MRSB) in 20 patients using water as an oral contrast agent, to improve the demonstrability of pathologic conditions without a large amount of intestinal fluid. Bowel lumen and folds were clearly visualized: duodenum in 13(65%), jejunal loops in 14 (70%), ileal loops in 15(75%), and ileocecum in 8 (40%) cases. Furthermore, conventional enteroclysis was performed in 16 of 20 patients, and the MRSB findings were comparable with those of conventional enteroclysis. If conventional enteroclysis is used as the gold standard, MRSB visualized luminal stenosis in 11 of 13(84.6%), displacement or extrinsic compression in 4 of 5(80%), polypoid lesion in 3 of 4(75%), and fistula formation in one of one cases. None of four ulcerative lesions could be visualized by MRSB. Our MRSB technique is a noninvasive, easy method that does not require a long time. Accordingly, MRSB can be used in addition to the conventional MR sequence. MRSB has potential usefulness for evaluating small-bowel disease without radiation exposure.

A [3C + 3C] annelation using 1, 1-bis(ethulthio)-2-propanone was applied to a new synthesis of the aporphine alkaloids. Condensation of the ketone with the Mannich base gave two isomeric cyclohexenones, which were converted into the aporphine framework by aromatization. (±)-Glaucine and (±)-nantenine were prepared by employing this new aromatic synthesis.

Aggressive fibromatoses commonly originate from the musculoskeletal system, mesentery, and retroperitoneum. We report a case of aggressive fibromatosis arising from the spermatic cord. On helical computed tomography, the lesion appeared as a solid mass with well-defined borders in the scrotum and with infiltrative features in the retroperitoneum.

(±)-Glaucine and (±)-nantenine were newly synthesized by aromatization of cyclohexenone derivatives which were prepared by [3C+3C] condensation of two units, 1, 1-bis(ethylthio)-2-propanone and the Mannich base.

We report a 50-year-old woman diagnosed with Sneddon’s syndrome and examined by CBF scintigraphy several times for follow-up of the disease. There were no significant changes in her CBF scintigraphic findings or neurological status during the 6-year follow-up period. Sneddon’s syndrome is a slowly progressive disorder in which livedo reticularis precedes cerebrovascular accidents. Because small cortical arteries are predominantly affected in Sneddon’s syndrome, MR and conventional angiography often fail to show any abnormal findings, and MR imaging may not visualize decreased CBF in the early stage. Therefore, CBF scintigraphy should be performed in patients who have or are suspected of having Sneddon’s syndrome.

O steoclast-type giant cell tumor of the pancreas (OGTP) is rare. It was originally described by Rosin [I] and is characterized by osteoclastlike giant cells and mononuclear stromal cells identical to those seen in giant cell tumor of bone. OGTP lacks the marked nuclear pleomorphism of and is distinct from the pleomorphic giant cell tumor of the pancreas. Here we describe the imaging findings ofthis rare tumor. To our knowledge, the helical CT findings of OGTP have not previously been described.