Subcutaneous fluid collection: An imaging marker for treatment response of infectious thoracolumbar spondylodiscitis.

PURPOSE: To evaluate prevalence of subcutaneous fluid collection (SFC) in infectious thoracolumbar spondylodiscitis (SD) compared with control patients and to investigate correlation between volume changes of SFC and treatment response of SD. MATERIALS AND METHODS: This retrospective study was approved by our institutional review board. From April 2011 to March 2012, 49 patients (24 SD and 25 non-SD patients) were enrolled. Prevalence of SFC was evaluated respectively for SD and non-SD patients using magnetic resonance imaging (MRI) on the sagittal short tau inversion recovery (STIR) imaging or fat-saturated T2-weighted imaging (T2WI), and compared. In SD patients with SFC, correlation was investigated between SFC volume on the 1st MRI and initial clinical status. The same analysis was conducted also for SFC volume changes from the 1st to 2nd or last MRI. RESULTS: SFC was found in 20 patients with SD (83.3%) and 3 non-SD patients (12%) with significant difference (p<.001). In 20 SD patients with SFC, 17 patients had follow-up MRI. For the 1st MRI, no significant correlation was found between volume of SFC and initial status of patients, including body weight, body mass index (BMI), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). However, significant positive correlations were found between changes of C-reactive protein (CRP) and SFC volume from the 1st to 2nd as well as from the 1st to the last MRI (each p<.05). CONCLUSION: SD patients had significantly higher prevalence of SFC than non-SD patients. Volume changes of SFC had significant correlation with changes of CRP, which can be used as an imaging marker for treatment response of SD on MRI.

Comparative study of vascular enhancement on post-contrast CT using three dosages of iodinated contrast media for the aim of detecting brain metastasis in patients with lung cancer.

OBJECTIVE: A prospective double-blind randomized study was performed to compare the contrast of vascular enhancement using three dosages of iodinated contrast media for a possible metastatic lesion in the brain. MATERIALS AND METHODS: Sixty-six patients with lung cancer received brain computed tomography (CT) with intravenous administration of iodinated contrast medium (CM). The patients were randomly assigned to receive one of the three types of CM: 30 g iodine, 24 g iodine, and 15 g iodine. Three radiologists judged the degree of vascular contrast enhancement and diagnosed the presence of brain metastasis. The CT numbers in major arteries were also measured. RESULTS: The subjective average scores with standard deviation were 2.06+/-0.48, 1.97+/-048, and 1.44+/-0.43, and the measured average CT numbers with standard deviation (SD) were 168.5+/-39.6, 166.1+/-28.6, and 146.1+/-27.0 HU with 30 g, 24 g, and 15 g iodine, respectively. The scores and the CT numbers in 15 g iodine were less than those with 30 g and 24 g iodine. Brain metastasis was detected in one patient each in groups A and C, and one false-positive case was found in group B. CONCLUSION: CT study with a dose of 24 g iodine showed equivalent quality on vascular enhancement in comparison with a 30 g iodine dose.

Trans-arterial infusion chemotherapy for recurrence of pleural dissemination after thymectomy.

We present a report of trans-arterial infusion chemotherapy through the intercostal arteries and subphrenic artery for pleural dissemination of recurrent thymoma after thymectomy. The disseminated tumor did not enlarge for more than a year after this treatment, and there were no side effects. Trans-arterial infusion chemotherapy appears to be a preferable procedure for pleural dissemination of thymoma.