An MRI-Based Quantification for Correlation of Imaging Biomarker and Clinical Performance in Chronic Phase of Carbon Monoxide Poisoning

PURPOSE: The purpose of this study was to determine the relation between quantitative magnetic resonance imaging biomarkers, and clinical performances in chronic phase of carbon monoxide intoxication. MATERIALS AND METHODS: Eighteen magnetic resonance scans and cognitive evaluations were performed, on patients with carbon monoxide intoxication in chronic phase. Apparent diffusion coefficient (ADC) ratios of affected versus unaffected centrum semiovale, and corpus callosum were obtained. Signal intensity (SI) ratios between affected centrum semiovale, and normal pons in T2-FLAIR (fluid-attenuated inversion recovery) images were obtained. The Mini-Mental State Exam, and clinical outcome scores were assessed. Correlation coefficients were calculated, between MRI and clinical markers. Patients were further classified into poor-outcome and good-outcome groups based on clinical performance, and imaging parameters were compared. T2-SI ratio of centrum semiovale was compared, with that of 18 sex-matched and age-matched controls. RESULTS: T2-SI ratio of centrum semiovale was significantly higher in the poor-outcome group, than that in the good-outcome group and was strongly inversely correlated, with results from the Mini-Mental State Exam. ADC ratios of centrum semiovale were significantly lower in the poor outcome group than in the good outcome group, and were moderately correlated with the Mini-Mental State Exam score. CONCLUSION: A higher T2-SI and a lower ratio of ADC values in the centrum semiovale, may indicate presence of more severe white matter injury and clinical impairment. T2-SI ratio and ADC values in the centrum semiovale, are useful quantitative imaging biomarkers for correlation with clinical performance in individuals with carbon monoxide intoxication.

Thrombophlebitis of the Penile Superficial Vein, Penile Mondor's Disease: A Case Report

Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease.

Small Bowel Obstruction in Children: Usefulness of CT for Diagnosis and Localization

PURPOSE: To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. MATERIALS AND METHODS: Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. RESULTS: Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n= 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7), closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. CONCLUSION: The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction.

Nontraumatic Subperiosteal Orbital Hematoma Associated with Ethmoid Sinusitis: A Case Report

Subperiosteal hematoma of the orbit is a rare disease and most of the cases occur in young adult males as a result of direct facial or orbital trauma. In the absence of direct facial or orbital trauma, nontranmatic subperiosteal orbital hematoma has rarely been reported in association with a sudden elevation of cranial venous pressure or venous congestion, systemic diseases associated with a bleeding diathesis and paranasal sinusitis. We report here on a rare case of subperiosteal orbital hematoma associated with ethmoid sinusitis, as was seen on CT imaging.

Cervical Thoracic Duct Cyst: A Case Report

Thoracic duct cysts are uncommon lesions that most commonly occur in the abdominal and thoracic portion of the thoracic duct: the cervical portion is the rarest location. The main causes of thoracic duct cyst are surgical injuries such as neck dissection and blunt trauma. We report here on a rare case of spontaneous cervical thoracic duct cyst that was noted on ultrasonography and CT. The thoracic duct cyst was confirmed by fine needle aspiration and it was treated by sclerotherapy.

Three Dimensional Images of the Sternum in Children with Using MDCT

PURPOSE: We wanted to analyze the three dimensional images with using multidetector CT scanning of the sternum in children, and we wanted to compare the CT findings with the children's age. MATERIALS AND METHODS: We studied the three dimensional images of the sternum of 67 children (62 were boys and 5 were girls). The age of the children was 3-15 years old (mean age: 7.5). We evaluated the number of sternal bodies, the presence of the xiphoid process and the bifid shape of each sternal body. RESULTS: The number of sternal bodies was from three to five; 30 patients had 3 bodies, 25 patients had 4 bodies and 5 patients had 2. The number of sternal bodies was 3.4 in Group I, 3.5 in Group II and 3.9 in Group III. As the children's age increased, the number of sternal body was statistically increased. When the number of sternal bodies was three, the mean age of children was 5.4 year; when it was four or five, the mean age of children was 8.1 year. The children's age was increased as the number of sternal bodies increased. The mean age of the children with a xiphoid process was 7.0 years, and the mean age of children without a xiphoid process was 8.1. There was no statistical difference between the two groups with or without xiphoid process. Among the 67 children, 9 had the bifid shape in the 3rd portion of the sternal body, 5 had the bifid shape in 4th portion, 2 had the bifid shape in 2nd portion and 1 had the bifid shape in 5th portion. CONCLUSION: The number of sternal bodies was mostly three or four. The number of sternal bodies was related to the children's age. There is no relationship between children's age and the presence of the xiphoid process. The bifid shapes are mostly shown in the 3rd and 4th portion of the sternal body.

Incidental Finding of a Precaval Right Renal Artery on CT: A Case Report

The right renal artery passing anterior to the inferior vena cava is a rare variant of the normal renal arterial anatomy, and identifying this anomaly is important for the planning of minimally invasive renal surgery. The presence of this precaval right renal artery was detected on the contrast-enhanced CT scan by identifying the right renal artery passing anterior to the inferior vena cava. We report here on a case of a precaval right renal artery as a main supplying artery, and this was incidentally found on CT.

Giant Presacral Schwannoma: A Case Report

Most giant sacral schwannomas are associated with moderate to massive bone destruction before they extend into the presacral space. These lesions can, on rare occasions, manifest as a giant tumor in the presacral space without bone destruction. We report here on the image findings of a presacral giant schwannoma in a 65-year-old man. On ultrasound and CT, the tumor appeared as an inhomogenous, well-demarcated mass that demonstrated some cystic changes and peripheral calcifications without sacral bone destruction. On the MR imaging, the tumor showed as an inhomogeneous, encapsulating mass with low signal intensity on both the T1 and T2-weighted images, except for some areas that showed cystic change.

CT Findings of Acute Appendicitis in Children

Acute appendicitis is the most common cause of surgical abdomen in children. Because of the various locations where you can find the appendix and the different presentation for the symptoms of appendicitis, the clinical diagnosis of appendicitis is often difficult in children, and radiologic diagnosis is becoming increasingly important. Being familiar with the findings of acute appendicitis on the MDCT axial image and the multiplanar reformation images may aid the physician in reaching an early diagnosis and so prevent complications and reduce negative appendectomy rates.

Paratracheal Air Cysts of Thoracic Inlet in Adults: CT Findings

PURPOSE: To evaluate the frequency of a paratracheal cyst on CT in an adult, and to compare the degree of loculation and the patient's age with the longest diameter of the air cysts. MATERIALS AND METHODS: Of 1520 patients, who underwent a CT scan, 41 patients with paratracheal cysts were enrolled in this study. There were 26-males and 15 females, whose ranged from 24 to 82 years (mean, 59.8). The CT findings were evaluated to determine the relationship between the degree of loculation and the longest diameter of the air cysts. Another tracheal diverticula or an air cyst, as well as the tracheal communication were also evaluated. RESULTS: The longest diameter of the paratracheal air cysts was 1 cm (p=0.043). The paratracheal air cysts 2 cm were multilocular. Four patients had another small tracheal diverticula, and one patient had another small paratracheal air cyst. Tracheal communication was observed in 7 patients (17%). CONCLUSION: The frequency of paratracheal air cysts in adults undergoing a CT scan was 2.7%. The longest diameter of the paratracheal air cysts was associated with the patient's age. The shape of air cysts became more multilocular as the longest diameter of the paratracheal air cysts increased. Another small tracheal diverticula or air cysts were observed in 12% of patients.

A Case of Kallmann's Syndrome with Unilateral Renal Aplasia and Diabetes Mellitus / 대한내분비학회지

Kallmann's syndrome is defined as the combination of hypogonadotropic hypogonadism and anosmia/hyposmia. The syndrome is a result of defect in the embryonic migratory pathway of gonadotropin-releasing hormone, which synthesizes neurons and olfactory axons. The hypogonadotropic hypogonadism results due to absence of or incomplete pubertal development and may be associated with anosmia, hyposmia, midline defect(color blindness, cleft-lip, cleft-palate, unilateral renal agenesis, sensorineural deafness), cryptorchidism and skeletal anomaly. Till date in Korea, few cases of Kallmann's syndrome have been reported but there are no available reports on cases of Kallmann's syndrome with unilateral renal aplasia and diabetes mellitus. We handled a case of Kallmann's syndrome associated with unilateral renal agenesis and diabetes mellitus. In the current work, we present a peculiar case as afore mentioned with the review of related literature.

The Usefulness of the Transabdominal Ultrasonography as a Screening Examination in the Evaluation of the Patient with Suspicious Gastric Disease

PURPOSE: To evaluate the usefulness of transabdominal ultrasonography as a screening examination in patients with suspicious gastric disease. MATERIALS AND METHODS: We selected 141 patients with epigastric pain and who were found to have antral gastric wall thickening of more than 5 mm in transabdominal ultrasonography, and who underwent gastroscopy immediately following the ultrasonography examination, because we suspected that these patients had gastric disease. We measured the full thickness of the five layers of the gastric wall and evaluated the preservation of this fivelayered structure. We respectively compared the gastric wall thickness and the preservation of gastric layers in 26 normal, 91 gastritis, 12 gastric ulcer, and 12 gastric cancer patients, who were classified based on the gastroscopy results. RESULTS: The mean thicknesses of the gastric wall in the normal, gastritis, gastric ulcer and gastric cancer patients were 5.13+/-0.14 mm, 6.71+/-1.33 mm, 8.08+/-2.80 mm, and 12.45+/-3.70 mm, respectively. The gastric walls in the gastritis, gastric ulcer and gastric cancer patients were significantly thicker than that in the normal patients (p 0.01). Except for two patients with gastritis and three patients with gastric ulcer, the stratification of the gastric wall was preserved in all of the normal, gastritis and gastric ulcer patients, whereas it was disrupted in all of the patients with gastric cancer. CONCLUSION: Transabdominal ultrasonography in the fasting state may be a helpful and convenient modality, which can serve as a screening examination in the evaluation of gastric disease. Therefore, careful attention and effort are needed to evaluate the gastric wall during transabdominal ultrasonography.

Diagnosis of Annular Pancreas Using Minimum Intensity Projection of Multidetector Row CT: Case Report

Annular pancreas is a rare congenital abnormality characterized by a ring of pancreatic tissue encircling the second portion of the duodenum, and it is definitively diagnosed by endoscopic retrograde cholangiopancreatography. We present here a case of annular pancreas that was diagnosed by the minimum intensity projection technique of multidetector row CT. On the CT scan, the annular pancreas was demonstrated as the pancreatic tissue with an aberrant pancreatic duct encircling the duodenum.

Paraquat Induced Lung Injury: Long-term Follow-up of HRCT

PURPOSE: To determine the long-term follow-up CT findings of paraquat-induced lung injury. MATERIALS AND METHODS: Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years, and more than above 7 years after poisoning were analyzed. RESULTS: We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. CONCLUSION: The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed.

Atypical Hepatic Hemangiomas with Multiple Calcifications Mimicking Hepatic Metastases: Case Report

Although hepatic hemangioma is the most common benign tumor of the liver, it is rarely associated with calcifications. We report on the case of an asymptomatic 58-year-old man in whom multiple hepatic masses containing calcifications were discovered incidentally at ultrasonography. The radiologic features mimicked those of multiple hepatic metastases.

Giant Cell Tumor of Short Tubular Bone: Case Report

Giant cell tumors of the bone commonly occur in the epiphyseal scar of a long tubular bone, representing about 5% of all primary bone tumors. A short tubular bone, such as one in the hand or foot, is the site of less than 5% of all giant cell bone tumors. The authors report two cases in which giant cell tumors arose in the short tubular bone, and describe the clinical manifestations and radiologic findings.

CT Findings of Congenital Transmesenteric Hernia: Case Report

Transmesenteric hernia occurs usually in adult patients who had history of an abdominal surgery or blunt abdominal trauma. Congenital mesenteric defect is a relatively common cause of internal hernia in children. However, the report of CT findings of congenital transmesenteric hernia is relatively rare. Thus, we report a case of congenital transmesenteric hernia occurring in a 13-year-old girl with intestinal obstructive symptoms, and include the CT findings.

Radiologic Findings and Follow-Up Evaluation

In esophageal perforation, fistulous tracts commonly occur between the esophagus and mediastinal or pleural spaces, but rarely between the esophagus and bronchi. The clinical manifestations and radiologic findings of esophageal perforation are nonspecific, and diagnosis is the often delayed; esophagography is the standard technique for evaluation of its location and degree. CT is useful in demonstrating the extraluminal manifestations of esophageal perforation and for follow-up after medical treatment, and may depict the various manifestations of perforation, according to the causes.

Peliosis Hepatis Mimicking Single Hepatic Mass: A Case Report

Peliosis hepatis is a rare disease characterized by cystic hepatic sinusoidal dilatation and the presence of multiple blood-filled spaces in the hepatic parenchyma. In most cases, multiple lesions and individual cysts not exceeding 1cm in diameter occur. We report a case in which the condition occurred in a 33-year-old woman who presented with general weakness and in whom a 3.5 cm-sized single hepatic mass was discovered incidentally at ultrasonography. The radiologic features mimicked those of a signle hepatic mass.

Pectus Excavatum

Pectus excavatum in which the sternum is depressed and the anterior chest wall is concave in shape, is the most common congenital deformity to affect this region of the body. Various deformities involving depression or protrusion are caused by the degree and location of the sternal depression, and associated deformities such as a tilted sternum and anterior convexity of costal cartilages may occur. The most common associated disorders are Poland syndrome, Marfan syndrome and scoliosis.