Detection of Acute Subarachnoid Hemorrhage: Comparison of FLAIR MR Imaging with Unenhanced CT

PURPOSE: Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. MATERIALS AND METHODS: We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. RESULTS: FLAIR MR image was superior to CT in detecting SAH in the posterior fossa (1.41+/-.74 vs 0.78+/-.80; p<0.05) and cortical sulci(1.11+/-.80 vs 0.70+/-.83; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. CONCLUSION: FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.

A Study on CT Attenuation and MR Signal Intensity of Protein Solution

PURPOSE: To correlate CT attenuation and MR signal intensity with concentration of protein solution. MATERIALS AND METHODS: CT and MR examinations of a phantom containing bovine serum albumin solutions of various concentrations ranging from 0 to 55% were performed. CT Hounsfield units(HUs), MR signal intensities, and apparent diffusion coefficients (ADCs) of each albumin solution were measured, and CT HUs and MR signal intensities of the solutions were compared with those of cerebrospinal fluid (CSF), white matter, and cortical gray matter. RESULTS: CT HU increased gradually with increasing albumin concentration. On T1-weighted images(T1WI), signal intensity increased with increasing albumin concentrations of up to 35% but then decreased. On T2-weighted images(T2WI), gradually decreasing signal intensity and increasing albumin concentration were oibserved. Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted images (DWIs) showed that signal intensity peaked at a concentration of 10% and then gradually decreased. The ADC of the solution gradually decreased as concentration increased. Compared with those of normal brain structures, the CT HUs of solutions at concentrations of over 20% were higher than those of white and gray matter. At T1WI, the signal intensities of 10-45% solutions were similar to or higher than that of the gray matter. At T2WI, the signal intensities of solutions above 25, 35, and 40% were lower than those of CSF, gray matter, and white matter, respectively. FLAIR images showed that the signal intensities of 5-35% solutions were higher than that of gray matter. CONCLUSION: The CT attenuation of albumin solution increased gradually with increasing concentration. MR signal intensities peaked at 35% concentration on T1WI and at 10% on FLAIR and DW images, respectively, and then gradually decreased. T2WI and ADC map images showed gradually decreasing signal intensity and ADC as albumin concentration increased.

The Usefulness of New Diagnostic Criteria on Color Doppler Ultrasound for Varicocele Diagnosis / 대한비뇨기과학회지

No abstract available.

False Negative of Doppler Ultrasonography During Testis Torsion in Animal Model / 대한비뇨기과학회지

PURPOSE: Our aim is to identify the false negative rate of doppler ultrasonography and to compare color doppler ultrasonography with pathologic findings during testis torsion in animal model. MATERIALS AND METHODS: Seventeen male house rabbits weighted 1.9-2.6kg were examined with doppler ultrasonography as control group and 1 rabbit was orchiectomized as pathologic control group. In 16 rabbits, right spermatic cord was torqued 720o count-clockwise and placed back into the scrotum, and 1, 3, 6, 9, 12, 18, 24, 48 hours after torsion, doppler ultrasonographic and pathologic findings were examined at twisted testicles. RESULTS: In 1 hour and 3 hours group, false negative rate of doppler ultrasonography were 100% and 6 hours after torsion false nagative rate was 63%. Nine hours after torsion false negative rate was 50%, 12 hours after torsion false negative rate was 25%. But after 18 hours group, all had decreased or disappeared blood flow. Before 9 hours after torsion, there was no pathologic changes in seminiferous tubules. In seminiferous tubules, number of spermatid decreased in 12 hours group and spermatid was absent and spermatocyte were markedly degenerated in 18 hours group. In 48 hours group, spermatid and spermatocyte were absent, number of Sertoli cell decreased markedly and diffuse infarction were seen. CONCLUSIONS: As time goes by, false negative rate of doppler ultrasonography was decreased. So if blood flow have been normal when doppler ultrasonography was done before 12 hours after torsion, doppler ultrasonography should be re-examined in suspected testis before 12 hours after torsion because of spermatocytes are degenerated after 12 hours.

A Case of Erythrodermic Form of Mycosis Fungoides / 대한피부과학회지

We report a case of an erythrodermic form of mycosis fungoides in a 68-year-old male, who showed generalized erythroderma with scales for 3 months. Lymphadenopathies in the inguinal and neck areas were present. Histopathological findings showed epidermotropism, perivascular atypical lymphocyte infilteration in the upper dermis, and dermatopathic lymphadenopathy in the inguinal lymph node. T cell markers were positively stained in the immunohistochemical study. These clinicopathological features were consistent with an erythrodermic form of mycosis fungoides(TNM IIl). The patient was treated with PUVA therapy and low dose chemotherapy.

Fractures of the Nasolacrimal Fossa and Canal: CT Findings and Clinical significance

PURPOSE: This study aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. MATERIALS AND METHODS: Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidenceof nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of thenasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associatedcomplications, clinical records were reviewed were reviewed. RESULTS: Three types of fracture were identified:avulsion, comminuted, and linear Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa,ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving thenasolacrimal canal were comminuted and four were linear ; all nasolacrimal fractures were associated with otherfacial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid) ; the remaining fourwere simple and unilateral. Nasolacrimal sac and dvct-related complications were documented in only two patients ;they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the problem wasresolved by conservative treatment without surgery. CONCLUSION: Fractures of the nasolacrimal fossa and canalwere accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all wereassociated with avulsion fractures of the nasolacrimal fossa.

Injury of Anterior Cruciate Ligament with Associated Bony Lesions: MR Image

PURPOSE: To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. MATERIALS AND METHODS: We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. RESULTS: Cmplete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37 %), and combined bony lesion in 14 (52 %). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23 %) of partial ACL tears ; combined bony lesion was seen in four such cases (31 %). There were eight cases of avulsion fracture ; the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6) ; the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). CONCLUSION: Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear.

Mesenteric Lymphadenitis and Acute Abdomen in Children: Correlation between Sonographic Findings and Clinical Symptom

PURPOSE: The correlation between sonographic findings and clinical symptoms was investigated in the patients with mesenteric lymphadenitis who had recurrent acute abdomen. MATERIALS AND METHODS: Seventy-eight children with recurrent acute abdominal pain without obvious primary disease were evaluated by sonography. The initial and follow-up sonography were performed in 17 children. The abdomen was divided into 3 areas. The number and size of mesenteric lymph nodes were observed in each zone, and was compared with the clinical findings. RESULTS: In 56(71.8%) of 78 cases, good correlation was seen in the area of the greatest size and number of the lymph nodes in the sonography. Most severe symptom, was seen in the right lumbar area(49 cases) and umbilical area(7 cases). In 17 cases of follow up, 14 cases showed decrease size and number of mesenteric lymph nodes while 2 cases showed increase in size and number of the nodes with aggravated symptoms. CONCLUSIONS: Ultrasonography was useful to detect and localize the enlarged mesenteric lymph nodes. Initial and follow-up sonography showed good correlation between the changes in number and size of the lymph nodes and symptoms.

Sonographic Findings of Ovarian Mass Torsion

PURPOSE: To evaluete the sonographic features of ovarian mass torsion. MATERIALS AND METHODS: We evaluated the sonographic findings in 22 cases of torsioned cystic ovarian mass, benign teratoma(n=21), and normal ovary (n=l) confirmed surgically on pathologically. We classified the ovarian mass into two groups as sonographic ally cystic (n=15) or non-cystic mass(n=6). The patients were 17-72 years old(mean:36.9). We retrospectively reviewed US examination with respect to (1) free fluid in Douglas pouch, (2)pelvic mass & mass wall thickening, (3)dilated uterine tube, (4)prominent follicles, (5) engorged vessels, and (6)beak-like echo in torsion site. The combined conditions of torsion were uterine myoma(n=l) and intrauterine pregnancy(n=3). RESULTS: In sonogram, sonographic cystic mass (n=15) group showed (1)free fluid in Douglas pouch (9/15), (2)mass wall thickening(6/15), (3)dilated uterine tube(2/15), and sonographic non-cystic mass(n=6) group showed (1) free fluid in Douglas pouch (3/6). In sonogram, torsion of the normal ovary(n=1) showed (1) free fluid in Douglas pouch, and (2) prominent follicles. CONCLUSION: If sonogram of reproductive aged women with acute abdomen show free fluid in Douglas pouch and pelvic mass with wall thickening, ovarian mass torsion is suggested. But clinical features of acute abdomen and clinical diagnosis of torsion are more important than sonographic features.

Chronic Subdural Hematoma with Sedimentation Level on CT: Correlation with Clinical and Operative Findings

PURPOSE: The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. MATERIALS AND METHODS: We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. RESULTS: All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. CONCLUSION: A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms.

Multiple coronary arteriovenous fistulae combined with ventricular septal defect: a case report

No abstract available in English.

Cineangiographic morphology of mitral valve

No abstract available.

UD diagnosis of idiopathic pyloris stenosis

No abstract available.

Congenital coronary artery fistula

Congenital coronary artery fistula(CCAF) is communication of a coronary artery or its main branch with one ofthe atria or ventricles, the coronary sinus, the superior vena cave, or the pulmoanry artery. In Korean peoples,only 4 cases of the CCAF were reported as rare as worldwide and authors want to report another case of CCAF,confirmed by operation. 10-years-old girl shows a fistula between sinus node artery of the right coronary arteryand right atrium on root aortogram with left-to-right shunt and Qp/Qs=1.58, in which simple ligation of the originof the sinus node atery from right coronary artery was performed. All of the 5 Korean CCAF(4 were previouslyreported and 1 of authors) were originated from right coronary artery, and of which 4 weee opening into rightventricle and 1 of authors were into right atrium. Associated cardiac anomaly was noted in only 1 case as singlecoronary artery, Ages were from 9 months of age to 10 years old and no adult left case were found. 3 were femaleand 2 were male patients.