[en] To report on the safety and efficacy of superselective transcatheter arterial chemoembolization(TACE) of tumor feeding branches originating from the cystic artery for the treatment of hepatocellular carcinoma(HCC). From, May 1955 to, September 1999, eleven HCC patients aged between 38 and 82 (mean, 57.4) years with tumor-feeding branches originating from the cystic artery underwent TACE. In eight, for whom superselection of these branches was possible, TACE was done with the use of Gelform and a mixture of Lipiodol and cisplatin, while for three, for whom superselection was impossible, a mixture of Lipiodol and cisplatin only was used. Immediately after TACE, remnant tumor staining was angiographically evaluated, and tumor response was determined by follow-up CT at one month. After procedure, the development of cholecystitis was clinically. Post-FACE angiography showed remnant tumor staining in one patients who underwent embolization with Gelform and the mixture fo Lipiodol and cisplatin, and in one for whom the mix ture of Lipodol and cisplationly was used. Among the eight for whom Gelfoam and the mixture of Lipiodol and cisplatin was used, one-month follow up CT showed compact Lipiodol uptake in five, partial Lipiodol uptake in three, no change in tumor size in six, increased tumor size in one, and decreased tumor size in one. Among the three for whom the mixture of Lipiodol and cisplatin only was used,one-month follow-up CT showed neither Lipiodol uptake nor change in tumor size in one patient, partial Lipiodol uptake and increased tumor size in one, and compact Lipiodol uptake and decreased tumor size in one. Cholecystitis developed in only one patient who underwent embolization with Gelfoam and the mixture of Lipiodol and cisplatin, but was cured by conservative treatment. Superselective TACE of tumor feeding branches originating from the cystic artery seems to be a safe and effective method for the treatment of hepatocellular carcinoma

[en] To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the branchial artery. Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographin findings were classified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III si either Types I or II acompainted by pleural in filtrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole the lung. Bronchial angiographic findings were divided into four groups: Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an intercostal artery; Group III comprises cases which belong to Group I or II and which a bronch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increased on bronchial angiography. Early post-embolic hemostasis occured in 96% of Type-I cases (47/49), 82% of Type II (36/44), 70% fo Type III (28/40), and 55% of Type IV (40/73). The average success rate was 74% (151/205). During the six month follow-up period, continued hemostasis was found in 80% of Type-I patients (36/45), 75% of Type II (30/40), 59% of Type III (20/34), and 48% of Type IV (20/42). The average long-term hemostasis rate was 66% (106/161). Bronchial angiography show that in systemic collateral arteries circulation increases very substantially, and in cases in which plain chest radiographs depict extensive pleural infiltration or complications associated with pulmonary tuberculosis, it is therefore difficult to expect good hemostatic results after embolization. In such instances we thus recommend aggressive treatment such as surgical intervention

[en] Angiomyolipomas commonly originate from renal parenchyma but extremely rarely from perinephric space. We report a case of angiomyolipoma of the perinephric space confirmed by radical nephrectomy. A 13-year-old boy presented with left flank pain and abdominal distension, first experienced five months earlier. Ultrasonography and CT indicated that in the space surrounding the left kidney, a huge fat-containing mass with linear strands was present

[en] To evaluate the usefulness of echo-planar FLAIR imaging in various cerebral lesions as compared with fast FLAIR imaging. We obtained consecutive fast FLAIR and echo-planar FLAIR images in 33 patients in whom MR imaging had revealed ischemic infarction (n=11), acute infarction (n=5), brain tumor (n=3),other conditions (n=3) or no abnormality (n=11). On both sets of images, percentage contrast and contrast to noise ratio (CNR) were calculated for white matter-gray matter and white matter-lesion. White matter-gray matter percentage contrast and CNR were lower on echo-planar FLAIR imaging than on fast FLAIR imaging (percentage contrast, 19±2 % vs 28±3 %, CNR, 2.77±0.5 vs 4.86±0.7). White matter-lesion percentage contrast on echo-planar FLAIR imaging was similar to or greater than that on fast FLAIR imaging; 75±12 % vs 45±11 % in ischemic infarction, 80±12% vs 78±11% in acute infarction, and 121±25 % vs 102±15 % for tumors. White matter-lesion CNR was similar on both sets of images: 8.3±0.9 vs 7.9±0.8 in ischemic infarction, 11±1.5 vs 9.5±1.2 in acute infarction, and 24±4 vs 27±3 for tumors. Due to high susceptibility to magnetization, echo-planar FLAIR imaging showed image degradation at the interface of the paranasal sinus and adjacent to the temporal bone. Echo-planar FLAIR imaging may be a useful pulse sequence in the diagnosis of various cerebral lesions

[en] To evaluate the incidence and characteristic findings of pineal cyst incidentally detected on magnetic resonance (MR) imaging. Brain MR images obtained in 2432 patients were retrospectively reviewed to determine the incidence and MR findings of pineal cysts, which were evaluated according to their size, shape, location, signal intensity, interval change, contrast enhancement and mass effect on adjacent structures. Cysts were encountered in 107(4.4 %) of 2432 patients evaluated. their size ranged from 1 X 1 X 1 to 15 X 8 X 9 (mean, 5.97 X 3.82 X 4.82)mm. All were spherical (n=53) or oval (n=54) in shape. Their margin was smooth and they were homogeneous in nature. On T1-weighted images, the cysts were seen to be hyperintense (n=57) or isointense (n=50) to cerebrospinal fluid, but less so than brain parenchyma. T2-weighted images showed them to be isointense (n=51)or hyperintense (n=56) to cerebrospinal fluid. The cysts were centrally located in 65 cases and eccentrically in 42. Compression of the superior colliculi of the tectum was demonstrated in 17 cases (15.9 %). NO patients presented clinical symptoms or signs related to either pineal or tectal lesions. Peripheral enhancement around the cyst after Gd-DTPA injection was demonstrated in 51 cases(100 %). Follow-up examinations in 19 cases demonstrated no interval change. The incidence of pineal cysts was 4.4 %. The MR characteristics of simple pineal cysts include: (1) an oval or spherical shape, (2) a smooth outer margin and homogeneous nature, (3) isosignal or slightly high signal intensity to cerebrospinal fluid on whole pulse sequences, (4) ring enhancement after contrast injection, (5) an absence of interval change, as seen during follow up MR study. These MR appearances of pineal cysts might be helpful for differentiating them from pineal tumors

[en] Pulmonary mucormycosis is a opportunistic mycosis, typically occurring in immunocompromised or diabetic patients. It is characterized as an infection of the pulmonary parenchyma and larger bronchi, and involves extensive vascular thrombosis and tissue necrosis. A variety of CT findings have been reported, but tracheal involvement is extremely rare. We report the case of a patient with tracheal mucormycosis placing particular emphasis on the CT findings

[en] Superior mediastinal widening, as seen on chest radiographs of traumatized patients, has been considered the hallmark of mediastinal injury. The usual causes of superior mediastinal widening are rupture of the aorta, esophagus or trachea, and hematoma as a result of spinal fracture. Posterior dislocation of the sternoclavicular joint is rarely a cause. We report a case of superior mediastinal widening resulting from traumatic posterior dislocation of the sternoclavicular joint, and describe the CT findings, including those of 3-D imaging

[en] Cholangiolocellular carcinoma is a rare lesion, intermediate in type between hepatocellular and cholangiocellular carcinoma. The radiologic findings of cholangiolocellular carcinomas have not been reported. We describe the ultrasound, CT, MR, and angiographic findings of a case of cholangiolocellular carcinoma not associated with liver cirrhosis

[en] We retrospectively evaluated superselective embolization with Gelfoam for the management of post-traumatic arterial priapism. Six male patients with post-traumatic priapism underwent pudendal angiography and embolization. We evaluated the time and incidence of detumescence after embolization and compared normal erectile function and its duration with the results of other reports. In all patients, color Doppler sonography was performed pre- and post-angiographically. On pudendal arteriography, intracavernosal arteriovenous fistulas were observed in all patients, and pseudoaneurysm of the cavernosal artery (or common penile artery) in three. Detumescence and normal erectile function were achieved in all patients after superselective embolization. Using color Doppler sonography, the location of the lesion causing priapism was found, in four patients, to be the proximal or middle one-third of the cavernosal artery. Pudendal angiography with superselective embolization with Gelfoam is a safe and effective method for the correction of post-traumatic arterial priapism

[en] To evaluate the incidence and degree of bile duct dilatation after partial gastrectomy due to gastric cancer and to determine any differences between gastroduodenostomy (Billoth 1) and gastrojejunostomy (Billoth 2). We retrospectively analyzed the follow up abdominal CT findings in 113 patients who had undergone partial gastrectomy without truncal vagotomy or cholecystectomy. In all cases, preoperative abdominal CT findings showed no evidence of bile duct dilatation. Among 113 patients, 41 underwent Billoth 1 surgery, and 72 underwent Billoth 2. No case showed clinical or radiological evidence of obstructive causes of bile duct dilatation. Among these patients, we decided the criteria for dilatation when this was noted. The grade was either mild (3-4mm), moderate (5-8mm), or severe (over 9mm), as measured at the central intrahepatic duct. Extra-hepatic duct dilatation was graded as mild (6-8mm), moderate (9-12mm) or severe (over 13mm). We analyzed serum bilrirubin and alkaline phosphatase levels. When the central intrahepatic duct was measured, 78 of 113 patients (69%) showed bile duct dilatation; 24 of 41 cases (58.5%) were in the billoth 1 group and 54 of 72 (75%) were in the Billoth 2 group. After measurement of the extra hepatic duct, 22 of 41 cases (53.6%) in the Billoth 1 group and 54 of 72 (75%) in the Billoth 2 group were found to be dilated. The results showed a slightly increased incidence of bile duct dilatation in the Billoth, 2 group but this was not statistically significant (p>0.05). In the laboratory, total, direct, and indirect bilirubin, as well as alkaline phosphatase levels, were measured. Higher levels were found in Billoth 2 than in Billoth 1 but all findings were within normal limits. Mild dilatation of the bile duct after partial gastrectomy was a not uncommon finding, and there was no significant difference of incidence or degree of dilatation according to the procedure performed. If a patient has no clinical symptoms, it appears that clinical evaluation does not require further study