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[en] Takayasu arteritis (TA) is an inflammatory disease of aorta and its major branches and pulmonary artery affecting young females in most cases. Diagnosis of TA in its early phase is important in prevention of serious complications. However, clinical diagnosis of TA may be difficult due to nonspecific symptoms. Thirty-three consecutive patients (aged 15 to 60 years; mean age, 44.6 years) with TA (19 in clinically active, 14 in inactive stage) were included in this study. Concentric wall thickening (1.2-4.0 mm ), stenosis or occlusion of one or both common carotid arteries or innominate artery was found in 78% (26/33) of patients with TA. Wall thickening or occlusion of one or both subclavian arteries was seen in 60.6% (20/33) of patients with TA. Most patients (91%, 31/33) except two chronic inactive patients with aortic stenosis had disease in at least one of four arteries at sonography. Because subclavian and carotid lesions are peculiar in young patients with TA. Carotid and subclavian US is sensitive and specific in diagnosis of TA as revealed in our study. Findings of carotid sonography in TA have been concentric wall thickening and calcifications. Early diagnosis mainly depends on detection of subtle mural thickening at sectional imaging studies, while stenosis or dilatation of aorta and its branches appears in the later stage. Changes in mural thickness after medical treatment could be assessed with sonography.
[en] The purpose of our study was to evaluate the CT findings of malarial spleens. We reviewed the patient records of 44 patients with malaria during a recent 3.5-year period and we selected 18 patients who underwent an abdominal CT scan. We retrospectively evaluated the CT findings of the malarial spleens and we compared then with those of a control group of 18 men. We analyzed the splenic size, whether or not there was mottled striped splenic enhancement during the arterial phase and the differences of splenic attenuation and the attenuation between the liver and spleen during the precontrast phase, the arterial phase and the portal phase between the two groups. In malarial patients, the spleen was enlarged in all cases (p < 0.001), and splenic attenuation and the degree of enhancement were significantly decreased during the precontrast phase, the arterial phase and the portal phase (p < 0.001). Loss of mottled striped enhancement during the arterial phase was seen in 11 cases (61.1%) (p < 0.001). The attenuation of the spleen was lower than that of the liver in 13 cases (72.2%) during the portal phase (p = 0.003) and in 1 case (5.6%) during the arterial phase (p = 1.000). Splenomegaly, decreased splenic enhancement, the lack of mottled striped enhancement during the arterial phase and lower attenuation than that of the liver during the portal phase are helpful CT findings to diagnose the malarial spleen
[en] We wanted to evaluate the MRI features and their diagnostic accuracy for SSL injury in the thoracolumbar spine. From December 2003 to June 2006, among 42 surgically treated patients with spinal fracture, the 35 patients who underwent MRI and who were surgically evaluated for SSL injury were included in this study. The sagittal MR images were evaluated for the presence of SSL injury and its level, location and distraction gap, the level and compression ratio of the fractured body, and the presence of ISL or yellow ligament injury and posterior osseous fracture. The sensitivity, specificity and accuracy of MRI were calculated. The distraction gap of the SSL and the compression ratio of the fractured body or posterior osseous fracture were statistically analyzed. Thirty-one among the 33 patients with surgically confirmed SSL injury were diagnosed on MRI. SSL injury was mostly seen at the thoracolumbar junction and near the upper spinous process. The mean distraction gap was 4.3 mm. The level of the fractured body was most commonly in the lower vertebra of the injured SSL level and the mean compression ratio was 21.8%. Combined SSL, ISL and yellow ligament injury were mostly seen. The sensitivity, specificity and accuracy were 93.9%, 50% and 91.4%, respectively. There was a statistically significant difference of the distraction gap of the injured SSL depending on the presence of posterior osseous fracture. MRI is an accurate modality for evaluating SSL injury and the associated findings
[en] Primary meningeal melanocytic neoplasms are rare lesions that originate from leptomeningeal melanocytes. An intradural meningeal melanocytoma in the thoracic spine is less common than a malignant melanoma, which is its malignant counterpart. We report a case of a histopathologically confirmed primary intradural meningeal melanocytoma in the thoracic spine along with a literature
[en] The aim of this study is to present our biopsy technique and to determine the efficacy of the ultrasound- guided fine-needle aspiration biopsy (US-FNAB) for predominantly cystic thyroid nodules (PCTNs). This study included patients that underwent US-FNABs on PCTNs, and were sampled for the solid component following the aspiration of a cystic component through one needle puncture between January to December of 2008. We retrospectively reviewed the cytopathology results as well as any complication associated with the procedure. Of the 76 PCTNs (range of maximal diameter: 0.4 cm-6.1 cm, mean: 2.39 cm) observed in the 75 patients (females: males = 63: 12, age range: 19-72, mean: 45.3 years old), the incidence rate of adequate and inadequate samples was 90.8% (69/76) and 9.2% (7/76) in the first US-FNAB, respectively. Further, 23 PCTNs were surgically removed in 22 patients, of which 15 PCTNs were benign and 8 were confirmed malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for USFNAB of PCTNs were 95.2%, 100%, 100%, 76.9%, and 95.8%, respectively. The data suggest that our technique for US-FNAB of PCTNs was effective and accurate
[en] The occurrence of an anastomosis between the coronary artery to the systemic artery is rare. However, the probability of hemodynamic changes sufficient to cause clinical symptoms is extremely low. Anastomosis of the coronary to bronchial artery can cause myocardial ischemia due to the decreased flow to the coronary arteries. The authors report a case of coronary to bronchial artery anastomosis presenting as coronary steal syndrome that was treated with transarterial microcoil embolization instead of surgical ligation
[en] To analyze the potential of MR to distinguish lung cancer from progressive massive fibrosis (PMF) in patients with coal worker's pneumoconiosis. The study consisted of 9 patients with pathologically proven lung cancer and 26 PMFs in 17 patients. All the patients had radiologic evidence of pneumoconiosis. T1-weighted FLASH images were obtained before and 0.5, 1, 2, 3, 4, 5, 7.5, 10, 12.5, and 15 minutes after injection of Gd-DTPA. T2-weighted fast spin-echo images were obtained. The imaging findings were evaluated for enhancement time curve, contrast uptake equivalent (CE), and enhancement factor (EF). On T1WI, there was no significant signal intensity difference between lung cancer and PMF. On T2WI, all lung cancer showed high signal intensity, as opposed to all PMFs which showed low signal intensity except for one PMF. Only one PMF showed high signal intensity on T2WI. For the dynamic contrast study, lung cancer showed faster and slightly stronger enhancement than PMFs. For a delayed image, most of the lung cancers (78%) showed washout, as opposed to a plateau in most of PMFs (73%) (p=0.0153). However, no difference was detected between the EFmax of lung cancer and PMFs (p=0.349). MR is potentially a useful tool in distinguishing lung cancer from PMFs in patients with coal worker's pneumoconiosis
[en] Intussusception is a rare disease in adults. Moreover, appendiceal disease is very rarely the leading cause of adult intussusception. We report a case in which ileocecocolic intussusception is secondary to an acute appendicitis in an adult, and describe the radiologic, clinical, and pathologic findings
[en] Hydrogel buckles, which are used in scleral buckling surgery for retinal detachment, have been associated with late complications after successful retinal reattachment surgery, including strabismus, extraocular motility restriction, extrusion through the eyelid or conjunctiva, intraocular erosion, and scleral erosion. Hydrogel buckles sometimes appear as well-marginated, circumferential, lobulating, contoured cystic masses mimicking orbital cysts on orbital CT or MRI. We report the radiologic findings in 5 patients whose hydrogel buckles needed to be differentiated from orbital cysts
[en] We report the potentials and limitations of computational fluid dynamics (CFD) analysis of patient-specific intracranial model with modification of proximal and distal length. Flow pattern does not seem to be affected by the length of proximal internal carotid artery. However, most of the flow was directed to the shorter distal part. Our study could serve as a technical reference to validating other tools and CFD results.