[en] We recently encountered two cases of emphysematous pyelonephritis with abscess formation, which have recovered by only conservative treatment and percutaneous abscess drainage(PAD). Two patients had diabetes mellitus. In the first case, initial CT showed left intrarenal abscess with air-fluid level. In the second case, CT showed right perirenal abscess with air-fluid level. PAD was performed under CT and US guidances, respectively. Both patients were successfully treated with PAD and conservative treatment. Follow-up after confirmation of abscess resolution by CT scan and contrast study through the catheter,we removed catheters two months and 40 days after PAD respectively

[en] To present CT findings of benign mass-like nodular lesions associated with chronic tuberculous empyema. We retrospectively reviewed the CT scans of nine patients with mass-like lesions associated with chronic tuberculous empyema, which were pathologically (operation=4, US-guided biopsy=3) or clinically (n=2) confirmed as benign lesions. Shape, number, size, presence of calcification and enhancement pattern of mass-like lesions were assessed. In all patients, chest CT showed unilateral calcified pleural thickening, with mass-like nodular lesions. Fluid within the pleural cavity was observed in eight patients, CT findings of mass-like lesions were multiple and nodular (n=9). Calcification was demonstrated within the lesions in four patients. In each case, the size of the largest nodules was 1-3 cm in diameter. In contrast, CT showed mild (n=6) to moderate (n=2) enhancement compared with adjacent muscles. The pathologic results of mass-like lesions were chronic inflammation (n=3) and necrosis (n=4). Benign mass-like lesions associated with chronic tuberculous empyema appeared as multiple nodules varying in size from 1 to 3 cm in diamter, with slight enhancement

[en] To evaluate the efficacy of each phases in two and three phase spiral CT in the detection of pancreatic adenocarcinoma. Two phase spiral CT images of 18 patients and three phase spiral CT images of 12 patients with pathologically-proven pancreatic ductal adenocarcinoma were retrospectively compared. Using a single spiral scan, images of early and delayed phases were obtained at 43 seconds and 2∼3minutes respectively initiating the after administration of 100-120cc of contrast material (2∼3cc/sec), Images of arterial, portal and delayed phases were also obtained at 25 and 60 seconds, and 3∼4minutes, respectively, by the use of a double spiral scan. CT scans were performed with 10mm collimation at 1:1 pitch table speed. Contrast between the tumor and adjacent pancreatic parenchyma were compared and graded and enhancement pattern of the tumor were analysed together. In 12 patients (66.7%), images of the early phase were superior to those of the delayed phase. images of the portal phase were superior to those of the arterial phase. Enhancement of tumor was seen in four patients;all tumors were less than 3cm in size. The early phase of two phase spiral CT is superior to the delayed phase and the portal phase of three phase spiral CT is superior to the arterial phase. Both arterial and portal phases are superior to the delayed phase

[en] Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics

[en] Primary squamous cell carcinoma is a rare tumor of the stomach with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers. We report a case of squamous cell carcinoma in the stomach associated with hypertrophic gastropathy and observed as a huge mass and wall thickening on the greater curvature site by a multidetector CT

[en] Endobronchial tuberculosis and bronchogenic cancer are common causes of atelectasis or obstructive pneumonitis in Korea. Differentiation between endobronchial tuberculosis and bronchogenic carcinoma is important for the treatment and prognosis but it is sometimes difficult to differentiate these two lesions with radiologic examinations. The purpose of this study was to find the differential points between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis. Forty patients in whom atelectasis or obstructive pneumonitis was detected on chest radiographs comprised the study. A definite mass opacity was not observed on chest radiographs in all patients. In these patients, the causes of obstruction were endobronchial tuberculosis (n = 20) and bronchogenic cancer (n = 20) which were microbiologically or pathologically confirmed. Double obstructive lesions were more frequently found in endobronchial tuberculosis (8/20) than in bronchogenic cancer (1/20). Multiple calcification along the bronchial wall and severe distortion of bronchi were observed only in endobronchial tuberculosis (4/20) and associated low density mass at obstruction site was only observed in bronchogenic cancer (6/20). Bronchial dilatation (11/20) and parenchymal calcifications (14/20) distal to obstruction site, air containing bronchogram at post obstructive bronchus (14/20) were more frequently found in endobronchial tuberculosis. Contour bulging at obstruction site (14/20), and only mucus bronchogram at post obstructive bronchus (14/20) were more frequently found in bronchogenic carcinoma. In patients with atelectasis or obstructive pneumonitis, endobronchial tuberculosis is characterized by double obstructive lesion, multiple calcifications at the bronchial wall, and severe distortion of the bronchi. Endobronchial carcinoma is characterized by a low density mass at the obstructive site

[en] We describe the 2D reformatted and 3D volume rendered images by MDCT in a patient with an episode of acute bleeding from the colonic stoma. This case indicates that the 2D reformatted and 3D volume rendered images are useful to detect this rare complication of portal hypertension, and they help to tailor adequate treatment for the patients with bleeding from stomal varices. Ectopic varices are an uncommon cause of gastrointestinal hemorrhage, but they account for up to 5% of all variceal bleedings (1). Bleeding from stomal varices has been reported in up to 20% of the patients suffering with chronic liver failure with permanent stoma (2). However, the diagnosis of stomal varices is difficult because bleeding from stoma may also be associated with lower gastrointestinal bleeding. To the best of our knowledge, the 2D reformatted and 3D volume rendered images by MDCT for visualization of ectopic stomal varices have not been previously reported in the medical literature

[en] A retained surgical sponge is easily diagnosed on plain abdominal radiographs; this is due to the presence of radiopaque markers in the sponge. However, it may be difficult to determine the location of a retained surgical sponge if the sponge penetrates and migrates into the small bowel and urinary bladder. We report a rare case of a retained surgical sponge located within the ascending colon that resulted in partial intestinal obstruction and spontaneous expulsion

[en] To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphsema. The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78(mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score;CES) and honeycombing (CT honeycombing score;CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. Evidence of emphysema was seen on HRCT in 20 fo 24 patients with IPF (83%). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p<0.01). Pulmonary function tests showed lower percent predicted FEVI (69.3%), FVC (64.7%), TLC (73.7%), and RV (77.3%), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEVI/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, an seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC(85%) and RV(100.7%); this contrasted with decreased TLC(72%) and RV (68%) in patients whose CHS was higher than their CES. Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status

[en] Testicular lymphoma only constitutes 1 to 7% of all testicular tumors, but the prognosis is worse because the primary testicular lymphoma is more lethal than testicular carcinomas. Only a few reports on the sonographic appearance of the primary testicular lymphoma have been published, but to our knowledge, there has been no report on this subject in this country. In this case report, the gray-scale and color doppler US findings of the primary testicular lymphoma in a 48-year-old man are described.