[en] To characterize the magnetic resonance (MR) imaging features of cervical tuberculous lymphadenitis. The cervical MR images of 14 patients with pathologically or clinically proven cervical tuberculous lymphadenitis were retrospectively analyzed. T1-and T2-weighted or proton density images and contrast enhanced MR images were obtained in all patients. Most patient had multiple (n = 12), unilateral lesions (n = 10), 8 mm to 45 mm is size, round (n = 46) or ovoid (n = 46) in shape and all with smooth and well-defined margins mostly at internal jugular chain (N2: 41, N3: 2, N4: 21). The signal intensities of the most lymph nodes were isointense or slightly hyperintense on T1-weighted images, and hyperintense (all) with variable homogeneity on T2-weighted and/or proton density images. After contrast enhancement most showed characteristic thin peripheral rim enhancement (n =71). The characteristic MR features of cervical tuberculous lymphadenitis would be multiple, unilateral enlarged lymph nodes which showed iso or slightly increased signal intensity on T1-weighted image, high signal intensity on T2-weighted and/or proton density image and peripheral rim enhancement

[en] The vertebral artery dissection is rare and increasingly recognized as a source of stroke. The purpose of this study is to describe causes, clinical manifestations. MRI and angiographic findings. Conventional angiograms (n 7) and magnetic resonance imaging (n = 6) were retrospectively analyzed in seven patients of vertebral artery dissection. The classification of the Krayenbuhl and Yasargil for vertebral artery segmentation was used for localization of vertebral artery dissection. Additionally, etiology and clinical manifestations were also retrospectively reviewed. Six cases were spontaneous type and one case was traumatic type. The clinical diagnoses of 6 spontaneous arterial dissection cases were wallenberg syndrome (4 cases), subarachnoid hemorrhage (1 case), and infarction of the cerebellum corresponding to PICA territory (1 case). A linear bright signal caused by thrombus was well visualized at the dissection area on sagittal T1 weighted spin echo MR images in all 6 cases. The characteristic angiographic findings were profound narrowing in 4 cases, pearl and string sign (including dissecting aneurysm) in 3 cases, complete obstruction in 3 cases, and a double density lumen (true and false lumen) extending to proximal basilar artery in one case. Spontaneous dissections were located at the V4 segment in all 6 cases. One traumatic dissection was located at the V2 segment. The most common site of the spontaneous dissection of the vertebral artery was V4 portion and a linear bright signal caused by thrombus was well visualized on sagittal T1 weighted spin echo MR images

[en] The purpose of this study was to assess the usefulness of CT angiography (CTA) with spiral CT in evaluation of intracranial vascular lesions. CTA and conventional angiography(CA) were performed in 22 patients with suspected intracranial vascular lesion. Nine patients had 10 aneurysms and 2 patients had arteriovenous malformation(AVM)s, while the remaining 11 patients had no vascular lesion. Twenty seconds after beginning injection of contrast media(100 mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second continuous exposure and 60-mm length) was performed with a table speed of 2 mm/sec and a section thickness of 2 mm. The starting point was selected at the floor of the sella trucica. The resulting data were reformatted by MIP and SSD after reconstruction of 1 mm interval. For aneurysm, its size, shape, direction, neck and the relationship to adjacent vessels were compared to CA. The aneurysm diameter was ranged between 3 mm and 20 mm and all aneurysms were clearly visualized with CTA. CTA findings of the size, shape, direction, and neck of aneurysms and the relationship between aneurysm and adjacent vessels were well correlated with CA. In one case of aneurysm, calcification of the aneurysm wall was demonstrated on CTA. In one case of AVM, the nidus and its arterial supply and venous drainage were well visualized. In the other case of AVM, however, the feeding artery of AVM was not demonstrated on CTA(it was also unclear on CA). CTA with spiral CT may be useful in the evaluation of intracranial vascular lesion and valuable as a screening test for intracranial aneurysm

[en] To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. We evaluated 41 cases (M:F = 1.7:1, average age = 49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II; intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. Submucosal fibrosis was present in 4 cases in Grade I (n = 21), 4 cases in Grade II (n = 6) and 8 cases in Grade III (n = 10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n = 17), 0 case in Grade II (n = 2) and 9 cases in Grade III (n = 9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (ρ = 0.0001, and ρ = 0.02, respectively) Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis

[en] To access the usefulness of magnetic resonance(MR) in the evaluation of orbital blowout fracture. Fourteen patients with orbital blowout fractures diagnosed by plain radiography(n=8) or computed tomography(CT)(n=6) were examined with MR. Twenty blowout fractures including six patients with two lesions were presented and the fracture site of the orbit was the medial wall in 11 cases and the orbital floor in nine cases. MR images in nine cases of six patients could be compared with CT scans. On MR images, we retrospectively evaluated the presence of fracture, herniation of orbital fat, abnormality of extraocular muscle, intraorbital hematoma and intrasinus hemorrhage. In nine cases we also compared these findings with CT scans. Eighteen orbital blowout fractures with fat herniation could be diagnosed on MR images. In only nine of these 18 cases, the fracture itself could be seen on MR images as a disruption of the orbital wall, which produce a signal void. But two blowout fractures without orbital fat herniation, seen on CT, were not detected on MR images. Twenty abnormalities of extraocular muscle in 18 cases were depicted on MR images. There were no significant differences between MR and CT in the evaluation of orbital fat herniation and extraocular muscle abnormality ; however,in one case oblique sagittal MR images provided more useful in formation about the status of the inferior rectus muscle. Intraorbital hematoma was detected by MR in three patients. We were able to establish the presence of intraorbital hematoma by using the different signal intensities from fat or muscle on T1- and/or T2-weighted images. MR was found to be superior to CT in one case of intraorbital hematoma because of the iso-density of hematoma compared to muscle. MR also detected intrasinus hemorrhage which on T1-weighted images revealed high signal intensity in ten cases. MR was intrasinus hemorrhage which on T1-weighted images revealed high signal intensity in ten cases. MR was more valuable in demonstrating intrasinus hemorrhage in one case where a CT scan showed only hypodense fluid. MR is a useful diagnostic modality in the evaluation of orbital blowout fracture with orbital fat herniation. Compared with CT, it also provides more valuable information about blowout fracture with orbital fat herniation. Compared with CT, it also provides more valuable information about associated extraocular muscle abnormality, subacute hemorrhage in the orbit and paranasal sinus

[en] Objectives: To evaluate the outcomes of simple aspiration and ethanol ablation in the management of symptomatic nonfunctioning parathyroid cyst (PC). Methods: We performed simple aspirations for 12 PCs in 12 patients from March 1997 to June 2010. PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level. Ethanol ablation (EA) was performed for recurrent PCs. Simple aspirations were performed using 23-gauge needles and EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance. We evaluated cyst volume, cosmetic score, symptom score, and complications. Results: Mean follow-up period of all patients was 19.2 ± 12.9 months (median, 15.0 months; range, 7–40 months). Simple aspiration was successful in four patients, and the mean volume reduction after simple aspiration was 98.2 ± 3.5% (range, 92.9–100%). In eight recurrent cases, EA resulted in a significant decrease in volume (P = 0.012), as well as in cosmetic (P = 0.011) and symptom (P = 0.01) scores at last follow-up; however two cases of primary failure of EA was treated by repeat EA. No major complications occurred in any patient. Conclusions: For symptomatic nonfunctioning PCs, simple aspiration could be a first line procedure for diagnosis and treatment, while EA can be a subsequent treatment modality for recurrent cases