[en] The tracheobronchial structures were evaluated by multidetector-row computed tomography (MDCT), which provided imaging information for one-lung anesthesia during thoracic surgery. The subjects consisted of 100 patients. Three-dimensional (3D) images of the tracheobronchial structures and the bronchial tubes were created. Individual differences were found in the tracheobronchial structures in 100 patients. The length and the diameter of the right main bronchus were measured with 3D images and were not related to the patient's physical appearance, such as body height. Problematic intubation cases included a short right main bronchus <10 mm, an anomaly of the right bronchus, and tracheal stenosis. The 3D images demonstrated problematic areas of the tracheobronchial structure and helped the anesthesiologists select the most appropriate bronchial tube suitable for the tracheobronchial structure variations. Therefore, this technique is considered to contribute to safer performance of one-lung anesthesia. (author)

[en] Regional cerebral blood flow (rCBF) values obtained by the TLU method with two ¹²³I-IMP SPECT scans and one point arterial blood sampling and rCBF obtained by the ARG method with one ¹²³I-IMP SPECT scan and fixed distribution volume (Vd) values were compared in 17 cases. A case with post ischemic hyperperfusion or luxury perfusion was not observed in our cases. The correlation coefficients between rCBF values and Vd values obtained by the TLU method were 0.49 (p<0.001) in 184 ROI without hypoactive areas on the early image, and 0.61 (p<0.001) in 207 ROI with hypoactive areas, respectively. A high rCBF value with a low Vd value was not observed in any region. Mean Vd value was 44.0±7.0 (mean±SD) in all regions. The correlation coefficients between rCBF values using the TLU method and those using the ARG method with Vd fixed at 44 and 50 were also 0.98. Error of the rCBF value was larger in the region of high rCBF, however, noticeable error of the rCBF value was not observed in the ARG method. The ARG method is more convenient for quantifying rCBF. Venous blood radioactivity at 10 min after ¹²³I-IMP infusion was smaller than arterial blood radioactivity, and the blood activity in the distal vein was larger than that in the proximal vein. The ratio of venous blood activity to arterial blood activity was 0.92±0.04 (mean±SD) at the back of the hand, however, the ratio was a variant in each case. Arterial sampling was thought to be a reliable method to obtain more stable and precise rCBF. (author)

[en] The usefulness of ^99mTc-MIBI scintigraphy for the detection of parathyroid lesions was evaluated in 17 patients with hyperparathyroidism. Delayed image was used to evaluate the lesions. Detectability of MIBI for parathyroid lesions was 86% (18/21). The smallest lesion detected was parathyroid hyperplasia weighted 270 mg. Ectopic parathyroid adenoma and bone metastases of parathyroid carcinoma were clearly demonstrated. Detectability of MIBI scintigraphy for the lesions including ectopic and metastatic lesions was the highest among those of ultrasonography, CT and MRI methods. MIBI scintigraphy was thought to be useful for the detection of parathyroid lesions, especially for ectopic and metastatic lesions. (author)

[en] To evaluate the usefulness of MIBI scintigraphy (MIBI) for parathyroid lesions, the detectability of lesions by MIBI was compared with that by Tl-Tc subtraction imaging, ultrasonography, CT and MRI in 56 histologically proved lesions. In neck lesions, ultrasonography (92%) and MIBI (85%) showed better detectability than those by the other three modalities. With MIBI, detectability was decreased for smaller parathyroid lesions that coexisted with thyroid disease. Among the five modalities, MIBI showed the highest detectability (88%) for ectopic or metastatic lesions. The smallest parathyroid lesions detected by MIBI were a parathyroid adenoma weighing 220 mg and a parathyroid hyperplasia weighing 200 mg. MIBI was thought to be more valuable for ectopic or metastatic parathyroid lesions. (author)

[en] Computed tomographic (CT) scans were performed in 179 patients with esophageal carcinoma to evaluate mediastinal lymph node metastasis. Histopathologic findings were compared with CT findings in a total of 7,218 resected lymph nodes. First, the criterion for lymph node metastasis on CT scans was 10 mm or more in long transverse diameter. The overall sensitivity and positive predictive value (PPV) were 19% (60 of 317 nodes) and 33% (60 of 180 nodes), respectively. Analysis of each of the eight subgroups of mediastinal nodes revealed that the PPV was more than 70% in node Nos. 105, 108, 110, and 112. In other subgroups, however, the PPV was less than 60%. Sensitivity was less than 50% in all eight subgroups. Second, the criterion for metastasis was 10 mm or more in short transeverse diameter. The overall sensitivity and PPV were 8% (26 of 317 nodes) and 63% (26 of 41 nodes), respectively. Analysis of subgroups showed that the PPV in NO.106 nodes increased to 92%. In NO.106 nodes, use of a 5 mm criterion in long transverse diameter increased sensitivity to only 55%. Of the 317 histopathologically proven metastatic lymph nodes, 90 nodes (28%) were 10 mm or more in size, 112 (35%) were 5-1O mm, and 115 (36%) were less than 5 mm. Of the 6,901 non-metastatic lymph nodes, 473 nodes (7%) were 10 mm or more in size. Small (less than 5 mm in size) metastatic nodes were present in all eight subgroups. Among No. 107 and 109 nodes, large (10 mm or more in size) non metastatic nodes were prominent, resulting in low sensitivity and PPV. We conclude that CT does not provide an accurate assessment of metastatic versus non-metastatic mediastinal lymph nodes in patients with esophageal carcinoma. (author)

[en] We present 9 cases of ectopic parathyroid lesions in which histological diagnosis is confirmed. We analyze the findings of imaging modalities including ^99mTc-MIBI scintigraphy, Tl-Tc subtraction imaging, ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), and we assess the usefulness of those imagings in determination of the location of the ectopic parathyroid lesion. MIBI scintigraphy was thought to be most useful for detection of the ectopic parathyroid lesion. (author)

[en] HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after ¹³¹I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after ¹³¹I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after ¹³¹I therapy.(author)

[en] The usefulness of MR mammography (MRM) in breast-conserving therapy was evaluated. The intraductal spread (IDS) is a serious problem in breast-conserving therapy, because it is well-known that IDS frequently causes local recurrence in preserved breast. A 1.5 T MR imager was used with a dedicated breast coil. The MR findings of breast cancer were irregular shape, inhomogenious structure, hyperenhancement in early phase of dynamic study and ringed enhancement. IDS was manifested by linear and band-like enhancements in MRM. Nodular enhancements away from main lesion were suggestive of daughter nodules. MRM was a useful method for detecting IDS and daughter nodules in breast cancer. (author)

[en] The aim of this study was to compare thoracic duct (TD) configuration depicted by magnetic resonance imaging (MRI) with TD configuration described in the anatomical literature. MRI Scans were acquired with a three-dimensional T2-weighted turbo spin echo (TSE) MRI with a two-dimensional prospective acquisition correction (PACE) technique in 63 patients. We found with MRI that TD displacement occurred more on the left side than that reported in the anatomical literature, and this tendency was more marked in elderly patients. In patients with marked leftward TD displacement, the TD configuration on MRI was compared to the descending aortic configuration on chest radiography. The degree of correspondence between the MRI findings and the anatomical literature was assessed by a χ² goodness-of-fit test, and P<0.05 indicated a significant difference. The degree of similarity was determined between TD configuration and aortic configuration by Kendall's coefficient of concordance (W). On MRI scans the TD was often located to the left of the mid-vertebral line compared to the location reported in the anatomical literature (P<0.001). Nine patients had marked leftward TD displacement, a configuration similar to that of the descending aorta (W=1); however, no association with age was established. The TD configuration depicted by MRI differed from that described in the anatomical literature. (author)

[en] We assessed the usefulness of telemammography by soft-copy diagnosis. A wide area network for teleradiology was set up incorporating seven institutions located in two prefectures. A total of 1053 subjects were enrolled. The first reading was performed using hard-copy images at the institution where mammography was undertaken. The second reading using hard-copy images was then performed. These images were transferred to our institution, where a second reading based on soft-copy images was performed. The result of soft-copy diagnosis were then compared with those of the hard-copy diagnosis. The diagnosis concordance rate, which was higher than category 3, was evaluated. Category 1 or 2 accounted for 956 cases at the stage of the second hard-copy diagnosis, of which category 1 or 2 accounted for 930 cases analyzed in the second soft-copy diagnosis. A category higher than 3 accounted for 97 cases at the second hard-copy diagnosis, of which a category higher than 3 accounted for 75 cases at the stage of the second soft-copy diagnosis. The κ-value for the diagnosis concordance rate was 0.751. The diagnostic concordance between hard-copy diagnosis and soft-copy diagnosis was good. Diagnostic accuracy showed no significant difference between the two. We conclude that soft-copy diagnosis by telemammography is useful, and that its application is desirable for screening mammography. (author)