[en] We wanted to investigate the feasibility of using FDG-PET for evaluating the antitumor effect of intraarterial administration of a hexokinase II inhibitor, 3-bromopyruvate (3-BrPA), in a rabbit VX2 liver tumor model. VX2 carcinoma was grown in the livers of ten rabbits. Two weeks later, liver CT was performed to confirm appropriate tumor growth for the experiment. After tumor volume-matched grouping of the rabbits, transcatheter intraarterial administration of 3-BrPA was performed (1 mM and 5 mM in five animals each, respectively). FDG-PET scan was performed the day before, immediately after and a week after 3-BrPA administration. FDG uptake was semiquantified by measuring the standardized uptake value (SUV). A week after treatment, the experimental animals were sacrificed and the necrosis rates of the tumors were calculated based on the histopathology. The SUV of the VX2 tumors before treatment (3.87±1.51 [mean SD]) was significantly higher than that of nontumorous liver parenchyma (1.72±0.34) (p < 0.0001, Mann-Whitney U test). The SUV was significantly decreased immediately after 3-BrPA administration (2.05±1.21) (p = 0.002, Wilcoxon signed rank test). On the one-week follow up PET scan, the FDG uptake remained significantly lower (SUV 1.41±0.73) than that before treatment (p 0.002), although three out of ten animals showed a slightly increasing tendency for the FDG uptake. The tumor necrosis rate ranged from 50.00% to 99.90% (85.48%±15.87). There was no significant correlation between the SUV or the SUV decrease rate and the tumor necrosis rate in that range. Even though FDG-PET cannot exactly reflect the tumor necrosis rate, FDG-PET is a useful modality for the early assessment of the antitumor effect of intraarterial administration of 3-BrPA in VX2 liver tumor

[en] We report on a case of spontaneous rupture of a bladder diverticulum, along with its cystographic and CT findings, in a 36-year-old woman. Three dimensional reformation of CT scanning is helpful for detecting the definite perforation site. To our knowledge, there has been no such report in the radiology literature describing the spontaneous rupture of a bladder diverticulum

[en] Intratumoral calcification is one of the most noticeable of radiologic findings. It facilitates detection and provides information important for correctly diagnosing tumors. In the abdominopelvic cavity, a wide variety of tumors have calcifications with various imaging features, though the majority of such calcifications are dystrophic in nature. In this article, we classify the imaging patterns of intratumoral calcification according to number, location, and morphology. Then, we describe commonly-encountered abdominopelvic tumors containing typical calcification patterns, focusing on their differentiable characteristics using the imaging patterns of intratumoral calcification

[en] We present here the radiological findings of a rare case of multiple focal nodular hyperplasia that was associated with portal vein atresia and portopulmonary hypertension in a young woman. This case illustrates and supports the pathophysiological hypotheses that were previously proposed for the coexistence of these three abnormalities

[en] Pulmonary metastases present a wide spectrum of radiological findings, some of which have been known to be useful for analogizing the possible origin or site of primary tumors. In the present report, we describe a unique case of pulmonary metastasis manifesting on chest computed tomography as multiple nodules with tortuous, serpentine, aneurysmal, dilated, inner intratumoral vessels. The metastasis originated from uterine sarcoma

[en] To compare the diagnostic performance and radiation dose between contrast-enhanced CT (ECT) alone, and combined unenhanced and contrast-enhanced CT (UE + ECT) for the assessment of adnexal mass. This retrospective study was approved by the Institutional Review Board. A total of 146 consecutive patients (mean age, 41.1 years) who underwent preoperative unenhanced and contrast-enhanced multidetector CT of the pelvis and had adnexal masses found at surgery were included. Two readers independently evaluated the likelihood of adnexal malignancy on a 5-point scale on two different imaging datasets (ECT alone and UE + ECT). The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance. Radiation dose to patients was calculated by the volume CT dose index (CTDIvol) and the dose length products (DLP) on each dataset. Of the total 178 adnexal masses, 133 masses were benign and 45 masses were malignant. For both readers, there is no significant difference of AUC values between ECT alone and UE + ECT for the detection of adnexal malignancy (reader 1, 0.93 vs. 0.95; reader 2, 0.92 vs. 0.91) (p > 0.05). The mean CTDIvol (12.6 ± 2.2 mGy) and DLP (641.2 ± 137.2 mGy) of ECT alone was significantly lower than the mean CTDIvol (21.5 ± 2.7 mGy) and DLP (923.6 ± 158.8 mGy) of UE + ECT (p < 0.0001). The use of unenhanced CT scan in addition to contrast-enhanced CT scan does not improve the detection of adnexal malignancy, but increases radiation exposure.

[en] The purpose of this study was to demonstrate the efficacy of bipolar radiofrequency ablation (RFA) using cooled-wet electrodes inducing coagulation in ex vivo bovine livers and in in vivo canine livers. In ex vivo experiments, 20 coagulations were created by monopolar (group A), and bipolar RFA (group B) using a 200 W generator (Valleylab) and one or two cooled-wet electrodes. In in vivo experiments, one coagulation was created by bipolar RFA in each of eight dogs via laparotomy. In ex vivo and in vivo experiments, RF was applied to one or two electrodes at 100 W for 10 min. The dimensions of the coagulations were compared in the two groups. In ex vivo experiments, the mean volumes of the coagulations produced in group B (54.0±16.5 cm³) were greater than those produced in group A (33.9±12.7 cm< Superscript/>³) (P=0.007). In in vivo experiments, bipolar RFA produced a coagulation of 39.4±15.6 cm³ without a major complication. The present study showed that a RF electrode system using two cooled-wet electrodes in the bipolar mode created larger coagulation volumes than the monopolar mode, and this system can be used to create large coagulation without major complications. (orig.)

[en] The US examination has been used to evaluate the infant and child having an inguino-scrotal bulge or mass for the non-invasive diagnostic work up to exclude neoplasm, cryptorchidism, lymphadenopathy, hydrocele of spermatic cord, etc. We performed this study to determine the characteristic ultrasound features of hydrocele of spermatic cord in children. From February 2002 to March 2007, 213 pediatric patients with swelling or palpable mass of the inguino-scrotal area, or suspected cryptorchidism underwent ultrasonography for evaluation of accurate diagnosis. Ninety three of 213 patients had a cystic lesion of the inguino-scrotal area. Among 93 patients, the sonographic images of 28 patients, who were confirmed as having hydrocele of the spermatic cord, were collected on a retrospective basis. The age of the patients ranged from 15 days to 11 years. The ultrasound images of the patients were subsequently reviewed to analyze the typical features in the diagnostic workup of hydrocele of spermatic cord. Eight patients were confirmed by surgery. Twenty patients who were less than one year old were clinically followed up. The most common finding was testicular hydrocele, which was found in 44 patients of the 93 patients that had a cystic lesion of the inguino-scrotal area. Of the 28 patients who had a hydrocele of spermatic cord, 10 patients had the lesions on the left side and 17 patients on the right side. One patient has bilateral hydrocele of spermatic cord. Well-defined elongated or elliptical-shaped cystic lesions were noted in the 24 of 29 cases (one patient had bilateral hydrocele of the spermatic cord). One patient had septations within elongated cystic lesion was seen and round shape in one case: tear drop shape was found in three cases. The most common ultrasound imaging of spermatic cord hydrocele is well-defined, elongated cystic mass separating the testes

[en] To evaluate the diagnostic performance of gray-scale renal sonographic findings for the diagnosis of acute pyelonephritis (APN) by using computed tomography as a reference standard. We retrospectively reviewed gray-scale renal sonographic findings of 48 patients for the detection of APN. All patients had clinical symptoms such as fever, flank pain, or dysuria and were confirmed as APN by contrast- enhanced CT. The presence of sonographic findings such as renal swelling, alteration of the parenchymal echogenicity, wall thickening of the renal pelvis, loss of the renal sinus fat echogenicity, and loss of the corticomedullary differentiation were evaluated. We also categorized all patients into mild APN or severe APN groups according to the volume of the morbid renal parenchyma on contrast-enhanced CT, and evaluated the aforementioned sonographic findings between the two groups. Overall diagnostic sensitivity, specificity, and accuracy of gray-scale renal ultrasonography (US) for the detection of APN were 32.5%, 72.0%, and 58.5%, respectively. The sensitivity and specificity of each sonographic finding were measured for each group. Renal swelling sensitivity and specificity were 33.8% and 70.8% for the mild APN group, but 45.8% and 66.7% for the severe APN group. Sensitivity and specificity for alteration of the parenchymal echogenicity were 41.7% and 79.2% for the mild APN group, but 58.3% and 66.7% for the severe APN group. The sensitivity and specificity for wall thickening of the renal pelvis was 37.5% and 95.8% for the mild APN group, but 50.0% and 95.8% for the severe APN group. The sensitivity and specificity of loss of the renal sinus fat echogenicity were 12.5% and 83.3% for the mild APN group, but 12.5% and 91.7% for the severe APN group. The sensitivity and specificity of the loss of the corticomedullary differentiation were 12.5% and 95.8% for the mild APN group, but 20.8% and 75.0% for the severe APN group. There was no significant difference of gray-scale renal US diagnostic accuracy for the detection of APN between the mild and severe APN groups (56.3%: 58.3%; p > 0.05). Although overall gray-scale renal US has poor sensitivity for the detection of APN, wall thickening of the renal pelvis is the most specific sonographic finding in the both mild and severe APN groups

[en] Extravaginal testicular torsion is known to be the predominant mechanism of the torsion in fetuses and neonates. In this torsion, twisting of the spermatic cord occurs outside the sac of the tunica vaginalis in the scrotum. Herein, we describe the sonographic findings of an extravaginal testicular torsion in a newborn baby who presented with a hard scrotal mass. Gray-scale ultrasound (US) showed hypoechoic linear striations in the testis with a thick hyperechoic peritesticular rim. Surgical exploration revealed an extravaginally twisted testis