[en] To evaluate normal human gastric wall layers in vitro using magnetic resonance (MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH (T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE (T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer (mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. The gastric wall was shown by T1FLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated T1FLASH to have two (n=6, 14.6%) and three (n=35, 85.4%); by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%). The signal intensity of each layer at T2TSE and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases, intermediate-low-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05). Both FLASH and T2TSE was the best overall image quality (p<0.05). In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality

[en] Autologous fat injection is one of the methods utilized for augmented mammoplasty methods. In this surgical procedure, the fat for transfer is obtained from the donor site of the patient's own body by liposuction and the fat is then injected into the breast. We report here cases of three patients who underwent autologous fat injection. Two of the patients had palpable masses that were present after surgery. The serial imaging findings and surgical method of autologous fat transfer are demonstrated

[en] Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients

[en] Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients

[en] Ultrasound-guided needle localization has been used prior to the surgical excision of nonpalpable breast lesions. The aim of the study was to assess the feasibility of the use of a saline immersion specimen ultrasound technique (immersion-US) to confirm the successful removal of breast lesions. The devised immersion-US technique was used to examine the excised tissues of 72 ultrasound-guided needle localized breast lesions of 58 patients (34 benign lesions, 30 high-risk lesions and 8 malignant lesions). Freshly excised specimens were placed in a container filled with saline and one radiologist scanned the surgically excised specimens using a high-frequency linear transducer. We evaluated successful lesion removal and the qualities of the immersion-US images. Miss rates were determined by the use of postoperative ultrasound during follow-up. All 72 lesions were identified by the use of immersion-US and satisfactory or excellent quality images were obtained for most lesions (70/72, 97%). Five (7%) lesions were initially identified as incompletely excised, based on the immersion-US findings, and prompt re-excision was undertaken. Follow-up ultrasound examinations showed no residual mass in the surgical field in any patient. The immersion-US technique was found straightforward and efficient to perform. Immersion-US was able to determine whether nonpalpable breast lesions had been successfully excised after ultrasound-guided needle localization

[en] To evaluate the difference in MR findings of metastatic adenocarcinoma and non-adenocarcinoma of the brain. The study group consisted of 19 patients with metastatic adenocarcinoma and 13 with metastatic non-adenocarcinoma: there were 64 adenocarcinomas and 45 non-adenocarcinomas. On T1WI, the signal intensity of the lesions was hypointense, isointense, and hyperintense in 57.8 %, 39.0%, and 3.2 % of adenocarcinomas: and 84.5%, 13.3%, and 2.2% of non-adenocarcinomas, respectively. On T2WI, signals were hyperintense, isointense, hypointense, and heterogeneous in 67.2%, 10.9%, 17.2%, and 4.7% of adenocarcinomas: and 80%, 0%, 8.9%, and 11.1% of non-adenocarcinomas, respectively. On T2WI, seven of 19 patients with adenocarcinoma and two of 13 with non-adenocarcinoma were either hypo- or isointense relative to the white matter. In the adenocarcinoma group, hypo- or isointensity was screen in four cases of gastrointestinal cancer, two of lung cancer, and one of endometrial cancer: in the non-adenocarcinoma group, this was seen in adenocarcinoma showed hypointensity on T2WI and hyperintensity on T1WI, and this was probably related to the presence of blood products. On histopathology, one case of adenocarcinoma showing hypointensity on T2WI was shown to contain mucin. When brain metastasis shows hypo- or isointensity on T2WI, adenocarcinoma is more likely than non-adenocarcinoma. (author). 14 refs., 4 figs

[en] We report a case of old gravel aspiration in a 57-year-old man who had been accidentally buried in a field of construction for ten hours, three years prior. A chest radiograph showed peribronchial pneumonic infiltrates in the right lower lobe, with a proximal ovoid radiopaque endobronchial density at the trunchus basalis. These findings were more clearly visualized on the 64-channel multidetector CT (MDCT). Moreover, the patient recovered from his condition, following a bronchoscopic retrieval. However, the patient had persistent bronchiectasis of the right lower lobe on a subsequent follow-up chest radiograph, one month later

[en] A tumor and mature ovarian cystic teratoma rarely coexist, but since it may affect treatment and prognosis, appropriate pre-surgical diagnosis is important. The purpose of this study was to evaluate the difference in CT findings between a tumor coexisting with a mature ovarian cystic teratoma and a simple mature ovarian cystic teratoma. Coexistent tumors were histopathologically diagnosed as squamous cell carcinoma in three patients, carcinoid in three, and fibrothecome in one. In contrast with a simple mature teratoma, a tumor coexisting with a mature cystic teratoma developed in older patients and had a more solid portion, which showed contrast enhancement but did not show calcification or a fat component. Where a tumor and mature cystic teratoma coexisted, ascites and the invasion of adjacent structures were also common. If, in an older patient, CT scanning reveals an ovarian cystic tumor with a large solid portion but no calcification or fat, coexistent tumor should be suspected. (author). 12 refs., 3 figs

[en] To evaluate the prevalence of capsular retraction in malignant hepatic tumors and the factors involved. Between January 1994 and December 1996, we retrospectively reviewed the CT scans of 152 patients with pathologically-proven, peripherally-located, malignant hepatic tumors. We evaluated size, site, portal and hepatic venous obstruction, bile duct dilatation, and liver atrophy in 18 cases involving capsular retraction. The overall prevalence of capsular retraction among malignant hepatic tumors was 18/152 (12 %); the prevalence was 9/129 (7%) in hepatocellular carcinoma, 6/14 (43 %) in cholangiocarcinoma and 3/9 (33 %) in metastatic cancer; among cases of cholangiocarcinoma and metastatic cancer, the prevalence was high (p<0.05). Portal venous obstruction was seen in six patients with hepatocellular carcinoma ( a high incidence; p=0.04) and one with cholangiocarcinoma. Hepatic venous obstruction was demonstrated in one patient with hepatocellular carcinoma and one with cholangiocarcinoma. Among cholangiocarcinoma patients, bile duct obstruction was seen in four and liver atrophy in three, but among metastatic cancer cases there were no similar findings. The main factors causing capsular retraction were portal venous obstruction in hepatocellular carcinoma and bile duct obstruction and liver atrophy in cholangiocarcinoma. (author). 16 refs., 3 figs

[en] To introduce dynamic cine-arthrography and compare it with MR arthrography in the diagnosis of intrinsic ligament and triangular fibrocartilage complex tears, based on arthroscopic findings. A total of thirty-eight wrists of 38 patients who had undergone both dynamic cine-arthrography and MR arthrography were enrolled. Dynamic cinearthrography was performed after puncture of the radiocarpal joint by slow injection of contrast under continuous fluoroscopic guidance during passive wrist exercise. We obtained 1.5- or 3-T MR arthrography with fat-suppressed T1-weighted coronal and axial images. We evaluated scapholunate and lunotriquetral ligaments and triangular fibrocartilage complex tears according to the Palmer classification system. Based on the arthroscopic findings, we compared the diagnostic values between the two examinations using Kappa values. The overall sensitivity and specificity of diagnosis of intrinsic ligament tears was similar between dynamic cine-arthrography and MR arthrography (scapholunate ligament: sensitivity 66.7% vs. 80%, specificity 100% vs. 95.7%, lunotriquetral ligament: sensitivity 75.0% vs. 75.0%, specificity 94.1% vs. 91.2%). For triangular fibrocartilage complex tears, all diagnostic values were the same (sensitivity 96.4%, specificity 100%). The inter-examination agreement was substantial to perfect (kappa value 1.000). Dynamic cine-arthrography is valuable in the diagnosis of intrinsic ligament and triangular fibrocartilage complex tears compared to MR arthrography.