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Biomedical subjects

B I Choi

Publications and source records attributed to B I Choi.

At least 19 recordsLinked to original sources

Intratumoral vascularity of experimentally induced VX2 carcinoma: comparison of color Doppler sonography, power Doppler sonography, and microangiography.

RATIONALE AND OBJECTIVES: Tumor vascularity is useful for characterizing tumors and determining tumor management. The recent development of power Doppler sonography has enhanced the sensitivity of color Doppler imaging in the detection of blood flow because of low power noise and less angle dependence. The purpose of this study was to compare the capability of color and power Doppler sonography with that of microangiography for showing tumor vascularity of VX2 carcinoma. METHODS: Color and power Doppler sonography was performed on VX2 carcinomas in the rabbit thighs, and their findings were correlated with those of microangiography. For qualitative analysis, tumor vascularity was categorized into four items including distribution of tumor vessels, crowdedness of vessels, small vessels, (> or = 0.1 mm), and micro-vessels (< 0.1 mm). Tumor blood flow signals of color Doppler sonography and power Doppler sonography were graded as 3, 2, 1, and 0 and were compared with tumor vascularity on microangiography. For quantitative analysis, percentages of tumor vascular area per tumor area on each study were compared. RESULTS: The mean scores of tumor vascularity on power Doppler sonography were 2.87, 2.73, 2.93, and 2.73 in tumor vascular distribution, crowdedness of vessels, small vessels, and micro-vessels, respectively. Those on color Doppler sonography were 2.4, 2.2, 2.8, and 1.67, respectively. Power Doppler sonography was statistically superior to color Doppler sonography in displaying tumor vascular distribution (P < 0.05) and micro-vessels (P < 0.01). The means and medians of percentages of tumor vascular area per tumor area were 22.7% and 23.5% on microangiography, 17.9% and 21.4% on color Doppler sonography, and 36.4% and 34.7 % on power Doppler sonography, respectively. Percentages of tumor vascular area per tumor area on both color Doppler sonography (r = 0.70) and power Doppler sonography (r = 0.84) were well correlated with those on microangiography. CONCLUSIONS: Power Doppler sonography can demonstrate the tumor vascularity on microangiography relatively well, however, it tends to overestimate the blood flow signals. Color Doppler sonography may have some limitations in imaging tumor vascular distribution and micro-vessels and tends to underestimate tumor vascularity, but can display the blood flow direction. Therefore, power Doppler and color Doppler sonography could complement each other in demonstrating the tumor vascularity.

Angiography

Benign obstruction of the hepatic inferior vena cava complicated by hepatocellular carcinoma: combined interventional management.

OBJECTIVE: The risk of hepatocellular carcinoma is increased with benign obstruction of the hepatic inferior vena cava (IVC). The purpose of this study was to assess the usefulness of combined interventional treatment for benign obstruction of the hepatic IVC associated with hepatocellular carcinoma. MATERIALS AND METHODS: In a retrospective review of 51 patients with benign obstruction of the hepatic IVC, hepatocellular carcinoma was detected in 15 patients coincidentally or during the follow-up period. Obstruction of the IVC was treated with percutaneous transluminal balloon angioplasty in five patients and metallic stent placement in two patients. Immediate postprocedural and follow-up venacavography was performed to evaluate the effectiveness of this interventional management. Hepatocellular carcinomas were managed with transcatheter chemoembolization in all 15 patients using an emulsion of 3-12 ml of an iodized oil and 20-50 mg of doxorubicin hydrochloride. Gelfoam embolization was performed in three patients. Transcatheter chemoembolizations were repeated in seven patients. Initial response and long-term response to treatment were evaluated by monitoring the level of serum alpha-fetoprotein and by follow-up CT and angiography. RESULTS: During the follow-up period (1-8 years), the IVC was widely open except in one patient who developed moderate stenosis. Clinical symptoms of vena caval obstruction disappeared in all patients. After initial transcatheter chemoembolization, complete remission of the tumor occurred in six patients and partial remission occurred in seven patients. Five of the seven patients who underwent further chemoembolizations remained unchanged or in remission. CONCLUSION: Radiologic interventional treatment plays a significant role in managing both kinds of lesions in patients with benign obstruction of the hepatic IVC complicated by, hepatocellular carcinoma. A follow-up regimen should be designed to detect small hepatocellular carcinoma as early as possible after obstruction of the hepatic IVC is diagnosed.

Adult

Hepatocarcinogenesis in liver cirrhosis: imaging diagnosis.

Hepatocellular carcinoma (HCC) frequently occurs in association with liver cirrhosis, as chronic liver disease is one of the most important factors in carcinogenesis. In addition to HCCs, recent reports of pathologic studies of resected specimens from cirrhotic liver describe associated small nodular lesions such as regenerative nodule, dysplastic nodule (adenomatous hyperplasia), and dysplastic nodule with subfocus of HCC (early HCC). In hepatocarcinogenesis of the cirrhotic liver, a regenerative nodule might be the first step in the development of HCC, going through phases of dysplastic nodule, early HCC and early advanced HCC in a multistep fashion. Fortunately, recent advances in various imaging techniques have facilitated the verification of these nodules. In this review, new nomenclature of small hepatocellular nodules, and detection and characterization of hepatic nodules in carcinogenesis with various imaging techniques are described with focus on the premalignant lesions and early stage of HCC. In addition, the efficacy of various imaging techniques for diagnosing them is discussed. Although the terms and definitions of these nodules are still variable and controversial, familiarity with the concept of these borderline lesions is important.

Carcinoma, Hepatocellular

Functioning islet cell tumor of the pancreas. Localization with dynamic spiral CT.

PURPOSE: The purpose of this study was to evaluate the usefulness of dynamic spiral CT, including multidimensional reformation, in the detection and localization of islet cell tumors of the pancreas. MATERIAL AND METHODS: Seven patients with histopathologically proven functioning islet cell tumors of the pancreas were studied with 2-phase contrast-enhanced spiral CT. Scanning of the arterial phase and late phase was started 30 s and 180 s, respectively, after injection of 100 ml of contrast medium at a rate of 3 ml/s. RESULTS: Axial images in the arterial phase depicted the lesions in 5 patients, but in the late phase in only one patient. Multiplanar reformatted images of the arterial phase depicted the lesions in all 7 patients. Maximal intensity projection images demonstrated all lesions with information of their relationship to the vascular structure. CONCLUSION: Dynamic spiral CT with scanning during the arterial phase and retrospective multidimensional reformation is useful for preoperative detection and localization of small islet cell tumors of the pancreas.

Adenoma, Islet Cell

Optimal MR protocol for hepatic hemangiomas. Comparison of conventional spin-echo sequences with T2-weighted turbo spin-echo and serial gradient-echo (FLASH) sequences with gadolinium enhancement.

PURPOSE: To compare conventional spin-echo (SE) sequences with T2-weighted turbo SE and serial gadolinium-enhanced T1-weighted FLASH sequences in the detection and characterization of hepatic hemangiomas, and to describe the enhancement characteristics of the lesions on dynamic MR imaging. MATERIAL AND METHODS: Forty-two patients with 66 hemangiomas were studied at 1.0 T or 1.5 T by using conventional SE sequences (T1-weighted, T2-weighted, and heavily T2-weighted), T2-weighted turbo SE sequences, and breath-hold T1-weighted FLASH sequences acquired before, immediately after, and 1, 2, 3, 5, and 10 min after injection of a bolus of gadopentetate dimeglumine. Images were quantitatively analyzed for lesion-to-liver contrast-to-noise (C/N) ratios, and qualitatively analyzed for lesion conspicuity. The enhancement pattern and the rapidity of enhancement were analyzed in small (<15 mm), medium (15-39 mm), and large (>39 mm) hemangiomas. RESULTS: In T2-weighted images, T2-weighted turbo SE and heavily T2-weighted SE images had higher C/N ratios than T2-weighted SE images (p=0.003). Lesion conspicuity was not significantly different in these 3 sequences (p=0.307). In T1-weighted images, T1-weighted FLASH images had higher C/N (p<0.001) and also better lesion conspicuity (p<0.001) than T1-weighted SE images. Immediate uniform enhancement was seen in 43% of small hemangiomas (9 of 21 lesions), and persistent central hypointensity was seen in 73% of large hemangiomas (11 of 15 lesions). Rapid enhancement was seen in 62% of small hemangiomas (13 of 21 lesions) and in 31% of medium or large hemangiomas (14 of 45 lesions). CONCLUSION: Further clinical study is needed for evaluating the differential diagnostic advantages of turbo SE T2-weighted imaging compared to the calculation of T2-values by means of a SE T2-weighted sequence. However, the results of the present study suggest that T2-weighted turbo SE imaging and precontrast and serial gadolinium-enhanced FLASH imaging have the potential to replace conventional SE imaging in the evaluation of hepatic hemangiomas.

Contrast Media

Peripheral cholangiocarcinoma of the liver: two-phase spiral CT findings.

PURPOSE: To determine characteristic features of peripheral cholangiocarcinoma on two-phase spiral computed tomographic (CT) scans. MATERIALS AND METHODS: Thirty-four patients with peripheral cholangiocarcinoma underwent two-phase spiral CT. Hepatic arterial phase and portal venous phase images were obtained 30 and 65 seconds, respectively, after the start of contrast material infusion. RESULTS: Thin, mild, incomplete rimlike contrast enhancement at the tumor periphery was seen on CT scans from both phases in 23 patients. Thick, continuous rimlike contrast enhancement and marked homogeneous contrast enhancement were present on scans in four patients and one patient, respectively. No definite contrast enhancement pattern was seen on scans in six patients. Other findings included increased lobar or segmental hepatic attenuation in adjacent normal liver during the arterial phase (n = 10), markedly low attenuation with amorphous areas of slightly high attenuation in the tumor during both phases (n = 33), internal septumlike linear structures (n = 8), narrowing or obstruction of the portal vein as it traversed the tumor (n = 16), and a patent hepatic vein (n = 4). CONCLUSION: Thin, mild, incomplete rimlike contrast enhancement at the tumor periphery and markedly low intratumoral attenuation with amorphous areas of slightly high attenuation during both scanning phases are typical findings of peripheral cholangiocarcinoma.

Bile Duct Neoplasms

Detection of hypervascular nodular hepatocellular carcinomas: value of triphasic helical CT compared with iodized-oil CT.

OBJECTIVE: The objective of this study was to compare the capability of arterial, portal venous, and delayed phases of helical CT with that of iodized-oil CT for revealing nodular hepatocellular carcinomas. MATERIALS AND METHODS: Forty-eight patients with nodular hepatocellular carcinomas underwent triphasic helical CT examination with 10-mm collimation at 10-mm/sec table speed. We injected 120 ml of contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial-phase, portal venous-phase, and delayed-phase images were obtained with 30-sec, 65-sec, and 360-sec delays, respectively. All 48 patients also underwent angiography and intraarterial infusion of iodized oil after helical CT; iodized-oil CT was performed about 2 weeks after infusion of iodized oil. Helical CT images were compared with iodized-oil CT images for revealing hepatic nodules. RESULTS: In 48 patients, 79 hepatocellular carcinomas were seen with iodized-oil CT. Using helical CT, the arterial phase revealed 68 lesions (86%), the portal venous phase revealed 53 lesions (67%), and the delayed phase revealed 57 lesions (72%). The arterial phase proved superior to the portal venous and delayed phases for revealing lesions (p = .0025). The portal venous phase showed no significant difference for revealing lesions compared with the delayed phase. When combined, helical CT of the arterial and portal venous phases revealed 73 lesions (92%); a combination of the arterial and delayed phases revealed 72 lesions (91%); and a combination of the portal venous and delayed phases revealed 63 lesions (80%). Any combination of two phases that included the arterial phase proved superior to the combination of the portal venous and delayed phases (p = .0033). Overall, the combination of the arterial and portal venous phases (92%) or the combination of all three phases (92%) proved best at revealing lesions. CONCLUSION: The arterial phase of helical CT is better for revealing nodular hypervascular hepatocellular carcinoma than are the portal venous and delayed phases. The combination of the arterial and portal venous phases is superior to the arterial phase alone. Also, the combination of the arterial and portal venous phases is equal to the combination of the three phases for revealing hypervascular hepatocellular carcinomas.

Carcinoma, Hepatocellular

Preoperative evaluation of the curative resectability of gastric cancer by abdominal computed tomography and ultrasonography: a prospective comparison study.

OBJECTIVES: We compared the ability of preoperative abdominal computed tomography (CT) with that of preoperative abdominal ultrasonography (US) in predicting the extent of tumor growth and the curative resectability of gastric cancer. METHODS: Abdominal CT and US were done in 95 patients with gastric adeno-carcinoma. The radiologic findings were prospectively compared with surgical and pathologic findings. RESULTS: The sensitivities of abdominal CT and US in detecting the perigastric lymph node involvement were 26.6% and 20%, respectively. The sensitivity of abdominal CT in predicting the pancreatic invasion (60%) was better than that of abdominal US (20%). However, there were 6 false positive diagnosis of pancreatic invasion by abdominal CT; in contrast, there was no false positive diagnosis of pancreatic invasion by abdominal US. Of 95 patients who underwent surgical exploration, 14 were found to have unresectable tumors because of extragastric organ involvement and distant metastases. Abdominal CT falsely predicted 8 of 14 cases in which curative gastric resection was impossible as resectable. Moreover, abdominal CT falsely predicted 5 of 81 cases in which curative gastric resection was possible as unresectable. Abdominal US falsely predicted 12 of 14 cases in which curative surgery was impossible as resectable. CONCLUSION: Preoperative abdominal Ct and US did not accurately predict the tumor extent and the curative resectability of the gastric cancer. Especially, abdominal CT finding of pancreatic invasion by gastric cancer should not be a contraindication for surgical exploration.

Abdomen

Isolation of Xenopus laevis TFIID subunit p22 reveals two distinct structural regions.

A cDNA clone encoding a Xenopus laevis (Xl) homologue of the TATA box-binding factor TFIID subunit p22, which shows similarities to histones H2B and H3, was isolated and sequenced. The deduced 164-amino-acid (aa) sequence was compared to those of homologues cloned from human and Drosophila melanogaster (Dm). Analysis showed that the TFIID subunit p22 consists of an approx. 60-aa less-conserved N-terminus and approx. 100-aa highly-conserved C terminus.

Amino Acid Sequence

Isolation and characterization of a cDNA encoding a novel human transcription factor TFIID subunit containing similarities with histones H2B and H3.

Using the yeast two-hybrid system, we isolated a human cDNA that encodes a protein (hp22) interacting with TATA box-binding factor TFIID subunit p80 containing similarity with histone H4. Sequence analysis showed that the open reading frame (ORF) specifies a 161-amino-acid (aa) polypeptide homologous to Drosophila melanogaster TFIID subunit p22 (dp22). Comparison of the aa sequence of human TFIID subunit p22 (hp22) with that of dp22 revealed that p22 is composed of two distinct regions; the less conserved N-terminal (20% identity) and the highly conserved C-terminal (65% identity) regions. Additionally, the C-terminal region was found to contain similarities with histones H2B and H3. Northern blot analysis showed mRNA corresponding to hp22 to be expressed in all tissues examined.

Amino Acid Sequence

Tuberculous colitis. Findings at double-contrast barium enema examination.

PURPOSE: This study was undertaken to elucidate characteristic findings of tuberculous (TB) colitis at double-contrast barium enema examination (DCBE). MATERIALS AND METHODS: Twenty-five patients with TB colitis diagnosed by biopsy (n = 13) or therapeutic trial (n = 12) were included. DCBE findings were retrospectively analyzed, with special emphasis on distribution of lesions and mucosal changes. RESULTS: Involvement was asymmetric in 12. The lesion was noted more commonly in the ascending colon (n = 23), cecum (n = 21), and terminal ileum (n = 19) compared with the transverse colon (n = 15) and descending and sigmoid colon (n = 9). Skipped lesions were seen in 13 patients. Sixteen patients had multiple ulcers that were mostly transverse or circumferential in alignment (n = 11). Depth of ulcers was superficial (< 2 mm) in 9 patients and deep in 13. Two patients had fistulas. Twelve patients had inflammatory polyposis. Three patients presented with mass, and misdiagnosis of malignant tumor was made in two. Thickening, deformity, and incompetence of the ileocecal valve were frequently noted (5, 6, and 8, respectively). CONCLUSION: DCBE revealed detailed mucosal changes of TB colitis. Ulcers aligned in transverse or circumferential pattern, involvement of the right side colon, and deformity of the ileocecal valve suggest diagnosis of TB colitis.

Adolescent

MR findings in human fascioliasis.

Fasciola hepatica is a trematode of herbivorous mammals, and man is infected by accidental ingestion of contaminated raw aquatic vegetables or water. There have been many reports on computed tomographic and cholangiographic features of human fascioliasis. However, findings of magnetic resonance (MR) imaging have not been reported. Hepatic fascioliasis produces three types of lesions in MR images arranged in tract-like fashion. The outermost area presents as an iso-signal area in T1WI, with slightly higher signal intensity in T2WI and diffuse enhancement after i.v. contrast. The second type presents as a well defined low signal area in T1WI, not enhanced, and also shows low signal intensity in T2WI. The third type has low signal intensity in T1WI, is not enhanced, and has high signal intensity in T2WI which is similar to fluid-containing inflammatory lesions such as pyogenic abscess. These findings suggest various changes associated with traumatic hepatitis caused by the migration of the worm in the liver. This diverse signal intensity can be a suggestive finding of fascioliasis.

Fascioliasis

Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization.

PURPOSE: To elucidate major complications and their predisposing factors in transcatheter oily chemoembolization (TOCE) for hepatic tumors. MATERIALS AND METHODS: In a retrospective study of 351 patients (aged 26-82 years) with hepatic tumors, TOCE was performed 942 times with an emulsion of iodized oil (3-40 mL) and doxorubicin hydrochloride (20-60 mg). In 126 patients, TOCE was followed by absorbable gelatin sponge embolization. RESULTS: Complications were severe postembolization syndrome (n = 53); hepatic insufficiency (n = 20), infarction (n = 1), or abscess (n = 1); intrahepatic biloma formation (n = 3); tumor rupture (n = 3); septicemia (n = 9); coagulopathy (n = 1); gastrointestinal bleeding (n = 10); gallbladder (n = 5) or splenic infarction (n = 4); pulmonary oil embolism (n = 6); and spinal cord injury (n = 1). Important predisposing factors were major portal vein obstruction, compromised hepatic functional reserve, biliary obstruction, previous biliary surgery, excessive amount (> 20 mL) of iodized oil, hepatic arterial occlusion after repeated TOCE, and nonselective embolization. CONCLUSION: Most patients with major complications after TOCE had preexisting risk factors.

Adult

Power versus conventional color Doppler sonography: comparison in the depiction of vasculature in liver tumors.

PURPOSE: To compare power and conventional color Doppler sonography in the depiction of the intratumoral vasculature of hemangiomas, hepatocellular carcinomas (HCCs), and metastases of the liver. MATERIALS AND METHODS: Thirty-two patients with liver tumors (12 hemangiomas, 11 HCCs, and nine metastases) were prospectively evaluated with power and conventional color Doppler sonography by using a 2-4-MHz convex probe with 2-MHz Doppler frequency. Power Doppler sonography was performed with a 75%-88% gain. Conventional color Doppler sonography was performed with a 55%-75% gain and a pulse repetition frequency of 700 Hz. Power Doppler signals and color Doppler signals interrogated in one plane were analyzed by two radiologists, who subjectively rated power Doppler sonography as superior, equal, or inferior to color Doppler sonography. RESULTS: Overall, power Doppler sonography was superior to color Doppler sonography in 18 patients and equal in 14 (P < .01). In hemangiomas, power Doppler sonography was superior to color Doppler sonography in 10 patients and equal in two (P < .01). In HCCs, power Doppler sonography was superior to color Doppler sonography in four patients and equal in seven (P > .05). In metastases, power Doppler sonography was superior to color Doppler sonography in four patients and equal in five (P < .05). CONCLUSION: Power Doppler sonography is more sensitive than color Doppler sonography in the depiction of the vasculature of liver tumors, particularly in hemangiomas.

Adult

Characterization of focal hepatic tumors. Value of two-phase scanning with spiral computed tomography.

BACKGROUND: Spiral computed tomography (CT) allows imaging of the liver during the peak contrast material levels due to the capability of fast data acquisition. The objective of this study was to evaluate the usefulness of two-phase spiral CT in the differential diagnosis of focal hepatic tumors. METHODS: One hundred two patients who had hepatic tumors (211 nodules; 149 hepatocellular carcinomas [HCCs], 36 metastases, and 26 hemangiomas) underwent two-phase spiral CT with 10-mm collimation at 10 mm/second table speed and 120 mL of contrast material injected at the rate of 3 mL/second. Computed tomography images of the hepatic arterial phase and late (equilibrium) phase were obtained at 35-second and 180-second delays, respectively. The enhancement patterns of tumors were divided into six types and were compared with the attenuation of surrounding liver parenchyma: totally high, peripherally high, centrally high, mixed, iso, and low. RESULTS: The common enhancement patterns of HCC in two-phase spiral CT were totally high in the arterial phase and low (n = 63, 42%) or iso (n = 28, 19%) in the late phase. Metastasis showed peripherally nonnodular high attenuation (n = 9, 25%) or low attenuation (n = 9, 25%) in the arterial phase and low attenuation in the late phase, followed by totally high attenuation in the arterial phase and iso in the late phase (n = 6, 17%). Hemangiomas showed totally or peripherally nodular enhancement in the arterial and late phases (n = 23, 89%). In distinguishing hemangiomas from malignant tumors, totally high or peripherally nodular high attenuation in the late phase was the most useful contrast enhancement pattern (96% of hemangioma vs. 0% of malignant tumors). In distinguishing HCCs from metastases, a combination of contrast enhancement pattern of totally high attenuation in the arterial phase and low in the late phase was the most useful contrast enhancement pattern (42% of HCCs vs. 0% of metastases). The predictability of differentiation between hemangiomas and malignant tumors and between HCCs and metastases was 99% and 90% with spiral CT, respectively. CONCLUSIONS: Two-phase spiral CT is useful in the differential diagnosis of focal hepatic tumors with evaluation of contrast enhancement patterns.

Adult

Hepatocellular carcinoma and portal vein invasion: results of treatment with transcatheter oily chemoembolization.

OBJECTIVE: Our objective was to evaluate the efficacy and safety of transcatheter oily chemoembolization therapy in a series of patients with hepatocellular carcinoma and portal vein invasion. MATERIALS AND METHODS: We retrospectively analyzed the results of transcatheter oily chemoembolization for 110 patients with hepatocellular carcinoma invading major portal branches. The Child's classes were A for 94 patients and B for 16. The main portal vein was partially (n = 33) or completely (n = 15) invaded in 48 patients, the right portal vein was invaded in 36, and the left portal vein was invaded in 26. Oily chemoembolization was performed with an emulsion of iodized oil and doxorubicin hydrochloride. Gelatin sponge particle embolization was added for 78 patients. Seventy-one patients underwent multiple treatment sessions. RESULTS: Our initial findings showed that 31 patients had complete or partial remission, with an overall median survival time of 6 months. The cumulative survival rates were 48% (6 months), 30% (1 year), 18% (2 years), and 9% (3 years). The parenchymal tumor extent was the most significant predicting factor for complications and efficacy of therapy. Of 33 patients with a parenchymal tumor limited to one or two segments of a hepatic lobe, 22 had complete or partial remission, with a median survival time of 22 months; this survival time was significantly longer than that (5 months) for 77 patients with a more extensive tumor (p < .0001). Hepatic insufficiency developed in 10 patients, and three of them died within 1 month after chemoembolization. All 10 patients had an extensive parenchymal tumor involving more than two hepatic segments, and four had impaired hepatic functional reserve of Child's class B. CONCLUSION: When a tumor is limited in extent and hepatic function is preserved, transcatheter oily chemoembolization is effective and safe for the palliation of hepatocellular carcinoma and major portal vein invasion. However, when a parenchymal tumor is extensive, chemoembolization is associated with a poor response and a risk of hepatic failure.

Adolescent

Undifferentiated embryonal sarcoma of the liver: US and CT findings.

Six cases of undifferentiated embryonal sarcoma (UES) were reviewed to determine their characteristic features on ultrasonography (US) (n = 5) and computed tomography (CT) (n = 6). US demonstrated a single large, echogenic mass with some anechoic spaces. Contrast-enhanced CT scan revealed a well-demarcated low-attenuation mass with hyperdense septations of variable shape and thickness. Discrepancy of internal architecture on US and CT was one of the important characteristics of UES. CT numbers were 25-47 HU in low-attenuation areas. Enhancing peripheral rim was found in four cases and some solid portions at the periphery or adjacent to the septa were found in all cases. Two patients who had follow-up US and CT without treatment showed enhancing solid portions, changing to hypodense as the tumor grew. When compared with the pathologic findings, US showed a more accurate representation of internal architecture than did CT. Familiarity with these US and CT findings of UES of the liver will be helpful in the differential diagnosis of primary hepatic tumors in childhood.

Adult

Uterine cervical carcinoma: evaluation of pelvic lymph node metastasis with MR imaging.

PURPOSE: To assess accuracy of magnetic resonance (MR) imaging in detection of pelvic node metastasis from uterine cervical carcinoma. MATERIALS AND METHODS: In 136 patients (aged 26-71 years [mean, 49 years]) with uterine cervical carcinoma seen between October 1990 and July 1992, maximum axial diameter (MAAD), minimum axial diameter (MIAD), and signal intensity enhancement ratio of positive nodes were measured. RESULTS: With MAAD of 1.0 cm, MR imaging had an accuracy of 90.4%, sensitivity of 62.2%, and specificity of 94.9% in detection of pelvic node metastasis. Mean MAAD and MIAD were 1.43 and 1.30 cm for true-positive nodes and 1.18 and 0.75 cm for false-positive nodes, respectively. Mean MAAD/MIAD was 1.09 for true-positive and 1.76 for false-positive nodes. With MIAD of 1.0 cm, MR imaging had an accuracy of 93.0% with 62.2% sensitivity and 97.9% specificity. No significant differences were noted in the degree of contrast enhancement between true-positive and false-positive nodes. CONCLUSION: The accuracy of MR imaging was fairly high in detection of pelvic node metastasis from uterine cervical carcinoma, and MIAD was a more accurate size criterion than MAAD.

Carcinoma