[2 cases of surgically treated bone metastasis due to hypernephroma].
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Biomedical subjects
Publications and source records attributed to H Seto.
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Among 54 patients with thoracic esophageal carcinoma (53 squamous cell carcinoma, 1 adenosquamous carcinoma), the usefulness of MR sagittal imaging for evaluating local extent (T factor) was examined by measuring the anteroposterior (AP) diameter of the tumor. The MR examination was performed using ECG gated scans with a 3 mm slice at 1.5 Tesla. T1-weighted sagittal images were obtained. In 10 patients the appearance of the esophagus was normal, and in 44 patients a tumor was detected in the sagittal section. Thirty-seven lesions were histologically proved (Tis, 1; T1, 3; T2, 3; T3, 15; T4, 15). Lesions classified as 30 mm were resected. They were located in the lower esophagus. It is concluded that lesions detected in MR sagittal images might be T3 or T4 tumors, and masses of >30 mm might extend to adjacent organs, although two tumors with an AP diameter < 25 mm also invaded the trachea.
Magnetic resonance (MR) angiographic studies of 14 patients with intracranial aneurysms (AN) were analyzed retrospectively as compared with contrast angiographic studies. Eighteen of 19 (95%) lesions were detected, and the relation between AN and their parent vessels was precisely assessed. The diameter of the smallest aneurysm detected in our case was 3 mm. However, small vessels around AN were not visualized. Therefore, MR angiography (MRA) is definitely not a substitute for preoperative contrast angiography. MRA is a useful screening tool for nonruptured AN, but further refinement is required to evaluate emergency ruptured AN.
We investigated a patient with extramedullary plasmacytoma in the retroperitoneal space with multiple metastases using abdominal CT scan and 67Ga scintigraphy. Abdominal enhanced CT revealed the retroperitoneal tumor mimicking lymphoma. 67Ga scintigraphy showed multiple tumor localization. We could detect retroperitoneal extramedullary plasmacytoma with multiple metastases using 67Ga scintigraphy. This retroperitoneal tumor may appear similar to lymphoma on CT.
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OBJECTIVE: The purpose of our study was to characterize the relationship between signal intensity on STIR MRI, histology, and liver function. MATERIALS AND METHODS: MRI was performed in 39 patients with chronic liver diseases [chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), liver cirrhosis (LC)] and 11 patients without liver dysfunction (normal). RESULTS: On STIR images, very low signal intensities compared with those of the spleen were seen in all 11 normal livers (100%), and brighter intensities were seen in chronic diffuse liver diseases (10 patients with CPH, 11 patients with CAH, and 18 patients with LC) (100%). The higher the signal grade on STIR images (moderate, marked), the more advanced was the chronic diffuse liver disease (p < 0.02). The levels of serum glutamic-oxaloacetic and glutamic-pyruvic transaminase increased in parallel with increasing signal intensity on STIR images (both p < 0.01). CONCLUSION: We found that the signal intensity of liver on STIR images appeared to be associated with the degree of histologic and/or clinical severity in patients with chronic liver disease.
We describe a patient with unilateral sialectasia of Stensen's duct. X-ray sialography, MR sialography, and ultrasonography showed multiple stenoses and rosary dilatation of Stensen's duct during stimulation of the parotid gland. Before stimulation, Stensen's duct showed focal dilatation as indicated by MR sialography and ultrasonography. The patient also had ipsilateral masseter hypertrophy (BMH), which may be a cause of sialectasia.
The effect of dietary manipulation on global tooth uptake of 47Ca-chloride was evaluated in three rat models of metabolic bone diseases verified by histologic bone study. The 24-hr tooth uptake of 47Ca-chloride was significantly decreased in the osteomalacic group, and was increased in the osteoporotic group at the fourth week. Tooth uptake closely paralleled femoral uptake at a correlation coefficient of 0.73 (p less than 0.01). The uptake of 47Ca-chloride in tooth was found to be more affected by dietary manipulation than that in femur in our rat models.
Tissue distribution studies of intravenously injected [131I]Lipiodol in rats were performed, and serial whole-body autoradiograms were obtained simultaneously for seven days. Most of the radiotracer was retained in the lungs. Lung uptake reached a maximum (42.44% ID/g) at 1 day, with an effective half-life of 3.0 days. The other organs showed markedly lower uptakes (less than 0.56% ID/g). The ratio between liver and lung reached a maximum (0.01) at 3 hr and then decreased with time, precluding adequate external imaging of the liver as compared with the lung.
A case of hepatic echinococcosis mimicing a solid tumor was presented. The echinococcosis appeared as an echogenic mass in US, a low density area in CT, and an area of low (T1-weighted image) and high (T2-weighted image) intensity in MRI. Echo-guided biopsy showed PAS-positive cuticle layer of echinococcus in the necrotic tissue. Anular features around the lesion noted in MRI seemed to imply increased hepatic tissue water (congestion and/or edema). When a solid tumor is noted in the liver, proper history taking and awareness of this disease will decrease the chance of misdiagnosis.
The precision of total-body and regional bone mineral measurements from whole body scans obtained by dual-energy X-ray absorptiometry (DEXA) was determined in a phantom and two normal subjects. Whole body scans were performed once a week for three months at the speed of 80 mm/sec. Coefficients of variation for measurements of total-body bone mineral content (BMC) in the phantom and the subjects were 1.7% and 1.5% (average), respectively. Moreover, plots of total-body BMC values with time showed no significant slope, indicating the stability of the instrument. Regional BMC measurement from whole body scans, however, resulted in larger precision errors than total-body BMC measurement. This is attributed to the more rapid scan speed and coarser scan width used in whole body scanning as compared with regional scanning. Good precision of total-body BMC measurement by DEXA is of great clinical value in the assessment of metabolic bone disease.
BACKGROUND AND PURPOSE: Retrograde cortical venous drainage (RCVD) is the most major risk factor for aggressive behavior of intracranial dural arteriovenous fistulas (DAVF). The purpose of this study was to assess the efficacy of relative cerebral blood volume (rCBV) map for RCVD in patients with DAVF. METHODS: Ten patients with angiographically proven DAVF with RCVD, 2 reference patients with DAVF without RCVD, and 10 control subjects underwent examinations with dynamic susceptibility contrast (DSC)-MR imaging. Four patients with DAVF with unilateral RCVD were evaluated, before and after treatment. The calculation of mean rCBV ratio was performed on a hemispheric basis. The mean rCBV ratio was defined as the value on one side (higher value side) divided by that on the other side (lower value side). RESULTS: In all patients with DAVF with RCVD, the rCBV map showed an increase in rCBV of the angiographically proved affected hemisphere. In 2 reference patients with DAVF without RCVD and all control subjects, the rCBV map showed no increase of rCBV. The mean rCBV ratio in patients with DAVF with RCVD was significantly higher than that of control subjects (P = .0002). Treatment response for RCVD was indicated by a decrease of CBV on the rCBV map and by a decrease of 22% in the mean rCBV ratio. CONCLUSIONS: Increased rCBV by DSC-MR correlated with RCVD in patients with DVAF. The assessment with rCBV for RCVD may be more quantitative than that with angiogram.
The bone mineral density (BMD) of the lumbar spine was determined by DPA in 280 normal Japanese volunteers and 11 osteoporotic women with compression fractures. In women, bone loss started from the mid thirties and accelerated after the age of 50 years at the rate of 0.75% (0.0074 g/cm2) per year. In men, bone loss started from the mid twenties and occurred linearly at the rate of 0.30% (0.0032 g/cm2). The overall diminutions in vertebral BMD throughout life in men and women were 13.0% and 24.3%, respectively. The mean vertebral BMD of the osteoporotic women with recent compression fractures was 37.5% lower than that of age-matched controls. The 90th percentile for vertebral BMD in this group was 0.584 g/cm2. By the age of 80 years, approximately one-fifth of normal Japanese women have BMD values less than this.
A case of pancreas divisum diagnosed by CT is reported. ERCP via the major pipilla revealed a very short pancreatic duct, which appeared to be abruptly interrupted by a tumor. CT, however, demonstrated two definite pancreatic moieties separated by a fat cleft, indicating the presence of pancreas divisum.
Air CT proved useful in yielding images of acoustic tumors as an air filling defect in 11 (24%) of 46 patients. Six of the 11 tumors were small ones of less than 1 cm in diameter. Air CT was also able to exclude an intracanalicular tumor in 29 patients (63%). MRI was performed for comparison in eight patients (nine tumors) already diagnosed by air CT as having an acoustic tumor. MRI detected eight (89%) of nine tumors. A false negative result on MRI was obtained only in one intracanalicular tumor (4.3 mm in size). This was considered to be attributable to limitations of spatial resolution including the wide slice thickness. A protocol for radiological investigation and management of patients whose clinical symptoms and/or audiovestibular examination are highly indicative of acoustic tumor is proposed and discussed.
As CT findings useful for the evaluation of the degree of severity in liver cirrhosis, the following items were chosen for statistical analysis: atrophy of the right lobe, enlargement of the left lobe, irregularity of the liver surface, ascites, varices or collaterals, and dilatation of the SMV. According to the frequency with which these six items were found, the CT findings were expressed in the form of a score, and the resulting scores agreed well with ICG values, portal-venous flow (Qp) ratios obtained from radionuclide angiography, and the scores on the Child-Turcotte criteria. A score of 5 or 6 meant severe cirrhosis. A score of 4 meant liver cirrhosis, however, the degree of severity could not be determined, because there was overlap among the cirrhotic groups. A score of 3 meant liver cirrhosis with a probability of about 90%. A score of 1 or 2 was nonspecific for evaluation. When a score of 0 was noted with splenomegaly, there was a probability of more than 90% that it was chronic hepatitis. In conclusion, this approach was considered to be useful for evaluating the degree of severity in liver cirrhosis and differentiating between liver cirrhosis and chronic hepatitis to some degree in Japanese.
Radionuclide detection and quantification of right-to-left shunting in two patients with pulmonary arteriovenous malformation and Rendu-Osler-Weber disease are described. Radionuclide studies are simple, atraumatic, and clinically useful in determining the vascular nature of the lesion and in quantifying the amount of right-to-left shunting with reasonable accuracy both before and after operation.