Bilateral renal aneurysms in a chronic hepatitis B patient.
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Adult↗
Biomedical subjects
Li-Jen Wang
Publications and source records attributed to Li-Jen Wang.
Bladder leiomyoma with right hydronephrosis.
The authors describe one female patient with leiomyoma of the bladder who presented with female pseudoprostate and right hydronephrosis. A computed tomography (CT) of the pelvis revealed a soft tissue mass, circumferential and heterogenous in appearance with some calcification inside the mass. Bladder leiomyoma might be one of the differential diagnoses with CT imaging findings of female pseudoprostate.
Diagnosis, Differential↗
Diagnostic value of the helical CT scan for traumatic aortic injury: correlation with mortality and early rupture.
To evaluate the value of helical computed tomography of the thorax (HCTT) as a definitive tool for diagnosing traumatic aortic injury, this study retrospectively examined 53 patients with blunt thoracic injuries and HCTT during a 5-year period. All CT scans were reviewed for direct signs of aortic injury and correlated with aortography or surgery. Correlations between clinical parameters, as well as combinations of direct signs and individual signs, and mortality were analyzed in all traumatic aortic injury (TAI) cases. Direct signs were seen on the HCTT in 25 cases and 22 had TAI. All false positive results came from the group with only a single direct sign depicted on HCTT. Among individual direct signs examined, intimal flap and luminal thrombus were the most specific (100%), whereas irregular aortic contour was the most sensitive (100%). A combination of > or = 3 direct signs (p = 0.006) and periaortic contrast material extravasation significantly correlated with early rupture and mortality (p = 0.002). In conclusion, intimal flap on HCTT is both the most specific and sensitive sign for TAI. TAI patients with > or = 3 direct signs, including periaortic contrast material extravasation, may not require aortography before immediate surgery.
Adolescent↗
Arterial bleeding in patients with intractable hematospermia and concomitant hematuria: a preliminary report.
OBJECTIVES: To assess the presence of arterial bleeding and its outcome after transcatheter arterial embolization (TAE) in patients with intractable hematospermia and concomitant hematuria. METHODS: In a 32-month period, 5 patients with hematospermia and concomitant hematuria who were unresponsive to medical treatment were enrolled in this study to undergo pelvic angiography. When angiography revealed arterial bleeding, TAE was done whenever possible to stop the bleeding. All patients were then followed up at the outpatient clinics by the referring urologists for the result of TAE on hematospermia and the presence of impotence. RESULTS: Arterial bleeding mainly from the internal pudendal artery was revealed by angiography in all 5 patients. The cessation of bleeding by TAE was successfully achieved in all patients. Hematospermia was improved in 3 patients. In the other 2 patients, hematospermia subsided after TAE but recurred at 12 and 23 months. Subsequent angiography of the 2 patients showed recurrent arterial bleeding, fed by blood flow from the opposite side. One of the 2 patients agreed to undergo a second TAE, after which the hematospermia disappeared. None of the 5 patients had impotence at follow-up. CONCLUSIONS: Patients with intractable hematospermia and concomitant hematuria may have arterial bleeding that can be detected by angiography. The cessation of the bleeding could be achieved by TAE without complication of impotence. However, long-term follow-up is necessary for possible reconstitution of blood flow from the opposite side.
Angiography↗
Removal of nanoparticles from CMP wastewater by magnetic seeding aggregation.
CMP wastewaters have high solids content resulted from abrasive nanoparticles. Tremendous amount of ultrapure water consumption also makes the removal of nanoparticles from CMP wastewaters an important issue. Magnetic seeding aggregation of silica nanoparticles from the oxide CMP wastewater is studied in this work. Magnetite nanoparticles were synthesized and used as seeding particles. The turbidity of the CMP wastewater was reduced from 110 NTU to 7 NTU when solution pH was 6 and no addition of salt. This is because silica and magnetite nanoparticles were highly oppositely charged and the aggregation between silica and magnetite nanoparticles was achieved by electrostatic attractions. When the seeded wastewater was placed in a magnetic field strength higher than 800 G, the turbidity of the CMP wastewater was reduced to 1 NTU, which was clearer than the CMP wastewater treated by many other technologies.
Electronics↗
Renal capsular leiomyoma--imaging features on computed tomography and angiography.
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Angiography↗
Transarterial embolization of ruptured angiomyolipoma associated with tuberous sclerosis.
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Adult↗
Predictions of outcomes of renal stones after extracorporeal shock wave lithotripsy from stone characteristics determined by unenhanced helical computed tomography: a multivariate analysis.
The aim of our study is to analyze the relationships between the characteristics of renal stones determined by unenhanced helical computed tomography (UHCT) and their outcomes after extracorporeal shock wave lithotripsy (ESWL) as well as to predict ESWL outcomes of renal stones by their UHCT characteristics with the use of multivariate analysis. During a 7-month period, 80 adult patients with renal stones underwent ESWL as well as UHCT both before and 3 months after ESWL. Of the 80 patients, 42 patients were classified as ESWL successes and 38 as ESWL failures based on their post-ESWL UHCT findings. For pre-ESWL UHCT, a stone number of more than 2 (P=0.0236), a maximal stone size of greater than 12 mm (P<0.0001), a stone burden of more than 700 mm3 (P<0.0001), a maximal stone density of more than 900 HU (P=0.0008) and nonround/oval stones (P=0.0007) were associated with ESWL failure outcomes. Multivariate analysis demonstrated that a stone burden of more than 700 mm3 (P=0.0003), the presence of nonround/oval stones (P=0.0072) and a maximal stone density of more than 900 HU (P=0.0430) were statistically significant predictors of a failure outcome for ESWL. Thus, the analysis of stone characteristics of renal stones by UHCT is helpful in selecting appropriate patients undergoing ESWL for favorable outcomes and reduces the overall costs of the treatment of renal stones.
Adult↗
Diagnosis of acute flank pain caused by ureteral stones: value of combined direct and indirect signs on IVU and unenhanced helical CT.
The aim of this study was to assess the usefulness of combined direct and indirect signs on intravenous urography (IVU) and unenhanced helical computed tomography (UHCT) for the diagnosis of ureteral stones in emergency patients with acute flank pain. During an 8-month period, 82 emergency patients with acute flank pain undergoing IVU and UHCT with sufficient clinical follow-up formed the study group. The presence or absence of direct sign (visualization of ureteral stones) and indirect signs on IVU and UHCT was recorded. The diagnostic accuracy of each direct/indirect sign and their combination for the diagnosis of ureteral stones on IVU and UHCT were analyzed and compared. Of the 82 patients, 66 had ureteral stones, four had passed urinary stones prior to imaging and 12 had other diseases. The diagnostic accuracies of direct signs on IVU and UHCT for the diagnosis of ureteral stones were 79.3 and 98.8%, respectively, which was more accurate than that of any single indirect sign on IVU and UHCT. However, the diagnostic accuracy of ureteral stones by IVU increased to 90.2% when using diagnostic criteria requiring the presence of a direct sign or at least three indirect signs, and by UHCT, it increased to 100% when using diagnostic criteria requiring the presence of a direct sign with at least one indirect sign. Therefore, for emergency patients with acute flank pain, the use of the above combinations of direct/indirect signs is useful as the diagnostic criterion for ureteral stones.
Acute Disease↗
Left mediastinal width and mediastinal width ratio are better radiographic criteria than general mediastinal width for predicting blunt aortic injury.
BACKGROUND: General mediastinal width, left mediastinal width, and mediastinal width ratio were compared as radiographic predictors of aortic injury. METHODS: A retrospective study investigated the chest radiographs of 51 patients admitted to a level 1 trauma center during a 6-year period for a thorough survey of aortic injury. Mediastinal width (MW >/= 8 cm), left mediastinal width (LMW >/= 6 cm), mediastinal width ratio (MWR >/= 0.60), and a combination of LMW and MWR were compared as predictors of aortic injury. The cutoff points were predetermined by receiver-operator-curve to accommodate 100% sensitivity for each criterion. RESULTS: Of the 51 patients, 21 had aortic injuries and 30 had normal imaging studies. All criteria had 100% negative predictive value. The specificities and positive predictive values, respectively, were 13.3% and 44.7% (MW), 40.0% and 53.8% (LMW), 43.3% and 55.3% (MWR), and 66.7% and 67.7% (combined LMW and MWR). The positive likelihood ratio of aortic injury was 3.00 when LMW was 6 cm or more and MWR was 0.60 or more. CONCLUSIONS: Both an LMW of 6 cm or more and an MWR of 0.60 or more are better radiographic criteria than an MW of 8 cm or more for predicting blunt aortic injury. Trauma patients with positive test results based on the combined LMW and MWR criteria should proceed immediately to aortography or helical computed tomography.
Adolescent↗
Hirayama flexion myelopathy: neutral-position MR imaging findings--importance of loss of attachment.
PURPOSE: To investigate the sensitivity and specificity of various neutral-position magnetic resonance (MR) imaging findings in the diagnosis of Hirayama flexion myelopathy. MATERIALS AND METHODS: The neutral-position cervical MR images of 46 patients and 51 control subjects were evaluated for the following findings: localized lower cervical cord atrophy, asymmetric cord flattening, abnormal cervical curvature, loss of attachment (LOA) between the posterior dural sac and subjacent lamina, and noncompressed intramedullary high signal intensity on T2-weighted MR images. The difference in frequency of these findings between the control and patient groups was examined by means of the chi(2) test. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of these MR imaging findings in the diagnosis Hirayama disease were calculated. Multivariate analysis of these findings was also performed. RESULTS: There was a significant difference in the frequency of these MR imaging findings between the control and patient groups (all comparisons, P </=.002). Among the MR imaging findings, localized lower cervical cord atrophy, asymmetric cord flattening, and LOA had accuracy of more than 80% in identification of the disease. After multivariate analysis, LOA was the only significantly important predictor of the disease, with odds ratio of 716.7 (95% CI: 71.9, 7,145.2). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of LOA were 93.5%, 98.0%, 97.7%, 94.3%, and 95.9%, respectively. CONCLUSION: LOA from posterior dural sac and subjacent lamina is the most valuable finding in the diagnosis of Hirayama disease at neutral-position MR imaging.
Adolescent↗
Multi-Slice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography.
BACKGROUND AND PURPOSE: To determine the accuracy of multislice computed tomographic (CT) angiography in diagnosing total versus near occlusions of the internal carotid artery (ICA). METHODS: Fifty-seven ICA total or near occlusions identified by catheter angiography were studied with multislice CT angiography 1 to 3 days after catheter angiography. CT angiography in diagnosing total versus near occlusions was analyzed by 2 radiologists independently. The results were compared with those of catheter angiography. RESULTS: Catheter angiography depicted 31 total occlusions, including 10 without a stump, 19 with a stump <2 cm, and 2 with a stump >2 cm. Among them, 22 had a downward extent of the retrograde ICA flow at or above the carotid siphon, 8 at the carotid canal, and 1 at the distal cervical ICA. Catheter angiography depicted 26 near occlusions, including 21 with a tight stenosis at the proximal third cervical ICA, 1 at the middle third, and 4 at the carotid canal or siphon. CT angiography correctly depicted all total and near occlusions. In total occlusions, the length of the stump and the retrograde flow were all accurately described by CT angiography. In near occlusions, the sites of tight stenoses were also correctly identified by CT angiography. CONCLUSIONS: Multislice CT angiography had an excellent correlation with catheter angiography in diagnosing total versus near occlusion of the ICA. It may be considered as a substitute of catheter angiography in confirming the ultrasonographic results in diagnosing total versus near occlusions of the ICA.
Adult↗
Cervical degenerative disease at flexion-extension MR imaging: prediction criteria.
PURPOSE: To determine if there are any neutral-position imaging criteria that can help predict functional cord impingement at flexion-extension cervical magnetic resonance (MR) imaging. MATERIALS AND METHODS: Sixty-two patients with cervical degenerative disease were evaluated with regard to the dynamic changes of canal stenosis at flexion-extension MR imaging. Functional cord impingement was considered if the cord was impinged or more impinged after neck flexion or extension. Selection criteria for neutral-position MR imaging, such as cervical curvature, canal space, degenerative stage, intramedullary high signal intensity on T2-weighted images, and resting instability, were evaluated for their ability to predict functional cord impingement at flexion-extension MR imaging (Fisher exact test, logistic regression analysis). RESULTS: MR images in 19 (31%) of 62 patients showed functional cord impingement at extension MR imaging compared with images in two (3%) patients at flexion MR imaging. Statistically significant differences were found for the criteria cervical degeneration stage (P <.001) and spinal canal space (P =.037) for predicting functional cord impingement at extension MR imaging. In contrast, no significant differences were found among selection criteria for flexion MR imaging. Probabilities of functional cord impingement at extension MR imaging were calculated with different combinations of degenerative stages and canal spaces. Probability could increase to 79% if the patient had both stabilization degeneration (disk protrusion or osteophytic formation with hypertrophy of the ligamentum flavum) and C7 canal space of 10 mm or less. CONCLUSION: None of the selection criteria evaluated in this study has the ability to predict functional cord impingement at flexion MR imaging; however, prediction of impingement at extension MR imaging can increase from 31% to 79% if proper criteria are selected.
Adolescent↗
Contrast material extravasation on contrast-enhanced helical computed tomographic scan of blunt abdominal trauma: its significance on the choice, time, and outcome of treatment.
BACKGROUND: Contrast-enhanced helical computed tomographic (CT) scan of blunt abdominal trauma is valuable for detecting contrast material extravasation (CME). The aims of this study were to determine its significance and investigate factors associated with the choice, time, and outcome of management. METHODS: CT scans of 32 consecutive trauma patients who had CME were reviewed for the sources of CME, types of CME, flat inferior vena cava, and multiple abdominal injuries. The medical records were reviewed for demographics, systolic blood pressure, Injury Severity Score (ISS), choice of management, time interval between CT scan and intervention, and outcome of intervention. RESULTS: Systolic blood pressure < 100 mm Hg was the most important factor (p = 0.0064) that failed observational therapy. When proceeding to intervention treatment, patients with a flat inferior vena cava (1.6 +/- 1.1 hours) had a significantly shorter time interval between CT scan examination and intervention when compared with those with a normal cava (10.9 +/- 16.0 hours) ( p= 0.0124). The mortality rate after intervention treatment was 18.8%. High ISS, uncontained CME in the extraperitoneum, and multiple abdominal injuries were important risk factors. After adjusted for ISS and multiple abdominal injuries, the risk of dying from extraperitoneal CME remained significant when compared with intraperitoneal CME (adjusted odds ratio, 82.26; 95% confidence interval, 1.06-6,363.17). CONCLUSION: Termination of observational therapy was appropriate for trauma patients who had CME and systolic blood pressure < 100 mm Hg. The coexistence of a flat inferior vena cava and CME was associated with early intervention treatment. Despite early intervention, the mortality rate was 18.8%. High ISS and multiple abdominal injuries were important factors, but the risk of dying from uncontained extraperitoneal CME was 82 times the risk of dying from intraperitoneal CME.
Abdominal Injuries↗
Imaging findings of urinary tuberculosis on excretory urography and computerized tomography.
PURPOSE: We performed a retrospective study to analyze findings on excretory urography (IVP) and computerized tomography (CT) in patients with urinary tuberculosis. MATERIALS AND METHODS: In a 16-year period 53 patients with a total of 47 IVP and 33 CT examinations were diagnosed with urinary tuberculosis at our hospital. IVP and CT were reviewed and compared for certain imaging findings, including moth-eaten calices, renal parenchymal masses, an amputated infundibulum, autonephrectomy, thick urinary tract walls, urinary tract calcifications, renal parenchymal cavities, hydrocalycosis, hydronephrosis or hydroureter due to stricture, extra-urinary tubercular manifestations and renal parenchymal scarring. RESULTS: The most common finding on IVP was hydrocalycosis, hydronephrosis or hydroureter due to stricture, whereas renal parenchymal scarring was the most common finding on CT. Imaging findings of renal parenchymal masses and scarring, thick urinary tract walls and extra-urinary tubercular manifestations were significantly more common on CT than on IVP. Three imaging patterns were noted on all 44 IVPs (100%) and 31 of 33 CTs (94%) with multiple imaging findings, including multiple stricture sites, a single stricture with 1 other imaging finding and autonephrectomy with another imaging finding other than stricture. CONCLUSIONS: When the 3 imaging patterns are shown on IVP and CT, tubercular cultures or biopsies are suggested to make the definite diagnosis of urinary tuberculosis. Thus, treatment can be initiated as early as possible.
Adult↗
Imaging spectrum of adrenal pseudocysts on CT.
The aim of this study was to analyze the imaging spectrum of adrenal pseudocysts on CT. The CT images of seven patients with pathologic diagnosis of adrenal pseudocysts in our hospital were reviewed for the size, cystic part, solid part, septum, calcification, acute hematoma, and layering appearance. The presence or absence of contrast enhancement of solid parts in each lesion was also assessed if possible. Of the seven adrenal pseudocysts, there were three pure cystic, three mixed cystic and solid, and one solid lesions on CT. Two of the three cystic pseudocysts were septated with calcifications. Layering appearance was present in two mixed lesions. There were central calcifications and acute hematomas in one solid mass. In our study, there was no contrast enhancement of the solid parts of adrenal pseudocysts. The CT appearances of adrenal pseudocysts may range from cystic, mixed, to solid masses. The presence of solid parts of adrenal pseudocysts on CT mimics those of adrenal neoplasms; however, no contrast enhancement of the solid part in the lesion may help in the diagnosis of adrenal pseudocysts and their differentiation from adrenal neoplasms.
Adrenal Gland Diseases↗
Magnetic resonance imaging of extrahepatic bile duct disruption.
Blunt injury of the extrahepatic bile duct is rare and hence a large series of scientific study of its MRI is difficult to perform. We present the MRI and MR cholangiography of a case of blunt extrahepatic bile duct injury proven at surgery. The diagnosis could be established based on MRI findings of an abrupt tapering of the extrahepatic bile duct with a retracted end, a discordant small-caliber proximal duct, massive ascites, and a hematoma in proximity to the bile duct injury. This non-invasive MRI study is a promising imaging modality to evaluate biliary tract injury.
Accidents, Traffic↗
Computerized tomography characteristics that differentiate angiomyolipomas from liposarcomas in the perinephric space.
PURPOSE: We performed a retrospective study to determine computerized tomography (CT) findings associated with perinephric angiomyolipomas or perinephric liposarcomas. MATERIALS AND METHODS: During the last 7 years 6 patients with perinephric angiomyolipoma and 12 with perinephric liposarcoma were seen at our hospital. Two radiologists who were blinded to the pathological diagnosis retrospectively evaluated the CT characteristics of perinephric angiomyolipoma and perinephric liposarcoma. The relationship of each CT characteristic with tumor type was compared using Fisher's exact test. RESULTS: The CT characteristics of perinephric angiomyolipoma were intratumoral linear vascularity (p = 0.001), aneurysmal dilatation (p = 0.025), bridging vessel sign (p = 0.005), hematoma (p = 0.025), beak sign (p = 0.001) and discrete intrarenal fatty tumors (p = 0.025). The CT characteristic of perinephric liposarcoma was a nonfatty soft tissue mass (p = 0.005). There was no significant difference in the presence of calcifications in both groups. CONCLUSIONS: This retrospective study suggests that analysis of CT characteristics (linear vascularity, aneurysmal dilatation, bridging vessel sign, hematoma, beak sign and discrete intrarenal fatty tumors) may help to differentiate perinephric angiomyolipoma from perinephric liposarcoma.
Adult↗