Biomedical subjects

M C Han

Publications and source records attributed to M C Han.

At least 19 recordsLinked to original sources

PubMed1998

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↗

PubMed1998

Mediastinal tuberculous lymphadenitis: CT findings of active and inactive disease.

OBJECTIVE: The purpose of this study was to analyze CT findings of active and inactive disease in patients with mediastinal tuberculous lymphadenitis. MATERIALS AND METHODS: Using biopsy and culture results, we categorized 49 consecutive patients with mediastinal tuberculous lymphadenitis studied with CT scans as patients with active disease (n = 37) or patients with inactive disease (n = 12). Follow-up CT scans were obtained after antituberculous therapy in 25 patients with active disease and three patients with inactive disease. In 10 patients (seven with active disease and three with inactive disease), CT findings were analyzed and correlated with pathologic findings. RESULTS: In all 37 patients with active disease, the nodes (n = 151) varied in size (1.5-6.7 cm; mean, 2.8 +/- 1.0 cm) and had central low attenuation and peripheral rim enhancement. Calcifications within the nodes were seen in seven patients (19%). In the 12 patients with inactive disease, the nodes (n = 34) varied in size (1.0-4.7 cm; mean, 2.1 +/- 1.0 cm) but were usually smaller than nodes in patients with active disease. In the patients with inactive disease, the diseased nodes were homogeneous and without low-attenuation areas. Calcifications within the nodes were seen in 10 (83%) of the 12 patients with inactive disease. Low-attenuation areas within the nodes corresponded pathologically to areas of caseation necrosis in seven patients with active disease and in no patients with inactive disease. After treatment, enlarged mediastinal nodes in patients with active disease shrunk and low-attenuation areas within the nodes disappeared in all 25 patients. However, the findings of calcified nodes in the three patients with inactive disease did not change after 6 months of follow-up. CONCLUSION: In these 49 patients with mediastinal tuberculous lymphadenitis, CT findings of nodes with central low attenuation and peripheral rim enhancement suggested active disease, and findings of homogeneous and calcified nodes suggested inactive disease. Low-attenuation areas within the nodes had pathologic correspondence to areas of caseation necrosis and may be a reliable indicator for disease activity.

Adolescent↗

PubMed1998

In vivo single-voxel proton MR spectroscopy in intracranial cystic masses.

PURPOSE: Our objective was to evaluate the proton MR spectroscopic pattern of the cystic contents of various intracranial masses and to report characteristic spectral patterns that may be helpful in the differential diagnosis of these lesions. METHODS: We evaluated 40 proton MR spectra obtained from cystic contents of various intracranial cystic masses in 39 patients, including gliomas (n = 14), metastases (n = 3), abscesses (n = 8), cysticercosis (n = 4), epidermoids (n = 3), and others (n = 7). Proton MR spectroscopy was performed on a 1.5-T MR unit using a point-resolved spectroscopic sequence with a 2 x 2 x 2 cm3 volume of interest. Assignment of the resonance peaks was based on previous studies. RESULTS: Adequate proton MR spectroscopic data were obtained in 35 cases (88%). In most gliomas and metastases, only a lactate resonance was observed. There was a trend toward a higher lactate peak in high-grade gliomas. A few tumors, including malignant gliomas and metastases, showed lipid signal combined with lactate signal. In abscesses, there were various combinations of lactate, acetate, succinate, amino acids (including valine, alanine, and/or leucine), and/or unassigned resonances. In cysticercosis, resonances of lactate, succinate, alanine, acetate, and/or unassigned resonances were observed. Three epidermoid cysts showed only lactate signal. There were no identifiable resonances from the arachnoid and porencephalic cysts. CONCLUSION: Only lactate is commonly observed in a variety of intracranial cystic masses, except for abscess and cysticercosis, in which resonances of acetate, succinate, amino acids, and/or unassigned metabolites can be seen in addition to a lactate peak.

Adult↗

PubMed1997

Re-evaluation of optimal dose of contrast medium for vascular enhancement in CT of the head and neck.

Adequate contrast enhancement of major neck vessels is more important than that of a tumour itself in CT of most head and neck tumours because of differentiation from neck node metastases. Our purpose was to re-evaluate the dosage of contrast medium for adequate vascular enhancement in CT of the head and neck. In a blind prospective fashion, 60 patients with a variety of head and neck lesions were randomised into three equal groups receiving 0.75, 1.0, or 1.25 ml/kg of meglumine ioglycate, 300 mg/ml. Contrast medium was administered by injector at 2 ml/s. The scan time and interscan delay were each 1 s, and total scan time 50-180 s. The scan was started immediately after administration of two-thirds of the contrast medium. The degree of vascular enhancement was assessed visually and quantitatively. We visually scored the degree of vascular enhancement as excellent (4 points), good (3), fair (2) or poor (1). For quantitative study, after measuring the CT numbers of the common or internal carotid artery (CA), internal jugular vein (IJV) and adjacent muscle at three levels, were calculated mean vessel/muscle contrast ratios. The degree of enhancement of the CA and IJV tended to increase with dose of the contrast media, but no examination was rated as showing poor enhancement in any group. The mean visual assessment scores for 0.75, 1.0, and 1.25 ml/kg were 2.7, 2.9 and 3.1, respectively; the mean ICA/muscle contrast ratios were 1.58, 1.55 and 1.63, and those of IJV/ muscle 1.65, 1.59 and 1.59. There was no significant difference between visual and quantitative assessment in any group. The results suggest that 0.75 ml/kg of contrast medium appears sufficient for vascular opacification for head and neck lesions when the CT scan can be completed in about 120 s.

Adolescent↗

PubMed1997

MR imaging of segmental renal infarction: an experimental study.

An experimental study was performed in 12 rabbits to evaluate the magnetic resonance (MR) imaging findings of segmental renal infarction. Three or four MR examinations were performed at 6 h, 1 day, 3 days, 1 week, 2 weeks, and 4 weeks following the ligation of segmental artery of the left kidney. The signal intensities of the infarcted area on both T1- and T2-weighted (T1W and T2W, respectively) images were lower than those of the non-affected area in the 6 h group, and pathological examination showed mild interstitial oedema and haemorrhage. The signal intensities of the lesion became higher on T1W images and higher or mixed on T2W scans in the 1 day group, in which the pathological findings were intense interstitial haemorrhage, interstitial oedema, and early coagulative necrosis. The signal intensities of the lesion on both pulse sequences were also higher in the 3 day and 1 week groups in which pathological examination showed progressive coagulative necrosis. The signal intensities of the lesions in the 2 and 4 week groups were lower on both pulse sequences, and the pathological finding was organizing fibrosis. Post-contrast T1W images demonstrated well the extent of the infarction in all but two cases, in which the signal intensities of the lesions were higher on pre-contrast T1W scans.

Animals↗

PubMed1997

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↗

PubMed1997

Radiological findings in serous surface papillary carcinoma of the ovary. Case reports.

Serous surface papillary carcinoma (SSPC) is a malignant tumor originating from the surface epithelium of the ovary, and is characterized by macroscopic normal ovaries accompanied by diffuse peritoneal dissemination. Therefore diagnosis of SSPC cannot usually be made preoperatively. We report on two cases of SSPC in which US, CT, and MR demonstrated nodularities along the surface of the normal-sized ovaries, adjacent organs and pelvic peritoneum in addition to findings of peritoneal seeding. These imaging findings may suggest the correct preoperative diagnosis of SSPC.

Cystadenocarcinoma, Papillary↗

PubMed1997

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↗

PubMed1997

An experimental study of embolic effect according to infusion rate and concentration of suspension in transarterial particulate embolization.

RATIONALE AND OBJECTIVES: The authors evaluate the embolic effect according to infusion rate and concentration of particulate suspension, focusing on arterial occlusion level. METHODS: The renal arteries of 14 rabbits were embolized with 150 to 250 microns polyvinyl alcohol (PVA) particles, divided into four groups according to two different infusion rates (1 mg/second and 0.1 mg/second) and two different concentrations of suspension (10 mg/mL and 2.5 mg/mL). Arteriograms obtained immediately and a week after embolization were assessed for occlusion level. For the nephrograms obtained a week after embolization, the opacifying areas were graded from 0 to 4. Median coronal sections of each kidney specimen were investigated for the presence of peripheral infarct grossly and for the presence of PVA particles in the small artery microscopically. RESULTS: Arteriograms showed various occlusion levels. Using a 0 to 4 grading system, the opacifying area of the nephrogram obtained 1 week after embolization was noted to be smaller in the low infusion rate group (P < 0.05). In gross and microscopic pathologic examination, the number of cases with peripheral infarct or PVA particles in the small artery (< 300 microns) was greater in the group with the low infusion rate and low concentration (P < 0.05). CONCLUSIONS: In transarterial particulate embolization, slower infusion of more diluted suspension provides for a more distal arterial occlusion.

Animals↗

PubMed1997

Brain abscess and brain tumor: discrimination with in vivo H-1 MR spectroscopy.

PURPOSE: To determine the ability to differentiate brain abscess from cystic or necrotic brain tumor with hydrogen-1 magnetic resonance (MR) spectroscopy. MATERIALS AND METHODS: H-1 MR spectroscopy was prospectively performed in seven consecutive patients with pyogenic brain abscess and in seven consecutive patients with necrotic or cystic brain tumor (five patients with glioblastoma and one each with pilocytic astrocytoma and metastasis from lung cancer) in whom radiologic images depicted ring-shaped areas of contrast material enhancement (indicative of a cystic or necrotic mass). Assignment of resonance peaks to metabolites was based on reports in the literature. RESULTS: In six of seven patients with abscess, there were various resonances attributed to lactate, valine, alanine, leucine, acetate, succinate, and unidentified metabolites (2.2, 2.9, 3.2, 3.4, and 3.8 ppm). In six of seven patients with tumor, there was only a resonance attributed to lactate. One patient with a tumor had an unidentified peak at 0.9 ppm (presumably attributed to lipid) in addition to the peak attributed to lactate. CONCLUSION: Spectral patterns from in vivo H-1 MR spectroscopy may permit differentiation of brain abscess from necrotic or cystic tumor.

Adult↗

PubMed1997

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↗

PubMed1997

Congenital cystic adenomatoid malformation of the lung: CT-pathologic correlation.

OBJECTIVE: The purpose of this study was to correlate CT findings of congenital cystic adenomatoid malformation (CCAM) of the lung with pathologic findings. MATERIALS AND METHODS: CT scans of CCAM from 21 consecutive patients were analyzed retrospectively by two chest radiologists who achieved consensus. Pathologic findings were assessed by an experienced pulmonary pathologist. Preoperative CT findings were correlated with pathologic findings. RESULTS: Areas with small cysts (< 2 cm in diameter) were seen on CT scans in 19 (90%) of 21 patients, whereas areas with a large cyst (> 2 cm in diameter) were observed in 18 patients (86%). Areas of consolidation (n = 9; 43%) with heterogeneous attenuation on enhanced scans and areas of low attenuation (lower than normal lung) around cystic lesions (n = 6; 29%) were also seen on CT scans. The diameter of the largest cyst seen on CT scans in each patient ranged from 1.0 to 8.0 cm (median, 4.5 cm). Cysts that CT showed to be filled with air, fluid, or both correlated completely with the pathologic findings. Areas of consolidation corresponded histologically to areas of glandular or bronchiolar structures with or without areas of endogenous lipoid or organizing pneumonia or mucus plugs. Areas of low attenuation corresponded to areas of microcysts blended with normal lung parenchyma. CONCLUSION: CT scans show the variable internal characteristics of CCAM and can suggest the underlying pathology of such lesions.

Adolescent↗

PubMed1997

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↗

PubMed1997

Invasion of the urinary bladder by uterine cervical carcinoma: evaluation with MR imaging.

OBJECTIVE: This study was performed to assess the accuracy of MR imaging in revealing invasion of the urinary bladder by uterine cervical carcinoma. SUBJECTS AND METHODS: Vesical invasion was evaluated in 300 consecutive patients who underwent MR imaging for preoperative staging of uterine cervical carcinoma. MR imaging was obtained with a 0.5-T unit using spin-echo T1- and T2-weighted images. Contrast-enhanced T1-weighted images were also obtained in 199 patients. MR imaging findings were compared with surgical or cystoscopic findings. MR images were then reevaluated in all cases to detect any additional MR imaging findings suggestive of vesical invasion. RESULTS: Among the 300 patients, vesical invasion was present in 12 patients. For detecting vesical invasion, MR imaging had a sensitivity of 83%, a specificity of 100%, and an accuracy of 99% (10 true-positives, 288-negatives, no false-positives, and two false-negatives). MR imaging findings that suggested vesical invasion were nodularity and irregularity of the bladder wall (n = 5), masses protruding into the bladder lumen (n = 2), and high signal intensity of the anterior aspect of the posterior wall of the bladder (n = 7). In addition, we saw abnormal soft-tissue strands in the uterovesical space in the two false-negative cases. On reevaluation of the MR images in the true-negative cases, we did not see nodularity or irregularity of the bladder wall, masses protruding into the bladder lumen, high signal intensity of the anterior aspect of the posterior wall of the bladder, or soft-tissue strands in the uterovesical space. CONCLUSION: Familiarity with the MR imaging findings that we have described may prove helpful before surgery in detecting vesical invasion by cervical carcinoma.

Adult↗

PubMed1997

Pulmonary tuberculosis in children: evaluation with CT.

OBJECTIVE: The purpose of our study was to describe the CT findings of pulmonary tuberculosis in children and to define indications for the use of CT. MATERIALS AND METHODS: CT findings in 41 consecutive children with confirmed tuberculosis were retrospectively analyzed by two radiologists. Chest radiographs and medical records were also reviewed to determine whether additional information provided by CT scans had altered clinical management of the disease. RESULTS: Mediastinal and hilar lymphadenopathy was seen in 34 patients (83%). In 29 of these patients, enlarged nodes had low-attenuation centers and enhancing rims. In the five other patients, enlarged nodes had calcification. Segmental (n = 12) or lobar (n = 8) air space consolidation was seen in 20 patients (49%), nodules of bronchogenic spread were seen in 12 patients (29%), and miliary nodules were seen in seven patients (17%). Bronchial (n = 15), pleural (n = 7), pericardiac (n = 1), or chest wall (n = 1) complications of tuberculosis were seen in 22 patients (54%). In eight (20%) of 41 patients, a diagnosis of tuberculosis was suggested only on CT scans, which revealed low-attenuation nodes with rim enhancement, calcifications, and nodules of bronchogenic spread or miliary nodules. These findings were not seen on chest radiographs. In 15 patients (37%), CT scans provided information that altered clinical management. Also two of these patients underwent surgery because of pleural and chest wall complications that were seen only on CT scans. CONCLUSION: Mediastinal or hilar lymphadenopathy revealed as low-attenuation nodes with rim enhancement or calcification was the most characteristic CT finding of pulmonary tuberculosis in children. CT can be useful when tuberculosis or its complications are suspected in children and the radiographic findings are normal or inconclusive.

Adolescent↗

PubMed1997

Tuberculosis of the central airways: CT findings of active and fibrotic disease.

OBJECTIVE: Management of patients with central airways tuberculosis differs according to the activity of the disease. The purpose of this study was to analyze CT findings of active and fibrotic disease in patients with central airways tuberculosis. MATERIALS AND METHODS: According to bronchoscopic findings and biopsy results, 41 patients with tuberculosis of the trachea and main bronchi were categorized as having active disease (n = 30) or fibrotic disease (n = 11). Follow-up CT scans were obtained after antituberculous therapy in 11 patients with active disease and two patients with fibrotic disease. All CT scans were retrospectively analyzed with particular attention to the locations of airway lesions, patterns of luminal narrowing, wall thickening of diseased airways, and presence of abnormal adjacent lymph nodes. RESULTS: Active disease in 30 patients involved the trachea (n = 20), the right main bronchus (n = 14), or the left main bronchus (n = 13). Seventeen patients had multiple lesions. On CT scans, these airways showed irregular (n = 24) or smooth (n = 4) narrowing in 28 patients: minimal (n = 5) or marked (n = 18) wall thickening with contrast enhancement in 23 patients: and obstruction with peribronchial cuffing in nine patients. Enlarged mediastinal lymph nodes were seen in 26 patients. Fibrotic disease in 11 patients involved the trachea (n = 6), the right main bronchus (n = 2), or the left main bronchus (n = 9). Six patients had multiple lesions. On CT scans, the airways showed smooth (n = 7) or irregular (n = 2) narrowing without (n = 5) or with minimal (n = 4) wall thickening in nine patients and obstruction without peribronchial cuffing in four patients. On follow-up CT scans, the findings for the airway lesions were almost normal in nine patients who had had initial active disease. However, the findings for airway narrowing did not change in two patients with fibrotic disease after 6 months of follow-up. CONCLUSION: Principal CT findings in our patients depended on disease stage. Central airways narrowing was seen in both active and fibrotic stages. However, in patients with active disease, CT scans showed irregular and thick-walled airways, a pattern that was reversible, whereas patients with fibrotic disease generally had smooth narrowing of airways and minimal wall thickening, a pattern that was not reversible during the follow-up period.

Adolescent↗

PubMed1997

Idiopathic pulmonary fibrosis vs. pulmonary involvement of collagen vascular disease: HRCT findings.

The purpose of this study is to assess the differences of high-resolution CT (HRCT) findings in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease (CVD). We analyzed the HRCT findings of 33 patients with IPF and 23 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change, and pulmonary volume loss. The predominant HRCT pattern was honeycombing for IPF (58%), and ground-glass opacity for CVD (57%). Predominantly subpleural involvement was seen in 90% of IPF and 83% of CVD patients. Mediastinal lymph node enlargement was seen in 61% of the patients with IPF and 13% with CVD (p = 0.0004). Pleural thickening was seen in 97% of the patients with IPF and 35% with CVD and the severity of pleural thickening is statistically significant (p = 0.00001). Pleural effusion was seen in 6% of the patients with IPF and 26% with CVD (p = 0.0351). The hilar height ratio was more than 1.5 in 52% of the patients with IPF and 30% with CVD (p = 0.2620). Although HRCT findings of IPF and pulmonary involvement of CVD are similar and overlap considerably, but patients with IPF showed a tendency to more progressed fibrosis than patients with CVD.

Adult↗

PubMed1996

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↗