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T Moteki

Publications and source records attributed to T Moteki.

10 recordsLinked to original sources

CT is useful for identifying patients with complicated appendicitis.

BACKGROUND AND AIMS: We often come across patients with complicated appendicitis (perforation, abscess formation, or peritonitis) and it is essential to get accurate and detailed information on these patients preoperatively. In this study, we investigated whether or not preoperative computed tomography is useful for identifying these patients. PATIENTS AND METHODS: Plain and intravenously-contrasted helical computed tomography was obtained preoperatively in 94 (75%) of 125 patients who underwent appendectomy. Twenty-eight (30%) of the 94 patients had complicated appendicitis (Compli(+) group). We compared clinical factors and computed tomography findings of the Compli(+) group with those of 66 other patients (Compli(-) group). RESULTS: There was no significant difference between the Compli(+) and Compli(-) groups in gender, white blood cell count, the present rate of an enlarged appendix, or appendicolith. Fat stranding and free fluid on computed tomography were significantly associated with complicated appendicitis by both univariate and multilogistic regression analysis. Fourteen (70%) of the 20 patients with fat stranding and free fluid on computed tomography had complicated appendicitis and only 1 (4%) of the 28 Compli(+) patients had neither fat stranding nor free fluid on computed tomography. CONCLUSION: Our study has indicated that fat stranding and free fluid on computed tomography are significant for complicated appendicitis and helical computed tomography is a powerful tool for identifying patients with complicated appendicitis preoperatively.

Adult↗

Diffusion-weighted EPI of cystic ovarian lesions: evaluation of cystic contents using apparent diffusion coefficients.

Diffusion-weighted echoplanar imaging (EPI) was performed to evaluate the contents of cystic ovarian lesions [33 endometrial cysts, 16 ovarian cysts, 5 serous cystadenomas, 6 mucinous cystadenomas, 13 malignant cystic ovarian tumors, and 3 benign cystic lesions mimicking malignant cystic ovarian tumor (BMMs)]. Apparent diffusion coefficient (ADC) values were calculated for the cystic contents. Many lesions showed unrealistically high ADC greater than water at body temperature (0.00324 mm(2)/sec), especially in lesions more than 12 cm in diameter. The higher ADC values were attributed to the sloshing effect: intermittent compression of large ovarian lesions by abdominal breathing before the breath-hold scan. When limited to lesions with ADC less than 0. 00324 mm(2)/sec, endometrial cysts and malignant cystic ovarian tumors showed lower ADC values than ovarian cysts and serous cystadenomas (P < 0.03). When further limited to lesions less than 12 cm in axial diameter, an additional ADC difference between malignant cystic ovarian BMMs was demonstrated (P < 0.03). Diffusion-weighted EPI showed the possibility that calculated ADC values might be useful in evaluating small to medium cystic ovarian lesions. J. Magn. Reson. Imaging 2000;12:1014-1019.

Adult↗

Evaluation of cystic ovarian lesions using apparent diffusion coefficient calculated from reordered turboflash MR images.

Reordered snapshot fast low-angle shot images with, and without, diffusion-perfusion gradients were used for the evaluation of contents of cystic ovarian lesions. Sonographically detected 51 cystic ovarian lesions (13 endometrial cysts, 17 ovarian cysts, 7 serous cystadenomas, 6 mucinous cystadenomas, 8 malignant cystic ovarian tumors) were studied. T1- and T2-weighted images, reordered snapshot fast low-angle shot images with and without diffusion-perfusion gradients (b = 106 and 0 s/mm2, respectively) were obtained. Using these images, apparent diffusion coefficients (ADCs) were calculated in the cystic contents of these lesions. Endometrial cysts and malignant cystic ovarian tumors showed lower ADC values than ovarian cysts, serous cystadenomas and mucinous cystadenomas (p < 0.02). There was no distinct ADC difference among ovarian cysts, serous cystadenomas, mucinous cystadenomas (p > 0.2). In conclusion, diffusion-weighted magnetic resonance imaging is possible to be useful to evaluate cystic contents of ovarian lesions.

Adult↗

Evaluation of cystic ovarian lesions using apparent diffusion coefficient calculated from turboFLASH MR images.

Serial turboFLASH (fast low-angle shot) images with and without diffusion-perfusion (DP) gradients were used to evaluate the contents of cystic ovarian lesions. 19 ovarian cysts seven serous cystadenomas, six mucinous cystadenomas and 13 malignant cystic ovarian tumours were studied. T1 and T2 weighted spin echo images, serial turboFLASH images with and without DP gradients (b = 295.1 and 0 s mm-2, respectively) were obtained. Using these images, the apparent diffusion coefficients (ADCs) were calculated within the cystic contents of these lesions. Approximately corrected ADC (ADC') values were also calculated in order to reduce T1 contamination from ADCs, using results of a phantom study. Ovarian cysts and serous cystadenomas showed larger ADC and ADC' values than the cystic contents of malignant ovarian lesions (p < 0.01). Mucinous cystadenomas show no distinct ADC difference to any other group of cases. However, if the highest ADC' loculus was selected as being representative, mucinous cystadenomas showed a larger ADC' value than malignant cystic neoplasms (p < 0.03). In conclusion, diffusion-weighted MRI is possibly of use in evaluating cystic contents of ovarian lesions.

Adult↗

Bronchial arterial angio-CT: evaluation of intradural and oesophageal enhancement before bronchial arterial infusion.

Ultrafast CT combined with bronchial angiography (BA angio-CT) demonstrated a supply from the bronchial arteries to the oesophagus and spinal cord which is not identified on conventional bronchial arteriography using a digital subtraction technique. 20 patients with bronchial carcinoma and one with lung metastasis were examined using BA angio-CT, before bronchial artery infusion. 20 ml of non-ionic iodinated contrast medium (300 mgI ml-1) was injected into the bronchial artery, and ultrafast CT of the whole mediastinum was commenced when 10 ml had been injected. The 6 mm single slice mode was used and 40 images were obtained. Intradural and oesophageal enhancement was evaluated on BA angio-CT, and compared with the findings on digital subtraction angiography (DSA) of the bronchial arteries. BA angio-CT clearly showed intradural enhancement in eight patients. Marked spinal cord enhancement was demonstrated in three, and a coaxial catheter technique was used to avoid infusing the intercostal branch of the intercostobronchial trunk. Oesophageal enhancement was demonstrated in 18 patients on BA angio-CT. In contrast, no enhancement of these structures was seen on bronchial arterial DSA. In conclusion, BA angio-CT enabled precise evaluation of intradural and oesophageal enhancement.

Adult↗

[A case of adenomyelolipoma].

We report case of adenomyelolipoma. CT and MRI revealed a large, capsulated, septated adrenal mass with abundant fat tissue. However, enhancing components were demonstrated at the capsule and septations on angiography. On the pathological study, the capsule and septations consisted of adrenal adenoma and the tumor contained various forms of myelolipomatous tissues. These myelolipomatous tissues were classified into 4 groups. Type I: Scattering of fat cells and hematopoietic elements without coalescence. Type II: Collection of myelolipomatous tissue with unclear margin or small myelolipomatous tissue that cannot be classified as type I or III. Diameter of the lesion is less than 1 cm. Type III: Collection of myelolipomatous tissue with clear margin or replacement of cortical nodule. Diameter of the lesion is less than 1 cm. Type IV: Collection of myelolipomatous tissue. Diameter of the lesion is equal to or greater than 1 cm. We defined adenomyelolipoma as a lesion combining adrenal adenoma (or hyperplasia) and various forms of myelolipomatous tissues (type I-IV) in view of the strong relationship between adrenal adenoma (or hyperplasia) and myelolipomatous tissue.

Adenoma↗

[A pilot study with lung-cancer screening CT (LSCT) at the secondary screening for lung cancer detection].

We have developed computed tomography (CT) equipment for lung-cancer screening (named LSCT) that can be used exclusively for lung-cancer screening with spiral volumetric CT and is available on a screening car. A pilot study with LSCT was performed from November 1992 to January 1993 on 118 screenees at the secondary examination of lung-cancer screening. Scan parameters were as follows: 120 kVp, 50 mA, slice thickness 10 mm, table feed 10 mm/sec, scan time 2 sec/rotation. All the screenees were scanned under quiet respiration instead of the breath-hold technique. Under these scan parameters, LSCT images were almost free from respiratory motion artifacts even at the lung base. Continuity of the bronchial tree and vessels was well maintained in consecutive slices. Pulmonary nodules approximately 5 mm in diameter were clearly depicted. By LSCT, 43 of 118 screenees were diagnosed to need further examinations. And 33 out of 43 screenees underwent detailed examinations. Finally, 16 lung cancers were confirmed. Ten of 16 patients with lung cancer underwent surgery; nine were in stage I and one in stage IIIA. LSCT was considered to be useful in lung-cancer screening.

Adult↗

Differentiation between hemangiomas and hepatocellular carcinomas with the apparent diffusion coefficient calculated from turboFLASH MR images.

Serial turboFLASH (fast low-angle shot) images with and without diffusion-perfusion (DP) gradients were used for the evaluation of and differentiation between hemangiomas and hepatocellular carcinomas (HCCs) of the liver. Twenty-six patients with 27 hemangiomas, and 19 patients with 21 HCCs were studied. T1- and T2-weighted spin-echo images, serial turboFLASH images with and without DP gradients (b = 294.8 and 0 sec/mm2, respectively) were obtained, and the apparent diffusion coefficient (ADC) was calculated for all lesions. Hemangiomas were detected as well-defined areas of decreased signal intensity on turboFLASH images obtained with DP gradients; HCCs showed slight or no obvious decrease in signal intensity on serial turboFLASH images obtained with DP gradients compared with turboFLASH images obtained without DP gradients, while a considerable percentage (76.5%) of nodular HCCs showed an obvious decrease in signal intensity at the margins. Hemangiomas had large ADC values compared with HCCs. Both ADC and T2 values were significantly different between hemangiomas and HCCs (P < .01). However, there was no obvious correlation between ADC and T2 values for either hemangiomas or HCCs (r = .18 and .48, respectively). On the basis of these results, the calculated ADC should be helpful for distinguishing hemangiomas from HCCs, and the ADC values may be useful even when T2 values are not helpful for making the distinction.

Adult↗

Differential diagnosis of renal lesions with US-angiography using intra-arterial CO2 microbubbles.

To differentiate renal masses, 58 patients with renal masses (39 men and 19 women, aged 23-81 years [mean age 60 years]) underwent US-angiography with intra-arterial infusion of carbon dioxide (CO2) microbubbles during conventional angiography; 32 patients had renal cell carcinomas; nine, transitional cell carcinomas; nine, renal complicated cysts; four, angiomyolipomas; two, acute focal bacterial nephritis and hematomas. Renal masses were classified into six enhancement patterns of US-angiography. Thirty-one (97%) renal cell carcinomas were histologically alveolar type and demonstrated the well-enhancement pattern. All nine renal complicated cysts showed the non-enhancement pattern. Although transitional cell carcinomas did not show definite neovascularity on conventional angiography, they were classified as the well-enhancement pattern in 4/9 (44%) and poor-enhancement pattern in 5/9 (56%) on US-angiography. Four angiomyolipomas were homogeneously enhanced. Complicated cysts were clearly differentiated from renal cell carcinomas by the enhancement pattern on US-angiography. But the differentiation between renal cell carcinomas and angiomyolipomas was difficult. US-angiography is useful for detecting fine neovascularity of renal lesions and also for the differentiation or renal cell carcinomas from complicated cysts or transitional cell carcinomas during conventional angiography.

Angiomyolipoma↗