論文

Helical CT became a reliable tool for diagnosing acute pulmonary thromboembolism (APTE) together with lower extremity ultrasound, though lung scintigraphy is still popular test for surveying and following the patients for APTE. Novel technology of multi-slice CT enabled us to obtain images on thinner slice thickness with better contrast. Development of workstation helped us to analyzing 3-dimensionally as well as providing useful 3D images quickly. CT venography, additional scan for surveying deep venous thrombosis, was utilized as an effective and time-saving technique. These condition should improve diagnostic accuracy of CT. MRI was proposed to be a promising tool for diagnosing APTE in a noninvasive manner.

Coccidioidomycosis is a disease known for its endemicity to the Southwest United States, Central America, and South America. However, with the current trend of increase tourist, the frequency of Coccidioidomycosis infections is increasing also. We reported a Japanese case of coccidioidomycosis with multiple thin-walled cavities in 35-year-old woman, and reviewed an update on the diagnosis, management, and treatment of the disease with pulmonary lesions caused by coccidioidomycosis infection.

The scanning technique used in our institute is as follows: The amount of contrast media is 3ml/s (flow rate) x scan time, and pre-scan delay is determined by test bolus. Retrospective reconstruction is given at diastolic phases on 70%, 75% and 80% of R-R interval at first, using multi-sector reconstruction method in the patients whose heart rate is higher than 65 and half reconstruction method in those who under 65.

PURPOSE: To analyze superparamagnetic iron oxide (SPIO)-mediated hepatic signal intensity change in cirrhotic and noncirrhotic liver and to investigate the relationship between pulse sequence effects in SPIO-enhanced magnetic resonance (MR) imaging for hepatic cirrhosis. MATERIALS AND METHODS: Twelve patients with and 12 patients without cirrhosis underwent T2-weighted fast spin-echo, T2*-weighted gradient-echo (GRE), and T1-weighted GRE MR imaging before and twice (early and late phase) after SPIO administration. To assess the effect of SPIO, postcontrast relative signal-to-noise ratio (SNR) changes were statistically analyzed with repeated measurements analysis of variance for each pulse sequence. RESULTS: No interaction was shown between groups and data time points for any pulse sequence. There was no significant difference in mean hepatic relative SNR change on T2-weighted fast spin-echo images between the cirrhotic group and noncirrhotic group (-38.6% and -40.7%, early phase; -42.2% and -49.6%, late phase, respectively). For GRE images, statistically significant differences in mean hepatic relative SNR change were found between the cirrhotic group and noncirrhotic group (-14.2% and -44.5%, early phase; -28.5% and -56.4%, late phase on T2*-weighted GRE images (P < .001); 31.8% and 12.9%, early phase; 23.8% and 2.2%, late phase on T1-weighted GRE images (P < .05), respectively. CONCLUSION: Decreased overall phagocytic activity in cirrhotic liver is more likely due to Kupffer cell dysfunction than to Kupffer cell depletion, since magnetic susceptibility effects on T2*-weighted GRE images depend on intracellular SPIO cluster size. © RSNA, 2002.

A 63-year-old male was admitted to the hospital on suspicion of right renal tumor. Although angiomyolipoma was highly suspected on CT, US, MRI, and angiography, liposarcoma could not be ruled out. Tumorectomy revealed it was retroperitoneal angiomyolipoma. We reported this rare case with a review of previous literature.