To correlate findings of chest radiograph with those of CT scan in aortic dissection.

We retrospectively analyzed findings of chest radiograph and CT scan of 10 aortic dissection patients(for men and six women ; aged 51-79 years old(mean 64 years)) and correlate findings of chest radiograph with those of CT scan.

Chest radiograph showed abnormal findings in nine cases(90%) with widening of wuperior mediastinum in nine(90%), disparity in size of ascending and descending aorta in four (40%), change in aortic configuration between successive examination in three (30%), bilateral pleural effusion in one(10%), and cardiomegaly in five(50%). CT scan showed atherosclerotic effusion in two(20%), pericardial effusion in one(10%), and mediastinal hematoma in two(20%). All patients with widening of superior mediastinum on chest radiograph showed aneurysm of ascending aorta and/or aortic arch on CT scan.

Chest radiograph is usually abnormal and the most common finding is wdening of superior mediastinum caused by aneurysm of ascending aorta and/or aortic arch. But normal chest radiograph may be observed in aortic dissection with mild degree aneurysm

To find out differential points between benign and malignant pleural disease.

We retrospectively analyzed the CT scans of 33 patients(20 men and 13 women ; mean age, 56) with pleural diseases including 12 malignant diseases(lung cancer(n=10), metastasis(n=2)) and 21 benign diseases(tuberculous empyema(n=12), bacterial empyema(n=7), hemothorax related exudate(n=2)).

In malignant diseases, irregular(n=3) or nodular(n=3), and mediastinal pleural thickening(n=6) were observed but extrapleural fat accumulation or pleural calcification were not.

In benign diseases, irregular pleural thickening was not observed in bacterial empyema but in tuberculous empyema(n=3) and hemothorax related exudate(n=1). Mediastinal pleural thickening and extrapleural fat accumulation were observed in tuberculous(n=5, 5) and bacterial(n=2, 2) empyema and hemothorax related exudate(n=1, 2) and pleura calcification was observed in tuberculous(n=3) and bacterial(n=2) empyema.

Findings of irregular or nodular pleural thickening were observed only in malignant disease with exception of tuberculous empyma and hemothorax related exudate. Extrapleural fat accumulation and pleural calcification were observed only in benign disease.

Ultrasound has been found to be accurate, reliable and noninvasive method in the measurement of spleen. The study was undertaken to obtain standard values of size in three dimensions and normal range of splenic volume by the use of splenic volumetric index(SVI) in normal korean adults.

We experienced 100 cases of abdominal ultrasonography of normal korean adults from May 1995 to August 1995.

1) The average size of spleen in adult male was 6.85±1.31cm in breadth, 4.93±1.27cm in thickness, 6.33±1.46cm in height ; in adult females, 6.61±1.23cm, 5.17±1.26cm, 6.33. 42cm, respectively ; total average, 6.73±1,27cm, 5.05±1.27cm, 6.33±1.39cm,respectively.

2) The average splenic volumetric index in adult male was 8.20±3.95; in adult females, 8.41±4.08 ; total average,8.31±4.00. There were no statistical differences of SVI and size between sex and age.

Although ultrasonography is less accurate than computed tomography, it is rapid and simple method for splenic measurement.

Acute appendicitis is very rare in infancy and early childhood. Delayed diagnosis of appendicitis may result in catastrophic outcome with perforation. We performed a retrospective analysis of clinical and radiologic findings of acute appendicitis occurring in the first 2 years of life.

Nine patients of acute appendicitis who were are less than two years of age proved by surgery and pathology were analyzed in terms of clinical symptoms and signs, and findings on preoperative plain abdominal roentgenography(9 cases), barium or gastrografin enema(6 cases), ultrasonography(8 cases) and abdominal CT scan(1 case).

All patients presented with nonspecific clinical symptoms and signs, such as vomiting and fever. All were complicated with perforation. Six were associated with periappendiceal abscess, and four with appendicolith. Plain abdominal roentgenogram showed generalized paralytic ileus and increased density on right lower quadrant in all cases, and diffuse for right lower abdominal wall bulging in some cases. Most cases of perforated appendicities and periappendiceal abscess were diagnosed by ultrasound and some cases by contrast enema or abdominal CT scan.

When the patients less than 2 years of age have nonspecific acute abdominal symptom with the roentgenographic findings of aggravating ileus and haziness in the right lower abdomen, ultrasonography might be considered as a helpful diagnostic tool for the early diagnosis of appendicitis. CT and contrast enema also might be helpful.

To investigate whether measurements of hepatic metastases before contrast administration are different from measuments after contrast administration. And to gain more effective follow up method by analyzing the difference of contrast between pre- and postcontrast scans.

Thirty patients with herpatic metastases were underwent conventional CT. Continuous 10mm thick slices were obtained from liver dome to pelvic inlet, then the patients received IV injection of contrast material, and same method as precontrast CT scan was performed. Additional 5mm thin slice scan was obtained in case of need. Three radiologists performed independent bidimensional measurements of the randomly selected lesion on both pre- and postcontrast images at the same level and analyzed the difference of the size and contrast.

The size of hepatic metastases were measured as smaller on postcontrast images ; average 41.4±43.5cm² on precontrast scan & 35.2±37.5cm² on postcontrast scan. There was significant difference by paired t-test(p<0.02). 24 of 30 cases(80%) showed better conspicuity on postcontrast images, 5(16.7%), on precontrast images and 1(3.3%) showed similiar conspicuity on both pre- and postcontrast images. The contrast of hepatic metastases was significantly higher on postcontrast scan by chi-square test(p<0.01).

Hepatic metastases are significantly smaller on postcontrast images. The contrast between metastatic lesion & liver parenchyme was better on postcontrast scan. Therefore, serial assessment of hepatic metastases size by CT should not be compared mixed pre- and postcontrast image. And postcontrast scan is more effective method than precontrast for follow up of hepatic metastasis.

Our purpose was to discuss the current results of renal transplantation at our institute and to document the usefulness of the ultrasonography in the follow-up of renal allograft.

Thirty five renal allografts who operated and followed-up at our hospital were included. All patients underwent renal duplex and Doppler sonography. According the clinical course of allograft, the sonographic findings were classified into successful renal transplantation(SRT), acute rejection(AR), chronic rejection(CR), and graft failure(GF). We retrogradely analyzed the sonographic findings as follows : renal size(length, width, thickness), cortex echogenicity, corticomedullary differentiation, renal sinus and pyramid, renal pelvis, resistive index(RI).

Results of allografts were as follows : SRT, 24 case(68.6%) ; AR, 6(17.1%) : CR, 3(8.6%) ; and GF, 2(5.7%). The changes of length of allografts were shown no statistically significant changes between the groups, but there is significant increase of thickness of allograft in AC and GF with significance. The mean RI was statistically increased in AR(RI=0.87), and the mean RI's of other groups were 0.65, 0.70, and 0.67 in order to SRT, CR, GF. Parenchymal echogenicities are changed in 66.7% of AC and CR, 25% of SRT, and 50% of GF without clinical significance. There are changes of CMJ, pyramid, sinus echo, renal pelvis of allografts, however, which were shown no statistical significance.

Even though we have small cases and short experiences of renal transplantation at our institute, we considered we have relatively good results and it was guessed there were many efforts for the renal transplantation. The duplex and Doppler sonography were useful tools in the follow-up of allograft, especially deciding acute rejection and graft failure, although it is difficult to decide chronic rejection and can not used to differentiate between the main parenchymal causes of graft failure.