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The usefulness of 3D-dynamic MR imaging with fat suppression and magnetization transfer contrast for assessing breast cancer extent and tumor profile was evaluated in 74 breasts with 67 malignant and 7 benign lesions. We classified breast cancer by the intraductal component of the main tumor. Five histological types were assigned: type 1 (DS 0) invasive carcinoma without intraductal component, type 2 (DS 1): intraductal component is less than 50% of whole tumor, type 3 (DS 2): intraductal component is nearly equal to 50%, type 4 (DS 3): intraductal component is more than 50%, type 5 (DS 4): pure DSIC or DCIS associated with microinvasive foci. Histologic results and preoperative MR imaging were analyzed regarding tumor size and enhancement pattern for the various tumor types (DS 0, 1, 2, 3 and 4). The three tumors occult to MR imaging were two DCIS and one Paget's disease. The other 64 breast cancers were detected on MR imaging. Tumor size measured with MR imaging correlated closely with histologic measurement in DS 0, 1 and 2, whereas less accuracy was noted in DS 3 and 4. Rapid enhancement was frequently seen in DS 0, 1, 2 and 3. Peripheral enhancement was highly specific for breast cancer. However, peripheral enhancement was not found in all cases of DS 4. Linear and nodular enhancement was frequently seen in DS 3 and 4. MR imaging was useful in predicting the intraductal component.

The usefulness of magnetic resonance cholangiopancreatography (MRCP) using the non-breath-hold one-shot technique was evaluated. Ten children suffering from congenital biliary dilatation (CBD) were included. Four of them were preoperative cases, and the remaining six postoperative. All MR images taken were compared with endoscopic retrograde cholangiopancreatography or intraoperative cholangiography. MR images using the non-breath-hold one-shot technique clearly showed the confluence of the common bile duct and the main pancreatic duct in seven of the cases. The confluence of the common bile duct and main pancreatic duct was obscure in the other three cases, mainly due to motion artifact. These results show that this non-breath-hold one-shot technique is useful for diagnosis and postoperative follow-up of congenital biliary dilatation in children.

Etiology of esophageal intramural pseudodiverticulosis is still unknown but several accompanying diseases have been reported, for example, reflux esophagitis, esophageal cancer, diabetes mellitus and so on. We have experienced a case of esophageal intramural pseudodiverticulosis with cancer improved by radiation therapy. In this case, there were esophageal cancer in the cervical esophagus, with intramural spreading in whole esophagus. This case was delivered irradiation to the entire esophagus by target rotation method. After irradiation, intramural pseudodiverticula, intramural spreading and primary site of esophageal cancer were improved. This is an interest case report that esophageal intramural pseudodiverticula with cancer was disappeared by radiation therapy.

Dual interval echo train fast SE (DIET-FSE) is a modified fast SE technique. It attenuates fat signals by applying a time interval between an excitation pulse and the first echo, which is the odd-number of the following echo interval, and by decreasing the number of high frequency refocusing pulses before collecting echoes in the center of the k space, which determines the contrast. Unlike many other fat-suppression methods, this technique is less affected by susceptibility effects. In this study, we compared DIET-FSE with FSE and conventional SE of the female pelvis. The results of DIET-FSE showed a stable, obvious fat suppression effect which resulted in the easy detection of pelvic organs such as the intestines and ovaries, as compared with FSE. The reductions in imaging time and motion artifacts also permitted more precise differentiation between the normal pelvic organs and lesions than conventional T2-weighted SE. These results imply that the DIET-FSE is useful for the diagnosis of female pelvic disorders.

To celebrate the year of centennial of X-ray discovery, we have to consider future development of radiology in 21st century. Since WC Röntgen discovered X-ray in 1895, the radiological science have been continuously expanded. Even reviewing the history of radiology in Japan, there have been several epoch-making masterpieces. We Japanese radiologists should be more proud of Japanese radiology. It is evident that radiology of the 21st century will develop more and more on the basis of computer technology. In clinical radiology, every procedure will become more rapid and non invasive, and imaging diagnoses cover not only morphology but also function of tissue and/or cell components. To foresee the future, it is essential to understand radiology in the past and the present. In this lecture, I have reviewed a history of radiology in Japan, clarified the problems at the present and emphasized the importance of computer skill. I would like to ask all of Japanese radiologists to march forward in the midstream of medical science in cooperation of Japanese society of Radiological Technology and Industries.

From January to December 1990, we performed a prospective survey of adverse reactions to contrast media at two different institutes of Juntendo University. We collected a total of 4555 case sheets during the period. The radiological procedures we investigated were computed tomography, intravenous urography, arteriography, venography and myelography. Low osmolar iodine contrast medium was used almost exclusively (except for five cases). The overall incidence of adverse reactions was 7.0%, and there were no severe or fatal reactions. The incidence of adverse reactions was higher in females (8.5%) than in males (6.1%). The incidence of adverse reactions increased according to the dose of contrast medium, especially when more than 101 ml was injected. Intra-arterial injection caused adverse reactions most often, followed by regular intravenous injections, followed by bolus intravenous injections. Adverse reactions occurred most often during injection. The next occurred in 5 minutes after injection, and then, 5-10 minutes after the injection of contrast medium. The incidence of adverse reactions was higher in patients with a history of allergy or previous reactions. Allergic adverse reactions were observed at a higher frequency. Pretesting was performed in 56.7% of the cases.

From January 1989 to December 1989, we performed a prospective survey of adverse reactions to contrast media at three institutes of Juntendo University. We collected a total of 4365 case cards during the period. Low osmolar iodine contrast media were given in all but one case. Procedures using contrast media included computed tomography, intravenous urography, arteriography, venography and myelography. The overall incidence of adverse reactions was 6.6%, and there were no severe or fatal reactions. The incidence of adverse reactions was about the same in both sexes. However, in males, the incidence was higher in the fifth decade, and in females, it was higher in the third and seventh decades. There was no relation between the dose of contrast medium and adverse reactions. Intravenous bolus injections caused adverse reactions more often, followed by intra-arterial injections and then usual intravenous injections. The incidence of adverse reactions in patients with a history of allergy or previous reactions was higher. Pretesting was performed in 48.9% of the cases.

In pelvic CT, several techniques (appropriate preparations) have been reported for the optimal diagnostic imagings. We demonstrated the usefulness and limitations of "Air Enema", which is one of preparations for hollow viscera in pelvic CT examination. From Oct. 1986 to Mar. 1987, 38 patients with gynecological abnormalities were evaluated by consecutive pre and post "Air Enema" CT. The patients aged 26-75 years with mean of 44.6 years. All patients were examined in prone position with 100 ml of 2% iopamidol in the urinary bladder and medical tampon in the vagina. Two consecutive scans were performed from the level of pubic symphysis to the 5th lumbar vertebra at 10 mm-15 mm intervals. The first scan was pre "Air Enema" CT, in which the rectum, entire colon and terminal ileum were not distended. The second scan was post "Air Enema" CT, in which the hollow viscera was distended by 1000 ml-1500 ml of air. Two images, each from pre and post "Air Enema" CT were evaluated on the efficacy for imaging diagnosis. In "Air Enema" CT, main useful effect was "replacement effect", which was that intrapelvic masses and/or intrapelvic paravascular spaces were clearly delineated by distended bowels. Detection and location of intrapelvic masses were correctly diagnosed when the masses were relatively small (5.3 cm in average diameter), but there were no advantages in cases in which the pelvic masses were large enough to occupy the pelvic cavity (12.7 cm in average diameter). Abdominal pain was the most common adverse reaction to this technique. But complaints usually disappeared in few hours after examination. Thus, "Air Enema" seems to be useful preparation for pelvic CT examination to detect relatively small intrapelvic masses and abnormalities.

Plain radiographs of forty-two infants with biliary atresia were reviewed to clarify the clinical significance of bone changes after surgery. The same surgical procedures (hepatoportojejunostomy with Suruga II enterostomy or choledochojejunostomy with Suruga II enterostomy) were performed in all cases except one at Juntendo University Hospital during 1977-1983. Bone changes were found in thirty-one patients during the 2 year period after surgery, and generalized osteopenia was the common radiological manifestation. In addition, sixteen patients were revealed to have rickets and/or fractures. The age of development of osteopenia ranged widely, but that of rickets and fractures ranged from 6 months to 2 years. It corresponded well to the age of recovering from physiological depression of bone mineral content in normal infants. Most rickets and fractures developed in association with other complications such as pulmonary infections. They were healed with treatment within 2-3 months after onset. But osteopenia persisted longer in most cases. Compared to cases without bone changes, jaundice was seen more frequently and the prognoses was worse in cases with bone changes. There was no relationship between rickets or fractures and prognosis. Biochemical data at the onset of bone changes included hypoalbuminemia and hypophosphatemia. Hypoalbuminemia, hypophosphatemia and hypocalcemia were seen in cases with rickets or fractures. But hypocalcemia was improved with treatment. From these observations, we considered that osteopenia reflected well the patients' general condition and prognosis, but most rickets or fractures which developed due to failure to meet the physiological high demand of calcium, did not play a major role for prognosis of biliary atresia.