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Purpose: To investigate treatment outcomes of uterine carcinosarcoma (CS) patients who underwent complete surgical resection of all visible disease and platinum-based adjuvant chemotherapy (multimodal therapy). Materials and Methods: The authors reviewed 127 uterine CS patients treated at this institution from 1990 to 2010. They operated 123 patients in clinical Stages 1-3, 97 of which underwent complete resection and systemic lymphadenectomy. Results: A total of 97 patients (FIGO 2008: Stage 1 in 50 patients, Stage 2 in six, Stage 3 in 37, and Stage 4 in four) underwent surgical staging, 74 of which were administered five cycles (median) of platinumbased adjuvant chemotherapy. The median overall survival (OS) associated with multimodal therapy 50.6 months compared with 34.9 months incomplete multimodal therapy. After multimodal treatment, 32.9% (32/97) patients showed recurrence (24/32 hematogenous). Conclusion: Multimodal therapy increased survival among uterine CS patients, but the recurrence rate remained high. Further consideration of treatment options for uterine CS is required. [ABSTRACT FROM AUTHOR]

Digital tomosynthesis with flat-panel detector radiography is a novel application that allows easy, swift volume data acquisition of any anatomical site of interest with arbitrary patient posture. A single sweep of the X-ray tube provides multiple tomographic images of high resolution. We present the first patient with olecranon fracture who underwent internal fixation and 1-year postoperative follow-up with tomosynthesis. The minimal metallic artifact by this modality successfully provided detailed information regarding the healing process of the fracture. [ABSTRACT FROM AUTHOR]

We report a case of subarachnoid hemorrhage with a ruptured aneurysm in the anterior communicating artery. On multiphase dynamic contrast-enhanced four-dimensional computed tomography angiography (4D CTA), we observed active bleeding from the aneurysm that manifested over time with a corkscrew-like, spindle-like, and lobulated appearance and nebulous enhancement, characteristics reported only individually previously. The volume data for 4D CTA is easy to obtain with newly developed multidetector-row computed tomography, and 4D CTA can be used for evaluating anatomical aspects, hemodynamics, and treatment selection in cases of a ruptured cerebral aneurysm. [ABSTRACT FROM AUTHOR]

Our patient was diagnosed with acute subarachnoid hemorrhage on plain head computed tomography (CT). Multiphase dynamic contrast-enhanced CT angiography on a 64-row multidetector scanner revealed a large aneurysm in the left middle cerebral artery that was not detected on conventional helical CT angiography. We believed that increased intracranial pressure and rough thrombus within the aneurysm delayed its peak enhancement. Our case demonstrates the diagnostic utility of four-dimensional CT with multiphase volume data in cases of lesions with delayed enhancement. [ABSTRACT FROM AUTHOR]

Purpose: We compared the accuracy of magnetic resonance imaging (MRI) measurements of pulsatile flow velocity in a small tube phantom using different spatial factors versus those obtained by intraluminal Doppler guidewire examination (as reference).Materials and Methods: We generated pulsatile flow velocities averaging about 20-290 cm/sec in a tube of 4 mm diameter; we performed phase-contrast cine MRI on pixels measuring 1.00(2)-2.50(2) mm(2). We quantified spatial peak flow velocities of a single pixel and a cluster of five pixels and spatial mean velocities within regions of interest enclosing the entire lumen in the phantom's cross-section. Finally, we compared the measurements of temporally mean and maximum flow velocity with the Doppler measurements.Results: Linear correlation was excellent between both measurements of spatial peak flow velocities in one pixel. The highest spatial resolution using spatial peak flow velocities of a single pixel allowed the most accurate MRI measurements of both temporally mean and maximum pulsatile flow velocity (r = 0.97 and 0.99, respectively: MRI measurement = 0.95x + 8.9 and 0.88x + 24.0 cm/s, respectively). Otherwise, MRI measurements were significantly underestimated at lower spatial resolutions.Conclusion: High spatial resolution allowed accurate MRI measurement of temporally mean and maximum pulsatile flow velocity at spatial peak velocities of one pixel. [ABSTRACT FROM AUTHOR]

Purpose: To compare three-dimensional segmented true fast imaging with steady-state precession magnetic resonance cholangiopancreatography (3D-trueFISP-MRCP) to conventional MRCP sequences with an oral negative contrast agent for diagnosing juxtapapillary diverticulum.Materials and Methods: A total of 42 patients with (n = 21) and without (n = 21) juxtapapillary diverticulum confirmed by endoscopic retrograde cholangiopancreatography (ERCP) were evaluated. Three MRCP sequences, 3D-trueFISP-MRCP, two-dimensional rapid acquisition with relaxation enhancement MRCP (2D-RARE-MRCP), and 3D T(2)-weighted turbo spin-echo MRCP (3D-TSE-MRCP), obtained after administering an oral negative contrast agent (FerriSeltz; Otsuka Pharmaceutical, Tokushima, Japan) were compared. Two radiologists independently and blindly interpreted the presence or absence of juxtapapillary diverticulum and its positional relationship against the papilla. The detectability of juxtapapillary diverticulum of each sequence as decided by consensus was then compared. Kappa statistics were used to measure interobserver agreement of the classifications.Results: The sensitivity, specificity, and accuracy for detecting juxtapapillary diverticulum of 3D-trueFISPMRCP (61.9%, 85.7%, and 73.8%) were substantively higher than those of 2D-RARE-MRCP (0.0%, 100%, and 50.0%) and 3D-TSE-MRCP (9.5%, 100%, and 54.8%). Interobserver agreement of the position of juxtapapillary diverticulum by 3D-trueFISP-MRCP was good (kappa = 0.55).Conclusion: 3D-trueFISP-MRCP can define juxtapapillary diverticulum even with an oral negative contrast agent, whereas conventional MRCP sequences cannot. [ABSTRACT FROM AUTHOR]

Purpose: We examined the spatial factors influencing magnetic resonance (MR) flow velocity measurements in a small tube phantom and used the same measurements obtained with an intraluminal Doppler guidewire as reference.Materials and Methods: We generated constant flow velocities from approximately 40 to 370 cm/s in a tube 4 mm in diameter. We then performed segmented k-space, phase-contrast cine-MR imaging to quantify spatial peak flow velocities of one pixel and of five adjacent pixels as well as spatial mean velocities within regions of interest in a cross section of the phantom. Pixel dimensions ranged from 1.00 x 1.00 mm to 2.50 x 2.50 mm. We compared the MR measurements with the temporally averaged Doppler spectral peak velocities.Results: For one pixel (r > 0.99: MR flow velocity for pixel dimension 1.00 x 1.00 mm = 1.03x + 9.8 cm/s), the linear correlation was excellent between flow velocities by MR and Doppler guidewire methods. However, for the five adjacent pixels, MR measurements were significantly underestimated using pixels 1.25 x 1.25 mm to 2.50 x 2.50 mm and for mean velocities for all pixel dimensions.Conclusion: Relatively high spatial resolution allows accurate MR measurement of constant flow velocity in a small tube at spatial peak velocities for one pixel. [ABSTRACT FROM AUTHOR]