Kiminori Abe

Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI

Conventional CT or MRI has low accuracy in assessing chest wall invasion in patients with peripheral lung cancer. For preoperative evaluation of chest wall invasion by peripheral lung cancer, respiratory dynamic (RD) MRI was carried out in 98 patients in whom conventional CT scan showed that the tumour was abutting the pleural surface, but there was no evidence of definite tumour invasion. We used 1.5‐T MR equipment. RD MR images were acquired by snapshot fast field echo sequence (repetition time = 8, echo time = 3, flip angle = 100) and 25 consecutive images were taken while the patient took deep breaths. These images were evaluated in cine mode to assess tumour movement along the chest wall. Sixty‐one patients underwent surgical resection of the tumour and RD MR findings were compared with those in pathological specimens. RD MR showed free tumour movement along the chest wall in 34 patients. At pathological examination, the RD MR findings were proved correct in all patients. Pathologically, 20 patients had chest wall invasion and their RD MR was positive (sensitivity 100%). There were seven false‐positive results among the 41 patients without chest wall invasion (specificity 82.9%). RD MR may improve the accuracy of conventional CT scan or MRI in the prediction of chest wall invasion of lung cancer, especially in patients in whom the results of conventional CT scan or MRI appear equivocal in the presence of a peripheral mass abutting the chest wall surface without obvious chest wall invasion.

Venous hemangioma of the mediastinum

Abstract Mediastinal hemangiomas are rare tumors. We present a case of venous hemangioma of the mediastinum. Computed tomography shows anterior mediastinal solid mass without enhancement effects. We believe that it is necessary to include a mediastinal hemangioma for differential diagnosis, when little or no enhancement effects are noted at early and delayed CT examination.

TRIAL OF TRANSNASAL ESOPHAGOGASTRODUODENOSCOPY

Background:  Esophagogastroduodenoscopy (EGD) is conventionally performed transorally, although this is often a rather unpleasant experience for the patient. In the present study, we examined the merits and demerits of transnasal EGD.