visitor # 1 since May 2003
JN : J Med Assoc Thai. 2004 Sep;87 Suppl 2:S179-84.
TI : Abnormal findings in breast imaging: a hospital-based survey in 4264 Thai women.
AU : Pak-art P, Bunjunwetwat D, Vajragupta L, Amornrattanapaijit W, Vajarapongse K, Sampatanukul P, Chatamra K.
EN-AB: OBJECTIVE: To evaluate the distributions of common and significant imaging findings from breast imagings at King Chulalongkorn Memorial Hospitals. MATERIAL AND METHOD: Data was collected from every mammography performed from November 1, 2001 to October 31, 2002. The reports were analyzed and imaging findings were recorded. The ACR BI-RADS category was applied to all cases. RESULTS: There were 4264 patients and all of them were female. The age range was between 19-90 years and average age was 50.1 years. The most common positive findings were cysts (39.22%), followed by focal lesions (14.76%), mass (8.69%), architectural distortion (7.83%), calcification (7.36%) and thick ducts (3.76%). According to ACR BI-RADS, most of the studies were in category 2 (42.59%), followed by category 1 (38.67%), category 3 (12.08%) category 5 (3.45%), category 4 (3.12%) and category 0 (0.09%). CONCLUSION: Breast imaging is the standard screening tool for breast cancer and can reveal different kinds of findings. Knowing the distribution of these findings helps both the radiologists to understand the scope of their work and the institution to audit their practice. (NO 16083184)
AU : Lertsanguansinchai P, Chottetanaprasith T, Chatamra K, Sampatanukul P, Wannakrairot P, Rojpornpradit P, Shotelersuk K, Lertbutsayanukul C, Boonjunwetwat D, Vajragupta L.
TI : Estrogen and progesterone receptors status in Thai female breast cancer patients : an analysis of 399 cases at King Chulalongkorn Memorial Hospital.
JN : J Med Assoc Thai 2002 Jun ; 85 (Suppl 1) : S193-S202
EN-AB: A retrospective review was performed on 576 patients who have been diagnosed breast cancer and referred to Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between January 1995-September 2001. There were three hundred ninety nine cases of invasive breast cancer that available for estrogen (ER) and/or progesterone (PR) receptor status. The mean and median age in our study were 49.6 year and 49.0 year respectively. About 60.9 per cent of the patients were pre and peri-menopause and 37.8 per cent were post-menopause. Most of the histological cell type were invasive ductal carcinoma which comprised of 92.7 per cent. Histologic grading were nearly equal for moderately and poorly differentiated grade: 43.66 per cent and 40.66 per cent. The results of our study showed 53.4 per cent of 399 patients had ER positive and 42.1 per cent of 380 patients had PR positive. The proportion of ER+PR+, ER+PR-, ER-PR+, and ER-PR- were 36.31 per cent, 15.53 per cent, 5.79 per cent and 42.37 per cent respectively. Older age and post-menopause women had higher ER+. While patients with increase tumor size, poorly differentiated grading, increase positivity of axillary lymph nodes and higher stage have more chance of ER negative and PR negative. (NO 07577)
AU : Vajragupta L, Jirappapa B.
TI : CT findings of pancreatic adnocarcinoma.
JN : Asean Journal of Radiology 2002 ; 3 (1) : 21-28 (NO 07579)
AU : Rungruxsisivorn T, Punyakhamlerd K, Vacharakupt L, Taechakraichana N, Limpaphayom K.
TI : Mammographic findings in women attending menopause clinic at King Chulalongkorn Memorial Hospital.
JN : Thai J Obstet Gynaecol 2002 Jan-Mar ; 14 (1) : 63-71 (NO 07861)
AU : Vajragupta L, Chingchit W.
TI : CT findings of primary gallbladder carcinoma.
JN : Chula Med J 2001 Sep ; 45 (9) : 777-793 (NO 06830)
AU : Vajragupta L, Jeerasomboonying T, Wacharasindhu S.
TI : Adrenocortical carcinoma in infant with IVC extension.
JN : Asean Journal of Radiology 2001 ; 2 (2) : 89-96 (NO 07578)
AU : Shuangshoti Shanop, Shuangshoti S, Vajragupta L.
TI : Meningiomas associated with hemorrhage : a report of two cases with a review of the literature.
JN : Neuropathology 1999 Jun ; 19 (2) : 150-160 (NO 06130)
AU : Chongsrisawat V, Vivatvakin B, Suwangool P, Vajragupta L, Poovorawan Y.
TI : Non-cirrhotic portal fibrosis associated with pulmonary arteriovenous communication and pulmonary arterial hypertension.
JN : Southeast Asian Journal of Tropical Medicine & Public Health 1998 Mar ; 29 (1) : 76-9
EN-AB: A case of non-cirrhotic portal fibrosis associated with pulmonary arteriovenous communication and pulmonary arterial hypertension is reported. The patient was a 7-year old boy who presented with hematemesis, cyanosis, hypoxemia and orthodeoxia. His liver pathology was compatible with non-cirrhotic portal fibrosis. His pulmonary angiography showed arteriovenous shunting and pulmonary arterial hypertension (mean pulmonary artery pressure 34 mmHg). His sister also had non-cirrhotic portal fibrosis with neither hypoxemia nor orthodeoxia. This report raises the possibility of non-cirrhotic portal fibrosis having a genetic etiology. (NO 05534)
AU : Jungthirapanich J, Watana D, Pongprasit P, Vananukul S, Vajaragupta L, Yenrudi S.
TI : Pediatric sarcoidosis presenting with hypertensive encephalopathy.
JN : ¨´ËÁÒÂàËµØ·Ò§á¾·ÂìJournal of the Medical Association of Thailand 1998 ¾.Â. ; 81 (11) : 911-917
EN-AB: A 3-year-old girl with simultaneous presentation of hypertensive encephalopathy, subcutaneous nodules, hepatosplenomegaly and proteinuria was presented. The sarcoidosis was confirmed by histologic demonstration of non-caseating granulomas in the liver, left kidney, a cervical lymph node and subcutaneous nodules. The proteinuria resolved spontaneously. During the six-month period of steroid therapy, the renal mass and hepatosplenomegaly were dissolved but the cervical lymphadenopathy still persisted. The hypertensive state was difficult to control which required a multiple antihypertensive drug regimen.
TH-AB: ¼Ùé»èÇÂà´ç¡ËÔ§ä·ÂÍÒÂØ 3 »Õ ÁÕ¡ÒÃªÑ¡¨Ò¡¤ÇÒÁ´Ñ¹âÅËÔµÊÙ§ µèÍÁ¹éÓàËÅ×Í§·Õè¤Íâµ ÁÕ¡éÍ¹à¹×éÍ·ÕèãµéË¹Ñ§ÈÕÃÉÐ µÑºÁéÒÁâµ áÅÐµÃÇ¨¾ºä¢è¢ÒÇã¹»ÑÊÊÒÇÐ ¡ÒÃÇÔ¹Ô¨©ÑÂâÃ¤ÊÒÃì¤ÍÂâ´ÊÔÊÍÒÈÑÂ¡ÒÃµÃÇ¨¾º¾ÂÒ¸ÔÊÀÒ¾·ÕèµèÍÁ¹éÓàËÅ×Í§ ¡éÍ¹à¹×éÍãµéË¹Ñ§ÈÕÃÉÐ µÑº áÅÐäµ ÀÒÇÐä¢è¢ÒÇÃÑèÇã¹»ÑÊÊÒÇÐËÒÂä´éàÍ§ ¨Ò¡¡ÒÃÃÑ¡ÉÒ´éÇÂ à¾Ãç´¹ÔâÊâÅ¹ à»ç¹àÇÅÒ 6 à´×Í¹ ¡éÍ¹·ÕèäµËÒÂä» µÑºÁéÒÁ ¢¹Ò´»¡µÔ áµèµèÍÁ¹éÓàËÅ×Í§·Õè¤ÍÂÑ§¤§âµÍÂÙè ¼Ùé»èÇÂÂÑ§¤§µéÍ§ãªéÂÒÅ´¤ÇÒÁ´Ñ¹àÅ×Í´ËÅÒÂ¢¹Ò¹ã¹¡ÒÃ¤Çº¤ØÁÀÒÇÐ¤ÇÒÁ´Ñ¹âÅËÔµÊÙ§. (NO 05919)
AU : Charoenvidhya D, Vajragupta L, Uerpairojkit B, Tannirandorn Y, Manotaya S, Tanawattanacharoen S.
TI : Fetal Imaging : MRI Versus Ultrasound.
JN : Thai Journal of Obstetrics and Gynaecology 1997 December ; 9 (4) : 225-262
EN-AB: Objective : To compare the ultrasound images with magnetic resonance imaging (MRI) in demonstrating abnormal fetal structures. Design : Case series. Setting : Division of Maternal-Fetal Medicine, Faculty of Medicine Chulalongkorn University. Subjects and methods : Five patients whose gestational age ranged from 31 to 38 weeks. All had previously undergone a transabdominal or transvaginal ultrasound examination showing fetal anomalies, then all patients were imaged with standard spin echo sequences T1-weighted image. Fast spin-echo sequences were perfprmed on T2-weighted images. Results : Three cases had abnormality of the brainie, microcephaly with encephalocele, occipital encephalocele and porencephaly. The other two cases were omphalocele and phocomelia. MRI gave more information than ultrasound in case of occipital encephalocele, microcephaly with encephalocele and porencephaly. Conclusion : Ultrasound remains the first choice of screening method for imaging the fetus in utero. MRI is a valid second-step diagnostic tool in pregnancy for further assessment of sonographically detected malformation especially those involving central nervous system. (NO 05614)
AU : Vajragupta L, Kukulprasong A.
TI : Computed tomography of cholangiocarcinoma.
JN : ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃ = Chulalongkorn Medical Journal 1996 Apr ; 40 (4) : 269-280
EN-AB: Objective : Cholangiocarcinoma is a common primary cancer of the bile duct especially in the northeastern part of Thailand. The purpose of this study was to analyze the computed tomographic (CT) findings in pathologically proven cholangiocarcinoma. Material and methods : The CT findings of 13 histologically proved cholangio carcinoma were retrospectively reviewed (9 males and 4 females; 37 - 68 years old; average age 53 years) Results : There were 15 lesions found in 13 patients and they were classified into 4 types. Type A. Intrahepatic mass with or without bile duct dilatation. Type B. Ill - defined mass with nonunion bile duct dilatation. (Hilar cholangiocarcinoma) Type C. Generalized bile duct dilatation without identified mass. Type D. Intraductal mass. The most common pattern was type A. (8 in 15 lesions) and the second most common was type B(4 in 15 lesions). Two of 15 lesions were type C and only 1 of was type D. The associated findings were hepatomegaly, tumor calcification and regional lymphadenopathy. Three cases had abdominal wall invasion. Conclusion : The most common CT findings in the studied cases was an intrahepatic mass with or without bile duct dilatation. Most of the masses were hypodense with minimal or no contrast enhancement. Although it is nonspecific, the additional findings of tumor calcification, lobar atrophy, history and clinical findings may be helpful for diagnosis.
TH-AB: ÇÑµ¶Ø»ÃÐÊ§¤ì : ÁÐàÃç§¢Í§·èÍ¹éÓ´Õ à»ç¹ÁÐàÃç§»°ÁÀÙÁÔ·Õè¾ºä´éºèÍÂ â´Âà©¾ÒÐã¹ÀÒ¤ µÐÇÑ¹ÍÍ¡à©ÕÂ§àË¹×Í¢Í§»ÃÐà·Èä·Â ¡ÒÃÈÖ¡ÉÒ¹ÕéÁÕÇÑµ¶Ø»ÃÐÊ§¤ì à¾×èÍÇÔà¤ÃÒÐËìÀÒ¾àÍ¡«àÃÂì¤ÍÁ¾ÔÇàµÍÃì·Õè¾ºã¹¼Ùé»èÇÂÁÐàÃç§·èÍ¹éÓ´Õ«Ö è§ä´éÃÑº¡ÒÃµÃÇ¨Â×¹ÂÑ¹·Ò§¾ÂÒ¸ÔÇÔ·ÂÒ ÇÑÊ´ØáÅÐÇÔ¸Õ¡ÒÃ : ¼ÙéÈÖ¡ÉÒä´é·Ó¡ÒÃÈÖ¡ÉÒÂéÍ¹ËÅÑ§ÀÒ¾àÍ¡«àÃÂì¤ÍÁ¾ÔÇàµÍÃì¢Í§¼Ùé»èÇÂ ÁÐàÃç§·èÍ¹éÓ´Õ 13 ¤¹ »ÃÐ¡Íº´éÇÂ ¼Ùé»èÇÂªÒÂ 9 ¤¹ ¼Ùé»èÇÂËÔ§ 4 ¤¹ ÍÒÂØÃÐËÇèÒ§ 37-68 »Õ ÍÒÂØà©ÅÕèÂ 53 »Õ ¼Å¡ÒÃÈÖ¡ÉÒ : ÀÒ¾àÍ¡«àÃÂì¤ÍÁ¾ÔÇàµÍÃì¾ºÃÍÂâÃ¤ 15 µÓáË¹è§ã¹¼Ùé»èÇÂ 13 ¤¹ «Öè§áºè§ÃÍÂâÃ¤·Õè¾ºÍÍ¡à»ç¹ 4 ª¹Ô´ ª¹Ô´ A. ¡éÍ¹à¹×éÍ§Í¡ã¹µÑº«Öè§¾ºËÃ×ÍäÁè¾º¡ÒÃ¢ÂÒÂµÑÇ¢Í§·èÍ¹éÓ´Õ ¾ºÁÒ¡·ÕèÊØ´ (8 ã¹ 15 ÃÍÂâÃ¤) ª¹Ô´ B. ¡éÍ¹à¹×éÍ§Í¡¢Íºà¢µäÁèªÑ´à¨¹ºÃÔàÇ³¢ÑéÇµÑº ÃèÇÁ¡Ñº¡ÒÃ ¢ÂÒÂµÑÇ¢Í§·èÍ¹éÓ´Õ«Öè§äÁèÊÁèÓàÊÁÍ ¾ºÃÍ§Å§ÁÒ (4 ã¹ 15 ÃÍÂâÃ¤) ª¹Ô´ C. ·èÍ¹éÓ´Õ¢ÂÒÂµÑÇÍÂèÒ§ÊÁèÓàÊÁÍâ´ÂäÁè¾ºà¹×éÍ§Í¡ (¾º 2 ã¹ 15 ÃÍÂâÃ¤) ª¹Ô´ D. ¡éÍ¹à¹×éÍ§Í¡ã¹·èÍ¹éÓ´Õ (¾º 1 ã¹ 15 ÃÍÂâÃ¤) ÊÔè§·Õè¾ºÃèÇÁ¡ÑºÃÍÂâÃ¤ä´éá¡è ÀÒÇÐµÑºâµ á¤Åà«ÕèÂÁã¹¡éÍ¹à¹×éÍ§Í¡, µèÍÁ¹éÓàËÅ×Í§¢éÒ§à¤ÕÂ§âµ áÅÐÁÕ¼Ùé»èÇÂ 3 ÃÒÂ·Õè¾º¡éÍ¹à¹×éÍ§Í¡ÅØ¡ÅÒÁÁÒÂÑ§¼¹Ñ§Ë¹éÒ·éÍ§ ÊÃØ» : ¾ºÅÑ¡É³Ð·Ò§ÃÑ§ÊÕ¨Ò¡ÀÒ¾àÍ¡«àÃÂì¤ÍÁ¾ÔÇàµÍÃìã¹¼Ùé»èÇÂÁÐàÃç§·èÍ¹éÓ ´Õ 4 áººµèÒ§ æ ¡Ñ¹ â´Âáºº·ÕèÁÕÅÑ¡É³Ð¡éÍ¹à¹×éÍ§Í¡ã¹µÑº «Öè§ÍÒ¨¾º ËÃ×ÍäÁè¾º¡ÒÃ¢ÂÒÂµÑÇ¢Í§·èÍ¹éÓ´ÕÃèÇÁ´éÇÂ¾ºÁÒ¡·ÕèÊØ´. (NO 03064)
AU : Vajragupta L.
TI : Ultrasonographic diagnosis of hepatobiliary system diseases.
JN : ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃ = Chulalongkorn Medical Journal 1996 Apr ; 40 (4) : 305-325
EN-AB: Ultrasonography has been widely used in diagnosis of various diseases for more than 10 years. Ultrasonography is a highly accurate, cost effective, noninvasive initial screening modality of choice in the evaluation and diagnosis of diseases of the liver and bile ducts. It is quick, safe, effective, relatively inexpensive and widely available. Ultrasonography depicts the causes of hepatomegaly, nature of the mass or masses in the liver (cystic, solid or complex masses), and causes of jaundice and right upper quadrant pain, etc. Final diagnosis in some patients can made by specific ultrasonographic findings and correlation with clinical data. In some cases, ultrasonographic findings are not specific, such as nonspecific hypoechoic mass in the liver demonstrated incidentally by ultrasonography. Further investigation for a final diagnosis should be done in these cases. Percutaneous needle biopsy under ultrasonographic guidance may be useful in further defining the focal liver mass without a characteristic imaging appearance. (NO 03068)
AU : Jungthirapanich J, Watana D, Vajragupta L, Yenrudi S.
TI : Familial juvenile nephronophthisis with the immune complex diffuse proliferative glomerulonephritis. a case report.
JN : ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃ = Chulalongkorn Medical Journal 1996 Sep ; 40 (9) : 737-744
EN-AB: A 4-year-old girl was found to have familial juvenile nephronophthisis. The diagnosis was established by a family history of renal disease, polydipsia, polyuria, growth failure, anemia, a defect in urine concentrating ability, a secretory defect form of distal renal tubular acidosis, the onset of renal failure in childhood, the typical sonographic appearance and the presence of medullary cysts. The unusual findings in this patient were the immune complex diffuse proliferative glomerulonephritis and the progression of renal insufficiency in early childhood.
TH-AB: ¼Ùé»èÇÂà´ç¡ËÔ§ä·ÂÍÒÂØ 4 »Õ ä´éÃÑº¡ÒÃÇÔ¹Ô¨©ÑÂà»ç¹ familial juvenile nephronophthisis â´ÂÁÕ»ÃÐÇÑµÔâÃ¤äµã¹¤ÃÍº¤ÃÑÇ ´×èÁ¹éÓºèÍÂ »ÑÊÊÒÇÐÁÒ¡ ¡ÒÃà¨ÃÔàµÔºâµªéÒ âÅËÔµ¨Ò§ ¤ÇÒÁº¡¾ÃèÍ§¢Í§¡ÒÃ·ÓãËé»ÑÊÊÒÇÐà¢éÁ¢é¹ ¤ÇÒÁ¼Ô´»¡µÔã¹¡ÒÃ¢Ñº¡Ã´¢Í§äµ ÁÕÀÒÇÐäµÇÒÂã¹ÇÑÂà´ç¡ ¡ÒÃµÃÇ¨äµâ´Â¤Å×è¹àÊÕÂ§¤ÇÒÁ¶ÕèÊÙ§¾ºÅÑ¡É³Ðà©¾ÒÐ¢Í§âÃ¤ µÃÇ¨ªÔé¹à¹×éÍäµ¾º«ÔÊµìã¹ medulla ÊÔè§¼Ô´»¡µÔã¹¼Ùé»èÇÂÃÒÂ¹Õé¤×Í ÁÕÀÒÇÐäµÇÒÂã¹ÍÒÂØ¹éÍÂ áÅÐµÃÇ¨¾ºäµÍÑ¡àÊºª¹Ô´à¾ÔèÁà«ÅÅì¢Í§ glomerulus ¨Ò¡ immune complex. (NO 03109)
AU : Vajragupta L, Arjhansiri K.
TI : Diagnosis of mycotic aneurysm of the superior mesenteric artery.
JN : Chulalongkorn Medical Journal 1995 ; 39 (1) : 45-53
EN-AB: Mycotic aneurysm of the superior mesenteric artery is rare. In our case,a 54-year old male patient with culture-negative infective endocarditis was presented with pain at the left side of abdomen and a palpable mass in the left paraumbilical region. A superior meenteric aneurysm was diagnosed by duplex doppler ÿultrasonography and confirmed by angiography. Aneurysmectomy and ileal resection was performed. (NO 02602)
AU : Shuangshoti S, Vajragupta L.
TI : Angiolipoma of thalamus presenting with abrupt onset suggestive of cerebrovascular disease.
JN : Clinical Neuropathology 1995 ; 14 (2) : 82-5
EN-AB: A 25-year-old man had angiolipoma of the left thalamus producing sudden severe headache, coma, right hemiparalysis, and aphasia as usually observed in cerebrovascular disease. The patient remained right hemiparalytic and aphasic after removal of the thalamic lesion. A vascular lesion was also detected angiographically in the left lateral ventricular choroid plexus but was not excised. Only 3 intracranial angiolipomas including the current instance were on record. However, it was only in our patient that the lesion suddenly presented with intracerebral hemorrhage. The pathogenesis of the angiolipoma was suggested to be associated with maldifferentiation of mesenchyme and/or its derivatives toward the vascular and adipose tissue within the same mass, resulting in the formation of the angiolipoma. (NO 02864)
AU : Boonjunwetwat D, Kengsurakarn S, Vajragupta L, Buachum V.
TI : Imaging of Caroli's disease : case report with review of literative.
JN : Chulalongkorn Medical Journal 1994 ; 38 (4) : 219-228
EN-AB: The diagnosis of Caroli's disease of an eight-month female infant was established by computer tomogram, ultrasound and hepatobiliar7 scintigraphy. The imaging clues were specifically demonstrated. CT, with strong contrast enhancement, showed the central dot sign within the saccular dilated intrahepatic bile ducts or multiple cyst-like structures. US showed muliple cysts with central tubular and dot echoes representing protrusion and bridge formation in the dilated intrahepatic bile ducts. The Tc-99m-IODIDA hepathobiliary scan confirmed through excretion of the radiotracer into the cystic structures that the muliple cysts in the liver were non-obstructive cystic dilatation of the bile ducts. (NO 02144)
AU : Vajragupta L, Vasuratna B, Vajarapongse K, Boonjunwetwat D.
TI : Ultrasonographic findings of pancreatic carcinoma.
JN : Chulalongkorn Medical Journal 1993 ; 37 (10) : 609-618
EN-AB: The ultrasound examinations of 43 patients with proven adenocarcinoma of pancreas were reviewed. Pancreatic masses were detected in 33 patients. Pancreatic duct and biliary tract obstruction were seen in 20 and 33 patients respectively. Liver metastasis were identified in 10 patients and missed in10, while regional lymphadenopathy were detected in 14 and missed in 12. Each of portal vein involvement, psoas muscle metastasis and ascites were seen. There was one patient whose ultrasound study was normal. The accuracy rate was 76.7 per cent. The usefulness of ultrasonography as the primary and effective method of investigation is discussed. (NO 02795)
AU : ¹ÃÔ¹·Ãì ÇÃÇØ²Ô, ÈÃÕÊØ´Ò ÊÔµ»ÃÕªÒ, »ÃÐ¨Ñ¡Éì ÁÙÅÅÍÍ, ÇÔâÃ¨¹ì ÇÔâÃ¨¹ÇÑ¸¹ì, ÅÑ´´ÒÇÑÅÂì ÇÑªÃÐ¤Ø»µì, ÈÈÔ¸Ã ÍÀÑÂÇ§Èì, Ê¹Ñè¹ ÃÑ§ÃÑ¡ÉÈÔÃÔÇÃ.
TI : Goiter hoarseness dysphagia.
JN : Chula J Intern Med = ¨ØÌÒÍÒÂØÃÈÒÊµÃìChula Journal of Internal Medicine 1993 May-Jun ; 6 (3) : 45-58 (NO 04043)
AU : Vajarpongse K, Bunjunwetwat D, Kaengsurakran S, Vajragupta L.
TI : CT scan and ultrasonic characteristie imaging of renal cell carcinoma.
JN : ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃ = Chulalongkorn Medical Journal 1991 ; 35 (10) : 651-661
EN-AB: The computerized tomographic (CT) and ultrasonographic (US) findings of 10 cases of renal cell carcinoma were reviewed. US was performed in nine patients (1O tumors); most of the findings (6 out of 10) were of a mass with complex echoes of mixed solid and cystic components. Three tumors were cystic in form, showing the characteristic appearance of a thick-walled cyst with echoic septation and growth projection containing internal bright echoes. Only one case showed multiple hyperechoic masses in the same kidney. CT was performed in eight patients (9 tumors). Characteristic findings were well-defined masses of mixed density. Six out of the nine tumors were mainly slightly more hyperdense than normal renal parenchyma on plain CT, showing patchy enhancement of a less than normally enhanced renal cortex. The other three cases were well-defined, thick- walled cysts, with septation and peripheral rim enhancement. All tumors were intrarenal masses, except one retroperitoneal mass which occurred following a previous nephrectomy for renal cell carcinoma of the left kidney. All involved kidneys preserved their excretory function. Only one case showed calcification in both the US and CT images. (NO 02693)
AU : Vajragupta L, Taratep S.
TI : Traumatic renal arteriovenous fistula. a case report.
JN : ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃ = Chulalongkorn Medical Journal 1991 ; 35 (10) : 669-675
EN-AB: Post-traumatic renal arteriovenous fistula is an uncommon complication of great significance. In this report, an excretory program revealed that a 20-year-old woman, admitted to Chulalongkorn Hospital with gross hematuria after blunt trauma, was found to have a non-functioning left kidney. Computerized tomography revealed evidence of a left perirenal hematoma and a non-functioning left kidney. Renal arteriography showed a left renal arteriovenous fistula as an early venous filling in the arteriographic phase. A thrombus in the left main renal artery was also found. The patient was managed by left nephrectomy. (NO 02694)
AU : Vajragupta L, Vajarapongse R, Pipatchaisiri S, Boonjunwetwat D.
TI : Imaging of renal abscesses.
JN : Chula Med J = ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃChulalongkorn Medical Journal 1990 Aug ; 34 (8) : 587-599
EN-AB: We retrospectively reviewed sonographic, excretory urographic and computed tomographic appearances of renal abscesses in 17 patients during January 1984 to June 1989. Each patient had sonography; 11 had excretory urography and 8 computed tomography. The most common sonographicfindings were an inhomogeneous hypoechoic well-defined mass with through transmission (12/17). The remaining soriographic patterns were thick-walled cysts with internal echo in 4, diffuse enlarged kidney with inhomogeneous parenchymal echo in 2, perinephric collection in 2, subcapsular collection in 1 and splenic extension in l. The excretory urography showed mass effect upon the pelvicalyceal system in 9 patients and faint excretion with enlarged kidney in 2 patients. 1he computed tomography revealed low-density mass with rim enhancement in 5 and without rim enhancement in 2 patients, thick-walled cyst with septation in 1, thickening of the Gerota's fascia in 5, edematous perirenal fat in 3, subcapsular collection in 2, perinephric collection in 2 and splenic extension in 1. Excretory urography is not a sensitive and specific method for visualizing small abscesses of the kidney. The number of positive excretory urogram increases as the mass becomes larger and more defined. Sonography is the fastest, least expensive and accurate method that can be used to identify and follow up renal abscess. The examination is not affected by poor renal function or allergy to contrast material. Percutaneous diagnostic needle aspiration and drainage by sonographic guidance can provide specific cytologic or bacteriologic proof of infection. Computed tomography is an expensive modality but it provides the most precise anatomic localization of the lesion. Computed tomography is help l in acutely or critically ill patients with high suspicions of renal abscess and uncertain sonographic findings. (NO 04940)
AU : Boonjunwetwat D, Treretanakulwongs J, Chomdej S, Vajarapongse K, Vajragupta L.
TI : The sonographic features of the retroperitoneal masses in infants and children.
JN : Chula Med J = ¨ØÌÒÅ§¡Ã³ìàÇªÊÒÃChulalongkorn Medical Journal 1990 Sep ; 34 (9) : 691-704
EN-AB: Sonograms of 23 infants and children with retroperitoneal mass were re rospectively reviewed, including 14 Wilms' tumors, 4 neuroblastomas, 3 teratomas and 2 lymphomas. The following sonographic criteria : size, location, internal echo pattern, anechoic areas, margination and the presence of hepatic metastasis were evaluated separately in each entity of disease. Most of the sonographic features of Wilms' tumor were large-sized, sharply marginated and echogenically heterogeneous with anechoic areas located at the kidney. In all cases of neuroblastomas, the mass was an inhomogeneously echoic solid mass of extra-renal origin; the presence of tumor calcification and hepatic metastases were presented in three of four cases. Three cases of teratomas showed the sonographic characteristics as a large, well-defined complex mass containing solid and cystic components with calcification. In two cases of non-Hodgkin's lymphoma; one with mass at the paraaortic area showed multiple, lobulated, low echoic masses representing lymph node enlargement. The other mass primarily arising from the cecum showed a target lesion. The spectrum of sonographic features of these retroperitoneal masses and the diagnostic value of sonography are discussed. (NO 04942)
AU : Suwanwela N, Lertlum S, Phanuphak P, Hanvanich M, Jimarkorn P, Vajarapongse K, Chomdej S, Vajaragupta L, Hemachudha T, Locharernkul C.
TI : Radiologic aspects of AIDS in Thailand.
JN : Chula Med J 1988 Jan ; 32 (1) : 43-58
EN-AB: An increasing number of patients with acquired immunodeficiency syndrome (AIDS) has been reported in Thailand. Radiologic findings including CT scan and ultrasonographic findings were studied in 7 out of a total of 11 AIDS patients from November 1984 to August 1987. Chest x-ray films were abnormal in all cases of which 4 were proven to be pneumocystis carinii pneumonia, 2 to be tuberculosis and one of no definite diagnosis. Radiologic features of pneumocystis carinii pneumonia were bilateral perihilar, basilar, diffuse reticulonodular infiltration, consolidation and atypical upper lobe infiltration. In tuberculosis, upper lobe infiltration and mediastinal node enlargement were seen. Diffuse mucosal plaques, irregular enlarged folds and ulceration were demonstrated in upper gastro-intertinal tract studies in three patients with Candida esophagitis. Evidences of cholecystitis in both CT scan and ultrasonography were seen in a patient with jaundice. He also had hypoechoice lesions in the liver, spleen and kidneys which later disappeared. On CT scan, two patients had evidences of mild degrees of cerebral atrophy. Another patient with AIDS-related complex (ARC) showed evidences of retroperitoneal node enlargements on CT scan and ultrasonography. Inhomogeneous density of cervical spinal cord and evidences of brain atrophy in this patient were also demonstrated on CT scan. (NO 01551)
AU : Vajarapongse K, Boonjunwetwat D, Taecholarn C, Khaoroptham S, Vajragupta L, Chayapum P.
TI : Value of ultrasonography in the evaluation of spinal dysraphism.
JN : Chula Med J 1987 Jan ; 31 (1) : 35-46
EN-AB: Ultrasonograms of eleven children with the clinical diagnosis of spinal dysraphism were retrospectively analysed. The study was correlated with clincal, operative and pathological findings. The spinal abnormalities demonstrated by ultrasound included spina bifida in 10 cases, lipomyelomeningocele in 6, myelomeningocele in 2, meningocele in one, dermoid in one, and epidermoid cyst with hydromyelia in one. The case of dermoid tumor was misdiagnosed by ultrasound to be lipoma and the case of epidermoid cyst with hydromyelia was misdiagnosed as lipomyelomeningocele. in addition, the other abnormalities demonstrated by ultrasound were neurogenic bladder with bilateral hydronephrosis in two cases and severe hydrocephalus in one. it is concluded that ultrasound examination should be used as an initial diagnostic modality for the evaluation of infants and children with minimal cutaneous stigmata or clinical signs of spinal dysraphism. However ultrasonography has a limited use, and computed tomography is generally accepted as the preferable method of examination in older children with intact bony spinal canal and in doubtful cases. (NO 00426)
AU : Vajragupta L.
TI : Ultrasonic diagnosis of intraductal hepatocellular carcinoma.
JN : Chula Med J 1987 Jan ; 31 (1) : 47-54
EN-AB: Hepatocellular carcinoma presented initially with obstructive jaundice from invasion of the bile duct is rather rare. The incidence is varied from 2 to 9 per cent, probably due to variation of environment and/or genetic factors. The present patient, 29-year-old man from Saraburi province was admitted at Chulalongkorn hospital on 4th February 1986 with a major symptom and sign of obstructive jaundice. The 1st ultrasonogram showed hepatomegaly with dilatation of intrahepatic bile duct and distended gallbladder. There was an echogenic mass without acoustic shadowing in the dilated common duct. Splenomegaly with minimal ascites was seen, suggestive of some degree of portal hypertension. The serum alpha fetoprotein was positive. At the operation, they found cirrhotic liver and necrotic material in the dilated common hepatic and common bile duct. Histological examination of the necrotic material was proved to be hepatocellular carcinoma. Follow up ultrasonogram 3 months after operation fortunately demonstrated a hyperechoic mass in the posterolateral aspect of the right lobe of liver, due to much decrease in degree of dilatation of the bile duct. (NO 01244)
AU : Vajarapongse K, Boonjunwetwat D, Vajragupta L, Tanphiphat C.
TI : Ultrasonographic evaluation of the single thyroid nodule.
JN : J Otolaryngol Head Neck Surg (Thai) 1986 Jul ; 1 (2) : 67-81
EN-AB: Ninety four patients with single thyroid nodule were examined by ultrasound at Chulalongkorn Hospital from January 1981 to December 1983. Ultrasonographic characteristics of the thyroid nodules were correlated with the pathology after excisional surgery. Of the 94 nodules, there were 55 adenomas, 23 adenomatous goiters, 12 carcinomas and four cysts. The ultrasonographic patterns of the 55 adenomas showed 32 (58.2 per cent) solid, six (30.9 per cent) complex nodules. The presence of peripheral sonolucent zone(halo) surrounding the thyroid mass was observed in 39 (70.9 per cent) adenomas. Of the 23 adenomatous goiters, ultrasound showed five (21.7 per cent) solid, four (17.4 per cent) cystic, eight (34.8 per cent) multinodular goiters and six (26.1 per cent) complex nodules. One complex nodule was partially calcified. The halo sign was found in 11 (47.8 per cent) nodules. The ultrasonographic patterns of 12 carcinomas were five (41.7 per cent) solid, six (50 per cent) complex and one (8.3 per cent) thick walled cystic nodule. The halo sign was present in three (25 per cent) nodules. (NO 00150)
AU : Poshyachinda M, Vajragupta L, Buachum V, Boonvisut S.
TI : Evaluation of radionuclide scintigraphy in intracranial abscess.
JN : J Med Assoc Thai 1985 Mar ; 68 (3) : 117-125
EN-AB: Retrospective analysis of patients with proven intracranial abscesses revealed abnormal radionuclide imaging in 53 of 55 patients (96 per cent) and abnormal cerebral angiography in 40 of 44 patients(91 per cent). Among these patients, 7 subdural abscesses exibited abnormal studies in both modalities. It is concluded that radionuclide imaging is a valuable alternative investigation for diagnosis of intracranial abscess when CT scan is not available. It is recommended that radionuclide angiography should be included in order to improve specificity in diagnosis. (NO 00016)
AU : Vajragupta L, Vajarapongse K, Vajarapongse R.
TI : Ultrasonographic evaluation of adrenal masses.
JN : Chula Med J 1985 Dec ; 29 (12) : 1313-1327
EN-AB: Ultrasonograms of 30 patients in 1982-1984 with suspected adrenal masses of various clinical diagnoses were retrospectively evaluated. The final diagnoses were proved by surgery, histology, laboratory tests and other radiological means. The most common adrenal mass was pheochromocytoma which were larger than 3 cm. Cortical adenomas were smaller than 2 cm. The echogenic appearances of pheochromocytoma and adenoma were mostly well defined masses with homogeneous low echogenicity. The ultrasonographic features of a large tumor with necrosis, hemorrhage or cystic degeneration were inhomogeneous low echogenic masses. The typical ultrasonographic pattern of the adrenal cyst was a thin wall echofree mass with high through transmission. We were able to make correct diagnosis of normal and abnormal adrenal glands upto 90 per cent. Ultrasonography is an excellent screening method for evaluating the adrenal gland when a mass is suspected and will yield information about the internal consistency of a lesion. (NO 00427)
AU : Boonjunwetwat D, Vajarapongse K, Vajragupta L.
TI : Ultrasonic and computed tomographic appearances of hepatic melioidosis.
JN : Chula Med J 1985 Dec ; 29 (12) : 1341-1348
EN-AB: Five cases of hepatic melioidosis were evaluated by ultrasonography which showed difference appearances. Two cases showed numerous small rounded low or anechoic lesions in the liver. One case showed multiple low and high echoic lesions. One case showed a complex mass and the last case showed no detectable abnormality. CT was performed only in one case and showed diffused small rounded low density areas in the liver. (NO 01239)
AU : Vajarapongse K, Wetchsetnont D, Vajragupta L, Buachum V, Saksornchai K.
TI : Ultrasonographic images of malignant hepatic neoplasms.
JN : Thai J Radiol 1984 Apr ; 21 (2) : 31-38
EN-AB: Ultrasound studies of 75 patients with proven malignant hepatic neoplasms were reviewed. 51 cases were hepatocellular carcinoma, 18 cases were metastases and 6 cases were cholangiocarcinoma. In hepatocellular carcinoma, 41 cases were single lesion, 7 cases were multiple and 3 cases were diffused parenchymal abnormality. The ultrasonographic features of hepatocellular carcinoma were found to be high level echogenic masses 35 cases, mixed high and low level echogenic masses 5 cases, bull's eye nodule 4 cases, low level echogenic masses 4 cases and diffused alteration of parenchymal echoes throughout the liver 3 cases. In metastatic lesions, 12 cases were multiple and 6 cases were single lesion. Homogeneous high level echogenic masses were 9 cases and poor echogenic masses in 6 cases. 2 cases of bull's eye nodule and 1 case of inhomogeneous different level echogenic masses were found. All cholangiocarcinoma showed high level echogenic masses with or without intrahepatic bile duct dilatation. There were no significant different ultrasonographic features among these groups of hepatic masses. The certain nature of the masses can not be determined by ultrasonographic images alone. (NO 00008)
AU : Vajarapongse K, Wetchsetnont D, Vajragupta L, Buachum V, Lerdlum S.
TI : Ultrasonography of amoebic liver abscess.
JN : Chula Med J 1984 Sep ; 28 (9) : 973-983
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