Creutzfeldt-Jakob disease causes progressive dementia and, eventually, death. The infectious agent is thought to be proteinaceous scrapie particles. Prompt diagnosis is essential to prevent human-to-human transmission. Progressive brain atrophy and areas of high signal intensity in the cerebral cortex and basal ganglia are well-known features of Creutzfeldt-Jakob disease depicted on T2-weighted magnetic resonance (MR) images. However, in the early stage of disease, the appearance of the brain on T2-weighted MR images often is normal, and it may be impossible on that basis to reach a diagnosis. Diffusion-weighted imaging therefore has gained attention as a useful modality for the early diagnosis of Creutzfeldt-Jakob disease. Even before the appearance of the characteristic periodic synchronous discharges on the electroencephalogram, diffusion-weighted images in most cases of Creutzfeldt-Jakob disease depict areas of abnormal signal hyperintensity in the cortex and in the basal ganglia or thalamus. These imaging abnormalities are accompanied by decreased apparent diffusion coefficient values suggestive of restricted diffusion within the tissue. However, if diffusion-weighted imaging findings of abnormal high signal intensity are restricted to the cerebral cortex, it may be necessary to differentiate between Creutzfeldt-Jakob disease and other conditions that may produce progressive dementia (eg, venous hypertensive en-cephalopathy; chronic herpes encephalitis; and the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes).

JPEG compression at ratios of 10:1 and 20:1 was tolerated in the detection of acute cerebral infarction at CT.

Mediastinal lung herniation is a rare condition characterized by protrusion of 1 lower lung through behind the heart into the opposite side of the chest, usually from right to left. We present a case of mediastinal lung herniation associated with pulmonary sequestration, which was confirmed both surgically and pathologically in a 13-year-old girl initially admitted with a diagnosis of pneumonia. Contrast-enhanced computed tomographic images using a multidetector-row computed tomography clearly demonstrated the right lung herniation toward the left and 2 aberrant systemic arteries supplying the sequestered lung mass. These arteries run through the herniated lung from right to left. Additionally, on the basis of pleural anatomy, we discuss herein the difference between a mediastinal lung herniation and horseshoe lung.

During the initial 8 months period of lBF-FDG PET/CT examination in our institution eleven cases of double cancers were detected. Eight cases were simultaneous second cancers and 3 cases are consecutive cancers. All cases are clinical ones and were referred from both outside hospitals and our own hospital. lBF-FDG PET/CT examination were utilized either to determine the extent of tumor or to stage the cancer or to detect recurrent tumors during the follow-up period.During the 8-months period 964 cases were studied. Therefore, the detection rates of simultaneous and consecutive cancers are 0.83% and 0.31% respectively. All together the detection rate of double cancer was 1.14%.To gain the general conception of double cancers the authors reviewed the autopsy registry of Japanese Society of Pathology during the four years from 2000 through 2003, and tabulated the combination of primary and second cancers. Frequently found combination of cancers were cancers of the thyroid, lung, stomach, liver, biliary tract, colon, rectum, and prostate.lBF-FDG PET/CT examination seems to be very useful in the management of cancer patients in terms of whole patient care.

A 56-year-old man presented with discomfort in the abdomen and backache. He lost his body weight by 10 Kg in 6 months.A large retroperitoneal mass was found in addition to the right renal mass.It seemed necessary to exclude additional tumor in theretroperitoneum.Abdominal CT with and without contrast enhancement showed Tumors in the right kidney and giant tumors in the retroperitoneum. Percutaneous core needle biopsy of the retroperitoneal tumor and renal tumor was carried out under CT control.Pathological study revealedsarcomatoid renal cell carcinoma in the retroperitoneal mass, but mostly fibrous tissue in the renal mass.Final diagnosis was sarcomatoid renal cell carcinoma with retroperitoneal extension. This type of renal cell carcinoma is noted to have very poor prognosis in the literature. Our case was also poor in prognosis, and the patient expired three months after the diagnosis was established.