c) per iventr icular rCBF d iminut ion with a normal global rCBF and MRI showing white mat ter hyper intensi t ies , eg, " 'micro- ang iopa thy" cor responding to the S P E C T defects.

Resu l t s : 94 (46.3%) were d iagnosed with AD, and 6 l (30%) were d iagnosed with Va D of wh ich 41/61 have whi te mat te r dis- ease on MRI and show poster ior rC B F d iminut ion s imilar to AD but wi thout global hypoper fus ion . These subjects demons t ra ted cogni t ive impa i rmen t less severe than pat ients with AD. 20/203 (9.85%) showed (AD-VaD) mi xed pat tern on S P E C T and MRI. 8/203 (8.86%) showed frontal lobe d iminut ion and 10/203 (4.95%) showed a pat tern o f p seudodemen t i a o f depress ion.

Conc lus ion: SPECT and M R I can differentiate demen t i a due to AD, VaD, frontal lobe involvement , and p seudodemen t i a o f de- pression. A s ignif icant n u m b e r o f pat ients with VaD presents with mic roang iopa thy on M R I and S P E C T rCBF pat tern mimick - ing AD. MRI correlat ion is therefore important .

(P-12) Dextrocardia: The Right Way John W. Wu, M D Wake Forest University School of Medicine, Winston-Salem, NC, T h o m a s S. Harle, MD, Kerry M. Link, M D

Congeni ta l hear t ma l fo rmat ion is a complex subject that can be qui te confus ing . C o m p l e x embryolog ica l changes , inexac t termi- nology, and complex ana t omy combi ne to c o m p o u n d the difficul- ties o f unders tand ing a c omp l ex topic. In this poster, the authors will a t tempt to provide a conceptua l f r amework to facilitate com- prehens ion o f the different types o f dextrocardia. A s u m m a r y of the embryologica l deve lopmen t o f a heart is presented along with a precise defini t ion o f the deve lopmenta l anomal ies based on the segmenta l ana tomy of the heart. Examples o f the major causes o f dextrocardia are presented, inc lud ing dextroposi t ion, an 'est o f the D-bulbo ventr icular loop, L- t ranspos i t ion o f the great vessels , and si tus inversus .

(P-13) CT Manifestations of Hypovolemic Shock Vahid Yaghmai , M D Evanston Hospital, Evanston, IL, Gary G. Ghahreman i , MD, Richard M. Gore, MD, Mar ia V. Graichen, MD, Elan M. Omess i , M D

A b d o m i n a l CT examina t ion should only pe r fo rmed on t r auma pat ients who are h e m o d y n a m i c a l l y stable. However , pat ients in hypovo lemic shock m a y t ransient ly main ta in stable vital s igns af- ter aggress ive vo lume replet ion and, therefore, be j udged to be candidates for C T imag ing by the t r auma surgeon. This exhibi t reviews mani fes ta t ions o f shock on the abdomina l C T of these crit ically ill pat ients . These inc lude intense renal e n h a n c e m e n t ( "shock kidney") , unusua l pancreat ic and adrenal enhancemen t , col lapsed IVC, mad a smal l aorta. Other equal ly impor tan t find- ings inc lude abnormal bowel e n h a n c e m e n t and free intraperito- neal fluid. Example s o f each f inding will be shown and potential pitfalls in d iagnos is will be d iscussed. A knowledge o f these f indings is crucial for the correct and expedi t ious m a n a g e m e n t o f these patients .

(P-14) Clinical Utility of Embolization in the Management of Myomas V. Mon ique McCorvey , M D Bryn Mawr Hospital, Bryn Mawr, PA, Vikram S. Dravid, MD, H u n g Q. Vu, MD, Rooseve l t McCorvey , MD, Bever ly R. Love, MD, Caro lyn G. Dudley, M D

P u r p o s e : W e a t tempt to descr ibe the role and illustrate the tech- n ique o f uter ine embol iza t ion in the m a n a g e m e n t o f m y o m a s .

Mate r i a l s : W e retrospectively reviewed cases in which emboliza- don was used either primarily or post-operatively in the manage- ment of myomas , with a view to est imate clinical feasibility and utility of the technique.

Resul t s : Embolization was used successful ly in all cases attempted. Rel ief o f symptoms (ie, menorrhagia and dysmenorrhea) was noted in all cases when embolizat ion was the primary technique in man- agement. Complete cessation of hemorrhage was achieved when embolization was used in the postoperative setting.

Conc lus ions : Embol iza t ion is feasible and o f clinical utility in the pr imary and postopera t ive m a n a g e m e n t o f uterine m y o m a s .

L e a r n i n g Ob jec t ive s : 1 .To provide a pictoral d isplay of the technique o f uterine embol iza t ion in the m a n a g e m e n t o f uter ine m y o m a s . 2.To elucidate the role o f embolo the rapy in the man- agemen t o f m y o m a s .

(P.15) Multimedia Content Production for Radiology Teach- ing and Presentation Brian J. Bartholmal, M D Wake Forest University School of Medi- cine, Winston-Salem, NC, Walter D. Liebkemann, MD, Daniel L. Schwarz, M D

P u r p o s e : M a n y of the imag ing modal i t ies used in radiology such as u l t rasound, f luoroscopy, dynamic MRI, and some nuclear medic ine s tudies may demons t ra te f indings which are best v iewed us ing rea l - t ime or dynamic informat ion display. W e de- scribe an inexpens ive and s t ra ightforward me thod for the incor- porat ion o f mul t imed ia and video into compute r -based radiology teaching files and presentat ions .

M a t e r i a l s a n d M e t h o d s : A PC-compat ib le personal compute r and a MiroVideo DC-30 video capture card attached to an S-VHS video camera were utilized for digitization o f video sequences. Edit ing and post -process ing o f the video as well as animat ion se- quences made f rom MRI, C T and nuclear medic ine still images were per formed us ing Adobe Premiere version 4.2 for W i n d o w s 95. Video compress ion was performed us ing Intel Indeo software vers ion 5.06.

Resul t s : Multiple video sequences up to 8 minutes in length and an imated sequences o f MRI, CT, and nuclear medic ine studies were produced and incorporated into a mul t imedia C D - R O M radi- ology teaching file which was distributed to f irst-year medical stu- dents as part o f their radiographic ana tomy course.

Conclus ion: Inexpens ive m o d e m hardware and software can be used to create computer -based video for incorporation into mult i- media teaching files and presentat ions.

(P-16) Complications of Central Vein Catheters: Radiologic Assessment and Management Saravanan Kasthuri , M D University of Tennessee, Memphis, TN, Mat thew T. Graham, M D

Radiologists have been actively involved in the diagnosis and man- agement of venous catheter-related complications.

In this poster we will discuss the clinical findings, radiologic imag- ing and interventional managemen t o f the various complications as- sociated with central vein catheters.

Complicat ions are presented in three groups: malposition, occlusion and mechanical problems. Managemen t is presented for each group.

Our goal is to provide an update on diagnosis and managemen t that will help to proactively prevent a number o f these complications.

(P-17) The Indications for and Variety of Venous Access Devices Matthew T. Graham, M D University of Tennessee, Memphis, TN, Saravanan Kasthuri , M D

P u r p o s e : Our presentat ion will educate radiology residents and medical students with the indications of venous access, the choices of venous access devices and how to select the appropriate device for a g iven patient.

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