• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.297-303
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• 2023

Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.285-295
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• 2023

With the development of technology, efforts to reduce the exposure dose received by patients in CT scans are continuing with the development of new reconstruction techniques. Recently, deep learning reconstruction techniques have been developed to overcome the limitations of repetitive reconstruction techniques. This study aims to evaluate the usefulness of images according to reconstruction techniques in pediatric chest CT images. Patient study conducted a study on 85 pediatric patients who underwent chest CT scan at P-Hospital in Gyeongsangnam-do from January 1, 2021 to December 31, 2022. The phantom used in the Phantom Study is the Pediatrics Whole Body Phantom PBU-70. After the test, the images were reconstructed with FBP, ASIR-V (50%) and DLIR (TF-Medium, High), and the images were evaluated by obtaining SNR and CNR values by setting ROI of the same size. As a result, TF-H of deep learning reconstruction techniques had the lowest noise value compared to ASIR-V (50%) and TF-M in all experiments, and SNR and CNR had the highest values. In pediatric chest CT scans, TF images with deep learning reconstruction techniques were less noisy than ASiR-V images with adaptive statistical iterative reconstruction techniques, CNR and SNR were higher, and the quality of images was improved compared to conventional reconstruction techniques.

• The Journal of the Korea Contents Association
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• v.19 no.8
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• pp.284-292
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• 2019

To evaluate the usefulness of pediatric chest CT scans by comparing the dose, examination time, and image quality by applying Helical mode, High-pitch mode, and Volume Axial mode to minimize the radiation exposure and obtain high diagnostic value. Revolution (GE Healthcare, Wisconsin USA) was used to divide PBU-70 phantom into Helical mode, High-pitch mode, and Volume Axial mode. After acquiring images, ROI is set for each image, heart, bone, lung, and back-ground air, and the average value is obtained by measuring CT number (HU) and noise (SD). SNR and CNR were measured and compared with DLP values provided directly by the equipment. Determining statistical significance Statistical analysis was performed using ONE-WAY-ANAOVA using SPSS 21.0. In this experiment, it was possible to inspect at a short time without deterioration of image quality with the lowest dose when using volume axial mode. Although the detector coverage of 16 cm is limited to all pediatric chest CT scans, it is recommended to be actively used in pediatric patients, and further study is needed to apply other test sites in volume axial mode.

• Journal of the Korean Society of Radiology
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• v.13 no.6
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• pp.879-887
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• 2019

The purpose of this study is to establish a physiological injection protocol according to body weight, in order to minimize amount of contrast medium and optimize contrast enhancement in pediatric patients performing thoracic CT examinations. The 80 pediatric patients under the age of 10 were studied. Intravenous contrast material containing 300 mgI/ml was used. The group A injected with a capacity of 1.5 times its weight, and groups B, C and D added 5 to 15 ml of normal saline with a 10% decrease in each. The physiologic model which can be calculated by weight about amount of injection of contrast medium and normal saline, flow rate and delay time were applied. To assess image quality, measured average HU value and SNR of superior vena cava, pulmonary artery, ascending and descending aorta, right and left atrium, right and left ventricle. CT numbers of subclavian vein and superior vena cava were compared to identify the effects of reducing artifacts due to normal saline. Comparing SNR according to the contrast medium injection protocol, significant differences were found in superior vena cava and pulmonary artery, descending aorta, right and left ventricle, and CT numbers showed significant differences in all organs. In particular, B group with a 10% decrease in contrast medium and an additional injection of saline showed a low degree of contrast enhancement in groups with a decrease of more than 20%. In addition, the group injected with normal saline greatly reduced contrast enhancement of subclavian vein and superior vena cava, and the beam hardening artifact by contrast medium was significantly attenuated. In conclusion, the application of physiological protocol for injection of contrast medium in pediatric thoracic CT examinations was able to reduce artifacts by contrast medium, prevent unnecessary use of contrast medium and improve the effect of contrast enhancement.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.503-508
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• 2019

In short a binary value according to a change in the tube voltage by using one of VOLUME AXIAL MODE of scanning techniques of chest CT image quality evaluation in order to obtain high image and to present the appropriate tube voltage. CT instruments were GE Revolution (GE Healthcare, Wisconsin USA) model and Phantom used Pediatric Whole Body Phantom PBU-70. The test method was examined in Volume Axial mode using the pediatric protocol used in the Y university hospital of mass-produced material. The tube voltage was set to 70kvp, 80kvp, 100kvp, and mAs was set to smart mA-ODM. The mean SNR difference of the heart was $-4.53{\pm}0.26$ at 70 kvp, $-3.34{\pm}0.18$ at 80 kvp, $-1.87{\pm}0.15$ at 100 kvp, and SNR at 70 kvp was about -2.66 higher than 100 kvp and statistically significant (p<0.05) In the Lung SNR mean difference analysis, $-78.20{\pm}4.16$ at 70 kvp, $-79.10{\pm}4.39$ at 80 kvp, $-77.43{\pm}4.72$ at 100 kvp, and SNR at 70 kvp at about -0.77 higher than 100 kvp were statistically significant. (p<0.05). Lung CNR mean difference was $73.67{\pm}3.95$ at 70 kvp, $75.76{\pm}4.25$ at 80 kvp, $75.57{\pm}4.62$ at 100 kvp and 20.9 CNR at 80 kvp higher than 70 kvp and statistically significant (p<0.05) At 100 kvp of tube voltage, the SNR was close to 1 while maintaining the quality of the heart image when 70 kvp and 80 kvp were compared. However, there is no difference in SNR between 70 kvp and 80 kvp, and 70 kvp can be used to reduce the radiation dose. On the other and, CNR showed an approximate value of 1 at 70 kvp. There is no difference between 80 kvp and 100 kvp. Therefore, 80 kvp can reduce the radiation dose by pediatric chest CT. In addition, it is possible to perform a scan with a short scan time of 0.3 seconds in the volume axial mode test, which is useful for pediatric patients who need to move or relax.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.186-189
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• 2013

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) now provides an important alternative diagnostic modality in patients with intrathoracic tuberculosis lymphadenopathy. The procedure is well tolerated in the outpatient setting, provides access to the mediastinal and hilar lymph node locations commonly in tuberculosis and also allows bronchial washing to be performed at the same procedure. However, there is no report of EBUS-TBNA applied to children to diagnose tuberculosis. We report a case of EBUS-TBNA applied to children who had intrathoracic tuberculosis lymphadenopathy.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.198-201
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• 2001

지방모세포종은 태생기 지방조직에서 기원하는 드문 양성종양으로 대부분 소아기에 발생하는데 이 종양의 약 70%는 사지에서 나타나고 간혹 다른 부위에서 보고되기도 한다. 저자들은 좌측 후종격동과 좌측 쇄골상부에 양성 지방모세포종을 보인 3세된 남아를 치험한바 있다. CT 소견상 지방을 함유한 종괴가 정상적인 흉강내 구조물을 누르고 있었고, 쇄골상부 및 종격동으로부터 합병증없이 절제되었다. 종괴는 황색을 띠었으며, 병리조직검사상 지방모세포종으로 진단되었다.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.308-311
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• 1993

Aberrant right subclavian arteries were experienced in two young children. This is a rare aortic arch anomaly that usually does not produce symptoms. Symtomatic patients require surgical interventions.We describe two young children who had aberrant right subclavian artery with symptoms of difficulty in swallowing and respiratory problems. Diagnosis was made by esophagography, aortography and 3-Dimension chest CT. Operation had been advocated through right thoracotomy without difficulty for ligation, division and anastomosis to the ascending aorta. Dysphagia lusoria was immediately relieved and postoperative course was uneventful. We consider that the right thoracotomy is the choice of operative approach and noninvasive diagnosis by 3-Dimension chest CT is easily made for infant with aberrant right subclavian artery.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.221-223
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• 2005

Congenital pleural effusions are uncommon. The majority of cases are due to chylothorax, hydrops fetalis, and infection. Effusions of this nature are, for the most part, self-limited. We experienced a rare case of a congenital unilateral pleural effusion due to an extralobar sequestraion with pulmonary lymphangiectasia. Pleural effusion was found by antenatal ultrasonography and confirmed by CT scans and CT angiography of the chest in the neonatal period. The patient underwent an open thoracotomy where extralobar sequestraion located between the diaphragm and the left lower lobe was removed. His postoperative course was uncomplicated and there was complete resolution of the pleural effusion.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.339-345
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• 2002

Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.