• Title/Summary/Keyword: 혈관내 초음파 영상

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Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

Emergency angioembolization performed in a hemodynamically unstable patient with grade V liver injury: The benefit of emergency angioembolization without computed tomography (혈역학적으로 불안정한 grade V 간손상에서 시행한 응급 혈관색전술: 전산화단층 촬영 없이 시행한 응급 혈관색전술의 이점)

  • Kang, Wu Seong;Park, Chan Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.235-239
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    • 2019
  • High-grade liver injury is associated with high morbidity and mortality rates. We report successful emergency angioembolization and early interventional radiology support to manage a high-grade liver injury in a 29-year-old man who presented following a fall during parachute training. Upon arrival, his blood pressure was 80/40 mmHg, and emergency ultrasonography showed a liver injury with perihepatic fluid collection. The patient's blood pressure reduced to 60/40 mmHg, and emergency angiography was performed without computed tomography (CT) (door to puncture time 36 min). After angioembolization, his blood pressure returned to 120/77 mmHg. Subsequent CT revealed no additional bleeding or hollow viscus injury. He was admitted to the Intensive Care Unit and discharged without complications 30 days after admission. In this case, emergency angioembolization (without performing CT) could successfully and safely treat a hemodynamically unstable patient with a high-grade liver injury.

Clinical Usefulness of Ultrasonography in the Diagnosis of Fatty Liver (지방간 진단에 있어 초음파 검사의 임상적 유용성 연구)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.349-357
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    • 2019
  • The purpose of this study was to evaluate the clinical significance of ultrasonographic classification of fatty liver in three grades. From June 2018 to April 2019, 1047 patients (818 males and 229 females) diagnosed as fatty liver among 3607 patients who underwent abdominal ultrasonography at Busan screening center. Ultrasonography was classified into three grades: Grade I (mild fatty liver), Grade II (moderate fatty liver), and Grade III (severe fatty liver) according to the degree of parenchyma texture, acoustic attenuation, Obesity index, hematological test, and metabolic syndrome. The average age of men in each sex increased with the increase of the fatty liver. Body mass index (BMI) and waist circumference were significantly increased in both men and women (p=.000). hematological analysis showed that AST, ALT, ${\gamma}-GTP$, TG, fasting blood sugar, and glycated hemoglobin were significantly different from each other (p<.05). In women, ALT, ${\gamma}-GTP$ and TG showed a significant difference with increasing fatty liver (p<.05). The prevalence of metabolic syndrome was significantly increased in both sexes as the grade of fatty liver increased (p=.000). Based on the results of this study, it is suggested that the use of ultrasound - guided fatty liver according to severity may be useful for the treatment and follow - up of fatty liver if the liver grade is divided in consideration of hematological variables and metabolic syndrome.

Occult Papillary Thyroid Carcinoma Presenting as a Huge Mediastinal Cystic Metastasis (종격동에 거대 낭성 전이를 일으킨 갑상선의 잠재성 유두상 암종)

  • Chekar, Jay Key;Song, Sang-Yun;Na, Kook-Ju;Ahn, Byoung-Hee;Oh, Sang-Gi;Jeong, In-Seok;Park, Min-Ho
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.113-116
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    • 2010
  • The initial presentation of distant metastases in patients with papillary thyroid carcinoma is quite rare. Most distant metastases are solid nodular lesions. A 67-year-old man who complained of severe dyspnea underwent surgery due to a large mediastinal cystic mass compressing the trachea and great vessels. Pathologically, the cystic mass was a metastatic thyroid papillary carcinoma. The thyroid evaluations were compatible with a well differentiated thyroid carcinoma. An occult thyroid carcinoma presenting as a large mediastinal cystic lesion is extremely rare.

Benign Adenomyoepithelioma of the Breast: Imaging Characteristics (유방의 양성 선근상피세포종: 영상 특징)

  • So Ra Shin;Eun Young Ko;Boo-Kyung Han;Eun Sook Ko;Ji Soo Choi;Haejung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.398-408
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    • 2023
  • Purpose This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast. Materials and Methods Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision. Results All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy. Conclusion Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.

Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

Single Extrahepatic Portosystemic Shunt in 3 Dogs: CT Findings and Progress (3마리의 개에서 발생한 단일 간외성 문맥전신 단락 증례)

  • Lee, Hee-Chun;Ji, Chang-Moo;Moon, Jong-Hyun;Cho, Kyu-Woan;Kim, Young-Ki;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.488-493
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    • 2012
  • Two Maltese (2-year-old, intact female and 4-month-old, intact female) and a Pekingese (10-year-old, intact male) dogs were referred due to vomiting, anorexia, head-pressing and hypersalivation. Physical examinations, complete blood count, serum chemical analysis, radiography, ultrasonography and computed tomography (CT) were evaluated. Laboratory findings in these dogs included high hepatic enzyme, serum bile acid and ammonia concentration. Microhepatia was found on abdominal radiographs in two dogs. The existence of portosystemic shunt was presented in abdominal ultrasonography. The shunt vessel was identified in all dogs by CT imaging. Based on three-dimensional CT reconstruction, the origin and termination of each shunt vessel were defined certainly. In consequence, each dog was diagnosed single extrahepatic portosystemic shunt. After diagnosis, surgical treatment was performed in all dogs. This case report describes clinical finding, imaging characteristics, and three-dimensional CT imaging of single extrahepatic portosystemic shunt cases.

Measurement of the Skin Blood Flow using Cross-Correlation (Cross-Correlation법에 의한 피부 혈류속도 측정)

  • Lee, Jeong-Taek;Im, Chun-Seong;Ryu, Jeom-Su;Lee, Jong-Su;Gong, Seong-Bae;Kim, Yeong-Gil
    • Journal of Biomedical Engineering Research
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    • v.19 no.4
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    • pp.379-384
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    • 1998
  • To measure precisely the blood velocity in the skin microcirculation, we have used time domain correlation (called Cross-Correlation) based on the processing of the backscattered RF signal obtained with a wideband echographic imaging transducer, although it is difficulties of adaptation of the pulsed wave system, because of the data processing in real time and the hardware problem. This dedicated technology based on a 20MHz echographic imaging system has been developed. We present how the experimental data, i.e. the backscattered RF signal, have to be analyzed. After RF lines realignment, stationary echo canceling procedure and correlation level control, a velocity profile has been obtained. In-vitro result show that velocity measurements as low as 0.1mm/sec attainable with a 80${\mu}m$ in axial resolution. We have also validated with in-vivo experimentation on the external ear of a rabbit using B-mode sector scanning image and M-mode image of a custom made 20MHz skin image system. The flow of the "auriculares caudales" vein, a microvessel of 600 m diameter, has been detected and studied. This technique will allow a more precise exploration of circulatory troubles in cutaneous pathologies.

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Correlation between Carotid Intima-media Thickness and Risk Factors for Atherosclerosis (경동맥 내중막 두께에 따른 죽상경화반의 위험요인과의 상관관계)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.339-348
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    • 2019
  • The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

Central Nervous System Complications of Coronary Artery Bypass Grafting - Comparison Between Off-Pump CABG and Conventional CABG (관상동맥 우회술 후의 중추신경계 합병증 - 심폐바이패스를 사용하지 않은 관상동맥 우회술과 기존의 관상동맥 우회술의 비교)

  • Chang, Ji-Min;Lee, Jeong-Sang;Kim, Ki-Bong;Ahn, Hyuk;Yoon, Byung-Woo;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.941-947
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    • 2000
  • Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.

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