• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.55-58
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• 2013

Persistent proatlantal artery (PPA) is a rare embryologically remnant carotico-vertebrobasilar anastomoses. There are two types of PPA according to embryological considerations, origin and anatomic course. Type I PPA usually originate from internal carotid artery and not traversing transverse foramen. Type II PPA traverses from external carotid artery to C1 transverse foramen. The PPA is usually found incidentally without clinical symptoms, but can be related to several clinically significant vascular lesions, such as hypoplastic vertebral artery, intracranial arteriovenous malformation and in a case of carotid endarterectomy or external carotid artery embolization. So, thorough understanding of this anomaly is needed and we report a case of type II PPA diagnosed by MR angiography.

• 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.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.641-644
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• 2007

A 50-year old man was admitted to our hospital because he complained of sudden abdominal pain. Multidetector abdominal CT showed proximal occlusion of the superior mesenteric artery. Emergency open laparotomy and Fogarty thrombectomy were done on admission day and repeat Fogarty thrombectomy and partial resection of the small bowel were done the next day. We report here on a case of superior mesenteric artery occlusion.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.201-208
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• 2018

The purpose of this study was to investigate the optimal flip angle by measuring the SNR and CNR according to the angle of changes of the MRI technique using the Image J program. A total of 30 normal volunteers were assessed by using a 1.5T magnetic resonance imaging system (Philips, Medical System, Achieva). For the MRI angiography, we set the region of interest in four regions and evaluated the SNR and CNR. The statistical significance of SNR and CNR was calculated by one-way ANOVA using quantitative analysis at five different positions. The Bonferroni method was used for post-hoc analyzes. Statistical significance was determined by using ANOVA analysis at p<0.05 and Bonferroni method was used as a post-hoc analysis. The results of this study, the measurement values of ACA(SNR:$876.59{\pm}14.22$, CNR:$1999.7{\pm}12.5$), PCA(SNR:$863.48{\pm}13.29$, CNR:$1870.18{\pm}12.56$), ICA(SNR:$1116.87{\pm}08.34$, CNR:$2979.37{\pm}14.69$) and MCA(SNR:$848.66{\pm}15.25$, CNR:$2199.25{\pm}13.48$) were obtained with the high signal intensity at $25^{\circ}$(p<0.05). The values of a1, a2, a3, p1, p2, p3, m1, m2 and m3 were also the same (p<0.05). Post-hoc analysis results, There was a statistically significant difference (p=0.000) between $10^{\circ}$, $15^{\circ}$, $20^{\circ}$ on the $25^{\circ}$ reference for the flip angle, but no significant results were obtained with $30^{\circ}$(p<0.05). In concision, because the signal intensity decreased at $30^{\circ}$, this study revealed that the optimal flip angles were $25^{\circ}$ in cerebrovascular MR angiography.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.84-87
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• 2017

Cerebral hyperperfusion syndrome (CHS) is a rare complication that can occur when conducting stent insertion or endarterectomy in patients with carotid artery stenosis and is known to be caused by various mechanisms when the blood volume abruptly increases. The main clinical symptoms are unilateral headache, hypertension, seizure, and focal neurologic deficit. Subarachnoid hemorrhage and parenchymal hemorrhage may lead to permanent impairment or death in severe cases. CHS can be predicted by using transcranial Doppler, perfusion magnetic resonance imaging, and single photon emission computed tomography. In our case report, a patient developed CHS subsequent to significant venous congestion caused by carotid artery stent insertion. The patient had preexisting, symptomatic bilateral carotid artery stenosis. Venous congestion occurs when the direction of blood flow changes because of increased blood volume in patients with well-developed collateral vessels. We believe that CHS can be predicted from this finding. This study reports the possibility that CHS could be confirmed by cerebral angiography after insertion of the internal carotid stent.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.94-100
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• 2005

Purpose : This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. Materials and Methods : Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. Results : A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3T-TOF MR angiography, TCD, and CA was high. Conclusion : 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.

• 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.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.688-691
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• 2002

Takayasu's arteritis is a chronic inflammatory disease of unknown cause. It predominantly affects the aortic arch and its branches. Concomitant involvement of coronary and renal arteries is a rare entity. In this report, we described successful treatment of a patient with Takayasu's arteritis associated with coronary and renal arteries stenosis. A 23-year-old woman was presented with chest pain on exertion. Angiographic studies demonstrated left main coronary, bilateral renal, and left subclavian arteries stenosis. She underwent angioplasty and stenting of bilateral renal artery. After one week, coronary artery bypass grafting using greater saphenous veins and aorto-subclavian bypass with PTFE vascular graft were done simultaneously. She was discharged on the 13th postoperative day without any complications.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.691-694
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• 2003

A 49-year-old woman had thoracic back pain for several years. Chest CT scan and MRI angiography revealed descending thoracic aortic aneurysm with a maximum diameter of 69 mm. Thoracic aortography showed not only the aortic aneurysm, but also coarctation of descending thoracic aorta at the level of aortic hiatus of the diaphragm. Intercostal artery arising Adamkiewicz artery was found in descending thoracic aortic aneurysm just above the coarctation, The aneurysm with coarctation of the aorta was successfully repaired with prosthetic graft replacement under left atrio-femoral bypass.