• Title/Summary/Keyword: Abdomen CT

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Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report

  • Cho, Sung Hoon;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.294-298
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    • 2021
  • Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

Diagnosis of Rare Case of Hepatoblastoma in a Dog

  • Son, Seongin;Lee, Seoung-woo;Jang, Min;Yun, Sungho;Kwon, Young-sam;Park, Jin-kyu;Lee, Kija
    • Journal of Veterinary Clinics
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    • v.38 no.2
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    • pp.85-88
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    • 2021
  • A 9-year-old, intact female Shih-tzu dog presented with a three-week history of anorexia, lethargy, and weight loss. Abdominal radiography revealed a mass in the right cranial quadrant of the abdomen that was displacing the right kidney caudally. Ultrasonography showed a large, irregular, heterogeneous hepatic mass and a small amount of peritoneal fluid. On computed tomography (CT), a large hypoattenuating mass with heterogeneous contrast enhancement occupied the right lateral lobe, and parts of the right medial and caudate lobes of the liver. There was no evidence of regional lymph node or pulmonary metastasis. Lobectomy of the right medial, right lateral and caudate liver lobes was performed, however, the patient did not recover from surgery. Hepatoblastoma was confirmed by histological examination. Hepatoblastoma is rare in dogs, and this is the first report describing CT imaging of hepatoblastoma in a dog.

Dose Reduction and Image Quality Assessment of the CareDose 4D Technique on Abdomen Liver Computed Tomography (복부 간 CT 검사에서 CareDose 4D 사용에 따른 선량 감소 및 화질 평가)

  • Seok, Jong-Min;Jeon, Woo-Jin;Park, Young-Joon;Lee, Jin
    • Journal of the Korean Society of Radiology
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    • v.11 no.3
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    • pp.109-115
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    • 2017
  • The purpose of this study was to evaluate the clinical efficacy of 128 MDCT (multi-detector computed tomography) for reducing the CareDose 4D dose and comparing the image quality with the fixed tube current technique. For this purpose, we conducted the phantom and clinical studies to evaluate the exposure dose and image of the subject before and after applying the CareDose 4D system in abdominal examination using 128 MDCT. In the phantom study, ROI (Region of interest) was located at the center, 3, 6, 9, 12 o'clock, into two groups: group A without CareDose 4D and Group B applied were measured. In the clinical study, ROI was located at the liver 8 segments, divided into two groups too. The measured items were CT number, noise, and dose length product (DLP) dose. The result of CTDIvol (CT Dose Index volume) measurements in phantom and clinical studies were lower than those before CareDose 4D application, and dose and effective dose were also measured lower (p<.05). There was no difference in CT number before and after application (p>.05). In conclusion, using CareDose 4D, we can obtain optimal image information without deteriorating image quality while reducing patient dose.

Evaluation of Radiation Exposure Dose for Examination Purposes other than the Critical Organ from Computed Tomography: A base on the Dose Reference Level (DRL) (전산화단층촬영에서 촬영 목적 부위와 주변 결정장기에 대한 피폭선량 평가: 선량 권고량 중심으로)

  • Lee, Seoyoung;Kim, Kyunglee;Ha, Hyekyoung;Im, Inchul;Lee, Jaeseung;Park, Hyonghu;Kwak, Byungjoon;Yu, Yunsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.121-129
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    • 2013
  • In this study measured patient exposure dose for purpose exposure area and peripheral critical organs by using optically stimulated luminescence dosimeters (OSLDs) from computed tomography (CT), based on the measurement results, we predicted the radiobiological effects, and would like to advised ways of reduction strategies. In order to experiment, OSLDs received calibration factor were attached at left and right lens, thyroid, field center, and sexual gland in human body standard phantom that is recommended in ICRP, and we simulated exposure dose of patients in same condition that equal exposure condition according to examination area. Average calibration factor of OSLDs were $1.0058{\pm}0.0074$. In case of left and right lens, equivalent dose was measure in 50.49 mGy in skull examination, 0.24 mGy in chest, under standard value in abdomen, lumbar spine and pelvis. In case of thyroid, equivalent dose was measured in 10.89 mGy in skull examination, 7.75 mGy in chest, 0.06 mGy in abdomen, under standard value in lumber spine and pelvis. In case of sexual gland, equivalent dose was measured in 21.98 mGy, 2.37 mGy in lumber spine, 6.29 mGy in abdomen, under standard value in skull examination. Reduction strategies about diagnosis reference level (DRL) in CT examination needed fair interpretation and institutional support recommending international organization. So, we met validity for minimize exposure of patients, systematize influence about exposure dose of patients and minimize unnecessary exposure of tissue.

Evaluation of Usefulness of an m-DIXON Technique during an Abdomen MRI Examination : A Comparison with an e-THRIVE Technique (복부 MRI검사에서 m-DIXON기법의 유용성 평가: e-THRIVE기법과 비교 분석)

  • Lee, Bo-Woo;Park, Myung-Cheol;Lee, Jin-Hoi;Kim, Ki-Jin;Bae, Seok-Hwan
    • Journal of Digital Convergence
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    • v.12 no.10
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    • pp.385-390
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    • 2014
  • This research is conducted to identify whether an m-DIXON technique which is useful for an abdomen MRI examination compared with an existing e-THRIVE technique is a clinically useful or not. There was evaluated quantitative and qualitative to 84 subjects who had abdomen MRI exam due to their liver disease were conducted during a period from September in 2013 to February in 2014. First of all the quantitative evaluation, the m-DIXON technique's SNR was $90.42{\pm}16.90$ and the e-THRIVE technique was $60.42{\pm}11.54$ and the m-DIXON technique's CNR was $52.38{\pm}22.58$ and the e-THRIVE technique was $46.31{\pm}20.25$. Secondly in the qualitative evaluation, the m-DIXON technique's image quality was $4.06{\pm}0.34$, a artifact was $3.64{\pm}0.22$, and fat suppression was $4.16{\pm}0.15$, the e-THRIVE technique's image quality was $3.14{\pm}0.35$, a artifact was $3.06{\pm}0.38$, fat suppression was $3.14{\pm}0.30$. In conclusion, m-DIXON technique for abdomen MRI examination showed superiority over both SNR as a quantitative anaylsis, CNR and a qualitative analysis.

Study on Optimum Contrast Medium Quantity during Abdominal CT using Dual Energy Technique (복부 CT 검사 시 이중에너지 기법을 통한 적정한 조영제 양에 관한 연구)

  • Kang, Min;Choi, Namgil;Han, Jaebok;Kim, Wook;Jang, Yeongill;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.9-16
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    • 2015
  • The purpose of this study is finding optimum contrast medium quantity during abdominal CT using dual energy technique. The study subjects are 30 patients who had received general single energy abdominal CT and received double energy technique follow-up abdominal CT. dual energy technique abdominal CT images were obtained after setting contrast medium quantities at 30%, 40%, 50%, 60% and 70% of contrast medium quantity at the time of single energy technique. Then the contrast enhancement (Hounsfield Unit; HU) was estimated by setting-up the regions of interest at aorta, inferior vena cava, hepatic portal vein and hepatic parenchymal. The obtained values were compared to the values of the same parts measured during single energy technique abdominal CT. The results of the study were as following. The 60% set up group had HU in aorta : $210.80{\pm}13.609$, IVC : $190.40{\pm}25.215$, hepatic portal vein : $198.40{\pm}21.232$ and hepatic parenchymal : $119.20{\pm}7.98$, The single energy abdomianl CT images had HU in aorta : $205.40{\pm}16.426$, IVC : $188.20{\pm}21.476$, hepatic portal vein : $195.40{\pm}22.744$ and hepatic parenchymal : $121.00{\pm}6.595$. Therefore, it is possible to obtain contrast enhancement by dual energy technique abdominal CT similar to the same by single energy technique abdominal CT by setting-up the quantity of contrast medium at 60% of contrast medium at the time of single energy technique abdominal CT. Based on the result of this study, it is possible to decrease existing quantity of contrast medium by _% and the injection velocity can be also decreased. Accordingly, it is believed that the result of study would be quite useful for patients who have renal function disorder, weak vein or side effect of contrast medium in the past.

Evaluation to Obtain the Image According to the Spatial Domain Filtering of Various Convolution Kernels in the Multi-Detector Row Computed Tomography (MDCT에서의 Convolution Kernel 종류에 따른 공간 영역 필터링의 영상 평가)

  • Lee, Hoo-Min;Yoo, Beong-Gyu;Kweon, Dae-Cheol
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.71-81
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    • 2008
  • Our objective was to evaluate the image of spatial domain filtering as an alternative to additional image reconstruction using different kernels in MDCT. Derived from thin collimated source images were generated using water phantom and abdomen B10(very smooth), B20(smooth), B30(medium smooth), B40 (medium), B50(medium sharp), B60(sharp), B70(very sharp) and B80(ultra sharp) kernels. MTF and spatial resolution measured with various convolution kernels. Quantitative CT attenuation coefficient and noise measurements provided comparable HU(Hounsfield) units in this respect. CT attenuation coefficient(mean HU) values in the water were values in the water were $1.1{\sim}1.8\;HU$, air($-998{\sim}-1000\;HU$) and noise in the water($5.4{\sim}44.8\;HU$), air($3.6{\sim}31.4\;HU$). In the abdominal fat a CT attenuation coefficient($-2.2{\sim}0.8\;HU$) and noise($10.1{\sim}82.4\;HU$) was measured. In the abdominal was CT attenuation coefficient($53.3{\sim}54.3\;HU$) and noise($10.4{\sim}70.7\;HU$) in the muscle and in the liver parenchyma of CT attenuation coefficient($60.4{\sim}62.2\;HU$) and noise ($7.6{\sim}63.8\;HU$) in the liver parenchyma. Image reconstructed with a convolution kernel led to an increase in noise, whereas the results for CT attenuation coefficient were comparable. Image scanned with a high convolution kernel(B80) led to an increase in noise, whereas the results for CT attenuation coefficient were comparable. Image medications of image sharpness and noise eliminate the need for reconstruction using different kernels in the future. Adjusting CT various kernels, which should be adjusted to take into account the kernels of the CT undergoing the examination, may control CT images increase the diagnostic accuracy.

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Bowel Wall Thickening on Computed Tomography in Children: A Novel Method of Measurement and Its Clinical Significance

  • Lee, Do Kyung;Cho, Ky Young;Cho, Hyun-hae;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.279-287
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    • 2021
  • Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report (반충손상 기전에 의한 간문맥손상에 대한 증례 보고)

  • Joonghyun Yoo;Sung-Joon Park;Seung Hwa Lee;Hwan Hoon Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1594-1599
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    • 2021
  • A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

The effect of atrophied pancreas as shown in the preoperative imaging on the leakage rate after pancreaticoduodenectomy

  • Ashraf Imam;Harbi Khalayleh;Meni Brakha;Ariel A. Benson;Naama Lev-Cohain;Gidon Zamir;Abed Khalaileh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.184-189
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    • 2022
  • Backgrounds/Aims: The soft texture of the pancreas parenchyma may influence the incidence of pancreatic leakage after pancreaticcoduodenectomy (PD). One possible method to assess pancreatic texture and atrophy, is via computed tomography (CT) scan of the abdomen. The purpose of our study was to evaluate the relation between the preoperative CT scan and the incidence of pancreatic fistula after PD. Methods: A retrospective single-center study including patients who underwent PD for a benign and malignant tumor of the periampullary region between the years 2000 and 2016. Demographic and imaging data were analysed and a correlation with the post-operative leak was evaluated. Results: Pancreatic leak was documented in 34 out of 154 (22.1%) patients. All the leakage cases occurred in the preserved pancreas group (33.1% of the total preserved pancreas group alone). No leak was documented in the atrophic pancreas group. This difference between the two groups was found to be statistically significant (p ≤ 0.00001). Conclusions: Atrophic pancreas in the preoperative CT scan may be protective against leakage after PD. These findings may help the surgeon to risk stratify patients accordingly. In addition, the findings suggest that patients with a preserved pancreas may require more protective methods to prevent leakage.