• Journal of Trauma and Injury
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• v.27 no.4
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• pp.145-150
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• 2014

Purpose: To assess the accuracy and role of single-contrast computed tomography (CT) in the management of anterior abdominal stab wound (AASW). Methods: During 8-years period, single-contrast CT was performed in 21 hemodynamically stable AASW patients (age range, 22-64 years; median age, 45 years), including 19 men and 2 women. CT scans were evaluated by one trauma surgeon and one senior resident to determine the depth of injury(peritoneal violation or not), and abnormal findings of intraperitoneal cavity associated with stab injury. We retrospectively reviewed medical records regarding operative findings. Results: Nine patients underwent abdominal surgery and 12 patients nonoperative management. In the abdominal surgery group, abnormal CT findings included peritoneal violation in 14 patients and abnormal intraperitoneal cavity findings in 5 patients. There was no statistical significant difference regarding abnormal CT findings between abdominal surgery group and nonoperative management group. Among the nine abdominal surgery patients, therapeutic laparotomy was performed on 4 patients. The positive predictive value (PPV) and negative predictive value (NPV) of peritoneal violation to predictive therapeutic laparotomy were 28.6% and 100%, respectively. In addition, the PPV and NPV of abnormal intraperitoneal cavity CT findings to predict therapeutic laparotomy were 40.0% and 87.5%, respectively. There was no statistical significant difference regarding the abnormal CT findings between therapeutic laparotomy group and non therapeutic laparotomy group. Conclusion: CT is a good adjunctive method to evaluate hemodynamicaly stable AASW patients. If peritoneal violation is not seen on CT scan, conservative treatment on local wound may be safely performed without additional abdominal surgery. However, further study is warranted to evaluate the exact role of CT in the diagnostic workup of AASW patients.

• Kosin Medical Journal
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• v.33 no.3
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• pp.391-395
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• 2018

We report a case of a patient with locally advanced prostate cancer who had only lymph node involvement without bone metastasis on F-18 FDG PET/CT. A 62-year-old Korean male was admitted to our hospital due to dysuria. His PSA level on admission was 79.35 ng/mL. A transrectal ultrasound-guided prostate biopsy confirmed prostate cancer and his Gleason score was 10 (5+5). F-18 FDG PET/CT demonstrated a hypermetabolic mass lesion with SUVmax 7.0 in the prostate and hypermetabolism with SUVmax 4.7 of the abdominal and pelvic lymph nodes. Tc-99m HDP bone scan showed no significant bone metastasis. The patient underwent hormonal therapy for 9 months. Follow-up F-18 FDG PET/CT showed significantly reduced size and FDG uptake in the prostate and abdominal and pelvic lymph nodes. In this case, treatment monitoring with F-18 FDG PET/CT showed decreased mass size and FDG uptake in the prostate and abdominal and pelvic lymph nodes.

• Journal of The Korean Society of Emergency Medicine
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• v.26 no.1
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• pp.29-37
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• 2015

Purpose: Stool exams are a useful tool for the early presumptive diagnosis of infectious bacterial diarrhea in the Emergency Department (ED). CT scans are often used to increase the physician's level of certainty and to facilitate patient triage by identifying the source of pain in most patients with an acute abdomen in the ED. This study was designed to investigate the correlation between stool exams and abdominal CT in patients with acute diarrhea visiting the ED. Methods: We conducted a retrospective study in the emergency department of a national university hospital from January 1, 2012 to June 30, 2013. The subjects consisted of 156 patients with acute diarrhea and abdominal pain who had stool exam results and abdominal CT findings. We divided the patients into three groups according to the stool exam results. Simultaneously, we evaluated their CT findings of the bowel and adjacent structures. Results: A total of 156 patients were enrolled. Frequency of abnormal CT findings showed statistically significant correlation with stool exams (p-value <0.001). Abnormal CT findings increased as WBCs and RBCs in stool increased (p-value <0.001). Conclusion: The stool exam was a statistically significant predictive variable in indirectly determining the severity of acute diarrhea and it showed correlation with the frequency of abnormal CT findings. It is suggested that stool exams can be used as a susceptible marker for predicting the probability of severe infectious colitis, and for making an early decision regarding close medical attention.

• Journal of Magnetics
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• v.21 no.4
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• pp.603-615
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• 2016

In this study, in order to determine the validity and accuracy of MR imaging of 3D gradient dual echo 2-point DIXON technique for measuring abdominal adipose tissue volume and distribution, the measurements obtained by CT were set as a reference for comparison and their correlations were evaluated. CT and MRI scans were performed on each subject (17 healthy male volunteers who were fully informed about this study) to measure abdominal adipose tissue volume. Two skilled investigators individually observed the images acquired by CT and MRI in an independent environment, and directly separated the total volume using region-based thresholding segmentation method, and based on this, the total adipose tissue volume, subcutaneous adipose tissue volume and visceral adipose tissue volume were respectively measured. The correlation of the adipose tissue volume measurements with respect to the observer was examined using the Spearman test and the inter-observer agreement was evaluated using the intra-class correlation test. The correlation of the adipose tissue volume measurements by CT and MRI imaging methods was examined by simple regression analysis. In addition, using the Bland-Altman plot, the degree of agreement between the two imaging methods was evaluated. All of the statistical analysis results showed highly statistically significant correlation (p<0.05) respectively from the results of each adipose tissue volume measurements. In conclusion, MR abdominal adipose volumetry using the technique of 3D gradient dual echo 2-point DIXON showed a very high level of concordance even when compared with the adipose tissue measuring method using CT as reference.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.151-156
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• 2010

Purpose: The liver is the second most common organ injured by blunt abdominal trauma. The purpose of this study was to determine the utility of liver transaminase in screening blunt abdominal trauma patients for traumatic liver injury. Methods: We retrospectively reviewed the medical records of 231 patients who sustained blunt trauma and were at risk for traumatic liver injury between June 2009 and August 2010. All of them underwent a focused assessment with sonography for trauma (FAST) and abdominal computed tomography (CT). Based on the diagnosis of abdominal CT, patients were divided into two groups: group I with liver injury and group II without liver injury. We compared the two groups and calculated the sensitivity, the specificity and the predictive values of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: Of 231 patients with no abdominal free fluid in the FAST, 33 had traumatic liver injury on abdominal CT. The mean AST and ALT levels in group I (311.6 IU/L and 228.1 IU/L, respectively) were significantly higher than the values in group II (48.4 IU/L and 35.6 IU/L, respectively). The cutoff to distinguish liver injury is 60 IU/L for AST and 58 IU/L for ALT, with 93.8% sensitivity and 79.8% specificity for AST, and 90.6% sensitivity and 87.4% specificity for ALT. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though no abdominal free fluid is shown on the FAST. If AST > 60 IU/L and/or ALT > 58 IU/L, abdominal CT was useful to confirm liver injury in this study.

• 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.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1082-1089
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• 2005

Purpose : Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. Methods : Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index(BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography(US) and the total and intra-abdominal fat area by abdominal computerized tomography(CT) were measured in the obese group. Results : The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it(r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and triglyceride level. Conclusion : Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.28-35
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• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.315-325
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• 2023

The purpose of this study was to predict abdominal obesity with 3-Dimensional computed tomography (3D CT) measurements of kidneys by analyzing the correlation between kidney sizes and abdominal obesity level. The subjects were 178 healthy adults without underlying diseases who had a comprehensive health examination at the Health Medical Center of Jesus Hospital in Jeonju. Abdominal obesity was measured by CT cross-sectional image at the level of the umbilicus and divided into visceral fat area, subcutaneous fat area, visceral fat/total fat ratio. The average comparison of kidney sizes classified according to abdominal obesity were performed through one-way analysis of variance (ANOVA) and Scheffe test. Pearson correlation analysis was performed to correlate all measurement values. The results of kidney size ANOVA analysis according to abdominal obesity were as follows. The means of kidney measurements according to visceral fat classification were significantly different in all kidney measurements (p<0.05). And in case of subcutaneous fat classification, the means of kidney measurements by 3D CT of the severe obesity group were significantly different in the right kidney width (p<0.05). In case of visceral fat area/total fat area ratio, the means of kidney measurements by 3D CT of the severe obesity group were significantly different in both kidneys width (p<0.05). Pearson correlation between kidneys measurements and CT abdominal obesity showed that visceral fat area had the highest correlation with the left kidney width measured by 3D CT (r=0.467) and subcutaneous fat area had correlation with the right kidney width measured by 3D CT (r=0.249). The visceral fat area/total fat area ratio had correlation with the left kidney width measured by 3D CT (r=0.291).

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.129-143
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• 2010

Objectives : This study examined search on how the obesity indices, that are largely used in clinics such as waist circumference(WC), body mass index(BMI) and waist-hip ratio(WHR), are related to the visceral fat that was measured from abdominal computed tomography(CT) and the ratio of visceral fat/subcutaneous fat. Then, two groups ware compared in order to find out which characteristics of ordinary adults relationship with the abdominal obesity. Two groups are divided as follows; ones who are obese based on the measurement of WC and the others who are obese based on the level of BMI. Methods : A group of 63 test subjects that were gathered in the oriental medical hospital of Kyung-Won university is divided into two groups; ones (n=51, general obesity; group A) who have $BMI{\geq}25$ and $WC{\geq}85$, and the others (n=12, abdominal obesity; group B) who have BMI<25 and $WC{\geq}85$. Then, each group's obesity indices, abdominal CT, lipid level, glucose, adiponectin, leptin and C-reactive protein(CRP) are compared. In addition, subjects are again divided into two to examine the characteristics; ones (n=14, visceral obesity; group C) with visceral obesity based on the ratio between visceral fat and subcutaneous fat measured through abdominal CT, and the others (n=38, non-visceral obesity; group D) who are obese but not viscerally obese. Results & Conclusions : As a measurement that applies abdominal visceral fat and subcutaneous fat, BMI and WC can be considered as an appropriate obesity index while WHR cannot appropriately apply the abdominal fat amount. Moreover, the study indicates that abdominal obesity group based on the ratio of visceral fat/subcutaneous fat has more significant difference than the abdominal obesity group based on the WC in case of blood lipid index.