• Title/Summary/Keyword: Anatomical location

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Successful use of a mesocaval shunt to treat refractory ascites in a chronic pancreatitis induced portal vein thrombosis

  • Souradeep Dutta;Bishal Pal;Duvuru Ram;Sreevathsa Kadaba Shyamprasad;Vishnu Prasad Nelamangala Ramakrishnaiah
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.204-209
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    • 2022
  • The state of intense peripancreatic inflammation in chronic pancreatitis can give rise to various vascular complications such as venous thrombosis and arterial pseudoaneurysms. Due to its intimate location with the pancreas, spleno-mesenteric-portal axis suffers the greatest blunt of thrombotic complications. Treatment modalities for such cases of chronic portal vein thrombosis have always been controversial and challenging. Medical management with anticoagulants is both risky and unsatisfactory due to presence of varices, hypersplenism, and persistence of the inflammatory pathology. Although endovascular techniques have been tried in various case reports, there are definite anatomical challenges in cases of long segment porto-mesenteric thrombosis with massive ascites. Surgical shunts have been historically described for cirrhotic and non-cirrhotic portal hypertensive patients. However, its use in patients with refractory ascites due to chronic pancreatitis induced portal vein thrombosis has not been reported in the medical literature. Here, we present a case of an extensive portal vein thrombosis with massive refractory ascites in a patient with alcohol-induced chronic pancreatitis successfully treated with a surgical mesocaval shunt using an interposition small diameter graft.

Usefulness of "Volumetrix Suite" with SPECT/CT (SPECT/CT 영상에서 Volumetrix Suite의 유용성)

  • Cho, Seung-Wook;Shin, Byeong-Ho;Kim, Jong-Pil;Yoon, Seok-Hwan;Kim, Tae-Yeub;Seung, Yong-Joon;Moon, Il-Sang;Woo, Jae-Ryong;Lee, Ho-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.166-171
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    • 2010
  • Purpose: The SPECT/CT is able to acquire diagnostic information resolved the difficult problems that discriminate regions of focals by intergrating functional images and anatomical images. We introduce the usefulness of "Volumetrix Suite" which can describe 3D images by the convergence of the SPECT/CT images and reference CT images. Materials and Methods: We applied Volumetrix Suite program (Volumetrix IR, Volumetrix 3D) to patients, Bone, Venography, Parathyroid, WBC, taken diagnostic CT examination which have same regions of focal in Seoul Metropolitan Government Seoul National University Boramae Medical Center. After acquiring SPECT/CT images and reference CT images, we fused a couple of scans applying for this programs. The CT scan of Infinia Hawkeye 4 shows limitation of anatomical information. For this reason, we tried to transfer CT images that have lots of diagnostic informations as the form of Dicom file in PACS, and changed from 2D images to 3D images after image registering in Xeleris Workstaion of Hawkeye 4. Results & Conclusion: By using Volumetrix Suite program, we're able to acquire more accurate anatomical informations with 3D rendering which can distinguish both location and range of focals in Infinia Hawkeye 4. Thus, the result of utilizing this program indicate that nuclear medicine anatomical images can be improved by providing more diagnostic imformations produced by its program.

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THE CLINICAL STUDY OF MAXILLARY SINUS SEPTA USED IN PANORAMA, CT (Panorama, CT를 이용한 상악동내 중격의 임상적 연구)

  • Jung, Jin-Won;Song, Kyoung-Ho;Lee, Seul-Ki;Kim, Jwa-Young;Yang, Byoung-Eun;Kim, Sung-Gon;Song, Sang-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.319-324
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    • 2008
  • Purpose: The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. Material & methods: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete & partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. Results: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete & partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area & dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. Conclusion: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete & partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.

Analysis of the Recurrence after Surgical Treatment of the Hemangioma in the Extremities (사지에 발생한 혈관종의 수술적 치료 후 재발에 대한 분석)

  • Kim, Young-Sin;Choi, Hee-Lack;Lee, Jun-Mo;Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.74-79
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    • 2010
  • Purpose: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. Materials and Methods: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. Results: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. Conclusion: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.

Seed-Based Resting-State Functional MRI for Presurgical Localization of the Motor Cortex: A Task-Based Functional MRI-Determined Seed Versus an Anatomy-Determined Seed

  • Ji Young Lee;Yangsean Choi;Kook Jin Ahn;Yoonho Nam;Jin Hee Jang;Hyun Seok Choi;So Lyung Jung;Bum Soo Kim
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.171-179
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    • 2019
  • Objective: For localization of the motor cortex, seed-based resting-state functional MRI (rsfMRI) uses the contralateral motor cortex as a seed. However, research has shown that the location of the motor cortex could differ according to anatomical variations. The purpose of this study was to compare the results of rsfMRI using two seeds: a template seed (the anatomically expected location of the contralateral motor cortex) and a functional seed (the actual location of the contralateral motor cortex determined by task-based functional MRI [tbfMRI]). Materials and Methods: Eight patients (4 with glioma, 3 with meningioma, and 1 with arteriovenous malformation) and 9 healthy volunteers participated. For the patients, tbfMRI was performed unilaterally to activate the healthy contralateral motor cortex. The affected ipsilateral motor cortices were mapped with rsfMRI using seed-based and independent component analysis (ICA). In the healthy volunteer group, both motor cortices were mapped with both-hands tbfMRI and rsfMRI. We compared the results between template and functional seeds, and between the seed-based analysis and ICA with visual and quantitative analysis. Results: For the visual analysis, the functional seed showed significantly higher scores compared to the template seed in both the patients (p = 0.002) and healthy volunteers (p < 0.001). Although no significant difference was observed between the functional seed and ICA, the ICA results showed significantly higher scores than the template seed in both the patients (p = 0.01) and healthy volunteers (p = 0.005). In the quantitative analysis, the functional seed exhibited greater similarity to tbfMRI than the template seed and ICA. Conclusion: Using the contralateral motor cortex determined by tbfMRI as a seed could enhance visual delineation of the motor cortex in seed-based rsfMRI.

Evaluation of the Interfraction Setup Errors using On Board- Imager (OBI) (On board imager를 이용한 치료간 환자 셋업오차 평가)

  • Jang, Eun-Sung;Baek, Seong-Min;Ko, Seung-Jin;Kang, Se-Sik
    • Journal of the Korean Society of Radiology
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    • v.3 no.3
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    • pp.5-11
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    • 2009
  • When using Image Guided Radiation Therapy, the patient is placed using skin marker first and after confirming anatomical location using OBI, the couch is moved to correct the set up. Evaluation for the error made at that moment was done. Through comparing $0^{\circ}$ and $270^{\circ}$ direction DRR image and OBI image with 2D-2D matching when therapy planning, comparison between patient's therapy plan setup and actual treatment setup was made to observe the error. Treatment confirmation on important organs such as head, neck and spinal cord was done every time through OBI setup and other organs such as chest, abdomen and pelvis was done 2 ~ 3 times a week. But corrections were all recorded on OIS so that evaluation on accuracy could be made through using skin index which was divided into head, neck, chest and abdomen-pelvis on 160 patients. Average setup error for head and neck patient on each AP, SI, RL direction was $0.2{\pm}0.2cm$, $-0.1{\pm}0.1cm$, $-0.2{\pm}0.0cm$, chest patient was $-0.5{\pm}0.1cm$, $0.3{\pm}0.3cm$, $0.4{\pm}0.2cm$, and abdomen was $0.4{\pm}0.4cm$, $-0.5{\pm}0.1cm$, $-0.4{\pm}0.1cm$. In case of pelvis, it was $0.5{\pm}0.3cm$, $0.8{\pm}0.4cm$, $-0.3{\pm}0.2cm$. In rigid body parts such as head and neck showed lesser setup error compared to chest and abdomen. Error was greater on chest in horizontal axis and in AP direction, abdomen-pelvis showed greater error. Error was greater on chest in horizontal axis because of the curve in patient's body when the setup is made. Error was greater on abdomen in AP direction because of the change in front and back location due to breathing of patient. There was no systematic error on patient setup system. Since OBI confirms the anatomical location, when focus is located on the skin, it is more precise to use skin marker to setup. When compared with 3D-3D conformation, although 2D-2D conformation can't find out the rolling error, it has lesser radiation exposure and shorter setup confirmation time. Therefore, on actual clinic, 2D-2D conformation is more appropriate.

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Anatomical Study of Superficial Peroneal Nerve Accessory Artery and Perforators in the Anterior Intermuscular Septum of Lower Leg Using Cadaveric Dissection (시체 해부를 통한 다리의 얕은종아리신경 동반동맥과 앞근육사이막에 존재하는 관통가지에 관한 해부학적 연구)

  • Kim, Jun Sik;Shin, Sang Ho;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Nam Gyun
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.695-699
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    • 2006
  • Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.

Usefulness of Scan Position Change on Dual Time Point PET-CT in Pancreas Cancer (췌장암 Dual Time Point PET/CT 검사에서 Scan Position Change의 유용성 평가)

  • Chang, Boseok;Kim, Jae Ho
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.299-305
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    • 2016
  • Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.

Microvasculature of Human Menisci (정상 반월상 연골의 혈관 분포)

  • Kim Sang Hoon;Cho Hong Sik;Lee Han Young;Lee Ki-Bum;Min Byung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.52-57
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    • 2003
  • Purpose : To evaluate the morphologic measurement and microvasculature of the normal human meniscus in Korean and to compare the difference of microvasculature according to the age and anatomical location. Materials and methods : Menisci of 21 cadavers divided into 3 groups according to the age. Each meniscus was divided into 10 parts of which the width and area of microvasculature were measured. Results : The average width of the medial and lateral menisci were $10.49{\pm}02.92mm$ and $10.55{\pm}2.05mm$, respectively. The average area of the microvasculature measured $20.29{\pm}8.44\%$ in the medial meniscus and $18.99{\pm}7.03\%$ in the lateral meniscus. The microvasculature of the medial meniscus was most abundant in the anterior horn and least abundant in the posterior horn (p<0.05). The lateral meniscus showed the most vessels in the posterior horn (p<0.05). The microvasculature of popliteal hiatus was not avascular but hypovascular. The area of microvasculature decreased with increasing age in all parts of the medial meniscus and body and posterior horn of the lateral meniscus (p<0.05). Conclusion : Differences in the anatomical distribution of the vessels were noted of both the medial and lateral menisci. The area of microvasculature generally decreased proportionally with increasing age in both medial and lateral meniscus.

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Association-Based Knowledge Model for Supporting Diagnosis of a Capsule Endoscopy (캡슐내시경 검사의 진단 보조를 위한 연관성 기반 지식 모델)

  • Hwang, Gyubon;Park, Ye-Seul;Lee, Jung-Won
    • KIPS Transactions on Software and Data Engineering
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    • v.6 no.10
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    • pp.493-498
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    • 2017
  • Capsule endoscopy is specialized for the observation of small intestine that is difficult to access by general endoscopy. The diagnostic procedure through capsule endoscopy consists of three stages: examination of indicant, endoscopy, and diagnosis. At this time, key information needed for diagnosis includes indicant, lesions, and suspected disease information. In this paper, these information are defined as semantic features and the extracting process is defined as semantic-based analysis. It is performed in whole capsule endoscopy. First, several symptoms of patient are checked before capsule endoscopy to get some information on suspected disease. Next, capsule endoscopy is performed by checking the suspected diseases. Finally, diagnosis is concluded by using supporting information. At this time, some association are used to conclude diagnosis. For example, there are the disease association between the symptom and the disease to identify the expected disease, and the anatomical association between the location of the lesion and supporting information. However, existing knowledge models such as MST and CEST only lists the simple term related to endoscopy and cannot consider such semantic associations. Therefore, in this paper, we propose association-based knowledge model for supporting diagnosis of capsule endoscopy. The proposed model is divided into two; a disease model and anatomical model of small intestine, interesting area(organs) of capsule endoscopy. It can effectively support diagnosis by providing key information for capsule endoscopy.