• Title/Summary/Keyword: CT Examinations

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Atypical Manifestation of Primary Hepatocellular Carcinoma and Hepatic Malignancy Mimicking Lesions (원발성 간세포암의 비특이적 영상 소견 및 간암으로 오인될 수 있는 병변에 대한 영상의학적 고찰)

  • Jiyoung Yoon;So Hyun Park;Su Joa Ahn;Young Sup Shim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.808-829
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    • 2022
  • Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI based on its distinctive imaging findings. These features include arterial phase hyperenhancement and washout on portal or delayed phase images. However, radiologists face significant diagnostic challenges because some HCCs exhibit atypical imaging characteristics. In addition to many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma, intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is crucial for appropriate management and treatment decisions. Therefore, this pictorial review presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions and discusses important clues that may help narrow down the differential diagnosis.

Segmental Liver Stiffness Evaluated with Magnetic Resonance Elastography Is Responsive to Endovascular Intervention in Patients with Budd-Chiari Syndrome

  • Peng Xu;Lulu Lyu;HaitaoGe;Muhammad Umair Sami;Panpan Liu;Chunfeng Hu;Kai Xu
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.773-780
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    • 2019
  • Objective: To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). Materials and Methods: Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31-56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. Results: Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839-0.943: inter-examination, ICC = 0.765-0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4-19.4%). Conclusion: Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.

Typical and Atypical Imaging Features of Malignant Lymphoma in the Abdomen and Mimicking Diseases (복부 악성 림프종의 영상 소견 및 비슷한 소견을 보일 수 있는 질병들)

  • Jong Eun Kim;So Hyun Park;Young Sup Shim;Sungjin Yoon
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1266-1289
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    • 2023
  • Malignant lymphoma typically presents with homogeneous enhancement of enlarged lymph nodes without internal necrotic or cystic changes on multiphasic CT, which can be suspected without invasive diagnostic methods. However, some subtypes of malignant lymphoma show atypical imaging features, which makes diagnosis challenging for radiologists. Moreover, there are several lymphoma-mimicking diseases in current clinical practice, including leukemia, viral infections in immunocompromised patients, and primary or metastatic cancer. The ability of diagnostic processes to distinguish malignant lymphoma from mimicking diseases is necessary to establish effective management strategies for initial radiological examinations. Therefore, this study aimed to discuss the typical and atypical imaging features of malignant lymphoma as well as mimicking diseases and discuss important diagnostic clues that can help narrow down the differential diagnosis.

A Study on the Utilization of Diagnostic Equipments and Patient Dose for Diagnostic Radiological Procedures in Korea (진단방사선영역에서 방사선장치의 이용실태 및 환자피폭선량에 관한 조사연구)

  • Kim Youhyun;Choi Jonghak;Kim Sungsoo;Lee Chanhyeup;Cho Pyongkon;Lee Youngbae;Kim Chelmin
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.10-15
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    • 2005
  • IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

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3-Dimensional Micro-Computed Tomography Study on Bone Regeneration with Silk Fibroin, rh-Bone Morphogenetic Protein Loaded-Silk Fibroin and Tricalcium Phosphate Coated-Silk Fibroin in Rat Calvaria Defect

  • Pang, Eun-O;Park, Young-Ju;Park, Su-Hyun;Kang, Eung-Sun;Kweon, Hae-Yong;Kim, Soeng-Gon;Ko, Chang-Yong;Kim, Han-Sung;Nam, Jeong-Hun;Ahn, Jang-Hun;Chun, Ji-Hyun;Lee, Byeong-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.1-11
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    • 2012
  • Purpose: The purpose of this study was to evaluate the bone regeneration capacity of silk fibroin (SF) when combined with beta tricalcium phosphate (${\beta}$-tricalcium phosphate [TCP]) and rh-bone morphogenetic protein (BMP) in vivo by micro-computed tomography (CT), soft x-ray, and histological analysis. Methods: A total of 56 critical size defects formed by a trephine bur made on 28 adult female Spague-Dawley rats were used for this study and the defect size was 5.0 mm in diameter. The defects were transplanted with (1) no graft material (raw defect), (2) autogenous bone, (3) SF ($10{\mu}g$), (4) SF-BMP ($10{\mu}g$, $0.8{\mu}g$ each), and (5) SF+${\beta}$-TCP ($10{\mu}g$). At 4 and 8 weeks after operation, the experimental animals were sacrificed. Samples were evaluated with soft x-ray, histological examinations and 3-dimensional micro-CT analysis. Results: In the 3-dimensional micro-CT evaluation, bone volume and bone surface data were higher in the SF-BMP ($12.8{\pm}1.5$, $138.6{\pm}45.0$ each) (P<0.05) and SF-TCP ($12.3{\pm}1.5$, $144.9{\pm}30.9$ each) group than in the SF group ($6.1{\pm}3.3$, $77.2{\pm}37.3$ each) (P<0.05), except for the autogenous group ($15.0{\pm}3.0$, $190.7{\pm}41.4$ each) at 4 weeks. At 8 weeks, SF-BMP ($16.8{\pm}3.5$, $173.9{\pm}34.2$ each) still revealed higher (P<0.05) bone volum and surface, but SF-TCP ($11.3{\pm}1.5$, $1132.9{\pm}52.1$ each) (P=0.5, P=0.2) revealed the same or lower amount compared with the SF group ($13.8{\pm}2.7$, $127.5{\pm}44.8$ each). The % of bone area determined by radiodensity was higher in the SF-TCP ($31.4{\pm}9.1%$) and SF-BMP ($36.2{\pm}16.2%$) groups than in the SF ($19.0{\pm}10.4$) group at the period of 4 weeks. Also, in the histological evaluation, the SF-BMP group revealed lower inflammation reaction, lower foreign body reaction and higher bone healing than the SF group at postoperative 4 weeks and 8 weeks. The SF-TCP group revealed lower inflammation at 4 weeks, but accordingly, as the TCP membrane was absorbed, inflammatory and foreign body reaction are increased at 8 weeks. Conclusion: The current study provides evidence that the silk fibrin can be used as an effective grafted material for tissue engineering bone generation through a combination of growth factor or surface treatment.

A Clinical Review of Primary Tracheal Carcinoma (원발성 악성기관종양의 임상적 고찰)

  • Ryu, Jeong-Seon;Cho, Hyun-Myung;Yang, Dong-Gyoo;Lee, Hong-Lyeol;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Shin, Kye-Chul;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.766-775
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    • 1997
  • Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.

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Study on the Availability of Repeated Flexible Bronchoscopy(RFB) (반복적 굴곡성 기관지경검사(RFB)의 유용성에 대한 연구)

  • Lee, Hong-Lyeol;Moon, Tae-Hoon;Cho, Jae-Hwa;Ryu, Jeong-Seon;Kwak, Seung-Min;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.365-376
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    • 2000
  • Background : Ever since Flexible Fiberoptic Bronchoscopy was introduced into clinical practice, it has played an important role in both diagnosis and therapy of respiratory diseases. Repeated bronchoscopic examinations is are not so uncommon. This study was designed prospectively to assess the clinical availability of the Repeated Flexible Bronchoscopy (RFB). Methods : Pre-established indications were as follows : 1) To confirm diagnosis or the cell type in proven malignancy 2) to diagnose or locate hemoptysis 3) to follow-up or confirm recurrence 4) to use in therapy. We performed RFB and analyzed the data in 156 patients during 28-month period. Results : The frequency of RFB was 23.0%. The indication for diagnosis or cell type of malignancy was 25 cases, of which 2 cases were confirmed by a third bronchoscopic examination and 3 cases by surgical procedures. Localization of the bleeding site was confirmed in 53.8%. RFB for small cell lung cancer yielded more information on residual or recurred lesion not apparent even with the CT scan in 30%. Previous cases of bronchostenosis due to endo-bronchial tuberculosis was shown to have worsened in 66.7%. Therapeutic manipulations were done in 126 cases, and bronchial suction was most common. Complications showed decreasing tendency with repeated examinations. Conclusion : The RFB for diagnosis or cell type of malignancy was useful in that comfirmation of diagnosis was possible in 85.7% of malignancy. More aggressive procedures should be employed including TBLB or TBNA. The RFB showed possible usefulness in the follow-up of patients with small cell lung cancer. For the patients with hemoptysis or endobronchial tuberculosis, the RFB did not the significance did not show significance because its results did not influence the diagnosis, therapy or clinical course.

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The relationship between radiological features and clinical manifestation and dental expenses of keratocystic odontogenic tumor

  • Min, Jung-Hyun;Huh, Kyung-Hoe;Heo, Min-Suk;Choi, Soon-Chul;Yi, Won-Jin;Lee, Sam-Sun;Bae, Kwang-Hak;Choi, Jin-Woo
    • Imaging Science in Dentistry
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    • v.43 no.2
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    • pp.91-98
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    • 2013
  • Purpose: This study was performed to identify correlations between keratocystic odontogenic tumor (KCOT) data from CT sections, and data on the KCOT clinical manifestation and resulting dental expenses. Materials and Methods: Following local Institutional Review Board (IRB) approval, a seven-years of retrospective study was performed regarding patients with KCOTs treated at the Seoul National University Dental Hospital. A total of 180 KCOT were included in this study. The following information was collected: age, gender, location and size of the lesion, radiological features, surgical treatment provided and dental expenses. Results: There was no significant association between the size of the KCOT and age, gender, and presenting preoperative symptoms. In both jaws, it was unusual to find KCOTs under 10 mm. The correlation between the number of teeth removed and the size of the KCOT in the tooth bearing area was statistically significant in the mandible, whereas in the maxilla, no significant relationship was found. Dental expenses compared with the size of the KCOT were found to be significant in both jaws. Conclusion: The size of KCOT was associated with a significant increase in dental expenses for both jaws and the number of teeth removed from the mandible. These findings emphasize the importance of routine examinations and early detection of lesions, which in turn helps preserving anatomical structures and reducing dental expenses.

Digital Restoration of Ring-Pommeled Sword by Using Technology of 3D Shape Information Processing (3차원 형상정보 처리기술을 이용한 환두대도의 디지털 원형복원)

  • Kim Young-Won;Jun Byung-Hwan
    • The Journal of the Korea Contents Association
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    • v.5 no.4
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    • pp.133-140
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    • 2005
  • Culture Technology is the basic technology which produces cultural contents in a narrow sense. All nations do their best in order to create new contents which can form international and cultural sympathy. If a variety of contents are created by applying Korean proper cultural heritages, they will be creative and competitive internationally. Therefore, technology of original cultural restoration is an essential and crucial skill. In this paper, 'gilt bronze dragon-phoenix ring-pommeled sword', a cultural heritage of baekje age, will be restored to the original form digitally on the basis of three-dimensional shape-information processing technology and the scientifically analyzed data. First of all, data from three-dimensional scanning is revised using stuffing and smoothing methods after sampling, extracting characteristics, and align. Then, they are modeled in a curved surface with NURBS and B-Spline. Secondly, textures are edited by estimating the color of components and the quality of materials, and then they are mapped. Original form model which was made was revised and corrected by specialists' examinations. The digitally revised ring-pommeled sword was combined with information technology, and it can be used to revise damaged cultural heritages by constructing formal database of ring-pommeled sword with regard to age, area and type. It can be also used as educational contents in archaeology or preservation science and cultural contents such as movies, broadcasts, games, animations and so on.

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Rate of Transformation and Normal Range about Cardiac Size and Cardiothoracic Ratio According to Patient Position and Age at Chest Radiography of Korean Adult Man (한국인 성인 남성의 흉부 방사선영상에서 자세와 연령에 따른 심장 크기 및 심흉비의 정상 범위와 변환율)

  • Joo, Young-Cheol;Lim, Cheong-Hwan;Kim, Yun-Min;Jung, Hong-Ryang;Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.179-186
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    • 2017
  • Purpose of this study is present the normal range of cardiac size and cardiothoracic ratio according to patient position(chest PA and AP) and age of Korean adult male on digital chest X - ray, And to propose a mutually compatible conversion rate. 1,024 males were eligible for this study, among 1,300 normal chest patients who underwent chest PA and low-dose CT examinations on the same day at the 'S' Hospital Health Examination Center in Seoul From January to December 2014. CS and CTR were measured by Danzer (1919). The mean difference between CS and CTR was statistically significant (p<0.01) in Chest PA (CS 135.48 mm, CTR 43.99%) and Chest AP image (CS 155.96 mm, CTR 51.75%). There was no statistically significant difference between left and right heart in chest PA and AP images (p>0.05). CS showed statistically significant difference between Chest PA (p>0. 05) and Chest AP (p<0.05). The thorax size and CTR were statistically significant (p<0.01) in both age and chest PA and AP. Result of this study, On Chest AP image CS was magnified 15%, CTR was magnified 17% compare with Chest PA image. CS and CTR were about 10% difference by changing posture at all ages.