• Title/Summary/Keyword: CT Scans

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The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair (COVID-19 폐렴의 다양한 CT 영상 소견: 급성 폐포 손상과 기질화 폐렴)

  • Yun Su Kim;Ung Rae Kang;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.359-370
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    • 2021
  • Purpose To analyze the findings and serial changes in chest CT lesions in 123 symptomatic patients with coronavirus disease 2019 (COVID-19). Materials and Methods From February 19 to April 7, 2020, a total of 123 confirmed COVID-19 patients (male, 44; female, 79; mean age, 59.2 ± 18.6) were enrolled in this retrospective study. A total of 234 CT scans were reviewed for the following patterns: acute alveolar insult (AAI) patterns: ground-glass opacity (GGO), crazy-paving appearance, mixed pattern, and consolidation; organizing pneumonia (OP) patterns: perilobular patterns, band opacity, curvilinear opacity, reversed halo opacity, and small nodular consolidation; resolving patterns: pure GGO, remnant curvilinear, small nodular consolidation, and serial changes of lung abnormalities. We compared the proportions of AAI pattern, OP pattern, or resolving pattern with time progression and analyzed the association between the patterns and disease severity using Pearson chi-square and Fisher's exact test. Results Predominant CT patterns were AAI pattern (87%) in the early hospital period group (0-10 days, after the onset of symptoms), OP pattern (45.7%) in the later hospital period group (after 10 days), and resolving pattern in discharge and follow-up group (47.2% and 84.8%, respectively). The difference in the proportions of predominant CT patterns with time progression was statistically significant (p < 0.001, Pearson's chi-square test). No statistically significant association was observed between the patterns and disease severity (p = 0.055, Fisher's exact test). No fibrous changes in the lesions were observed on follow-up CT scans. Conclusion The serial CT scans of COVID-19 patients showed the spectrum of COVID pneumonia CT manifestations as different phases of lung injury and repair.

Optimal Phase of Dynamic Computed Tomography for Reliable Size Measurement of Metastatic Neuroendocrine Tumors of the Liver: Comparison between Pre- and Post-Contrast Phases

  • Huh, Jimi;Park, Jisuk;Kim, Kyung Won;Kim, Hyoung Jung;Lee, Jong Seok;Lee, Jong Hwa;Jeong, Yoong Ki;Shinagare, Atul B.;Ramaiya, Nikhil H.
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1066-1076
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    • 2018
  • Objective: The reliability of size measurements of liver metastases from neuroendocrine tumors (NETs) on contrast-enhanced computed tomography (CT) phases made by different readers may be hampered due to transient, variable rim enhancement in arterial phase (AP) or portal venous phase (PVP) images. We aimed to assess the reliability of tumor size measurements in pre- and post-contrast scans. Materials and Methods: The study coordinator selected target lesions according to Response Evaluation Criteria in Solid Tumors 1.1 guidelines in 44 consecutive patients with pathologically confirmed NET liver metastases. Two blinded readers measured the longest diameters of target lesions on pre-contrast, AP, and PVP images twice with a 4-week interval. Inter- and intra-observer agreements were evaluated using Bland-Altman plots and 95% limit of agreement (LOA) calculations. Results: Of the 79 target lesions (approximate mean size of 3 cm), 45 showed rim enhancement. Inter-observer agreement assessed based on LOA was highest in pre-contrast CT images (-6.1-5.7 mm), followed by PVP (-7.9-7.1 mm) and AP (-8.5-7.4 mm) images. Intra-observer agreement showed the same trend: -2.8-2.9 mm and -2.9-2.9 mm for readers 1 and 2, respectively, on pre-contrast CT, -2.8-2.9 mm and -3.0-3.2 mm, respectively, on PVP, and -3.2-4.2 mm and -3.4-3.2 mm, respectively, on AP images. Mean tumor diameters differed significantly among the phases in the following increasing order: pre-contrast CT, PVP, and AP images. Conclusion: There was better inter- and intra-observer agreement in size measurements of NET liver metastases on pre-contrast scans than on AP and PVP scans. Pre-contrast CT may be the optimal for measuring NET liver metastases if its accuracy is proven.

The Correlation between CT Images and Pathological Findings in Metastatic Cervical Lymph Nodes (두경부 악성종양에서 경부임파절전이에 대한 CT Scan의 진단적 의의)

  • Lee Won-Sang;Kim Kwang-Moon;Chung Kwang-Hyun;Chang Hoon-Sang;Kim Jee-Woo;Kim Dong-Ik
    • Korean Journal of Head & Neck Oncology
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    • v.4 no.1
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    • pp.5-11
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    • 1988
  • CT examination has been used in the preoperative examination of patients with head and neck cancer. The accuracy of CT in detecting nodal metastases has not been well established. We studied 35 patients (41 neck specimens) with head and neck cancer who underwent neck dissection. Surgical pathologic findings were compared with preoperative CT scan to establish the diagnostic accuracy for cervical lymph node metastases. The results of physical examination, CT scans of neck and histologic examinations were compared each other. The overall diagnostic accuracy of CT was 83.3%. Comparison with clinical accuracy shows the CT scan to be superior to the clinical examination in spite of careful physical examination, particularly in detecting occult metastases.

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Evaluation of the usefulness of Images according to Reconstruction Techniques in Pediatric Chest CT (소아 흉부 CT 검사에서 재구성 기법에 따른 영상의 유용성 평가)

  • Gu Kim;Jong Hyeok Kwak;Seung-Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.285-295
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    • 2023
  • With the development of technology, efforts to reduce the exposure dose received by patients in CT scans are continuing with the development of new reconstruction techniques. Recently, deep learning reconstruction techniques have been developed to overcome the limitations of repetitive reconstruction techniques. This study aims to evaluate the usefulness of images according to reconstruction techniques in pediatric chest CT images. Patient study conducted a study on 85 pediatric patients who underwent chest CT scan at P-Hospital in Gyeongsangnam-do from January 1, 2021 to December 31, 2022. The phantom used in the Phantom Study is the Pediatrics Whole Body Phantom PBU-70. After the test, the images were reconstructed with FBP, ASIR-V (50%) and DLIR (TF-Medium, High), and the images were evaluated by obtaining SNR and CNR values by setting ROI of the same size. As a result, TF-H of deep learning reconstruction techniques had the lowest noise value compared to ASIR-V (50%) and TF-M in all experiments, and SNR and CNR had the highest values. In pediatric chest CT scans, TF images with deep learning reconstruction techniques were less noisy than ASiR-V images with adaptive statistical iterative reconstruction techniques, CNR and SNR were higher, and the quality of images was improved compared to conventional reconstruction techniques.

Bone scintigraphy in patients with pain

  • Shin, Seung Hyeon;Kim, Seong Jang
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.165-175
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    • 2017
  • Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities.

Interference Issuses of Radio Frequency Identification Devices in Magnetic Resonance Imaging Systems and Computed Tomography Scan

  • Periyasamy, M.;Dhanasekaran, R.
    • Journal of Magnetics
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    • v.20 no.3
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    • pp.295-301
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    • 2015
  • We evaluated certain issues related to magnetic resonance imaging (MRI) coupled with the use of active 2.5 GHz radio frequency identification (RFID) tags for patient identification using low field (0.3 T) MRI and computed tomography (CT) scans. We also investigated the performance of the RFID reader located outside the MRI room by considering several factors. A total of ten active RFID tags were exposed to several MRI sequences and X-rays of CT scan. We found that only card type active RFID tags are suitable for patient identification purpose in MRI environment and both wristbands as well as card tags were suitable for the same in CT environment. Severe artifacts were found in the captured MRI and CT images when the area of the imaging was in proximity to the tags. No external factors affected the performance of active RFID reader stationed outside the MRI scan room.

Frequently Asked Questions in the Interpretation of Preoperative and Postoperative Chest CT Scans Related to Lung Cancer Imaging

  • Lee, Kyung-Soo
    • 대한핵의학회:학술대회논문집
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    • 2002.05a
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    • pp.25-27
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    • 2002
  • With the advent of multidetector-row CT, lung cancer imaging is much more promising than before. However, the effectiveness of multidetector-row CT in making an initial diagnosis, staging, and evaluating post-treatment changes of lung cancer still remains to be proved. Fast imaging along with volumetric data set and attendant multi-planar imaging provide much more details on the anatomic changes and pathology associated with lung cancer. However, with images showing anatomic and pathologic changes only, radiologists confront with several questions the answers of which may help evaluate lung cancer more thoroughly. The frequent questions that I have in dally practice of chest CT interpretation are as follows.

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The Role of Bone Scans in Routine Preoperative Evaluations of Non-Small Cell Lung Cancer Patients. (비소세포 폐암의 병기에 있어 통상적인 골 스캔의 역할)

  • 김영태;홍장미;이재익;이정상;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.659-663
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    • 2002
  • The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.

Customized Cranioplasty Implants Using Three-Dimensional Printers and Polymethyl-Methacrylate Casting

  • Kim, Bum-Joon;Hong, Ki-Sun;Park, Kyung-Jae;Park, Dong-Hyuk;Chung, Yong-Gu;Kang, Shin-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.541-546
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    • 2012
  • Objective : The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting. Methods : A total of 16 patients with large skull defects (>100 $cm^2$) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect. Results : The median operation time was $184.36{\pm}26.07$ minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously. Conclusion : Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.

Establishment of Injection Protocol of Test Bolus for Precise Scan Timing in Canine Abdominal Multi-Phase Computed Tomography

  • Choi, Sooyoung;Lee, In;Choi, Hojung;Lee, Kija;Park, Inchul;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.93-96
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    • 2018
  • This study aimed to establish an injection protocol to determine the precise CT scan timing in canine abdominal multi-phase CT using the test bolus method. Three dynamic scans with different contrast injection parameters were performed using a crossover design in eight normal beagle dogs. A contrast material was administered at a fixed dose of 200 mg iodine/kg as a test bolus for dynamic scans 1 and 2, and 600 mg iodine/kg as a main bolus for dynamic scan 3. The contrast materials were administered with 1 ml/s in dynamic scan 1, and 3 ml/s in dynamic scan 2 and 3. The mean arrival time to the appearance of aortic enhancement in dynamic scan 3 was similar to that in dynamic scan 2, and different significantly to that in dynamic scan 1. The mean arrival time to the peak aortic and pancreatic parenchymal enhancement in dynamic scan 3 was similar to that in dynamic scan 1, and different significantly to that in dynamic scan 2. In multi-phase CT scan, a test bolus should be injected with the same injection duration of a main bolus, to obtain the precise arrival times to peak of arterial or pancreatic parenchymal enhancement.