• Parasites, Hosts and Diseases
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• 제49권1호
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• pp.69-72
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• 2011

Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.

• Imaging Science in Dentistry
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• 제35권4호
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• pp.231-234
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• 2005

Coronoid impingement can cause limitation of mouth opening. In many cases, it appears to be related to the coronoid hyperplasia. We present a case of mouth opening limitation caused by coronoid impingement on the posterior surface of the zygomatic bone without coronoid hyperplasia. The bony changes in coronoid and zygoma including surface irregularity and discontinuity of the cortex and sclerotic change of inner medullary space were noted on computed tomography (CT) scans in different level of axial planes. Through another CT scans in open mouth position could demonstrate that those bony changes were caused by the contact of both surfaces against each other. In case coronoid impingement is suspected of the many possible causes, the open mouth CT scans will be needed to reveal the direct impingement of coronoid on zygoma even without coronoid hyperplasia.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.119-124
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• 2020

Background: This study was performed to compare glenoid version and inclination measured using two-dimensional (2D) images from computed tomography (CT) scans or three-dimensional (3D) reconstructed bone models. Methods: Thirty patients who had undergone conventional CT scans were included. Two orthopedic surgeons measured glenoid version and inclination three times on 2D images from CT scans (2D measurement), and two other orthopedic surgeons performed the same measurements using 3D reconstructed bone models (3D measurement). The 3D-reconstructed bone models were acquired and measured with Mimics and 3-Matics (Materialise). Results: Mean glenoid version and inclination in 2D measurements were -1.705° and 9.08°, respectively, while those in 3D measurements were 2.635° and 7.23°. The intra-observer reliability in 2D measurements was 0.605 and 0.698, respectively, while that in 3D measurements was 0.883 and 0.892. The inter-observer reliability in 2D measurements was 0.456 and 0.374, respectively, while that in 3D measurements was 0.853 and 0.845. Conclusions: The difference between 2D and 3D measurements is not due to differences in image data but to the use of different tools. However, more consistent results were obtained in 3D measurement. Therefore, 3D measurement can be a good alternative for measuring glenoid version and inclination.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.71-77
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• 2008

Purpose: The Glasgow Coma Scale (GCS), though it is widely used for triage, has been criticized as being unnecessarily complex. Recently, a 3-point Simplified Motor Score (SMS, defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for triage after traumatic brain injury when compared with the GCS as the criterion standard. The purpose of this study was to validate the SMS. Methods: We analyzed the patients who visited Kyungpook National University Hospital emergency center after traumatic brain injury from 2006 January to 2006 June. The test performance of the GCS, its motor component, and SMS relative to three clinically relevant traumatic brain injury outcomes (abnormal brain CT scans, Abbreviated Injury Scale $(AIS){\geq}4$, and mortality) were evaluated with areas under the receiver operating characteristic curves (AUCs). Results: Of 504 patients included in the analysis, 25.6% had an abnormal brain CT scans, 13.1% had $AIS{\geq}4$, and 5.0% died. The AUCs for the GCS, its motor component, and SMS with respect to the abnormal CT scans were 0.776, 0.715, and 0.716, and respectively, those for $AIS{\geq}4$ and mortality, were 0.969, 0.973, and 0.968, and 0.931, 0.909, and 0.909, respectively. Conclusion: The 3-point SMS demonstrated similar test performance when compared with the 15-point GCS score and its motor component for triage after traumatic brain injury in our populations.

• 핵의학기술
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• 제18권1호
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• pp.10-18
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• 2014

암에 대한 진료 및 치료 효과 판정 등에 유용한 PET 검사가 증가되면서 추적검사 시 SUV의 정확한 비교를 위해 EANM 등에서는 동일한 장비에서 검사를 시행하는 것을 권고하고 있어 동일한 기종의 PET/CT 활용에 대한 관심이 커지고 있다. 하지만 병원의 환경상 여건이 허락되지 않는 경우가 많아 정확한 SUV 비교를 위한 Factor 개발, 장비간 호환 등의 방안을 마련하는데 관심이 높아지고 있다. 이런 관점에서 기종이 다른 3대의 PET/CT 장비를 대상으로 SUV를 평가하여 장비간 호환성이 가능한지 실험해 보았다. Discovery 690, Discovery 690Elite, Discovery 710 장비를 대상으로 ACR phantom, NEMA IEC Body phantom, SNM Chest phantom, $^{68}Ge$-cylinder phantom에 대한 SUV를 측정하여 장비간 비교를 시행하였다. 장비 별 SUVmean과 $SUV_{max}$를 측정하여 비교해 본 결과, $SUV_{mean}$의 경우 각 phantom 별로 장비간 차이는 최대 3.61%, 최소 0.19%였고 $SUV_{max}$는 장비 별로 최대 4.11%, 최소 0.03% 정도 차이가 발생하였다. 제조사에서 권고하는 장비간 SUV 허용 범위는 5%이며 실험에 사용된 3대의 PET/CT 장비간 SUV 차이는 이에 포함된다. 이는 CT 기종의 차이에 따른 SUV의 변화는 크지 않음을 유추할 수 있다. 병원마다 동일한 장비를 여러 대 구입하기에는 현실적인 어려움이 있으므로 기종이 다른 PET/CT 장비의 SUV가 허용 가능한 범위 내에 있는 장비를 활용한다면 동일한 장비 사용을 권고하는 추적검사의 경우 예약 일정 변경 등의 검사 효율성이 증가되고 정량평가의 정확도를 높여 줄 것이다.

• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.234-241
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• 2019

Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

• 방송공학회논문지
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• 제28권3호
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• pp.293-301
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• 2023

표준화되지 않은 의료 데이터 수집 및 관리는 여전히 수동으로 진행되고 있어, 이 문제를 해결하기 위해 딥 러닝을 사용해 CT 데이터를 분류하는 연구들이 진행되고 있다. 하지만 대부분 연구에서는 기본적인 CT slice인 axial 평면만을 기반으로 모델을 개발하고 있다. CT 영상은 일반 이미지와 다르게 인체 구조만 묘사하기 때문에 CT scan을 재구성하는 것만으로도 더 풍부한 신체적 특징을 나타낼 수 있다. 이 연구는 axial 평면뿐만 아니라 CT 데이터를 2D로 변환하는 여러가지 방법들을 통해 보다 높은 성능을 달성할 수 있는 방법을 찾고자 한다. 훈련은 5가지 부위의 CT 스캔 1042개를 사용했고, 모델 평가를 위해 테스트셋 179개, 외부 데이터셋으로 448개를 수집했다. 딥러닝 모델 개발을 위해 ImageNet으로 사전 학습된 InceptionResNetV2를 백본으로 사용하였으며, 모델의 전체 레이어를 재 학습했다. 실험결과 신체 부위 분류에서는 재구성 데이터 모델이 99.33%를 달성하며 axial 모델보다 1.12% 더 높았고, 조영제 분류에서는 brain과 neck에서만 axial모델이 높았다. 결론적으로 axial slice로만 훈련했을 때 보다 해부학적 특징이 잘 나타나는 데이터로 학습했을 때 더 정확한 성능 달성이 가능했다.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.237-247
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• 2020

Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

• Korean Journal of Radiology
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• 제21권1호
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• pp.88-100
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• 2020

Objective: We aimed to develop and validate a deep learning system for fully automated segmentation of abdominal muscle and fat areas on computed tomography (CT) images. Materials and Methods: A fully convolutional network-based segmentation system was developed using a training dataset of 883 CT scans from 467 subjects. Axial CT images obtained at the inferior endplate level of the 3rd lumbar vertebra were used for the analysis. Manually drawn segmentation maps of the skeletal muscle, visceral fat, and subcutaneous fat were created to serve as ground truth data. The performance of the fully convolutional network-based segmentation system was evaluated using the Dice similarity coefficient and cross-sectional area error, for both a separate internal validation dataset (426 CT scans from 308 subjects) and an external validation dataset (171 CT scans from 171 subjects from two outside hospitals). Results: The mean Dice similarity coefficients for muscle, subcutaneous fat, and visceral fat were high for both the internal (0.96, 0.97, and 0.97, respectively) and external (0.97, 0.97, and 0.97, respectively) validation datasets, while the mean cross-sectional area errors for muscle, subcutaneous fat, and visceral fat were low for both internal (2.1%, 3.8%, and 1.8%, respectively) and external (2.7%, 4.6%, and 2.3%, respectively) validation datasets. Conclusion: The fully convolutional network-based segmentation system exhibited high performance and accuracy in the automatic segmentation of abdominal muscle and fat on CT images.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.553-559
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• 2008

Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.