• Title/Summary/Keyword: CT angiography

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Long-Term Clinical and Radiologic Outcomes after Stent-Graft Placement for the Treatment of Late-Onset Post-Pancreaticoduodenectomy Arterial Hemorrhage (췌십이지장절제술 후 발생한 후기 출혈에서 스텐트-그라프트를 이용한 치료의 장기적 임상, 영상의학적 결과)

  • Woo Jin Kim;Chang Ho Jeon;Hoon Kwon;Jin Hyeok Kim;Ung Bae Jeon;Suk Kim;Hyung Il Seo;Chang Won Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.600-612
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    • 2021
  • Purpose To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stent-graft patency was evaluated using serial CT angiography images. Results All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28-1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.

Focal Nodular Hyperplasia in Liver: A Case Report (간 국소 결절성 과형성의 방사선학적 소견)

  • Seong, Ki-Ho;Cho, Jae-Ho;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.400-404
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    • 1995
  • Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonography and hyperdense mass lesion on early-phase IV bolus CT and isodense mass lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.

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Differential Diagnosis of CT Images in Children with Neuroblastomas and Ganglioneuroblastomas

  • Zhuang, Bo;Lv, Deng-Kun;Gao, Si-Ju;Meng, Jing-Jing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10509-10512
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    • 2015
  • Objective: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). Materials and Methods: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. Results: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). Conclusions: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.

Diagnostic Imaging of Portosystemic Shunt using CT in Two Dogs (전산화단층촬영을 이용한 문맥전신단락의 진단 증례)

  • Jung, Joo-Hyun;Chae, Woong-Joo;Chang, Jin-Hwa;Chae, Ho-Cheol;Kim, Wan-Hee;Lee, Ki-Chang;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.461-466
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    • 2007
  • Two dogs were admitted with a history of anorexia, ataxia, shivering, lethargy, hypersalivation and seizure. Patients were suspected for portosystemic shunts on the basis of clinical signs, increased hepatic serum profiles on the blood test, microhepatica on plain abdominal radiographs, and an abnormally dilated and tortuous vessel on abdominal ultrasonographs. To diagnose PSS and to further evaluate type, shape, and location of shunt and hepatic vasculatures, the computed tomography (CT) angiography for portal and systemic circulation was performed. The shape, location and pathway of extrahepatic single shunt were confirmed in two dogs. Dual phases (the arterial phase and the venous phase) CT angiography and reformatted and three-dimensional images offered good understanding of PSS and planning surgical treatment.

Three-Dimensional Image Registration using a Locally Weighted-3D Distance Map (지역적 가중치 거리맵을 이용한 3차원 영상 정합)

  • Lee, Ho;Hong, Helen;Shin, Yeong-Gil
    • Journal of KIISE:Software and Applications
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    • v.31 no.7
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    • pp.939-948
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    • 2004
  • In this paper. we Propose a robust and fast image registration technique for motion correction in brain CT-CT angiography obtained from same patient to be taken at different time. First, the feature points of two images are respectively extracted by 3D edge detection technique, and they are converted to locally weighted 3D distance map in reference image. Second, we search the optimal location whore the cross-correlation of two edges is maximized while floating image is transformed rigidly to reference image. This optimal location is determined when the maximum value of cross-correlation does't change any more and iterates over constant number. Finally, two images are registered at optimal location by transforming floating image. In the experiment, we evaluate an accuracy and robustness using artificial image and give a visual inspection using clinical brain CT-CT angiography dataset. Our proposed method shows that two images can be registered at optimal location without converging at local maximum location robustly and rapidly by using locally weighted 3D distance map, even though we use a few number of feature points in those images.

A Study on the Optimum Amount of Contrast Media in Brain Angiography (뇌 혈관검사 시 적정 조영제량에 관한 연구)

  • Kim, Gyoo-Hyung;Lee, Sang-Ho
    • Journal of radiological science and technology
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    • v.41 no.2
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    • pp.123-128
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    • 2018
  • Recently, the use of contrast agents has been increasing as a broader range of tests and dynamic tests have become common due to the development of equipment and imaging techniques such as Multi-Detector CT. However, the side effects of using contrast agents have been reduced by the development of non-ionic contrast agents, but they are still occurring often. The purpose of this study was to propose a method to minimize the side effect of contrast agent by using the amount of contrast agent injected to the brain angiography test to suppress excessive use of contrast agent and analyze the amount of contrast agent. Patients who were prescribed Brain Angiography due to cerebrovascular disease, According to the results of the comparison of the results obtained by dividing into 4 groups of 10ml each according to the amount of contrast medium injected with contrast agent according to the BMI of the patient, BA and SNR were not different between groups, and even if the amount of contrast injection was reduced, there was no problem in the evaluation of CT angiography through 3D reconstruction. This result shows that even if the contrast medium is injected into the blood vessels of the patient first and then the contrast medium is used as the physiological saline solution, the contrast medium is reduced by 40% it can be expected to minimize.

Doses of Coronary Study in 64 Channel Multi-Detector Computed Tomography : Reduced Radiation Dose According to Varity of Examnination Protocols (64 채널 Multi-Detector Computed Tomography를 이용한 관상동맥검사의 선량 : 검사 프로토콜 다변화에 따른 환자선량 감소)

  • Kim, Moon-Chan
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.299-306
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    • 2009
  • Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.

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Arteriovenous Malformation of the Scalp : Efficacy of Computed Tomography Angiography

  • Moon, Kang-Seok;Yoon, Seok-Mann;Shim, Jai-Joon;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.396-398
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    • 2005
  • We report a rare case of scalp arteriovenous malformation[AVM]. A 55-year-old woman presented with a pulsatile palpable mass on her left temporo-parietal scalp. She complained of insomnia because of bruit, which was audible when she lay on her left side. Computed tomography angiography[CTA] for the scalp vessel showed AVM on the left temporo-parietal region. Multiple enlarged arteries, such as the superficial temporal artery, posterior auricular artery, and occipital artery, were directly connected to the elongated dilated superficial temporal vein. Digital subtraction angiography also showed similar results. Fistulous portions were clearly delineated on both modalities. Surgical excision of the malformations, including feeding arteries and the draining vein, resulted in immediate relief of the symptoms. Usefulness of CTA in the diagnosis of vascular lesions on the scalp was emphasized.