• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.742-755
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• 1997

Background : Endobronchial tuberculosis(ET) is still relatively common disease in Korea. We intended to evaluate the length of endobronchial lesion, peribronchial thickness, luminal irregularity and associated mediastinal lymph node enlargement with Chest CT to get information for such aggressive treatment as electrocautery, laser therapy and so on of bronchial stricture in ET, and also to compare the change of Chest CT finding with that of bronchoscopic finding after one month of anti-tuberculosis treatment. Method : We performed CT in 26 patients who were diagnosed as ET by bronchoscopy at Boramae Hospital from November 1991 to March 1996. After classifying ET into seven subtypes according to bronchoscopic finding, we analyzed the CT finding of each subtype. And we followed up the bronchoscopy, CT, and PIT after one month of anti-tuberculosis treatment, and compared the change of CT findings with those of bronchoscopic findings in nine patients. Results : Age of the patients was from 17 to 73 years old, and the ratio of male to female was 1 : 25 with absolute female predominance. The site(s) of bronchial involvement by tuberculosis is one in 14 cases, two in nine cases and three in one case, respectively, and the left main bronchus was the most frequently involved site (13 cases for multiple involvements and 7 cases for single involvement among 26 cases). The length of bronchial involvement by tuberculosis which was measured by CT was from 10 to 55 mm, and there was a tendency that the length of involved lesion in fibrostenotic type was shorter than that of actively caseating type. Bronchial stricture on CT was noticed in 25 (96%) cases and the range of severity was from total occlusion to near-normal and also showed wide variation even though the subtype of ET was same. The increase of peribronchial thickness which was measured by CT, was noticed in 21 cases (91%) among 23 cases (in which the measurement was possible), and there was no improvement of peribronchial thickness in those cases which showed little improvement in bronchial stricture despite anti-tuberculosis treatment. There was no difference in the luminal irregularity of involved bronchi on CT in relation to bronchoscopic subtypes. The mediastinal lymph node enlargement, defined as the diameter of lymph node was larger than 1cm on CT, was detected in 20 cases (77%), and right side was more frequently involved (L : R = 1 : 5.2). The CT finding usually showed extrinsic bronchial compression but showed direct invasion in two cases which were bronchoscopically classified as tumorous type. When follow-up bronchoscopy and CT was performed after one month of anti-tuberculosis treatment in nine patients, CT showed significant improvement in peribronchial thickness and mediastinal lymph node enlargement. Bronchial stricture was also improved in 6 cases but aggravated in 3 cases despite anti-tuberculosis therapy. In two cases which were classified as fibrostenotic type by bronchoscopy, CT showed significant improvement in bronchial stricture, interestingly. Conclusion : We concluded that the role of Chest CT was complimentary to bronchoscopy in ET, since CT was useful in evaluating the length of bronchial involvement, peribronchial thickness, and mediastinal lymph node enlargement.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.335-336
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• 2007

Meniscus-like presentation of ulcerating gastric carcinoma on upper gastrointestinal series radiograph was first described in 1921 by Carman and has since been known as a useful differential diagnostic sign in radiology. In 1982 using then newly introduced computed tomography (CT) Widder and Mueller revisited the meniscus sign. Their study was primarily focused on a dynamic assessment of the demonstrability of the meniscus sign that largely depends on the judgment and technical skill of examiner, especially graded compression and patient positioning. One year earlier Balfe et al. assessed the diagnostic reliability of gastric wall thickening as observed on CT scan in adenocarcinoma, lymphoma and leiomyosarcoma and concluded that it is not a reliable finding. In contrast, however, Lee et al. recently emphasized that the wall thickness measurement on CT of exophytic carcinoma, myoma and ulcers was a useful diagnostic means. Thus, it appears that gastric wall thickening or mucosal heave-up is by itself not as reliable as the meniscus sign. The electronic search of world literature failed to disclose earlier report of this sign demonstrated by $^{18}F-FDG$ positron emission tomography and computed tomography (PET/CT). The present communication documents $^{18}F-FDG$ PET/CT finding of the meniscus sign as encountered in a case of ulcerating gastric carcinoma, the histological diagnosis of which was moderately differentiated tubular adenocarcinoma. Unlike most gastric tumors without ulceration that tend to unimpressively accumulate $^{18}F-FDG$ the present case of Borrmann type III gastric carcinoma demonstrated markedly increased $^{18}F-FDG$ uptake.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.186-187
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• 2006

A 64-year-old female with glioblastoma multiforme (GBM) was assigned to our department for whole body PET/CT scan. She ingested 1 liter of pure water as negative oral contrast just before PET/CT examination. FDG-PET/CT images showed a very intense hypermetabolic, focal lesion in the abdominal cavity around descending colon. The SUVmax of the lesion was 17.2. But there was no abnormal lesion corresponded to the area of PET scan in the combined contrast enhanced CT scan. We suggested considering a malignant lesion due to very intense glycolytic activity. Conventional abdominal CT scan & colonoscopy were accomplished within one week after PET/CT evaluation. There was no abnormality in both examinations. We executed follow-up PET/CT evaluation after 1 month and couldn't find any abnormality around the corresponding area. So we concluded the hypermetabolism was colonic physiologic uptake. A colonic physiologic uptake is a well known cause of false positive finding. Nuclear physicians should be considered the possibility of malignancy when interpret focal colonic uptake, especially incidental finding. There are a few reports that using of negative oral contrast is able to reduce gastrointestinal physiologic uptakes. But as we can see in this case, although we used negative oral contrast, intense physiologic uptake is detected and maxSUV is able to up to 17.2. So, it is important to keep a fact in mind. Even though there is a colonic physiologic uptake in PET/CT image, it may be able to show very intense hypermetabolism regardless of using negative oral contrast.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.82-93
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• 1995

Three-dimensional reconstruction of computed tomographic image(3D CT) is a well-established imaging modality which has been investigated in various clinical settings. It is commonly performed in case of congenital or developmental abnormalities, and traumatic fracture of skull and face that requires reconstruction of osseous structure. However reporting the 3D CT in laryngeal or tracheal stenosis is rare and its results are obscure. The authors performed 3D CT in six cases of tracheal stenosis and found diagnostic value of 3D CT. A Comparision of diagnostic information obtained from plain X-ray, 2D CT and 3D CT has performed in total six cases of tracheal stenosis. Surgical treatment of the tracheal stenosis was following in these cases : tracheal end to end anastomosis In 1 case, laryngotracheal end to end anastomosis in 2 cases. 3D CT information was compared with operative finding. In two of six cases, satisfactory information was not obtained from 3D CT in evaluating an exact stenosis of trachea. Future, it will be helped in evaluating of tracheal stenosis by 3D CT.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.150-153
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• 2009

Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased $^{18}F$-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of $^{18}F$-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.

• The Journal of Korean Medicine
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• v.23 no.4
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• pp.91-97
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• 2002

Objective: This study was conducted to know the survival probability of the patients with cerebrovascular disease. Method: 1,341 patients who were suspected of having cerebrovascular disease clinically were investigated by telephone and NHIC (National Health Insurance Corporation) data. Conclusion: 1. The study population was grouped as 'Negative Brain CT findings' (11.8%), 'Hemorrhage' (12.4%) and 'Infarction' (75.7%). 2. The survival probabilities calculated by the Life Table method were statistically significant among brain CT finding groups (P<0.01). 3. The mean survival time calculated by the Kaplan-Meier method were also statistically significant among brain CT finding groups (P<0.01). 4. The result of Cox regression model was that sex (OR=0.7), age (OR=1.07), diabetes mellitus (OR=1.38), and heart disease (OR=1.69) affected the survival of the patients with cerebrovascular disease.

• The Journal of the Korea Contents Association
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• v.11 no.10
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• pp.333-341
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• 2011

To compare between calcium scoring CT (CSCT) and Low-dose CT (LDCT) image finding for coronary artery calcification (CAC) in screening of lung disease by MDCT. A total of 61 subjects who retired-workers exposed to inorganic dust were performed LDCT and CSCT by using a MDCT scanner on the same day, after be approved by the institutional review board, and obtaining the written informed consent from all subjects. LDCT images were read for detecting lung diseases as well as CAC by a experienced chest radiologist, then the subjects were divided either the positive group with CAC or the negative group without it. The CSCT was used to quantify and detect the presence of calcification in the coronary artery, and score of CAC calculated by using a Rapidia software (ver 2.8). In all coronary arteries, calcium score of positive group was higher better than that in negative group, especially in the total calcium (13.7 vs. 582.9, p=0.008) and the left anterior descending artery (3.2 vs. 249.0, p=0.006). CAC findings between CSCT and LDCT image were showed excellent agreement in cut-off point 100(K-value=0.80, 95% CI=0.69-0.91) from total calcium score. CAC findings on LDCT images showed the higher relation with CSCT. Therefore, the obstructive coronary artery disease could be predicted by CAC on LDCT images for screening of lung diseases.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.780-785
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• 1997

Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.33-41
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• 2007

Bone scan using radioactive isotope can be more effective than conventional X-ray radiograph for finding jaw lesion because it takes an image of the physiologic change of bone. This study is designed to show how available bone scan is able to diagnose jaw lesion better than simple X-ray and CT, as well as to determine a basis of diagnosis for jaw lesion using bone scan. The 77 patients, visiting the Oral & Maxillofacial Surgery, Department of Dankook University Hospital from January 2002. to August 2005. who were diagnosed histopathologically with postoperative malignant tumor, osteomyelitis, and bone infiltrative benign disease. Preoperative X-ray, CT, bone scan were taken and were compared with histopathologic finding. Also to compare specificty of each lesion in bone scan, bone density was measured to compare. The results were as follows. 1. Among the 25 cases of oral malignant tumor of bony invasion, a positive diagnosis associated with histopathologic evaluation, 22 cases(88%) in bone scan, 14 cases(56%) in CT image, and 10 cases40%) in simple X-ray. 2. Among the 31 cases of osteomyelitis, a positive diagnosis associated with histopathologic evaluation, 30 cases(97%) in bone scan, 23 cases(74%) in CT image, and 19 cases(61%) in simple X-ray. 3. Among the 11cases of bone infiltrative benign disease, a positive diagnosis associated with histopathologic evaluation, 11 cases(100%) in bone scan, 10 cases(91%) in CT image, and 6 cases(55%) in simple X-ray. 4. Measurement of bone density in each group showed no statistical significant difference between malignant tumor and osteomyelitis as well as benign bone disease. But, a statistical significance was seen between osteomyelitis and benign bone disease. From this results, bone scan are more sensitive than simple X-ray and CT image in jaw lesion diagnosis, but specificity shows no significant difference. Therefore, it should be suggested that evaluation of bone scan must be carrying out in reference to final histopathologic diagnosis.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.417-422
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• 2023

In this study, normal saline was diluted with the contrast medium at a certain ratio for the purpose of reducing the image quality poor and side effects caused by the contrast medium during CT examination. At this time, by finding the energy level of DECT that can compensate for the decrease in contrast of the image according to the degree of dilution, the usefulness of applying DECT for compensating the difference in image contrast was investigated through comparative analysis by applying SNR, CNR, and SSIM. As a result, when a dilution ratio of 4 (contrast medium): 6 (normal saline) and the energy level of DECT of 65 keV were applied, the contrast difference was the most similar to that when using the undiluted contrast medium. At this time, SNR was 813.71 ± 37.6, CNR was the highest at 921.87 ± 17.1, and SSIM index was measured at 0.851, which is the most similar to 1. The results of this study are meaningful in providing basic information for finding the appropriate dilution rate and energy level for each examination site through future clinical studies. It is believed that it can be reduced.