• Journal of Chest Surgery
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• v.20 no.2
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• pp.358-366
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• 1987

A case of malignant fibrous histiocytoma [MFH] of left pulmonary artery was reported in the 27 year-old male. He was admitted because of hemoptysis for several times. Chest x-ray revealed nodular lesions in left hilar area and left upper lobe. A left thoracotomy was performed followed left upper lobectomy. The main tumor was originated from the pulmonary arterial bifurcation and proximal portion of the left pulmonary artery. By light microscopy, there were many pleomorphic giant cells, which displayed the storiform pattern. And in those area, dilated or compressed vascular channels were involved by tumor cells, suggesting origin of This tumor. Pulmonary artery angiography and chest CT revealed this tumor was originated from pulmonary artery. It would be the first reported primary malignant fibrous histiocytoma of the pulmonary artery in our country. Postoperative prognosis was uneventful, but recently he was suffered from dyspnea, that was noticed by OVD follow-up for 1 month, probably the heart failure sign due to pulmonary arterial flow obstruction.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.66-70
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• 2002

Pulmonary Sequestration is a rare congenital malformation during embryouic development which results in a cystic mass of nonfunctioning lung tissue. A diagnosis of a pulmonary sequestration has traditionally relied upon identifying the pathological arterial vessels by arteriography, computed tomography, and magnetic resonance imaging. We reported a case of pulmonary sequestration diagnosed by Doppler sonography and subsequent CT angiography. A 21-year-old-woman admitted to hospital for an investigation of recurrent pneumonia with left lower chest pain. A doppler ultrasound sonography showed an aberrant blood supply from the descending thoracic aorta to the left lower chest lesion. The pulmonary sequestration was confirmed by the subsequent CT angiograph.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2011.10a
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• pp.554-556
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• 2011

The occurrence of various vascular diseases due to the need for accurate and rapid diagnosis was emphasized. Several limitations to the presence of pulmonary vascular angiography for chest CT imaging was aware of the need for diversity in medical image processing with Insight Toolkit(ITK) suggested pulmonary vascular division. In this paper, by contrast, based on the value of a two-step partitioning of the lungs and blood vessels to perform the process of splitting. Lung area segmentation of each stage image enhancement, threshold value, resulting in areas of interest cut image acquisition and acquired pulmonary vascular division in lung area obtained by applying the fill area. Partitioned on the basis of pulmonary vascular imaging to obtain three-dimensional visualization image of the pulmonary vascular analysis and diagnosis of a variety of perspectives are considered possible.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.279-284
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• 2017

Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.489-493
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• 2004

Unilateral pulmonary artery agenesis is a rare congenital anomaly usually associated with other cardiovascular anomalies such as tetralogy of Fallot or septal defect. Unilateral pulmonary artery agenesis without other coexisting cardiovascular abnormality (isolated unilateral pulmonary artery) is extremely rare and often asymptomatic until adulthood. In these patients, diagnostic clue is found in a plain chest roentgenogram, showing a hyperlucent contracted hemithorax. We have recently experienced a case of isolated right pulmonary artery agenesis, which was diagnosed by chest dynamic CT, perfusion scan, echocardiogram and 3-dimensional reconstruction cardiac CT angiography in a 50-year old female who had suffered from mild dyspnea on exertion and improved with conservative treatment. We report this case with a brief review of the relevant literature.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.74-78
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• 2007

Systemic artery to pulmonary vessel fistula (SAPVF) is an abnormal communication between the systemic arterial circulation and the pulmonary circulation. Most SAPVF are congenital, but some SAPVF may also develop as a consequence of trauma, neoplasm, and inflammation of pleura or lung parenchyma. A 38-year-old man was referred to our department for hemoptysis. He underwent an operation for traumatic diaphragm rupture 16 years ago. Chest CT scan and angiography revealed SAPVF between several intercostal arteries and pulmonary vessels. He had an angiographic transcatheter embolization and the SAPVF disappeared at follow-up chest CT. To the best of our knowledge, this is the first case report of traumatic SAPVF in Korea.

• Tuberculosis and Respiratory Diseases
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• v.72 no.4
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• pp.352-359
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• 2012

Background: The purpose of this study was to evaluate whether measuring the ratio of descending aortic enhancement (DAE) to main pulmonary artery enhancement (MPAE) on pulmonary computed tomography angiography (PCTA) can predict poor outcome in patients with acute massive or submassive pulmonary embolism (PE). Methods: We retrospectively, reviewed computed tomgraphy findings and charts of 37 patients with acute PE and right ventricular dysfunction. We divided the enrolled patients into 3 groups; group Ia (n=8), comprised of patients with major adverse event (MAE); group Ib (n=5), consisted of those with PE-related MAE; and group II (n=29), those without MAE. We analyzed the right ventricular diameter (RVD)/left ventricular diameter (LVD) and DAE/MPAE on PCTA. Results: For observer 1, RVD/LVD in group Ia ($1.9{\pm}0.36$ vs. $1.44{\pm}0.38$, p=0.009) and group Ib ($1.87{\pm}0.37$ vs. $1.44{\pm}0.38$, p=0.044) were significantly higher than that of group II. For observer 2, RVD/LVD in group Ia ($1.71{\pm}0.18$ vs. $1.41{\pm}0.47$, p=0.027) was significantly greater than that of group II, but RVD/LVD of group Ib was not ($1.68{\pm}0.2$ vs. $1.41{\pm}0.47$, p=0.093). For both observers, there was a significant difference of DAE/MPAE between group Ib and group II ($0.32{\pm}0.15$ vs. $0.64{\pm}0.24$, p=0.005; $0.34{\pm}0.16$ vs. $0.64{\pm}0.22$, p=0.004), but no significant difference of DAE/MPAE between group Ia and group II ($0.51{\pm}0.3$ vs. $0.64{\pm}0.24$, p=0.268; $0.53{\pm}0.29$ vs. $0.64{\pm}0.22$, p=0.302). Intra-class correlation coefficient (ICC) for the measurement of DAE/MPAE (ICC=0.97) was higher than that of RVD/LVD (ICC=0.74). Conclusion: DAE/MPAE measured on PCTA may predict PE-related poor outcomes in patients with massive or submassive PE with an excellent inter-observer agreement.

• Proceedings of the Korea Information Processing Society Conference
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• 2004.05a
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• pp.703-706
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• 2004

나선형 CT 혈관촬영에서 획득한 영상의 분석를 통해서 폐색전증이 의심되는 부위를 자동으로 검출하는 방법으로, 연구 대상은 20명의 환자를 대상으로 분석하였으며 CT 검사 후 방사선과 의사가 정상소견을 받은 환자 5명과 폐색전증이 있는 판독소견을 가진 15명을 대상으로 비교 분석하였다. CT 검사하는 동안에 조영제를 투입하면, 폐색전증이 발생한 부위는 조영제 양과 분포가 불균등하여 명암값이 낮게 검출된다. 검출방법으로는 전처리 작업으로 폐영역만을 분할하고, 분할된 폐영역에서 혈관을 찾기 위해 모폴로지기법를 적용하여 세선화(thinning) 작업을 진행한다. 다음 공정으로는 경계선을 찾아 local watershed를 적용하여 혈관을 검출하고, 검출된 혈관내에서 원형모델을 적용하여 모폴로지(morphology)을 통해 국소 부위의 미세한 농도변화를 인지하여 색전이 발생한 영역을 자동검출하였다. 본 논문의 자동검출시스템에서는 색전증이 있는 경우에 true positive의 발생빈도는 case 당 4.5개가 검출되었다. 정상인의 경우에도 혈류의 흐름, 혈류의 분기점, 노이즈로 인한 false positive의 빈도는 case 당 2.6개가 발생하여 전체적으로 false positive는 5.2개가 검출되었다. 본 논문은 false positive의 비율이 높게 검출되었지만 폐영역 CT 검사의 컴퓨터지원진단시스템(computer aided diagnosis)의 향후 연구과제에 방향을 제시할 수 있을 것이라 사료된다.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.70-83
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• 2022

Acute coronary syndrome (ACS) is mainly caused by atherosclerotic coronary artery disease (CAD); however, it can also occur in patients with non-atherosclerotic CAD. Conventional coronary angiography only shows the lumen of arteries, indicating the presence of stenosis or dilatation. Thus, it has limited value in evaluating the coronary artery wall and offers low specificity for diagnosing CAD. Coronary CT angiography provides additional information, including the depiction of the concerned vessel and the aorta, as well as the pulmonary artery, which permits the diagnosis of non-atherosclerotic CAD and the differentiation of various causes of the disease. In this review, we present the pathophysiology and CT imaging features of non-atherosclerotic CAD.

• Korean Journal of Radiology
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• v.23 no.8
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• pp.794-802
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• 2022

Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23-65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions). TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion: Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.