• Title/Summary/Keyword: CT scan findings

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Spontaneous Disappearance of a Pericardial Cyst: Case Report and Literature Review

  • Moffa, Angelo Pio;Stoppino, Luca Pio;Loizzi, Domenico;Milillo, Paola
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.72-75
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    • 2018
  • Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared. Although the spontaneous resolution of these lesions is rare, this article highlights the possibility of conservative management in select cases.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging (요추 MR영상에 포함된 경흉추 시상T2강조영상의 효용성 평가)

  • Seo, Jiwoon;Park, So Young;Lee, Joon Woo;Lee, Guen Young;Kang, Heung Sik
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.91-100
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    • 2013
  • Purpose : To evaluate the usefulness of cervicothoracic spine sagittal T2-weighted images (CT SAG T2WIs) included in routine lumbar spine MRI. Materials and Methods: Institutional review board approval was obtained and informed consents were waived for this retrospective study. The study group comprised 2,113 patients who underwent lumbar spine MRI from January 2005 to December 2005. CT SAG T2WIs were added in the routine lumbar spine MRIs. Radiologic reports were reviewed retrospectively for pathologic lesions on CT SAG T2WIs by one radiologist. Information of additional cervical or thoracic spine MRI and/or CT for further evaluation of positive findings on CT SAG T2WIs and their treatment were collected by retrospectively reviewing medical records. Results: The CT SAG T2WIs revealed 142 pathologic lesions in 139 (6.58%) of the 2,113 patients. They were easily obtained without positional change in a scan time of less than 2 minutes. Additional cervical or thoracic spine MRI and/or CT for positive findings on CT SAG T2WIs were performed in 13 patients. Seven patients underwent surgical treatment. Conclusion: CT SAG T2WIs included in routine lumbar spine MRI were useful in finding the pathologic lesions in cervicothoracic spine for the patients who assumed to have lesions in lumbar spine.

USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER (구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성)

  • Yu, Min-Gi;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

Usefulness Comparative Experimental Study of the CT and MR Imaging in the Dog Clonorchiasis (잡견 간흡충증의 전산화단층촬영과 자기공명영상의 유용성에 관한 실험적 연구)

  • Goo, Eun-Hoe;Kweon, Dae-Cheol;Kim, Dong-Sung;Choi, Chun-Kyu
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.33-39
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    • 2003
  • Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.

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The Role of Chest CT Scans in the Management of Empyema (농흉에서 전산화 단층촬영의 의의)

  • Heo, Jeong-Suk;Kwun, Oh-Yong;Sohn, Jeong-Ho;Choi, Won-Il;Hwang, Jae-Seok;Han, Seung-Beom;Jeon, Young-June;Kim, Jung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.397-404
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    • 1994
  • Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

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Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

  • Noh, Gi Tark;Lee, Kyoung Ju;Sohn, Hee Jung;Lee, Kyung Han;Heo, Won Seok;Koh, Byung Sung;Han, Un Mi;Bae, Young A
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.72-75
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    • 2016
  • Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Imaging Features of Eosinophilic Bronchopneumopathy in Three Dogs (세 마리 개에서 호산구성 기관지폐병증의 영상학적 특징)

  • Ji, Seo-Yeoun;Yi, Kang-Jae;Kim, Jun-Young;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.194-197
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    • 2012
  • Three dogs were presented with a history of dyspnea and cough. Physical examination, blood analysis, bronchoalveolar lavage and radiography of three dogs were evaluated. And additionally, computed tomography and lung biopsy were performed on one dog. They showed normal laboratory examination results. The radiographic findings noted alveolar and bronchointerstitial infiltration with bronchiectasis. For one dog, nodules scattered throughout both lung fields on survey radiographs were confused with pulmonary neoplasia, so CT scan was used to rule out neoplasia. Bronchoalveolar lavage revealed abnormally high levels of eosinophils in all dogs. On histopatholgic exam, eosinophilic bronchiolitis and eosinophilic and histiocytic alveolitis were confirmed. Consequently, all dogs were diagnosed as eosinophilic bronchopneumopathy. Symptoms regressed dramtically within a few days after treatment with oral corticosteroids. Radiographs and CT scan are useful for diagnosis and prognosis of eosinophilic bronchopneumopathy.

Frontonasal Bone Flap for Treating a Paranasal Sinus Cyst Diagnosed by CT in a Thoroughbred Racehorse

  • HeeEun Song;Eun-bee Lee;Kyung-won Park;Seyoung Lee;Yong-woo Chun;Chull-gyu Park;Hyohoon Jeong;Jong-pil Seo
    • Journal of Veterinary Clinics
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    • v.40 no.3
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    • pp.209-214
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    • 2023
  • A 3-year-old Thoroughbred gelding was referred to the Jeju National University Equine Hospital with prolonged unilateral nasal discharge for several months. A sinus cyst was suspected based on the history, symptoms, endoscopic findings, and radiographic results. Computed tomography (CT) scan revealed that the cyst (7.5 × 8.0 × 10.0 cm) was located between the rostral maxillary sinus and the frontal sinus, causing distortion and remodeling of the overlying bones, swelling of the overlying cutaneous tissues, and a slight deviation of the nasal septum. Standing surgery under sedation was decided to remove the cyst. A frontonasal bone flap was performed using an oscillating bone saw, and the cyst filled with pus was removed. To support the approach to the maxillary sinus, trephination was performed. The horse was treated with sinus lavage via catheterization, nebulization, antibiotics, and nonsteroidal anti-inflammatory drugs. The horse was discharged 18 days after the surgery without signs of any complication. This case showed that a CT scan could be a valuable tool for the diagnosis and subsequent surgical management of paranasal sinus cysts in horses. Also, the frontonasal bone flap was useful for exposing and removing the large-sized of cyst in the paranasal sinus.

Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy (유방암 절제술 후 방사선치료를 시행한 환자의 골스캔에서 보이는 방사전 유발 늑골골절)

  • Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Kim, Jin-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.287-293
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    • 2009
  • Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.