• Journal of Chest Surgery
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• v.35 no.7
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• pp.568-572
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• 2002

We present a case of a 47-year-old woman with benign solitary fibrous tumor of the pleura originated in the diaphragm which was discovered incidentally on a chest radiograph. Chest radiograph, sonograph, computed tomographic scan and magnetic resonance image studies proved a well circumscribed and lobulated fibrous tumor of the pleura. During the subsequent right thoracotomy, the tumor was found to be encapsulated and consisted of firm mass. It was connected to the diaphragm with $5{\times}4$cm area by pedicle. Most of the tumor was free of adhesion. It was excised completely together with attached diaphragm. The tumor measured $23.5{\times}13.5{\times}8.0$cm and the pathologic diagnosis was benign solitary fibrous tumor and the attached diaphragm was free of disease.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1690-1696
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• 2021

Objective: To describe the anatomic locations and imaging features of posterior lung herniation in unilateral pulmonary agenesis and aplasia, focusing on radiograph-CT/MRI correlation. Materials and Methods: A total of 10 patients (seven with pulmonary agenesis and three with pulmonary aplasia, male: female = 1:9, mean age 7.3 years, age range from 1 month to 20 years) were included. Chest radiographs (n = 9), CT (n = 9), and MRI (n = 1) were reviewed to assess the type of lung underdevelopment, presence of anterior and posterior lung herniation, bronchus origin, supplying artery, and draining vein of the herniated lung. Results: Pulmonary agenesis/aplasia more commonly affected the left lung (n = 7) than the right lung (n = 3). Anterior lung herniation was observed in nine of the 10 patients. Posterior lung herniation was observed in seven patients with left pulmonary agenesis/aplasia. Two patients showed posterior lung herniation crossing the midline but not beyond the aorta, and five patients showed the posteriorly herniated right lower lobe crossing the midline to extend into the left hemithorax farther beyond the descending thoracic aorta through the space between the esophagus and the aorta. This anatomical configuration resulted in a characteristic radiographic finding of a radiolucent area with a convex lateral border and a vertical medial border in the left lower lung zone, revealing a tongue-like projection on CT and MRI. Conclusion: Posterior lung herniation occurs in unilateral left lung agenesis/aplasia. Approximately 70% of the cases of posterior lung herniation reveal a unique radiolucent tongue-like projection in the left lower lung zone on imaging studies, which is caused by the extension of the posteriorly herniated right lung farther beyond the descending aorta.

• Journal of Life Science
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• v.16 no.1
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• pp.58-63
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• 2006

There was cross-sectional study on investigating the factors related asbestos-related disease on chest radiograph of workers exposed to asbestos in ship repair. According to Occupational Safety & Health Administration asbestos standard, medical surveillance, chest radiologic study, pulmonary function test and medical questionnaire are performed in 118 subjects exposed to asbestos for 10 years or more in ship repair. The sixteen out of 118 subjects $(13.6\%)$ were observed asbestos-related disease finding on chest radiography. Significant factors related to those finding on chest radiography were abnormal pulmonary function test, cough, sputum, past history of respiratory disease, work duration. Workers with Significant factors related asbestos-related disease finding on chest radiography should be managed on a strict program. Further, factors unrelated with asbestos-related disease finding on this study should be evaluated prospectively for medical surveillance program of workers exposed to asbestos.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.442-445
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• 2002

We present an algorithm for automatic anatomically adaptive image enhancement of digital chest radiographs. Chest images were exposed using digital radiography system with a 0.143 mm pixel pitch, l4-bit gray levels, and 3121 ${\times}$ 3121 matrix size. A chest radiograph was automatically divided into two classes (lung field and mediastinum) by using a maximum likelihood method. Each pixel in an image was processed using fuzzy domain transformation and enhancement of both the dynamic range and local gray level variations. The lung fields were enhanced appropriately to visualize effectively vascular tissue, the bronchus, and lung tissue, etc as well as pneumothorax and other lung diseases at the same time with the desired mediastinum enhancement. A prototype implementation of the algorithm is undergoing trials in the clinical routine of radiology department of major Korean hospital.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.296-299
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• 2012

The aorta is the most common major thoracic artery injured by blunt chest trauma. Injuries to major aortic arch branch arteries can also occur but are much less common than aortic injuries in the setting of blunt trauma. Although internal mammary artery (IMA) injury is uncommon and rarely diagnosed in cases of blunt chest trauma, it is one of the important sources of bleeding in chest trauma. IMA bleeding can cause ongoing blood loss and may lead to serious conditions such as extensive hemothorax, anterior mediastinal hematoma or its catastrophic complication, cardiac tamponade. However such arotic and branch artery injuries are not easily detected by plain radiograph, and are detected indirectly because of associated mediastinal hematoma. Herein, we report a case of IMA injury caused by blunt chest trauma secondary to pedestrian traffic accident. The injured patient was successfully treated by transcatheter arterial embolization (TAE).

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.535-542
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• 2004

Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

• Korean Journal of Radiology
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• v.24 no.9
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• Progress in Medical Physics
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• v.19 no.3
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• pp.143-149
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• 2008

The aim of this study is to suggest the method for image enhancement of digital chest radiograph and evaluate clinically the quality of the resultant image. A nonlinear iterative filter was developed in order to reduce quantum noise preserving edge. Dynamic range was adjusted and adaptive image enhancement was performed based on the property of anatomic region and the degree of compatibility with neighboring pixels. The lung fields were enhanced appropriately to visualize effectively vascular tissue, bronchus and lung tissue with the desired mediastinum enhancement. Clinic evaluation was performed by three radiologists with at least 8 years experience. The anatomic regions of 11 in PA and 9 in Lateral were observed carefully in each 100 radiographs according to ITU (International Telecommunication Union) recommendation 500 protocol. The result showed the mean 3.4 between good and adequate. This means that the clinical utility of the image quality is enough. In this study, image enhancement was carried out considering image display device and human perceptual system to prevent the loss of useful anatomic information. In order to increase the diagnostic accuracy in digital radiograph, the continuous study on image enhancement is needed.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.5 no.4
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• pp.829-840
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• 2001

In this study, we propose a method for quantifying the degree of advance of pulmonary emphysema by using chest X-ray images. With this method, we devise two schemes for this purpose. One is for detecting blood vessels by using a deformable model with the tree-like structure and using an evaluation function specialized by knowledge about blood vessels appeared in chest X-ray images, and the other is for quantifying the degree of advance by using several features, which were extracted from blood vessels, and the equation of quantitative evaluation. In order to evaluate the performance, we applied the proposed method to 189 ROIs(Regions of Interest) of ten chest X-ray images and compared the values by the proposed method with those by a medical doctor.

• Journal of Trauma and Injury
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• v.25 no.3
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• pp.97-100
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• 2012

We report a case of delayed diagnosed pneumonia due to an aspirated metallic crown, which had been detached from a molar tooth. Dental prosthesis should be checked and a careful review of the chest radiograph is mandatory when an elderly patient with delirium after hip fracture surgery develops pneumonia postoperatively.