• Title/Summary/Keyword: Contrast Enhanced Ultrasonography

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Walled-off Pancreatic necrosis in a Dog

  • Hwang, Tae-sung;Park, Su-jin;Lee, Jae-hoon;Jung, Dong-in;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.146-149
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    • 2018
  • A 7-year-old, castrated, male Maltese dog presented with hyporexia and depression for 3 days. Elevated serum amylase, lipase activities, and liver enzyme values were found upon blood examination. An abdominal mass was seen on radiographs caudal to the gastric body in the left middle abdomen. In the left middle abdomen, abdominal ultrasonography also revealed a massive, irregularly marginated, heterogeneous mass of unknown origin, and in the right cranial abdomen, heterogeneously hypoechoic pancreatic tissue and hyperechoic change of adjacent mesenteric fat were observed. Contrast-enhanced computed tomography showed an irregular contour of the left pancreatic limb as well as heterogeneously enhanced parenchyma. A low-attenuating peripancreatic fluid collection with a thin and irregular wall was also seen. Based on these findings, an atypical pancreatic abscess with necrotizing pancreatitis which manifested as walled-off necrosis was suspected. The mass was excised, and the pancreatic abscess was confirmed by histopathologic examination. No complications were found in the patient after two months of follow-up examination.

Diagnosing Hepatocellular Carcinoma Using Sonazoid Contrast-Enhanced Ultrasonography: 2023 Guidelines From the Korean Society of Radiology and the Korean Society of Abdominal Radiology

  • Woo Kyoung Jeong;Hyo-Jin Kang;Sang Hyun Choi;Mi-Suk Park;Mi Hye Yu;Bohyun Kim;Myung-Won You;Sanghyeok Lim;Young Seo Cho;Min Woo Lee;Jeong Ah Hwang;Jae Young Lee;Jung Hoon Kim;Ijin Joo;Jae Seok Bae;So Yeon Kim;Yong Eun Chung;Dong Hwan Kim;Jeong Min Lee
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.482-497
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    • 2023
  • Sonazoid, a second-generation ultrasound contrast agent, was introduced for the diagnosis of hepatic nodules. To clarify the issues with Sonazoid contrast-enhanced ultrasonography for the diagnosis of hepatocellular carcinoma (HCC), the Korean Society of Radiology and Korean Society of Abdominal Radiology collaborated on the guidelines. The guidelines are de novo, evidence-based, and selected using an electronic voting system for consensus. These include imaging protocols, diagnostic criteria for HCC, diagnostic value for lesions that are inconclusive on other imaging results, differentiation from non-HCC malignancies, surveillance of HCC, and treatment response after locoregional and systemic treatment for HCC.

Diagnosis of Hepatocellular Carcinoma Using C-11 Choline PET/CT: Comparison with F-18 FDG, Contrast-Enhanced MRI and MDCT

  • Chotipanich, Chanisa;Kunawudhi, Anchisa;Promteangtrong, Chetsadaporn;Tungsuppawattanakit, Puntira;Sricharunrat, Thaniya;Wongsa, Paramest
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3569-3573
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    • 2016
  • Purpose: The aim of this study was to compare C-11 choline and F-18 FDG PET/CT, gadoxetic-enhanced 3-T MRI and contrast-enhanced CT for diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: Twelve chronic hepatitis B patients suspected of having HCC by abdominal ultrasonography received all diagnostic modalities performed within a one-week timeslot. PET/CT results were analyzed visually by two independent nuclear medicine physicians and quantitatively by tumor to background ratio (T/B). Nine patients then had histopathological confirmation. Results: Six patients had well differentiated HCC, while two and one patient(s) were noted with moderately and poorly differentiated HCC, respectively. All were detected by both CT and MRI with an average tumor size of $5.7{\pm}3.8cm$. Five patients had positive C-11 choline and F-18 FDG uptake. Of the remaining four patients, three with well differentiated HCC showed negative F-FDG uptake (one of which showed negative results by both tracers) and one patient with moderately differentiated HCC demonstrated no C-11 choline uptake despite intense F-18 FDG avidity. The overall HCC detection rates with C-11 choline and F-18 FDG were 78% and 67%, respectively, while the sensitivity of F-18 FDG for non-well differentiated HCC was 100%, compared with 83% of C-11 choline. The average T/B of C-11 choline in well-differentiated HCC patients was higher than in moderately and poorly differentiated cases (p=0.5) and vice versa with statistical significance for T/B of F-18 FDG (p = 0.02). Conclusions: Our results suggested better detection rate in C-11 choline for well differentiated HCC than F-18 FDG PET. However, the overall detection rate of PET/CT with both tracers could not compare with contrast-enhanced CT and MRI.

A Case of Lemierre's Syndrome, Misdiagnosed as a Simple Deep Neck Infection on Initial Ultrasonography Followed by an Abscess Aspiration Trial (초음파에서 단순 심경부 감염증으로 오인하여 흡인치료를 시도한 내경정맥 혈전정맥염 (레미에르 증후군) 1례)

  • Lee, Dong Yun;Kim, Sang Bin;Ban, Myung Jin
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.31-34
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    • 2019
  • Lemierre's syndrome is rare disease characterized by anaerobic sepsis, internal jugular vein thrombosis, septic emboli that resulted from head and neck infection. Lemierre's syndrome has significant morbidity, so immediate, accurate diagnosis and treatment is needed. It is necessary to perform contrast-enhanced computed tomography (CT) for diagnosis. Systemic antibiotics is recommended, and surgical interventions, anticoagulation may beis considered for treatment. We report misdiagnosed case as a simple deep neck infection on initial ultrasonography with simultaneous abscess aspiration but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan. We report a case of a 45-year-old patient, who was diagnosed with a simple deep neck infection and treated with simultaneous abscess aspiration, but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.

Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule

  • Moon, You Ho;Kim, Jung ho;Jeong, Won joon;Park, Sin-Youl
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.127-129
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    • 2018
  • Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

A Parametric Image Enhancement Technique for Contrast-Enhanced Ultrasonography (조영증강 의료 초음파 진단에서 파라미터 영상의 개선 기법)

  • Kim, Ho Joon;Gwak, Seong Hoon
    • KIPS Transactions on Software and Data Engineering
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    • v.3 no.6
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    • pp.231-236
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    • 2014
  • The transit time of contrast agents and the parameters of time-intensity curves in ultrasonography are important factors to diagnose various diseases of a digestive organ. We have implemented an automatic parametric imaging method to overcome the difficulty of the diagnosis by naked eyes. However, the micro-bubble noise and the respiratory motions may degrade the reliability of the parameter images. In this paper, we introduce an optimization technique based on MRF(Markov Random Field) model to enhance the quality of the parameter images, and present an image tracking algorithm to compensate the image distortion by respiratory motions. A method to extract the respiration periods from the ultrasound image sequence has been developed. We have implemented the ROI(Region of Interest) tracking algorithm using the dynamic weights and a momentum factor based on these periods. An energy function is defined for the Gibbs sampler of the image enhancement method. Through the experiments using the data to diagnose liver lesions, we have shown that the proposed method improves the quality of the parametric images.

Ultrasonographic and Magnetic Resonance Imaging Findings of Testicular Lymphoma (고환림프종의 초음파검사 및 자기공명영상 소견)

  • Cho, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.105-112
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    • 2010
  • Purpose : To evaluate the specific radiologic findings of testicular lymphoma which will be able to differentiated from other testicular tumors. Materials and Methods : Pathologically confirmed eight cases were included in this study. All eight cases were performed ultrasonography and four cases were performed magnetic resonance image. On ultrasonography, the size, location, shape, margin, internal echogenicity, homogeneity and vascularity were evaluated. On magnetic resonance image, the shape, margin, homogeneity, signal intensity on T1- and T2-weighted images, degree and homogeneity of the contrast enhancement and contrast enhancement change on dynamic enhancement study. Results : The margin of the mass was smooth on 6 of 8 patients. Internal echogenicity of the mass lesion was hypoechoic than normal testicular parenchyme on 7 of 8 patients. Four cases were homogeneous, 3 cases were relatively homogeneous and 1 case was heterogeneous. All 8 cases showed increased vascularity. The mass lesion was iso-signal intensity on T1-weighted image and low-signal intensity on T2-weighted image. All four cases were enhanced homogeneously and mildly than enhancing normal testicular parenchyme. On dynamic enhancement study, the mass lesion is progressively enhanced with time. Conclusion : The possibility of testicular lymphoma should be considered when testicular mass was homogeneously hypoechoic and low signal intensity on T2-weighted image in old age patients.

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Incidentally found unicentric plasma cell variant Castleman's disease in mesentery: focus on ultrasonography and CT findings (우연히 발견된 장간막의 단중심성 형질세포형 Castleman병 1예: 초음파와 CT 소견 중심으로)

  • Kim, Hyun Min;Kim, Bong Soo;Jung, In Ho;Hyun, Chang Lim;Jung, Seung Wook;Jo, Jae Min
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.19-22
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    • 2018
  • Castleman's disease is a benign lympho-proliferative disorder that commonly occurs in mediastinum. It is known that the disease rarely occurs in mesentery. Most localized abdominal Castleman's diseases are histologically hyaline vascular type. The contrast-enhanced CT in patient with hyaline vascular type Castleman's disease shows a well-defined mass with homogenously intense enhancement. On the other hand, the patient with plasma cell variant has systemic symptoms, but not specific imaging features. We report a unicentric plasma cell variant Castleman's disease in mesentery nearby superior mesenteric artery as presenting a single mass, not accompanied by systemic symptoms with similar characteristics to hyaline vascular type.

Medical Parameter Extraction Using Time-Density Data in Contrast-Enhanced Ultrasound Image Sequence (조영증강 초음파영상에서 밀도변화 데이터를 이용한 진단 파라미터 추출 기법)

  • Lee, Jun-Yong;Jung, Joong-Eun;Kim, Ho-Joon
    • KIPS Transactions on Software and Data Engineering
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    • v.4 no.7
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    • pp.297-300
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    • 2015
  • In medical ultrasonography, transit time and contrast enhancement patterns are considered as important parameters to analyze liver diseases. In many recent researches, time-intensity curves(TIC) have been used for calculating the transit time of the contrast agents. However, the intensity curve may include the variations which are caused by the micro-bubble effect of contrast agents. In this paper, we propose a complementary approach to diagnostic parameter extraction which utilizes a density information as well as the intensity data. The proposed technique improves the accuracy in extraction of the transit time and velocity of contrast agents for detection and characterization of focal liver lesions. Through the experiments using a set of clinical data, we show that the proposed methods can improve the reliability of the parametric image data.

A Case of Wandering Spleen (유주 비장 1례)

  • Lee, Suk Jin;Kim, Yong Woo;Chun, Yong Soon;Song, Min Seob
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.248-252
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    • 2004
  • Wandering spleen is a rare condition characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. Ultrasonography shows the absence of the spleen in left upper quadrant (LUQ) and the presentation in the lower abdomen of a homognous mass whose sonographic appearance is consistent with that of a spleen. Contrast-enhanced CT reveals the absence of the spleen in LUQ, a soft tissue mass resembling spleen in the lower abdomen, and the splenic pedicle of whirled appearance. We present a case of wandering spleen, which could be diagnosed with US and CT by the ectopic location of spleen and the whirling pattern of splenic pedicle.

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