• Title/Summary/Keyword: Contrast-enhanced computed tomography

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Surgical Removal of Intrathoracic Lipoma from Herniated Omentum through the Diaphragmatic Defect in an Abyssinian Cat

  • Lee, Jiyeon;Park, Hyojin;Kim, Jieyoo;Kim, Na-Hyun;Lee, Dongbin;Lee, Hee-Chun;Hwang, Tae-Sung;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.4
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    • pp.174-178
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    • 2021
  • A nine-year-old neutered male cat was presented with chronic cough and vomiting. Thoracic radiography showed regions of fatty opacity in the right caudoventral region. On positive contrast celiography, contrast agent did not move into thoracic cavity. Computed tomography revealed 7-mm diameter of defect at the right diaphragmatic crus and a 2-mm diameter defect at the left ventral diaphragmatic crus. Through the right diaphragmatic defect omental herniation was confirmed by the presence of contrast enhanced omental vessel running across the diaphragm. On exploratory thoracotomy, the omentum protruded into the thorax through the right diaphragmatic defect, and it contained a yellowish lipomatous mass. The protruded omentum containing a mass in the thorax was removed, and the right diaphragmatic defect was closed. Histopathologic examination revealed that the protruded omentum showed normal omental structure and the adipose mass showed lipoma surrounded by fibrous tissue. In conclusion, a thorough examination is necessary to confirm the origin of the mass located near the diaphragm.

The Use of FDG PET for Nodal Staging of Non-Small-Cell Lung Cancer (비소세포폐암 환자의 국소 림프절 전이 발견을 위한 FDG PET의 이용)

  • 백희종;박종호;최창운;임상무;최두환;조경자;원경준;조재일
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.910-915
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    • 1999
  • Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

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Automatic Liver Segmentation of a Contrast Enhanced CT Image Using a Partial Histogram Threshold Algorithm (부분 히스토그램 문턱치 알고리즘을 사용한 조영증강 CT영상의 자동 간 분할)

  • Kyung-Sik Seo;Seung-Jin Park;Jong An Park
    • Journal of Biomedical Engineering Research
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    • v.25 no.3
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    • pp.189-194
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    • 2004
  • Pixel values of contrast enhanced computed tomography (CE-CT) images are randomly changed. Also, the middle liver part has a problem to segregate the liver structure because of similar gray-level values of a pancreas in the abdomen. In this paper, an automatic liver segmentation method using a partial histogram threshold (PHT) algorithm is proposed for overcoming randomness of CE-CT images and removing the pancreas. After histogram transformation, adaptive multi-modal threshold is used to find the range of gray-level values of the liver structure. Also, the PHT algorithm is performed for removing the pancreas. Then, morphological filtering is processed for removing of unnecessary objects and smoothing of the boundary. Four CE-CT slices of eight patients were selected to evaluate the proposed method. As the average of normalized average area of the automatic segmented method II (ASM II) using the PHT and manual segmented method (MSM) are 0.1671 and 0.1711, these two method shows very small differences. Also, the average area error rate between the ASM II and MSM is 6.8339 %. From the results of experiments, the proposed method has similar performance as the MSM by medical Doctor.

Cerebellar Pilocytic Astrocytomas with Spontaneous Intratumoral Hemorrhage in Adult

  • Kim, Min-Su;Kim, Sang-Woo;Chang, Chul-Hoon;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.363-366
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    • 2011
  • Cerebellar pilocytic astrocytomas (PAs) are benign gliomas predominantly found in the pediatric population. Intracranial hemorrhages are extremely rare in initial presentations of cerebellar PAs. There are no reports in the medical literature of adult cerebellar PA cases presenting with intratumoral hemorrhage. We report 2 cases of adult cerebellar pilocytic astrocytomas with intratumoral hemorrhage. The first case is a 37-year-old woman presenting with severe headache, nausea, and vomitting. Computed tomography demonstrated an acute hemorrhage adjacent to the right cerebellar hemisphere and hydrocephalus. Magnetic resonance imaging (MRI) revealed a cerebellar vermian tumor with the hemorrhage as a mixed isoin-tense area in the T2-weighted image, and as a mixed hyperintense area in the contrast-enhanced T1-weighted image. The second case is a 53-year-old man presenting with headache for 3 weeks. MRI revealed a cerebellar hemispheric tumor with the hemorrhage as a mixed hyperintense area. It had a cystic mass with a heterogeneous enhanced mural nodule in the gadolinium-enhanced T1-weighted image and a fluid-fluid level within the cyst in the T2-weighted image. Both of them underwent radical resections of their respective lesions. Histological examination of the specimens revealed typical astrocytoma, including a hemorrhagic portion. Both patients recovered postoperatively and continue to do well at present. The medical literature on hemorrhagic cerebellar PAs is also reviewed.

Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma (둔상 후 복부 전산화단층촬영에서 조영제 유출로 동맥색전술을 시행받은 환자의 복강내와 후복막강/골반강내 출혈 비교)

  • Yoon, Ji Young;Kim, Sun Hyu;Ahn, Ryeok;Hwang, Jae Cheol;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.199-205
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    • 2009
  • Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

A Case of Primary Endobronchial Neurilemmoma Without Intraspinal Extension

  • Kim, Mi-Young;Kim, Hyun-Ji;Kim, Ah-Lim;Kim, Hyeong-Seok;Shin, Hyun-Woong;Jeong, Seung-Wook
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.54-57
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    • 2012
  • Neurilemmoma is a benign and slowly growing neurogenic tumor. Intrathoracic neurilemmoma often develops in the chest wall and posterior mediastinum, but endobronchial neurilemmoma is extremely rare. The diagnosis of endobronchial neurilemmoma with preoperative imaging findings is challenging and is usually made via postoperative pathological examination. These authors encountered a case of primary endobronchial neurilemmoma in a 52-year-old woman who had no symptoms. A $3.0{\times}2.6$ cm mass in the right lower lobe projecting into the mediobasal segmental bronchus was shown in the results of the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the chest. Benign neurilemmoma was confirmed via bronchoscopic biopsy, and surgical resection (sleeve bronchial excision and end-to-end anastomosis) was performed.

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A Giant Hydatid Cyst in the Interventricular Septum with Papillary Muscle Involvement

  • Sabzi, Feridoun;Faraji, Reza
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.349-352
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    • 2013
  • We present here a 44-year-old male patient with hydatid disease who was referred to our hospital due to dyspnea and chest pain for the last 2 month before admission. Using echocardiography and contrast-enhanced computed tomography the heart hydatid was diagnosed. However, hydatid disease of the interventricular septum is rare; particularly, the involvement of mitral apparatus with mitral regurgitation (MR) is an exceptionally rare presentation. Early diagnosis and an integrated treatment strategy are crucial. Surgical excision was performed and the patient had an uneventful recovery and follow-up at 3 months.

Splenic Infarction due to Torsion of Wandering Spleen - A Case Report - (유주 비장의 염전에 의한 비장 경색 - 1예 보고 -)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.183-188
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    • 2008
  • Wandering spleen is very rare condition in children characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. We experienced a case of splenic infarction due to torsion of a wandering spleen in a 6-year-old boy who presented with fever, vomiting, and abdominal pain of 2 day's duration. On physical examination, there was severe tenderness in the left upper quadrant of the abdomen. The plain abdominal radiograph showed marked colonic gaseous distension. Contrast-enhanced abdominal computed tomography scan showed decreased density of spleen in the normal position, consistent with infarction. At emergency laparotomy, a wandering spleen twisted $360^{\circ}$ on its pedicle was found. Despite splenic detorsion, blood flow could not be restored. Splenectomy was therefore performed. The child was discharged 7 days after surgery without any complications.

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Metastatic Brain Neuroendocrine Tumor Originating from the Liver

  • Lee, Guk Jin;Jo, Kwang Wook;Kim, Jeana;Park, Il Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.550-553
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    • 2015
  • A 67-year-old male presented with left temporal hemianopsia and left hemiparesis. A contrast-enhanced magnetic resonance image revealed a $4.5{\times}3.5{\times}5.0cm$ rim-enhancing mass with central necrosis and associated edema located in the left occipital lobe. Of positron emission tomography and abdominal computed tomography, a 9-cm mass with poor enhancement was found in the right hepatic lobe. Craniotomy and right hemihepatectomy was performed. The resected specimen showed histological features and immunochemical staining consistent with a metastatic neuroendocrine tumor (NET). Four months later, the tumors recurred in the brain, liverand spinal cord. Palliative chemotherapy with etoposide and cisplatin led to complete remission of recurred lesions, but the patient died for pneumonia. This is the first case of a metastatic brain NET originating from the liver. If the metastatic NET of brain is suspicious, investigation for primary lesion should be considered including liver.

Unusual Peritoneal Metastasis of Late Recurrent Uterine Cervical Cancer: A Case Report and Literature Review (후기 재발성 자궁 경부암의 비전형적인 복막 전이: 증례 보고 및 문헌 고찰)

  • Sangmin Park;Hee Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.904-909
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    • 2022
  • Uterine cervical cancer is one of the most common malignancies of the female genital tract. Most recurrent cases of uterine cervical cancer are diagnosed within two years after primary treatment, and late recurrence after a disease-free interval of more than five years is rare. In addition, peritoneal metastases usually present as multifocal discrete nodules in the peritoneal cavity with nodular or diffuse peritoneal thickening. Herein, we report an extremely rare case of late recurrent cervical cancer peritoneal metastasis with an unusual manifestation of a large, solitary necrotic mass in the right subphrenic space on contrast-enhanced CT.