• Title/Summary/Keyword: Contrast-enhanced ultrasonography

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Radiologic Findings of Cervical Mass Type Cervical Pregnancy (자궁경부 종괴형 자궁경부임신의 영상 소견)

  • Cho, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.43-51
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    • 2005
  • Background: To examine the ultrasonographic and magnetic resonance (MRI) imaging findings of a cervical mass type cervical pregnancy. Materials and Methods: The ultrasonographic and MRI findings of 5 patients pathologically confirmed as having a cervical pregnancy were analyzed retrospectively. On ultrasonography, the size and echo pattern of the uterine cervix, the shape and echo pattern of the lesion, the degree and the pattern of blood flow on the color Doppler study and the spectral Doppler pattern were analyzed. The shape, signal intensity, and degree and pattern of enhancement of the lesion were evaluated on MRI. Results: The uterine cervix was enlarged and the size of the lesion was 6.1 to 7.1 (average, 6.5) cm. The endocervical canal was irregularly dilated and showed heterogeneous echogenicity in all 5 cases. Four of the 5 lesions were heterogeneously hyper- or mixed echoic and remaining one was relatively homogeneous echogenic. Doppler ultrasonography revealed an increased vascularity of the peritrophoblastic flow pattern. In all 4 cases where MRI performed, the lesion was irregular in shape and the margin was not sharply demarcated. The T2-weighed image showed that the lesions were mixed signal intensity. Three of the 4 lesions contained high signal intensity nodular portions and a low signal intensity rim was observed along the margin of the nodular portions. The T1-weighted image revealed multiple signal voids along the periphery of the lesions and high signal intensity portions as a result of hemorrhage were noted. The dynamic enhanced study showed that the high signal intensity portions on the T2-weighted image were strongly enhanced similar to the vessels on the early phase and the contrast enhancement gradually decreased with time. Conclusion: A cervical mass type cervical pregnancy can be correctly diagnosed using the patient's clinical symptom, the elevation in the serum ${\beta}$-HCG level, and characteristic ultrasonographic and MRI findings.

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Ultrasonographic and Computed Tomographic Features of Dermoid Cyst of the Neck in a Dog: A Case Report

  • Seong-Ju Oh;Gunha Hwang;Eun-Chae Yun;Dongbin Lee;Sung-Lim Lee;Hee Chun Lee;Tae Sung Hwang
    • Journal of Veterinary Clinics
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    • v.41 no.4
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    • pp.252-257
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    • 2024
  • A 13-year-old castrated male mixed-breed dog presented for a health screening with a small nodule on the left hindlimb, which was revealed to be a mast cell tumor. A CT scan was performed to evaluate the mast cell tumor, and it incidentally revealed a well-marginated, fluid-attenuating, non-contrast enhanced mass in the deep ventral region of the left lower neck. Ultrasonography confirmed a well-capsulated mass with a cranio-ventrally protruding lesion extending into sternohyoid muscles. The outer layer of the mass had a hypoechoic thick wall and the internal parenchyma contained hyperechoic foci and multiple hyperechoic parallel lines. The mass was surgically resected. Histopathological examination confirmed a dermoid cyst characterized by cornifying squamous epithelial cells, keratinaceous debris, and hair shaft fragments. The dog showed no signs of recurrence or additional abnormalities three months post-surgery. This report highlights the importance of considering dermoid cysts in the differential diagnosis of neck masses on imaging examinations using CT or ultrasonography.

Primary Angiosarcoma of Accessory Parotid Gland : A Case Report of Long Term Follow-up (부이하선에 생긴 원발성 혈관육종 1예의 장기추적)

  • Lee, Hyo Won;Kim, Deok Su;Jang, Gyu Ho;Kim, Jeong Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.54-57
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    • 2015
  • Angiosarcoma is a rare and highly malignant neoplasm which develops from the endothelium of blood vessels. A few cases of primary angiosarcoma of the parotid gland have been reported. However, there is no report of primary angiosarcoma of the accessory parotid gland. In this case, we report a primary angiosarcoma of the accessory parotid gland in a 45-year-old man with growing cheek mass. Ultrasonography revealed a $2.0{\times}2.6cm$ sized homogeneous hypoechoic mass and computed tomography showed a contrast enhanced homogeneous mass. Fine needle aspiration biopsy suggested a benign tumor. The mass was completely excised with a minimal vertical incision. The histopathology showed anastomosing vascular channels lined by atypical endothelial cells and many branching vessels with staghorn appearance with positive immunohistochemical staining for CD34, a highly specific endothelial marker. The patient underwent postoperative radiotherapy and was followed for 8 years without recurrence and metastasis.

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Masticator space abscess in a 47-day-old infant

  • Kim, Eun-Hee;Jeon, Ju-Hee;Shim, Yoon-Hee;Lee, Kyu-Seok;Kim, So-Young;Kim, Eun-Ryoung
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.350-353
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    • 2011
  • A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about $2.0{\times}1.5cm$ that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

Canalicular Adenoma of the Parotid Gland (이하선에 발생한 소관 선종)

  • Shin Dong-Woo;Chung Woung-Youn;Shim Jeong-Yun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.269-274
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    • 1997
  • Parotid canalicular adenoma is a benign neoplasm that is predominantly composed of branching and interconnecting cords of single or double rows of columnar epithelium in a very loose stroma. There has been considerable confusion in the literature concerning the terminology of canalicular adenoma. However, thesedays it has been newly-recognized as a discrete entity of the monomorphic adenoma group. Canalicular adenoma has a remarkable predilection for occurrence in the minor salivary glands such as the upper lip, in contrast with basal cell adenoma that occurs predominantly in major salivary glands such as the parotid gland. We have experienced a case of canalicular adenoma of the parotid gland in a 65-year-old woman. The patient had a palpable mass on the preauricular area for the last 15 years and recently noticed a mild pain and discomfort on the mass. Neck ultrasonography showed a low echogenic mass of 1.0cm in diameter in the right parotid gland and a neck CT scan showed a well-enhanced rectangular-shaped mass. A superficial parotidectomy was performed for the lesion and the final pathologic diagnosis turned out to be 'multifocal canalicular adenoma'.

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Recent Updates of Abbreviated MRI for Hepatocellular Carcinoma Screening (간세포암 감시를 위한 단축 자기공명영상의 최신지견)

  • Jeong Woo Kim;Chang Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.280-297
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    • 2021
  • International guidelines recommended screening with ultrasonography (US) every 6 months for patients at risk for hepatocellular carcinoma (HCC). However, US demonstrates low sensitivity for the early detection of HCC. Magnetic resonance imaging (MRI) plays an important role in the noninvasive diagnosis of HCC, but it is not suitable for surveillance due to its lengthy examination and high cost. Therefore, several studies have been using various abbreviated MRI strategies, including noncontrast abbreviated MRI, dynamic contrast-enhanced abbreviated MRI, and abbreviated MRI using hepatobiliary phase image for HCC surveillance. In this article, we aim to review these various strategies and explore the future direction of HCC surveillance considering the cost-effectiveness aspect.

Comparative Study on Signal Strength of Mechanical Index Using Ultrasound Machines with SonoVue Contrast (Sonovue 초음파 조영제를 이용한 장비 간 Mechanical Index의 변화에 따른 신호 강도 비교연구)

  • Kim, Myung-Seok;Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.21-29
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    • 2019
  • The purpose of this study was to compare the MI using SonoVue along with different machines output and to infer the meaning of the signal difference under the same condition. All of the comparative instruments showed strong signal values at early stage as MI value increased. Over time, the inter-instrumental signal values showed signal attenuation under all conditions except for 10 min of the condition of MI 0.1 of RS85A. E9 and EPIQ7 showed signal degradation due to microbubble collapse over time at all MI values. In the comparison of equipment, the signal strengths of MI 0.1, 0.2, and 0.4 were high in order of EPIQ7, RS85A and E9. In the quantitative analysis, there were statistically significant from the SNR and CNR that were obtained from RS85A and E9 (P-value<0.05). In the quantitative analysis, Epiq7 was statistically significant except for CNR as the MI value was changed In the contrast-enhanced ultrasound, even though MI value was low (MI <0.05), it will be helpful for diagnosis, controlling the MI and scan time because a difference in signal intensity was shown between the three machines.

The Correlations of Parameters Using Contrast Enhanced Ultrasonography in the Evaluation of Prostate Cancer Angiogenesis (전립선암쥐모형의 신생혈관생성의 평가를 위해 시행된 역동적 조영 증강 초음파에서 얻은 변수간의 상관성연구)

  • Hwang, Sung Il;Lee, Hak Jong;Kim, Kil Joong;Chung, Jin-haeng;Jung, Hyun Sook;Jeon, Jong June
    • Ultrasonography
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    • v.32 no.2
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    • pp.132-142
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    • 2013
  • Purpose: The purpose of this study is to investigate the correlations of various kinetic parameters derived from the time intensity curve in a xenograft mouse model injected with a prostate cancer model (PC-3 and LNCaP) using an ultrasound contrast agent with histopathologic parameters. Materials and Methods: Twenty nude mice were injected with human prostate cancer cells (15 PC-3 and five LNCaP) on their hind limbs. A bolus of $500{\mu}L$ ($1{\times}10^8$ microbubbles) of second-generation US contrast agent (SonoVue) was injected into the retroorbital vein. The region of interest was drawn over the entire tumor. The time intensity curve was acquired and then fitted to a gamma variate function. The maximal intensity (A), time to peak (Tp), maximal wash-in rate (washin), washout rate (washout), area under the curve up to 50 sec ($AUC_{50}$), area under the ascending slope ($AUC_{in}$), and area under the descending slope ($AUC_{out}$) were derived from the parameters of the gamma variate fit. Immunohistochemical staining for VEGF and CD31 was performed. Tumor volume, the area percentage of VEGF stained in a field, and the count of CD31 (microvessel density, MVD) positive vessels showed correlation with the parameters from the time intensity curve. Results: No significant differences were observed between the kinetic and histopathological parameters from each group. MVD showed positive correlation with A (r=0.625, p=0.003), washin (r=0.462, p=0.040), $AUC_{50}$ (r=0.604, p=0.005), and $AUC_{out}$ (r=0.587, p=0.007). Positive correlations were also observed between tumor volume and $AUC_{50}$ (r=0.481, p=0.032), washin (r=0.662, p=0.001), and $AUC_{out}$ (r=0.547, p=0.012). Washout showed negative correlations with MVD (r=-0.454, p=0.044) and tumor volume (r=-0.464, p=0.039). The area percentage of VEGF did not show any correlation with calculated data from the curve. Conclusion: MVD showed correlations with several of the kinetic parameters. CEUS has the potential for prediction of tumor vascularity in a prostate cancer animal model.

A Prospective Study on the Value of Ultrasound Microflow Assessment to Distinguish Malignant from Benign Solid Breast Masses: Association between Ultrasound Parameters and Histologic Microvessel Densities

  • Ah Young Park;Myoungae Kwon;Ok Hee Woo;Kyu Ran Cho;Eun Kyung Park;Sang Hoon Cha;Sung Eun Song;Ju-Han Lee;JaeHyung Cha;Gil Soo Son;Bo Kyoung Seo
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.759-772
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    • 2019
  • Objective: To investigate the value of ultrasound (US) microflow assessment in distinguishing malignant from benign solid breast masses as well as the association between US parameters and histologic microvessel density (MVD). Materials and Methods: Ninety-eight breast masses (57 benign and 41 malignant) were examined using Superb Microvascular Imaging (SMI) and contrast-enhanced US (CEUS) before biopsy. Two radiologists evaluated the quantitative and qualitative vascular parameters on SMI (vascular index, morphology, distribution, and penetration) and CEUS (time-intensity curve analysis and enhancement characteristics). US parameters were compared between benign and malignant masses and the diagnostic performance was compared between SMI and CEUS. Subgroup analysis was performed according to lesion size. The effect of vascular parameters on downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4A masses was evaluated. The association between histologic MVD and US parameters was analyzed. Results: Malignant masses were associated with a higher vascular index (15.1 ± 7.3 vs. 5.9 ± 5.6), complex vessel morphology (82.9% vs. 42.1%), central vascularity (95.1% vs. 59.6%), penetrating vessels (80.5% vs. 31.6%) on SMI (all, p < 0.001), as well as higher peak intensity (37.1 ± 25.7 vs. 17.0 ± 15.8, p < 0.001), slope (10.6 ± 11.2 vs. 3.9 ± 4.2, p = 0.001), area (1035.7 ± 726.9 vs. 458.2 ± 410.2, p < 0.001), hyperenhancement (95.1% vs. 70.2%, p = 0.005), centripetal enhancement (70.7% vs. 45.6%, p = 0.023), penetrating vessels (65.9% vs. 22.8%, p < 0.001), and perfusion defects (31.7% vs. 3.5%, p < 0.001) on CEUS (p ≤ 0.023). The areas under the receiver operating characteristic curve (AUCs) of SMI and CEUS were 0.853 and 0.841, respectively (p = 0.803). In 19 masses measuring < 10 mm, central vascularity on SMI was associated with malignancy (100% vs. 38.5%, p = 0.018). Considering all benign SMI parameters on the BI-RADS assessment, unnecessary biopsies could be avoided in 12 category 4A masses with improved AUCs (0.500 vs. 0.605, p < 0.001). US vascular parameters associated with malignancy showed higher MVD (p ≤ 0.016). MVD was higher in malignant masses than in benign masses, and malignant masses negative for estrogen receptor or positive for Ki67 had higher MVD (p < 0.05). Conclusion: US microflow assessment using SMI and CEUS is valuable in distinguishing malignant from benign solid breast masses, and US vascular parameters are associated with histologic MVD.

Pancreatic Exocrine Adenocarcinoma in a Cat (고양이에서 발생한 췌장 외분비 선암종 1례)

  • Park, Noh-Won;Lee, Seung-Yeoun;Lee, So-Yun;Song, Sun-Hye;Choi, Yang-Kyu;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.189-192
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    • 2013
  • An 8-year-old, neutered female Korean short hair cat was referred with severe vomiting and anorexia. Abdominal mass effect was seen in the cranial abdomen on radiographs, and a mass with a heterogeneous echogenic pattern was observed medial to the right kidney on ultrasonography. On computed tomography, a large mass with soft tissue attenuation and a contrast-enhanced capsule was seen. In histopathological findings, the acinar structures were lined with irregular cuboidal cells that have pale eosinophilic cytoplasm and round to oval nuclei. Based on these diagnostic imaging and histopathological findings, the mass was diagnosed as pancreatic exocrine adenocarcinoma.