• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5799-5804
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• 2014

Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.4
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• pp.193-200
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• 2023

Purpose: Crohn's disease (CD) is a chronic, idiopathic bowel disorder that can progress to partial or complete bowel obstruction. At present, there are no reliable diagnostic tests that can readily distinguish between acute inflammatory, purely fibrotic and mixed inflammatory and fibrotic. Our aim is to study the utility of contrast enhanced ultrasound (CEUS) in combination with shear wave elastography (SWE) to differentiate fibrotic from inflammatory strictures in children with obstructive CD of the terminal ileum. Methods: Twenty-five (19 male) children between 2016-2021 with CD of the terminal ileum were recruited into the study. Among these patients, 22 had CEUS kinetic measurements of tissue perfusion, including wash-in slope (dB/sec), peak intensity (dB), time to peak intensity (sec), area under the curve (AUC) (dB sec), and SWE. In total, 11 patients required surgery due to bowel obstruction. Histopathologic analysis was performed by a pathologist who was blinded to the CEUS and SWE test results. Results: Patients that underwent surgical resection had significantly higher mean area under the curve on CEUS compared to patients responsive to medical therapy (p=0.03). The AUC also correlated with the degree of hypertrophy and the percent fibrosis of the muscularis propria, as determined by histopathologic grading (p<0.01). There was no difference in the mean elastography measurements between these two patient groups. Conclusion: CEUS is a useful radiological technique that can help identify pediatric patients with medically refractory obstructive fibrotic strictures of the terminal ileum that should be considered for early surgical resection.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.889-902
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• 2021

Purpose To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS. Materials and Methods In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity, specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa. Results On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69). Conclusion The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.

• 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.

• Korean Journal of Veterinary Research
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• v.58 no.2
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• pp.99-101
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• 2018

A 5-year-old intact female Persian cat was referred with anorexia and vomiting. Physical examination revealed icterus in the pinna, oral mucosa, and sclera. Ultrasonography revealed several findings including uniformly hyperechoic hepatic parenchyma compared to adjacent falciform fat, increased attenuation of the ultrasound beam, and poor visualization of intrahepatic vessel borders. Computed tomography revealed hypoattenuation of the hepatic parenchyma with a radiodensity value of -60 Hounsfield units. The adjacent intrahepatic vessels appeared hyperattenuated relative to the hepatic parenchyma as if the vessels were contrast-enhanced. Based on ultrasonography and computed tomography results, the cat was tentatively diagnosed as feline hepatic lipidosis.

• 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.

• Proceedings of the Korea Information Processing Society Conference
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• 2012.11a
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• pp.369-372
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• 2012

조영증강 의료 초음파 영상에서 조영제의 확산효과에 대한 분석은 간질환과 연관된 각종 병변을 검출하고 분석하는 과정에서 매우 유용한 정보를 제공한다. 본 연구에서는 초음파 영상에서 조영제의 확산 패턴을 분석하고 이를 영상화하는 방법을 제안한다. 이 과정에서 부수적으로 호흡에 의한 흔들림 현상을 보정하고 노이즈의 영향을 극복할 수 있는 방법론을 고찰한다. 호흡주기에 따른 모멘텀 요소를 고려한 ROI 추적 기법은 측정과정에서의 흔들림과 노이즈에 의한 오류를 최소화 할 수 있게 한다. 조영제의 확산 단계에 따라 서로 다른 노이즈 비율을 고려하여 동적 가중치를 할당하는 방법으로써 흔들림을 보정하였으며, 조영제의 전이 시간과 패턴을 분석하고 그 특성을 분류함으로써 간 병변 분석을 위한 효과적인 영상화기법을 구현하였다. 또한 생성된 영상에서 노이즈를 제거하고 영상을 개선하는 방법으로서 MRF 기반의 최적화 알고리즘을 적용하는 영상 개선 기법을 제시한다.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.165-171
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• 2023

Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

• Investigative Magnetic Resonance Imaging
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• v.17 no.3
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• pp.192-199
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• 2013

Purpose : To retrospectively evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging (DCE-MRI) in detecting recurrent prostate cancer after HIFU of clinically localized cancer, as compared with T2-weighted imaging (T2WI). Materials and Methods: Twenty-six patients with increased prostate-specific antigen levels after HIFU were included in this study. All MR examinations were performed using T2WI and DCE-MRI, followed by transrectal ultrasound-guided biopsy. MRI and biopsy results were correlated in six prostate sectors. Residual or recurrent cancer after HIFU was defined as local tumor progression if biopsy results showed any cancer foci. Two independent readers interpreted the MR images. Results: Of 156 prostate sectors, 51 (33%) were positive for cancer in 17 patients. For detecting local tumor progression, the sensitivity of DCE-MRI and T2WI was 80% and 57% for reader 1 (P < 0.001) versus 84% and 61% for reader 2 (P < 0.001), respectively. The specificity and overall accuracy between DCE-MRI and T2WI showed no statistical difference in both readers (P > 0.05). Interobserver agreement of DCE-MRI and T2WI was moderate and fair, respectively. Conclusion: For detecting local tumor progression of prostate cancer after HIFU, DCE-MRI was more sensitive than T2WI, with less interobserver variability.