• Title/Summary/Keyword: Evidence-based imaging

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Comparison of Direct Digital Radiography and Conventional Film Screen Radiography for Detection of Peritoneal Fluid in Dogs (개에서 복수의 평가에 있어서 필름-증감지 방사선 사진과 디지털 방사선 사진의 비교)

  • Choi, Ho-Jung;O, I-Se;Lee, Ki-Ja;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.18-22
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    • 2012
  • This study was performed to evaluate the sensitivity of conventional film-screen radiography (CFSR) and direct digital radiography (DDR) for detection of various amounts of free peritoneal fluid. Ten adult male healthy beagles were used in this study. Radiographic examinations were performed in the right lateral and ventrodorsal positions. Fluid was injected in increments of 2.0 ml/kg of body weight up to 20.0 ml/kg of body weight. The images of CFSR and DDR were evaluated by two veterinary radiologists for evidence of abdominal fluid without knowledge of injected fluid volume. Data were evaluated by using the receiver operation curve (ROC) analysis and the area under the curve (AUC). There was no significant difference in detection of peritoneal fluid between DDR and CFSR in the ROC analysis. The accuracy of CFSR (0.805) was relatively higher than that of DDR (0.733), based on the ROC analysis and AUC. AUC of CFSR was higher in most injection doses. These results suggest that CFSR is more accurate than DDR for the detecting peritoneal fluid. Therefore, for situation in which digital radiographs are equivocal or small amount of fluid is suspected, other imaging modalities, such as ultrasonography would be helpful for determining the presence of fluids.

A Case of Atypical Thrombotic Microangiopathy (비전형적 혈전성 미세병증 1례)

  • Oh, Ji Young;Park, Se Jin;Kim, Ki Hwan;Lim, Beom Jin;Jeong, Hyeon Joo;Ki, Jung Hye;Kim, Kee Hyuck;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.149-153
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    • 2013
  • We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.

A Study on the Methods of Building Tools and Equipment for Digital Forensics Laboratory (디지털증거분석실의 도구·장비 구축 방안에 관한 연구)

  • Su-Min Shin;Hyeon-Min Park;Gi-Bum Kim
    • Convergence Security Journal
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    • v.22 no.5
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    • pp.21-35
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    • 2022
  • The use of digital information according to the development of information and communication technology and the 4th industrial revolution is continuously increasing and diversifying, and in proportion to this, crimes using digital information are also increasing. However, there are few cases of establishing an environment for processing and analysis of digital evidence in Korea. The budget allocated for each organization is different and the digital forensics laboratory built without solving the chronic problem of securing space has a problem in that there is no standard that can be referenced from the initial configuration stage. Based on this awareness of the problem, this thesis conducted an exploratory study focusing on tools and equipment necessary for building a digital forensics laboratory. As a research method, focus group interviews were conducted with 15 experts with extensive practical experience in the digital forensic laboratory or digital forensics field and experts' opinions were collected on the following 9 areas: network configuration, analyst computer, personal tools·equipment, imaging devices, dedicated software, open source software, common tools/equipment, accessories, and other considerations. As a result, a list of tools and equipment for digital forensic laboratories was derived.

Quantitative Analysis of Magnetization Transfer by Phase Sensitive Method in Knee Disorder (무릎 이상에 대한 자화전이 위상감각에 의한 정량분석법)

  • Yoon, Moon-Hyun;Sung, Mi-Sook;Yin, Chang-Sik;Lee, Heung-Kyu;Choe, Bo-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.98-107
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    • 2006
  • Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.

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A Computed Tomography-Based Anatomic Comparison of Three Different Types of C7 Posterior Fixation Techniques : Pedicle, Intralaminar, and Lateral Mass Screws

  • Jang, Woo-Young;Kim, Il-Sup;Lee, Ho-Jin;Sung, Jae-Hoon;Lee, Sang-Won;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.166-172
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    • 2011
  • Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.

A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism (폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구)

  • Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Hwang, Jung-Hwa;Kim, Dong Hun;Goo, Dong-Erk;Choi, Deuk-Lin
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.473-479
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    • 2005
  • Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis

  • Seunghee Na;Dong Woo Kang;Geon Ha Kim;Ko Woon Kim;Yeshin Kim;Hee-Jin Kim;Kee Hyung Park;Young Ho Park;Gihwan Byeon;Jeewon Suh;Joon Hyun Shin;YongSoo Shim;YoungSoon Yang;Yoo Hyun Um;Seong-il Oh;Sheng-Min Wang;Bora Yoon;Hai-Jeon Yoon;Sun Min Lee;Juyoun Lee;Jin San Lee;Hak Young Rhee;Jae-Sung Lim;Young Hee Jung;Juhee Chin;Yun Jeong Hong;Hyemin Jang;Hongyoon Choi;Miyoung Choi;Jae-Won Jang;Korean Dementia Association
    • Dementia and Neurocognitive Disorders
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    • v.23 no.1
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    • pp.54-66
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    • 2024
  • Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.