• Title/Summary/Keyword: HRCT

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Duplicated Internal Auditory Canal: High-Resolution CT and MRI Findings

  • Linsheng Wang;Lihong Zhang;Xian Li;Xiang Guo
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.823-829
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    • 2019
  • Objective: To summarize the high-resolution computed tomography (HRCT) and magnetic resonance imaging (HRMRI) features of duplicated internal auditory canals (DIACs). Materials and Methods: Ear HRCT data of 64813 patients with sensorineural hearing loss (SNHL), obtained between August 2009 and November 2017, were reviewed. Among these patients, 12 (13 ears) were found to have DIACs, 9 of whom underwent HRMRI. Their images were evaluated by two otoradiologists. Results: The rate of occurrence of DIAC among SNHL patients was 0.019% (12/64813). The internal auditory canals of 13 ears were divided into double canals by complete (n = 6) and incomplete (n = 7) bony septa, with varied orientations ranging from horizontal to approximately vertical. All of the anterosuperior canals extended into the facial nerve (FN) canal, except for 1, which also extended to the vestibule. The posteroinferior canals ended in the cochlea and vestibule, except for 2, which also connected to the FN canals. Magnetic resonance images revealed that 77.8% (7/9) and 22.2% (2/9) of vestibulocochlear nerves (VCNs) were aplastic and hypoplastic, respectively. Furthermore, 88.9% (8/9) of FNs were normal, except for 1, which was hypoplastic. All of the affected ears also had other ear anomalies: a narrow, bony cochlear nerve canal was the most common other anomaly, accounting for 92.3% (12/13). Malformations of other systems were not found. Conclusion: Double-canal appearance is a characteristic finding of DIAC on HRCT, and it is usually accompanied by other ear anomalies. The VCN usually appears aplastic, with a normal FN, on HRMRI.

The Correlation of TUNEL Apoptotic Index with Clinicoradiologicopathologic Scores in Interstitial Lung Disease (간질성 폐질환에서 TUNEL 아포프토시스 지수와 임상적, 방사선학적, 및 병리학적 지표와의 상관관계)

  • Kim, Youn-Seup;Myung, Na-Hye;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.136-147
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    • 2002
  • Background : Interstitial lung disease has various manifestations that are differentiated by their pathology, progress and treatment. However, all manifestations eventually progresses to pulmonary fibrosis. Recent studies have shown that apoptosis of pulmonary epithelial cells might be related to pulmonary fibrosis. The correlation of the apoptotic index with the clinical manifestations, pathological findings, HRCT findings and the response to treatment were examined. Materials and Methods : Twenty subjects (14 men, 16 women), who had been diagnosed with interstitial lung disease through an open lung biopsy, were enrolled in this study. The subtypes were one AIP, two NIP, eight BOOP, and seven UIP cases. The apoptotic index was scaled from 0-2 depending on the fraction of positive staining cells by TUNEL method. The clinical severity was assessed by a modification of a previously developed CRP scoring system. The pathologic scores were based on 4 components: fibrosis, cellularity, desquamation, and granulation. In the HRCT study, each lobe was scored by the radiologists on a scale for both fibrosis and ground-glass attenuation. The treatment response was assessed by an increase in more than 10% of the CRP score, and comparing the results 3 months before and after treatment. Results : The apoptotic index showed no correlation with the CRP and HRCT scoring system. The apoptotic index correlated with the pathologic elements including fibrosis, cellularity and the desquamation score (p<0.05). Of the 16 patients who received corticosteroid therapy, 9 patients (56.3%) responded to therapy. There was no correlation between the response to corticosteroid and the apoptotic index. In the case of patients with acute and subacute ILD, the apoptotic index showed a correlation with the cellularity, desquamation, and the total histological score (p<0.05). In the case of patients with chronic ILD, the apoptotic index correlated with the fibrosis and cellularity score (p<0.05). Conclusion : Apoptosis of the pulmonary epithelial cells is implicated in the pathogenesis of interstitial lung disease particularly on a pathological basis.

A Case of Atypical Pathogen Pneumonia, associated with Recurrent into Diffuse Pneumonic Consolidation (재발성 경과를 취한 비정형 병원균주 폐렴 환자 1예)

  • Oh, Jong-Kap
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.391-400
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    • 2011
  • Pneumonia is an infection of the lungs and respiratory system and can be classified by a variety of factors such as infectious agents, etiology, infection area, and other criteria. From a 46-year-old male, who was suspected of being infected with atypical pathogen pneumonia and underwent such tests as serological testing, examination of sputum, urine examination, parasite examination, bronchoscopy, needle biopsy and so on, no significant abnormality was found. This patient also showed no specific symptoms like auscultatory abnormalities, high fever, nonproductive cough, muscle stiffness, sputum production, dyspnea. Prescription of broad-spectrum oral antibiotics and ant-parasitic didn't seem to be effective against bacterial and atypical pathogen. The patient's condition alternately repeated between natural cure and recurrence. The average healing process during which scarring, nodule recurrence and disappearance on the lungs happened was about 20 days. Chest radiography and chest high resolution computerized tomographic scans(HRCT scan) was performed to depict parenchymal aberrations and demarcate the extent and distribution of atypical pathogen pneumonia. As a result, chest radiography did not show the specific symptoms, whereas areas of opacity (seen as white) which represent consolidation were revealed in chest HRCT scan. This indicates that only chest radiography is not that useful for early diagnosis of atypical pathogen pneumonia in patients, since it can't show exactly what the symptom is because of the barriers such as diaphragm, liver, and spine. Therefore, it is desirable that chest HRCT should be used in the diagnosis to compare with the results of chest radiography. Here, report with literature investigations the case of recurrent atypical pathogen pneumonia.

The Correlation between Radiologic Findings and Clinicopathological Prognostic Factors in Small Peripheral Adenocarcinoma of Lung (말초 폐 발생 소형 선암에서 화상적 소견과 병리적, 임상적 예후와의 관계)

  • Park, Jae-Kil;Cho, Kyu-Do;Park, Kuhn;Moon, Seok-Whan;Rha, Suk-Joo;Choi, Si-Young;Jung, Jung-Im
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.423-431
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    • 2004
  • Background : Tumor size in lung cancer is not as good a prognostic factor for adenocarcinoma as it is for other types of lung cancer; therefore it is difficult to estimate the prognosis preoperative. However, there have recently been some reports on the radiologic findings correlating to the clinicopathologic prognostic factors in peripheral small adenocarcinoma of lung. We tried to evaluate the prognostic importance of High-Resolution CT (HRCT) findings of such adenoearcinoma, Material and Method: One houndred and seventy-six surgically resected small peripheral adenocarcinoma measuring 3 cm or less in greatest dimension were reviewed radiologically and clinicopathologically. Result: The patients with greater extent of ground-glass attenuation (GGA) had better clinico-pathological factors. The tumors with gross appearance of GGA or bubble-like shape showed better clinicopathological prognostic factors than scar-like or solid shape. Conclusion: HRCT findings of small peripheral adenocarcinomas of the lung correlated well with the histologic and clinical prognostic factors. We can predict the post-operative prognosis with the radiologic findings.

A Novel Method for Automated Honeycomb Segmentation in HRCT Using Pathology-specific Morphological Analysis (병리특이적 형태분석 기법을 이용한 HRCT 영상에서의 새로운 봉와양폐 자동 분할 방법)

  • Kim, Young Jae;Kim, Tae Yun;Lee, Seung Hyun;Kim, Kwang Gi;Kim, Jong Hyo
    • KIPS Transactions on Software and Data Engineering
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    • v.1 no.2
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    • pp.109-114
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    • 2012
  • Honeycombs are dense structures that small cysts, which generally have about 2~10 mm in diameter, are surrounded by the wall of fibrosis. When honeycomb is found in the patients, the incidence of acute exacerbation is generally very high. Thus, the observation and quantitative measurement of honeycomb are considered as a significant marker for clinical diagnosis. In this point of view, we propose an automatic segmentation method using morphological image processing and assessment of the degree of clustering techniques. Firstly, image noises were removed by the Gaussian filtering and then a morphological dilation method was applied to segment lung regions. Secondly, honeycomb cyst candidates were detected through the 8-neighborhood pixel exploration, and then non-cyst regions were removed using the region growing method and wall pattern testing. Lastly, final honeycomb regions were segmented through the extraction of dense regions which are consisted of two or more cysts using cluster analysis. The proposed method applied to 80 High resolution computed tomography (HRCT) images and achieved a sensitivity of 89.4% and PPV (Positive Predictive Value) of 72.2%.

Comparison of Noise and Doses of Low Dose and High Resolution Chest CT for Automatic Tube Current Modulation and Fixed Tube Current Technique using Glass Dosimetry (유리선량계를 이용한 관전류자동조절기법과 고정관전류기법에서 저선량 및 고해상 흉부CT의 노이즈 및 선량 비교)

  • Park, Tae Seok;Han, Jun Hee;Jo, Seung Yeon;Lee, Eun Lim;Jo, Kyu Won;Kweon, Dae Cheol
    • Journal of Radiation Industry
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    • v.11 no.3
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    • pp.131-137
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    • 2017
  • To compare the radiation dose and image noise of low dose computed tomography (CT) and high resolution CT using the fixed tube current technique and automatic tube current modulation (CARE Dose 4D). Chest CT and human anthropomorphic phantom were used the RPL (radiophotoluminescence) dosimeters. For image evaluation, standard deviation of mean CT attenuation coefficient and CT attenuation coefficient was measured using ROI analysis function. The effective dose was calculated using CTDIvol and DLP. CARE Dose 4D was reduced by 74.7% and HRCT by 64.4% compared to the fixed tube current technique in low dose CT of chest phantom. In CTDIvol and DLP, the dose of CARE Dose 4D was reduced by fixed tube current technique. For effective dose, CARE Dose 4D was reduced by 47% and HRCT by 46.9% compared to the fixed tube current method, and the dose of CARE Dose 4D was significantly different (p<.05). Noise in the image was higher than that in the fixed tube current technique. Noise difference in the image of CARE Dose 4D in low dose CT was significant (p<.05). The low radiation dose and the noise difference of the CARE Dose 4D were compared with the fixed tube current technique in low dose CT and HRCT using chest phantom. The radiation doses using CARE Dose 4D were in accordance with the national and international dose standards. CARE Dose 4D should be applied to low dose CT and HRCT for clinical examination.

Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline (2020년 개정 진료 치침에 따른 과민성폐렴의 진단)

  • Soojung Park;Yu-Whan Oh;Eun-Young Kang;Hwan Seok Yong;Cherry Kim;Ki Yeol Lee;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.817-825
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    • 2021
  • Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

Idiopathic Pleuroparenchymal Fibroelastosis Presenting in Recurrent Pneumothorax: A Case Report

  • Noh, Hyun Jin;Seo, Yun;Huo, Sol Mi;Kim, Tae Jung;Kim, Hyo Lim;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.184-187
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    • 2014
  • Idiopathic pleuroparenchymal fibroelastosis (PPFE) is a rare, recently classified entity that consists of pleural and subjacent parenchymal fibrosis predominantly in the upper lungs. In an official American Thoracic Society/European Respiratory Society statement in 2013, this disease is introduced as a group of rare idiopathic interstitial pneumonias. We describe a case of a 76-year-old woman with cough and recurrent pneumothorax. She was admitted to our hospital with severe cough at first. High resolution computed tomography (HRCT) disclosed multifocal subpleural consolidations with reticular opacities in both lungs, primarily in the upper lobes, suggesting interstitial pneumonia. Rheumatoid lung was diagnosed initially through an elevated rheumatoid factor, HRCT and surgical biopsy at the right lower lobe. However, one month later, pneumothorax recurred. Surgical biopsy was performed at the right upper lobe at this time. The specimens revealed typical subpleural fibroelastosis. We report this as a first case of idiopathic PPFE in Korea after reviewing the symptoms, imaging and pathologic findings.

Clinical Analysis of Contralateral Bulla of Lung on HRCT in the Patients Having Video-Assisted Thoracoscopic Surgery for Unilateral Primary Spontaneous Pneumothorax (자연 기흉 수술 환자에서 반대편 폐기포에 대한 임상적 고찰)

  • Shin, Dong-Il;Oh, Tae-Yoon;Chang, Woon-Ha;Kim, Jung-Tae;Jeong, Young-Kyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.687-693
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    • 2010
  • Background: It is controversial whether the presence of bullae on the contralateral lung on HRCT plays a role in occurrence of contralateral primary spontaneous pneumothorax. We analyzed the significance of bullae on the contralateral lung and the risk factors associated with contralateral occurrence of primary spontaneous pneumothorax. Material and Method: Three hundred ninety four patients who were undergone Video-Assisted Thoracoscopic Surgery for primary spontaneous pneumothorax between January 2004 and December 2009 were reviewed. The clinical features, HRCT and treatment of these patients were analyzed retrospectively. Result: Twenty eight of 394 patients had contralateral occurrence (7.10%). The average time was $13.06{\pm}9.79$ months. A presence of contralateral bullae of lung on HRCT may not seem to be significant for occurrence of contralateral primary spontaneous pneumothorax (p=0.059). But bullae numbers were much more in contralateral pneumothorax patients (p=0.011). Younger than 20, being underweight (Body Mass Index < $18.5 kg/m^2$) are independent risk factors for contralateral occurrence (odds ratio, 5.075 (1.679~5.339), 2.366 (1.048~5.339) respectively). Conclusion: The presence of bullae on the contralateral lung on HRCT was not significantly influenced the occurrence of contralateral primary spontaneous pneumothorax. However, age, body mass index, and the number of bullae were significant factors for the contralateral pneumothorax. We suggest that those high risk patients may require special attentions and general supportive care to prevent occurrence of contralateral primary spontaneous pneumothorax during the follow-up.

A Study of Pulmonary Function and HRCT Findings in Asthma Patients According to the Response after Treatment (기관지 천식 환자에서 치료 반응의 차이에 따른 폐 기능 및 고해상 CT 소견의 고찰)

  • NamKung, Eun-Kyung;Kim, Kyung-Ho;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Park, Jae-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1051-1062
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    • 1997
  • Background : In asthma, airway obstruction is usually reversible, either spontaneously or with treatment. However, the responses to treatment are variable and some patients show an irreversible component of airflow obstruction. This may be associated with structural changes in the airway. To assess the relationship between the difference in airway reversibility and structural changes, we evaluated the HRCT findings and pulmonary function test. Methods : We studied 40 asthmatic subjects who had had acute exacerbation of symptoms and had showed normal chest X-ray findings. They had monitered PEFR daily, and had performed PFT and HRCT within three days after initiation of treatment. According to serial PEFR, they were grouped into 3 categories (Group 0 ; initial PEFR was within normal limit, Group 1 ; revealed increment of 30% in PEFR within 3 days after initiation of treatment, Group 2 ; revealed within 2 weeks) and then grouped again into 4 (Group 0, Group 3 ; reached to normal value of PEFR within 3 days after initiation of treatment, Group 4 ; within 2 weeks, Group 5 ; not within 2 weeks). Results : (1) Age in Group 0 was significantly lower than other groups(p<0.05), but there was no significance in other groups. (2) Duration of asthma in Group 2 was significantly longer than Group 0, 1(p<0.05). (3) FVC(%) and FEV1(%) were significantly decreased with delayed response to the treatment (p<0.05). (4) $FEV_1$/FVC(%) in Group 1, 2 were significantly lower than Group 0(p<0.05). $FEV_1$/FVC(%) in Group 5 was significantly lower than Group 0,3,4 (p<0.05). (5) Air trapping was increased significantly with delayed response to the treatment (p<0.05). (6) Mucus impaction in Group 0 was significantly larger than Group 1,2 (p<0.05). $FEV_1$/FVC(%) in Group 0,4,5 were significantly larger than Group 3 (p<0.05). Conclusion : Difference in reversibility of airway obstruction was associated with age, duration of asthma and severity of initial airflow obstruction There was no definite difference in HRCT findings in asthma.

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