• Title/Summary/Keyword: Head CT

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The Study of Decrease Artifact when Scanning Head and Neck PET/CT(Decrease Radiation Dose of Patient) (두경부 PET/CT검사 시 인공음영 감소에 관한 연구 (환자 피폭선량 경감))

  • Kim, Ki-Jin;Kim, Gha-Jung;Yoo, Se-Jong;Kim, Jeong-Ho
    • Journal of the Korea Safety Management & Science
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    • v.18 no.1
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    • pp.153-158
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    • 2016
  • Beam hardening artifact can be caused by metal material when performing PET exam. Therefore, we studied a solution decreasing artifact caused by metallic dental implant. The higher voltage, the lesser artifact in CT exam. But Higher voltage dosen't affect PET exam. The thicker silicon the lesser artifact in CT and PET exam. Both methods make less artifact in CT and PET exam. But considering safety of patient, the way of using silicon is better.

Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism

  • Kim, Myung-In;Kim, Jun-Hwa;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Ryu, Sun-Youl;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.36.1-36.7
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    • 2015
  • Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

Diagnostic Usefulness of FDG-PET in Cervical Metastasis of Squamous Cell Carcinoma of the Head and Neck (두경부 편평세포암종의 경부 전이에 대한 F-18 FDG PET의 진단적 유용성)

  • Kim Chan-Jong;Kim Jae-Seung;Kang Woo-Seuk;Nam Soon-Yuhl;Choi Seung-Ho;Kim Sang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.2
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    • pp.142-147
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    • 2003
  • Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

Analysis of Aspiration Risk Factors in Severe Trauma Patients: Based on Findings of Aspiration Lung Disease in Chest Computed Tomography

  • Heo, Gyu Jin;Lee, Jungnam;Choi, Woo Sung;Hyun, Sung Youl;Cho, Jin-Seong
    • Journal of Trauma and Injury
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    • v.33 no.2
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    • pp.88-95
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    • 2020
  • Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.

Radial displacement of clinical target volume in node negative head and neck cancer

  • Jeon, Wan;Wu, Hong-Gyun;Song, Sang-Hyuk;Kim, Jung-In
    • Radiation Oncology Journal
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    • v.30 no.1
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    • pp.36-42
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    • 2012
  • Purpose: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Materials and Methods: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. Results: The mean radial displacements were 2.26 (${\pm}1.03$) mm in the control group and 3.05 (${\pm}1.97$) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. Conclusion: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

The Dependence of CT Scanning Parameters on CT Number to Physical Density Conversion for CT Image Based Radiation Treatment Planning System (CT 영상기반 방사선치료계획시스템을 위한 CT수 대 물리적 밀도 변환에 관한 CT 스캐닝 매개변수의 의존성)

  • Baek, Min Gyu;Kim, Jong Eon
    • Journal of the Korean Society of Radiology
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    • v.11 no.6
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    • pp.501-508
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    • 2017
  • The dependence of CT scanning parameters on the CT number to physical density conversion from the CT image of CT and CBCT electron density phantom acquired by the CT scanner using in radiotherapy were analyzed by experiment. The CT numbers were independent of the tube current product exposure time, slice thickness, filter of image reconstruction, field of view and volume of phantom. But the CT numbers were dependent on the tube voltage and cross section of phantom. As a result, for physical density range above 0, the maximum CT number difference observed at the tube voltage between 90 and 120 kVp was 27%, and the maximum CT number difference observed between CT body and head electron density phantom was 15%.

Aesthetic Surgery for a Posttraumatically Split Medial Head of the Clavicle (쇄골의 외상성 분리증의 미용적 치료)

  • Choi, M.Seung Suk
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.535-537
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    • 2007
  • Purpose: We experienced a patient with posttraumatic duplication of the sternoclavicular joint causing a protruding deformity, whose major complaint was aesthetic. The patients history, radiologic findings, and surgical treatment are reported. Methods: A 41-year-old bus driver complained a bony prominence at the left medial clavicle, which had developed after a fracture. The patient was annoyed by the protrusion, which was even visible, when he was wearing a pullover. A three dimensional CT scan showed that the medial head was split into two portions, of which the anterior portion was protruding. In general anesthesia the anterior portion of the medial head was excised. Results: The bony prominence was corrected successfully. Follow up three dimensional CT scans showed that the anterior cortex of the clavicle had regenerated completely at the resection line one year after the operation. Conclusion: Surgical interventions for complications after clavicular fracture are usually carried out, only if there is a limitation of function or if it is painful. We report of a patient with posttraumatic bifurcation of the medial clavicular head, most probably caused by malunion. Upon the patient's request, the deformity causing protrusion of the medial clavicular area was successfully resected for cosmetic reasons.

A Case Of Cavernous Sinus Syndrome and Mutifocal Cerebral Infarction Related To Mucormycosis Of Sphenoid Sinus

  • Jeon, Seok Won;Kim, Chang Hoi;Kim, Joo Yeon;Kwon, Jae Hwan
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.454-462
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    • 2018
  • A 54-year-old man, suffering from severe headache and ophthalmoplegia after undergoing endoscopic sinus surgery was referred to a tertiary hospital. Computed tomography (CT) revealed soft tissue density lesions in the left sphenoid sinus. The internal carotid artery was shown to be occluded in brain magnetic resonance imaging (MRI) scans without any other cerebral lesion. Endoscopic view of left nasal cavity shows whitish hyphae in the ethmoid and the sphenoid sinuses. We diagnosed him with cavernous sinus syndrome caused by mucormycosis and conducted endoscopic sinus surgery to remove remaining lesions and decompress orbit and optic nerves. After the revision surgery the patient's headache and ophthalmoplegia were improved. However, multifocal cerebral infarctions were newly discovered in a postoperative CT scan. We experienced a case of mucormycosis of sphenoid sinus resulting in occlusion of internal carotid artery and multifocal cerebral infarction, and report it with a brief review of these disease entities.

Usefulness of MRI 3D Image Reconstruction Techniques for the Diagnosis and Treatment of Femoral Acetabular Impingement Syndrome(Cam type) (대퇴 골두 충돌 증후군(Cam type)의 진단과 치료를 위한 자기공명 3D 영상 재구성 기법의 유용성)

  • Kwak, Yeong-Gon;Kim, Chong-Yeal;Cho, Yeong-Gi
    • The Journal of the Korea Contents Association
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    • v.15 no.11
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    • pp.313-321
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    • 2015
  • To minimize CT examination for Hip FAI diagnosis and operation plan. also, whether the MRI 3D images can replace Hip Clock face image was evaluated when performing Hip FAI MRI by using additional 3D image. This study analyzed Hip MRI and 3D Hip CT images of 31 patients in this hospital. For the purpose of evaluating the images, one orthopedic surgeon and one radiology specialist reconstructed Clock face, at MR and CT modality, by superior 12 o'clock, labrum front 3 o'clock, and the other side 9 o'clock, centering on Hip joint articular transverse ligament 6 o'clock. Afterwards, by the Likert Scale 5 point scale (independent t-test p<0.005), this study evaluated the check-up of A. retinacular vessel, B. head neck junction at 11 o'clock, A. Epiphyseal line, B. Cam lesion at 12 o'clock, and Cam lesion, Posterior Cam lesion at 1,2,3 and 4 o'clock. As for the verification of reliability among observers, this study verified coincidence by Cohen's weighted Kappa verification. As a result of Likert scale for the purpose of qualitative evaluation about the image, 11 o'clock A. retinacular vessel MR average was $3.69{\pm}1.0$ and CT average was $2.8{\pm}0.78$. B. head neck juncton didn't have a difference between two observers (p <0.416). 12 o'clock A. Epiphyseal line MR average was $3.54{\pm}1.00$ and CT average was $4.5{\pm}0.62$(p<0.000). B. Cam lesion didn't have a difference between two observers (p <0.532). 1,2,3,4 Cam lesion and Posterior Cam lesion were not statistically significant (p <0.656, p <0.658). As a result of weighted Kappa verification, 11 o'clock A.retinacular vessel CT K value was 0.663 and the lowest conformity. As a result of coincidence evaluation on respective item, a very high result was drawn, and two observers showed high reliability.

The Usefulness of Three-Dimensional Imaging with Spiral CT for Evaluation of the Upper Airway Lesions (상부기도병변의 평가에 있어 나선식컴퓨터단층촬영술을 이용한 3차원적 영상의 유용성)

  • 김진환;김현웅;소상훈;노영수;임현준;윤대영
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.43-51
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    • 1998
  • Background: Three-dementional imaging with spiral CT(3D spiral CT) is a well established imaging modality which has been investigated in various clinical settings. However the 3D spiral CT in upper airway disease is rarely reported and its results are still obscure. Objectives: To access the usefulness of 3D spiral CT imaging in patients with upper airway diseases. Materials and Methods We performed 3D spiral CT in fourteen patients In whom upper airway diseases were clinically suspected. Nine of these patients had upper airway stenosis, two had laryngeal cartilage fracture, and three had laryngo-hypopharyngeal cancer. For evaluation of location and extent of the lesions, we compared the findings of 3D imaging with those of air tracheogram, conventional 2D CT images, endoscopic and operative findings. Results: In case of stenosis, 3D spiral CT provide significant useful information, particularly the site and length of the stenotic segment. But, it was difficult to define the fracture of the laryngeal framework and to detect the cartilagenous invasion by head and neck cancer using the 3D imaging. Conclusion : The 3D spiral CT was an useful adjunctive method to assess some kind of upper airway disease but not in others. So, we should compare the findings of 3D images with those of other diagnostic tools for accurate diagnosis of the upper airway disease.

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