• Title/Summary/Keyword: Head CT

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A Case of Liposarcoma of Hypopharynx (하인두에 발생한 지방육종 1예)

  • Kim, Yong-Hyun;Nam, Sang-Won;Min, Soo-Kee;Park, Bum-Jung
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.237-239
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    • 2011
  • Liposarcoma is the second most common sarcoma of the adult life, next to malignant fibrous histiocytoma. Liposarcoma in larynx and hypopharynx is extremely rare. The symptoms are variable, but it has a clinical importance because they can cause unpredictable airway obstruction, particularly during the induction of general anesthesia. A 79-year-old male patient was referred to our department for mild airway obstruction and throat discomfort. Neck CT scan showed a mass within both postcricoid area and pyriform sinus. The mass was removed via laryngeal microsurgery. In this article, we report a case of liposarcoma of the posterior wall of hypopharynx with a review of the related literature.

Clinical Usefulness of MR FLAIR Image in Mild Head Injuries (경증 두부외상 환자에서 MR FLAIR 영상의 임상적 유용성)

  • Kim, Sei-Yoon;Whang, Kum;Kim, Hun-Joo;Lee, Myoung-Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1182-1186
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    • 2001
  • Objectives : MR fluid-attenuated inversion recovery(FLAIR) image uses paired long inversion time and relaxation time that nulls the signal from CSF. With nulling of the CSF long echo time readout could be used to increase T2-weighting, hence improving the conspicuousness of most tissue lesions without the deleterious effects of CSF artifact seen on T2 weighted sequence. We examed the usefulness of FALIR image in the diagnosis of mild head injury. Methods : A total of 38 patients with mild head injury were examined by FLAIR image. We compared those images with CT scan and T1, T2-weighted images. Careful observation of MR images were done by two well-trained neuroradiologists. Each image was compared for conspicuousness and detectability of traumatic lesions might have shown abnormal signal intensities. The Wilcoxon signed ranks test was used for statistical evaluation. Results : The FLAIR image was significantly more sensitive than those of other images(p<0.001). T2 FFE(Fast Field Echo) image was more useful for detection of small petechial hemorrhages. Conclusion : FLAIR image is considered to be more sensitive than those of conventional MR images in the evaluation of mild head injuries.

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Metastatic Papillary Thyroid Carcinoma Masquerading as Type II Branchial Cleft Cyst : A Case Report (제2형 새열 낭종으로 오인된 전이성 갑상선 유두상 암종 1예)

  • Kim, Seung-Woo;Kim, Jung-Min;Kim, Choon-Dong
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.34-36
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    • 2012
  • In case of lateral cervical cystic lesions, the differential diagnoses include branchial cleft cyst(BCC), teratoma, dermoid, hemangioma and lymphangioma etc. But sometimes metastatic cystic lymph nodes may exist in lateral neck. In such circumstance, the primary lesions are known to stem from oropharynx, nasopharynx, salivary and thyroid gland etc. A-66-year-old-male came to our clinic, due to the lateral cervical mass for 5 years. We performed the neck CT, sonography and sono-guided FNAC. He was initially diagnosed with the benign cyst such as BCC. We performed the excisional biopsy on left level II, but the pathologic report was revealed as metastatic papillary thyroid carcinoma(PTC). And then he received the total thyroidectomy with neck dissection. The final diagnosis was cystic metastasis from PTC. We learn a valuable lesson form this case in the following. Even if the simple cervical cyst is presumed with radiology and clinical pattern, more careful considerations on the basis of history and radiologic findings are mandatory.

Lung Metastasis of Thyroid Papillary Carcinoma which was Temporarily Treated for Milliary Tuberculosis (파종성 폐결핵으로 오인된 갑상선 유두상암종의 폐전이)

  • Na, Hong-Shik;Lee, Je-Hyuck;Paeng, Jae-Pil;Jung, Kwang-Yoon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.16-20
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    • 2000
  • The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

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A Case of Interarytenoid Scar Disguising Bilateral Vocal Cord Palsy (양측성 성대 마비로 오인된 피열간 반흔 1예)

  • Shin, Dong-Hyuk;Kim, Yong Won;Lee, Yongsik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.1
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    • pp.36-38
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    • 2014
  • The patient suffered cardiac arrest 8 months before presentation. She has been suffering hoarseness and exertional dyspnea and nocturnal stridor. Upon flexible laryngoscopy, her vocal cords showed no motion and fixed in paramedian position. There was no causal finding on neck CT. EMG showed some muscular activity. Under the suspicion of crico arytenoid fixation, we performed suspension laryngoscopy, and found the arytenoid cartilage was fixed with short and stout scar, which was removed with scissors. Just after surgery she regained her voice and respiration.

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Delayed Bilateral Abducens Nerve Palsy after Head Trauma

  • Kim, Min-Su;Cho, Min-Soo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.396-398
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    • 2008
  • Although the incidence of unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of head trauma cases, bilateral abducens nerve palsy following trauma is extremely rare. In this report, we present the case of a patient who developed a bilateral abducens nerve palsy and hypoglossal nerve palsy 3 days after suffering head trauma. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images demonstrated clivus epidural hematoma and subarachnoid hemorrhage on the basal cistern. Herein, we discuss the possible mechanisms of these nerve palsies and its management.

A Case of Paratracheal Air Cyst Causing Dyspnea (호흡곤란을 유발한 기관주위 공기낭 1 예)

  • Han, Chang-Hee;Park, Sung-Ho;Choi, Kyung-Min;You, Ji-Hoon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.64-67
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    • 2009
  • Paratracheal air cysts are rare lesions and detected incidentally during CT scan or autopsy. Histopathologic diagnoses of paratracheal air cysts include trachocele, tracheal diverticulum and lymphoepithelial cyst. The cysts are lined by ciliated columnar epithelium and have communication with trachea. Previous reports suggested an association with obstructive lung disease because of increased expiratory pressures in these patients. Most of these cysts are asymptomatic but rarely cause productive cough, wheezing, recurrent laryngeal nerve paralysis and difficult intubation. We report a case of paratracheal air cyst causing dyspnea with a review of literature.

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Two Cases of Tracheobronchopathia Osteochondroplastica (기관기관지이소성 골연골형성증 2례)

  • Kim, Hyo Jun;Lee, Yun Ji;Jung, Min Jung;Park, Ki Nam
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.103-106
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    • 2018
  • Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic tracheobronchial abnormality characterized by diffuse cartilaginous and osseous nodules protruding into the airway lumen of the trachea and bronchus. TO is easy to misdiagnose because of nonspecific symptoms and chest CT scan with pathologic biopsy is necessary for definitive diagnosis. We report two cases of patient with TO who underwent laryngomicroscopic biopsy and tracheostomy with literature review.

Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better"

  • uz Zaman, Maseeh;Fatima, Nosheen;Zaman, Areeba;Zaman, Unaiza;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3465-3468
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    • 2016
  • Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

Availability of the Optic Nerve Sheath Diameter Measured by Using Ultrasonography as a Secondary Survey for Patient with Head Injuries in the Emergency Department (응급실에 내원한 두부외상환자의 2차 평가로써 초음파를 이용한 시각신경집 지름 측정은 유용한가?)

  • Lee, Dong Wook;Lee, Jung Won;Park, Sae Hoon;Park, Ihl Sung;Lee, Hyun Jung;Yoo, Byeong Dae;Moon, Hyung Jun
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.104-110
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    • 2013
  • Purpose: Bedside ultrasonography is available in most emergency departments, and detecting the intracranial pressure is elevated is critical. Our objective is to evaluate the availability of bedside optic nerve ultrasound (ONUS) as a secondary survey for patients with head injuries in the emergency department (ED). Methods: From September, 2012, to March, 2013, we performed a prospective study of patients presenting to the ED after an accident. Patients with head injuries but without obvious ocular trauma or ocular disease were included. The ONUS was performed using a 3 to 12 MHz linear probe on closed eyelids after a primary survey. We analyzed the correlation between the brain computed tomography (CT) findings that suggested elevated intracranial pressure (ICP) and the Optic nerve sheath diameter (ONSD) measured by using ONUS. Results: A total of 81 patients were enrolled. Forty-seven had CT results consistent with elevated ICP, and their mean ONSD was $5.98{\pm}0.59$ mm; the mean ONSD of patients who showed no signs of elevated ICP on CT was $4.63{\pm}0.21$ mm. The sensitivity and the specificity for the ONSD, compared with elevated ICP, were 98.87% and 100%, respectively, when the cut-off value was set to 4.96 mm. The area under curve (AUC) was 0.997 in the receiver operating characteristic curve (ROC curve). Conclusion: An evaluation using ONUS is a simple noninvasive procedure and is a potentially useful tool as a secondary survey to identify an elevated ICP.