• Korean Journal of Radiology
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• 제20권5호
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• pp.773-780
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• 2019

Objective: To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). Materials and Methods: Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31-56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. Results: Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839-0.943: inter-examination, ICC = 0.765-0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4-19.4%). Conclusion: Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.

• Korean Journal of Radiology
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• 제24권2호
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• pp.109-132
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• 2023

Lymphatic disorders encompass a broad spectrum of diseases involving the lymphatic system, ranging from traumatic lymphatic leaks to lymphatic malformations. Lymphatic disorders can be categorized into traumatic and non-traumatic disorders according to their etiology. These two categories may be further divided into subgroups depending on the anatomical location of the lymphatic pathology and their association with clinical syndromes. Thoracic duct embolization was a milestone in the field of lymphatic intervention that encouraged the application of percutaneous embolization techniques to treat leaks and reflux disorders in the lymphatic system. Additional access routes for embolization, including retrograde thoracic duct and transhepatic lymphatic access, have also been developed. This article comprehensively reviews a variety of options for the treatment of lymphatic disorders, from conservative management to the most recent embolization techniques.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1595-1598
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• 2012

The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.

• Korean Journal of Radiology
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• 제24권2호
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• pp.95-108
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• 2023

Recent advances in lymphatic imaging have provided novel insights into the lymphatic system. Interventional radiology has played a significant role in the development of lymphatic imaging techniques and modalities. Radiologists should be familiar with the basic physiology and anatomy of the lymphatic system to understand the imaging features of lymphatic disorders, which reflect their pathophysiology. This study comprehensively reviews the physiological and anatomical aspects of the human lymphatic system as well as the latest lymphatic imaging techniques.

• Korean Journal of Radiology
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• 제24권8호
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• pp.752-760
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• 2023

Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

• 대한방사선기술학회지:방사선기술과학
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• 제43권3호
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• pp.169-176
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• 2020

Interventional radiology is performed under real-time fluoroscopy, and patients are exposed to a wide range of exposures for a long period of time depending on the examination and procedure. However, studies on radiation protection for patients during an intervention are insufficient. This study aims to evaluate the doses exposed during the intervention and the applicability of 3D printing materials. The organ dose for each intervention site was evaluated using a monte carlo simulatio. Also, the dose reduction effect of the critical organs was calculated when using a shielding device using 3D printing materials. As a result, the organ dose distribution for each intervention site showed a lower dose distribution for organs located far from the x-ray tube. It was analyzed that the influence of scattered rays was higher in the superficial organs of the back of the human body where x-rays were incident. The dose reduction effect on the critical organ using the 3D printing shield showed the highest testis among the gonads, and in the case of other organs, the dose reduction effect gradually decreased in the order of the eye, thyroid, breast, and ovary. Accordingly, it is judged that the 3D printed shield will be sufficiently usable as a shielding device for the radiation protection of critical organs.

• 대한영상의학회지
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• 제85권2호
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• pp.363-371
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• 2024

목적 급성 담낭염은 간동맥 화학 색전술 후에 발생하는 비교적 드물지 않게 발생하는 합병증이며, 대부분 수술적 혹은 중재적 치료 없이 호전된다. 간동맥 화학 색전술 직후에 촬영한 cone beam CT 소견을 이용하여, 수술적 혹은 중재적 치료를 필요로 하는 담낭염의 발생률과 위험인자를 분석하고자 하였다. 대상과 방법 본 연구에서는 6년 동안 시행된 2633건의 간동맥 화학 색전술에 대해 후향적으로 분석하였다. 그중 시술 직후에 촬영한 cone beam CT에서 담낭에 색전 물질이 남아 있는 120명을 선택하여 급성 담낭염의 발생률과 위험인자에 대해 분석하였다. 결과 수술적 혹은 중재적 치료를 필요로 하는 담낭염의 전체 발생률은 0.45%였다. 색전 물질이 남아 있는 환자들 중에서는 10%에서 담낭염이 발생했다. 담낭염이 발생한 12명 중 8명은 담낭동맥의 색전술을 받은 환자들이었다. 결론 대부분의 담낭의 색전물질 침적은 추가적인 치료를 필요로 하지 않고 호전되지만, 담낭동맥의 색전술을 받은 경우에는 담낭염의 발생률이 높아 면밀한 모니터링이 필요하다.

• Korean Journal of Radiology
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• 제20권1호
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• pp.18-33
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• 2019

In this study, we summarize the clinical role of magnetic resonance imaging (MRI) in the diagnosis of patients with malignant uterine neoplasms, including leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, uterine carcinosarcoma, and endometrial cancer, with emphasis on the challenges and disadvantages. MRI plays an essential role in patients with uterine malignancy, for the purpose of tumor detection, primary staging, and treatment planning. MRI has advanced in scope beyond the visualization of the many aspects of anatomical structures, including diffusion-weighted imaging, dynamic contrast enhancement-MRI, and magnetic resonance spectroscopy. Emerging technologies coupled with the use of artificial intelligence in MRI are expected to lead to progressive improvement in case management of malignant uterine neoplasms.

• Korean Journal of Radiology
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• 제25권1호
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• pp.8-10
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• 2024

• Korean Journal of Radiology
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• 제25권5호
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• pp.459-472
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• 2024

Hyperpolarized (HP) carbon-13 (¹³C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1-¹³C]pyruvate as a probe and its conversion to [1-¹³C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP ¹³C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP ¹³C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, and prostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP ¹³C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP ¹³C-MRI.