• Title/Summary/Keyword: Intervention-Radiology

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Progression of periapical cystic lesion after incomplete endodontic treatment

  • Huh, Jong-Ki;Yang, Dong-Kyu;Jeon, Kug-Jin;Shin, Su-Jung
    • Restorative Dentistry and Endodontics
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    • v.41 no.2
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    • pp.137-142
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    • 2016
  • We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

Balloon Angioplasty in a Pediatric Renal Artery Occlusion (소아 신장 동맥 폐색에서의 풍선 혈관성형술)

  • Song, Hwayoung;Jung, Hye Doo;Kim, Jeong-Eun;Lee, Sang Min;Hong, Wonju;Lee, Kwanseop
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.332-336
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    • 2018
  • Renal artery injury is a rare complication in blunt trauma, but can cause devascularization of the kidney, leading to renal failure. It requires early diagnosis and management. The treatment of renal artery injury still remains controversial, but recent studies have reported the successful treatment outcome with endovascular stent placement. Nevertheless, there is no standard treatment strategy in cases of pediatric patients. We report a case of a 16-year-old girl with right renal artery occlusion associated with a grade IV liver laceration. She was treated with only balloon angioplasty, and the kidney showed marked improvement of parenchymal perfusion with normalized renal function. Treatment with only balloon angioplasty can be a treatment option in pediatric patients with renal artery injury.

Hemorrhagic Complications Following Ultrasound-Guided Breast Biopsy: A Prospective Patient-Centered Study

  • Heera Yoen;Hyun-Ah Chung;So-Min Lee;Eun-sung Kim;Woo Kyung Moon;Su Min Ha
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.157-165
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    • 2024
  • Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion: US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

Inferior Vena Cava Stenosis Following Orthotopic Liver Transplantation: Differentiating Points from False Positives (뇌사자 간이식 후 발생한 하대정맥 협착: 위양성과의 감별점)

  • Yeonsoo Choi;Jin Hyeok Kim;Ung Bae Jeon;Joo Yeon Jang;Tae Un Kim;Hwaseong Ryu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.713-718
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    • 2023
  • Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.

Successful TAE after DCS for Active Arterial Bleeding from Blunt Hepatic Injury in a Child: A Case Report

  • Park, Chan Ik;Lee, Sang Bong;Yeo, Kwang Hee;Lee, Seungchan;Park, Sung Jin;Kim, Ho Hyun;Kim, Jae Hun;Kim, Chang Won;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.29 no.2
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    • pp.47-50
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    • 2016
  • Transcatheter arterial embolization (TAE) for blunt hepatic injury in children is not common and is especially rare after damage control surgery (DCS). We report a successful TAE after DCS on a child for massive bleeding from the left hepatic artery due to a motor vehicle accident. The car (a sport utility vehicle) ran over the chest and abdomen of a 4-year-old boy. On arrival, initial vital signs were as follows: blood pressure, 70/40 mmHg; heart rate, 149/min; temperature, $36.7^{\circ}C$; respiratory rate, 38/min. After resuscitation, computed tomography was done, and a suspicious contrast leakage from a branch of the left hepatic artery and a spleen injury (grade V) were found. TAE was performed successfully after DCS for a liver injury.

Management strategies for congenital isolated hydronephrosis and the natural course of the disease

  • Jung, Jiwon;Lee, Joo Hoon;Kim, Kun Suk;Song, Sang Hun;Moon, Dae Hyuk;Yoon, Hee Mang;Cho, Young Ah;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.1-10
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    • 2022
  • Congenital isolated hydronephrosis encompasses a spectrum of physiologic states that spontaneously resolve and pathologic obstruction that necessitates surgical intervention. Distinguishing patients whose condition will resolve, those who will require stringent follow-up, and those who will eventually need surgical intervention present a challenge to clinicians, particularly because no unified guidelines for assessment and follow-up have been established. The recognition of the natural course and prognosis of hydronephrosis and a comprehensive understanding of the currently proposed consensus guidelines may aid in multidisciplinary treatment and in providing proper counseling to caregivers. In this review, we aimed to summarize the literature on the grading systems and management strategies for congenital isolated hydronephrosis.

Assessment of Treatment Response in Patients With Severe Asthma Using Visual and Quantitative Analysis of Chest CT

  • Han Na Lee;Jin An;Miji Lee;Hye Jeon Hwang;Jooae Choe;Jihye Yoon;Ji-Hyang Lee;Min-Hye Kim;Young-Joo Cho;Sang Min Lee;Tae-Bum Kim;Joon Beom Seo
    • Korean Journal of Radiology
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    • v.25 no.7
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    • pp.673-683
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    • 2024
  • Objective: To evaluate the role of visual and quantitative chest CT parameters in assessing treatment response in patients with severe asthma. Materials and Methods: Korean participants enrolled in a prospective multicenter study, named the Precision Medicine Intervention in Severe Asthma study, from May 2020 to August 2021, underwent baseline and follow-up chest CT scans (inspiration/expiration) 10-12 months apart, before and after biologic treatment. Two radiologists scored bronchiectasis severity and mucus plugging extent. Quantitative parameters were obtained from each CT scan as follows: normal lung area (normal), air trapping without emphysema (AT without emph), air trapping with emphysema (AT with emph), and airway (total branch count, Pi10). Clinical parameters, including pulmonary function tests (forced expiratory volume in 1 s [FEV1] and FEV1/forced vital capacity [FVC]), sputum and blood eosinophil count, were assessed at initial and follow-up stages. Changes in CT parameters were correlated with changes in clinical parameters using Pearson or Spearman correlation. Results: Thirty-four participants (female:male, 20:14; median age, 50.5 years) diagnosed with severe asthma from three centers were included. Changes in the bronchiectasis and mucus plugging extent scores were negatively correlated with changes in FEV1 and FEV1/FVC (ρ = from -0.544 to -0.368, all P < 0.05). Changes in quantitative CT parameters were correlated with changes in FEV1 (normal, r = 0.373 [P = 0.030], AT without emph, r = -0.351 [P = 0.042]), FEV1/FVC (normal, r = 0.390 [P = 0.022], AT without emph, r = -0.370 [P = 0.031]). Changes in total branch count were positively correlated with changes in FEV1 (r = 0.349 [P = 0.043]). There was no correlation between changes in Pi10 and the clinical parameters (P > 0.05). Conclusion: Visual and quantitative CT parameters of normal, AT without emph, and total branch count may be effective for evaluating treatment response in patients with severe asthma.

A RADIOLOGIC STUDY OF POST-OPERATIVE MAXILLARY CYST (술후성상악낭종의 방사선학적 연구)

  • Lim Yoon Sik;Park Tae Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.12 no.1
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    • pp.35-42
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    • 1982
  • Post-operative maxillary cyst may arise after the surgical intervention for maxillary sinusitis with the symptoms of swelling, pain and pus discharge in the buccal region. The author analized 66 cases clinically and radiographically which were diagnosed as post- operative maxillary cyst in SNUH during 5 years (1977. 8-1982. 7). The obtained results were as follows; 1. This cyst occurred more frequently in male than in female and the incidence is the highest in the 4th decade. 2. The right side was more frequently affected than the left side. 3. Initial radical operations of the maxillary sinueses were performed mainly between the age of 15 and 24 years. 4. The duration between the initial operation and the onset of cyst was mainly from 10 to 24 years. 5. Pain, swelling and pus discharge in the buccal region were most frequent chief complaints. 6. In panoramic radiographs, most of the post-operative maxillary cysts were monolocular type, showing distinct border, with smooth margin and without any definite sclerotic border. 7. In Waters' view, 43 cases showed radiographic changes due to cyst.

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Two Cases of Nasopharyngeal Carcinoma Treated with Co-60 HDR ICR (강내 조사를 이용한 비인강압 치험2예)

  • Shin, Sei-One;Kang, Cheol-Hoon;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.197-201
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    • 1990
  • The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system(RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.

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Ulnar artery access for intracranial mechanical thrombectomy procedure: A salvage option after failed trans-femoral and trans-radial access

  • Muhammad U Manzoor;Abdullah A Alrashed;Ibrahim A Almulhim;Sultan Alqahtani;Fahmi Al Senani
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.429-433
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    • 2023
  • 84 years old gentle man with past medical history of hypertension and diabetes presented with sudden onset right sided weakness and aphasia for two hours. Initial neurological assessment revealed National Institute of Health Stroke Scale (NIHSS) 17. Computed tomography (CT) scan demonstrated minimal early ischemic changes along left insular cortex with occlusion of left middle cerebral artery (MCA). Based on clinical and imaging findings, decision was made to perform mechanical thrombectomy procedure. Initially, right common femoral artery approach was utilized. However, due to unfavorable type-III bovine arch, left internal carotid artery could not be engaged via this approach. Subsequently, access was switched to right radial artery. Angiogram revealed small caliber radial artery, with larger caliber ulnar artery. Attempt was made to advance the guide catheter through the radial artery, however significant vasospasm was encountered. Subsequently, ulnar artery was accessed and successful thrombolysis in cerebral infarction (TICI) III left MCA reperfusion was achieved with a single pass of mechanical thrombectomy via this approach. Post procedure neurological examination demonstrated significant clinical improvement. Doppler ultrasound 48 hours after the procedure demonstrated patent flow in radial and ulnar arteries with no evidence of dissection.