• Korean Journal of Radiology
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• 제24권1호
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• pp.39-50
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• 2023

Objective: To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC). Materials and Methods: In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with DP (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC). Results: For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1-1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3-23.4) on CT were independently associated with ICPN-IC. Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6-10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3-15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0-1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676; p = 0.002). Conclusion: ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP.

• Imaging Science in Dentistry
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• 제48권2호
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• pp.127-129
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• 2018

Radiopacity in the maxillary sinus can be observed in various conditions, such as in the presence of lesions in the maxillary sinus or as a sequela of maxillary sinus surgery. This report describes the case of a 57-year-old female patient who had no previous history of surgical treatment or traumatic injury of the nose or maxillary sinus. Both maxillary sinuses were indistinguishable on panoramic radiography and showed signs of radiopacity. Computed tomography images revealed that the maxillary sinuses were filled with bony tissue and exhibited signs of sinus mucosal thickening. Biopsy results showed fragments of trabecular bone with fibrous tissue.

• 치과방사선
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• 제29권1호
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• pp.223-239
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• 1999

Purpose: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. Materials & Methods: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. Results: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). Conclusion: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.299-307
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• 2020

Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS). Materials and Methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans. Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%). Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

• 한국임상수의학회지
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• 제39권5호
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• pp.258-263
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• 2022

An eight-year-old, intact female, Shih-Tzu, weighing 4.5 kg presented with complaints of anorexia, pale mucous membrane, and vomiting for the past 5 days. On physical examination, nausea, abdominal pain, and melena were noted. On hematologic examination, severe anemia and thrombocytosis were identified. On radiographs examination, soft tissue opacity with small faint mineral opacity mass in the mid-abdomen and two mineral opacity regions in the cranial aspect of mass were identified. Ultrasonographic findings showed thickening of descending duodenal wall with loss of layering and mineralization within the duodenal wall and mesentery adjacent to the duodenal lesion. Computerized tomography showed circumferential wall thickening of descending duodenum with mineralization. Mineralization of the mesentery and mesenteric lymph nodes was identified. Based on the diagnostic imaging, the tentative diagnosis was descending duodenal tumor with dystrophic mineralization. Endoscopy revealed mucosal hemorrhage and erythema within the descending duodenum and stomach. Surgery was performed, and mineralization in the pancreatic tail to duodenum and mesentery was found. Resection of the duodenum, regional lymph node, and mineralized pancreatic region and the duodenal anastomosis were performed. The histologic examination revealed a high-grade undifferentiated duodenal carcinoma with metastases to the regional lymph node and mesentery. The patient was managed with supportive therapy for 8 days and discharged. The patient was followed up for 5 months and there were no complications.

• 대한영상의학회지
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• 제85권3호
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• pp.637-642
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• 2024

직장 매독은 매독 감염(syphilis infection)에서 드물게 발생하며 증상 및 내시경, 영상 소견이 비특이적이다. 직장 매독은 일반적으로 동심성 장벽비후, 점막 충혈, 직장간막 지방침윤, 림프절병증 등으로 나타난다. 직장암은 비대칭적 장벽비후, 림프절 괴사를 보여 두 질환 감별에 도움을 얻을 수 있다. 하지만 두 질환의 중복되는 소견이 많아 환자의 병력을 고려하지 않고 직장 매독과 직장암을 구분하기는 매우 어렵다. 직장 매독은 직장암 외에도 염증성 장 질환 등 다른 양성 질환으로 오인하여 필요 없는 검사를 하거나 치료가 지연되는 경우가 많다. 저자들은 악성 종양으로 의심되었던 직장 매독 증례를 경험하여 이 증례 보고에서 내시경 및 영상, 병리학적 소견에 대하여 자세히 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.489-494
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• 2008

A patient complaining of chronic dull pain in the right maxillary area showed slight haziness and small ovoid radiopacity in the right antrum, which was not extended into the choanal area in radiographic views. At operation, lots of mucoid fluid admixed myxoid soft tissues was discharged and the polypoid mucosal tissues were removed. In histological examination, the removed tissues showed a polyp by the overgrowth of dermal connective tissues exhibiting severe myxoid degeneration. Throughout the entire specimen, the inflammatory reaction was diffuse but not so remarkable to produce the mucosal thickening and necrosis. The polypoid tissues were diffusely infiltrated with neutrophiles and plasma cells, but few eosinophils, resulted in the extensive myxoid degeneration together with severe vascular degeneration. Therefore, we suggest that the antral polyp is basically different in its pathogenesis and prognosis from the common maxillary sinusitis of odontogenic origin, thus the antral polyp should be carefully diagnosed when the inflamed antral lesion is recurred and diffusely degenerative with myxoid changes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.102-107
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• 2004

저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.323-327
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• 2007

Although most clinicians now agree that sinusitis can afflict children of all ages, appropriate diagnosis remain controversial. Sinusitis is one of the most challenging diagnoses for a clinician, because there is a lack of validated diagnostic criteria for acute rhinosinusitis. Symptoms generally include nasal congestion, purulent nasal discharge, and cough .The physical examination is often unsuccessful in confirming the diagnosis. If purulent discharge is seen oozing from the middle meatus, the diagnosis of acute rhinosinusitis is almost certain. Purulent drainage may also be seen in the posterior pharynx and accompanied by halitosis. Absence of light by transillumination may indicate acute rhinosinusitis. Imaging studies are not necessary to confirm the diagnosis of sinusitis in children younger than 6 years and should be used sparingly in children older than 6 years. Sinus radiographs still have several advantages over CT scanning including the relatively low cost and the ability to obtain films without the use of sedation in younger children. Positive findings of sinusitis on plain film include air-fluid levels, complete opacification, or mucosal thickening greater then 4 mm. The CT scan however, is significantly more sensitive then plain films in detecting these abnormalities. Although recovery of bacteria from a sinus aspiration is considered reference standard for diagnosis in pediatric rhinosinusitis, its routine used by pediatricians is not practical and therefore is not recommended.

• Journal of Gastric Cancer
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• 제11권4호
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• pp.234-238
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• 2011

A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close followup. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.