• Title/Summary/Keyword: Radiologic findings

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Solitary Plasmacytoma of the Bone: Radiologic Findings (골단일 형질세포종 : 방사선학적 소견)

  • Yoon, Choon-Sik;Kim, Myung-Joon;Ahn, Chang-Soo;Suh, Jin-Suck;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.61-68
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    • 2000
  • Purpose : We examined the patients to evaluate the radiologic findings of solitary plasmacytoma of the bone. Materials and Methods : We retrospectively reviewed radiologic findings of 9 cases with solitary plasmacytoma of the bone (SPB) for recent 5 years, but 2 cases were not included this study due to an abnormal finding of bone marrow and another 2 cases were not included due to an abnormal manifestations of computed tomography (n=1) and MRI (n=1). Results : Among 5 cases, 4 cases had an osteolytic bone destruction and 1 case had an osteosclerotic bone destruction on the plain radiograph. Computed tomography and MRI showed more informations about trabeculated bone destruction and the soft-tissue extension of the lesion comparing to plain radiographs. The MRI finding of SPB in 4 cases showed a relatively high signal intensity on T1-weighted image and intermediate signal intensity on T2-weighted image, on which the signal intensity of the lesion is slightly higher than that of the muscle. One case had an extensive soft-tissue involvement and multiple necrosis, which presented iso to low signal intensity on T1-weighted image and high heterogeneous signal intensity on T2-weighted image. The Gadolinium-enhanced T1-weighted images of 5 cases showed diffusely strong enhancement of the lesion except on the necrosis areas. Conclusion : Computed tomography and MRI may present some characteristics of SPB and demonstrate another foci of plasma cell infiltrates, so these can be helpful for the diagnosis and treatment of SPB.

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Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.60-65
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    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

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$^{67}Ga$ Scan of Primary Hepatocellular Carcinoma; Correlation with Angiography (원발성 간암의 $^{67}Ga$ Scan소견 ; 혈관조영술 소견과의 비교)

  • Kim, Myung-Joon;Yoo, Hyung-Sik;Lee, Jong-Tae;Suh, Jung-Ho;Park, Chang-Yun;Lee, Do-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.27-33
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    • 1989
  • The relationship between angiographic findings and those of $^{67}Ga$ scan was evaluated in 30 patients with primary hepatocellular carcinoma diagnosed by either pathological examination or laboratory, radiologic findings. Twenty-three cases revealed hot activities on $^{67}Ga$ scan and definite tumor stains on angiography. Main findings of $^{67}Ga$ scans of 7 cases were isoactivity in 5 and cold area in 2, 5 of which revealed faint or no tumor stain on angiography. Cold areas within the primary hepatocellular carcinoma were noted in 9 cases by $^{67}Ga$ scan. In 6 cases these were due to tumor necrosis. Remaining 3 cases had arterioportal shunt, portal vein thrombosis and one had necrosis as well. These results indicate that gallium uptake of primary hepatocellular carcinoma seems to be relatively correlated with tumor stains on angiography. It is well known that the necrotic portion of primary hepatocellular carcinoma does not uptake gallium and it's the main cause of cold areas on $^{67}Ga$ scan. And we suspect that the hemodynamic changes of primary hepatocellular carcinoma such as large arterioportal shunt, portal vein thromosis may cause the decreased activity on $^{67}Ga$ scan.

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The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Treatment of Traumatic Pancreas Injury (외상성 췌장 손상에서 내시경적 담췌관 조영술의 역할)

  • Jeong, Min-Young;Kim, Young-Hwan;Kyoung, Kyu-Hyouck;Lee, Sung-Koo;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.136-142
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    • 2011
  • Purpose: Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury. Methods: We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed. Results: A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation. Conclusion: Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.

A Clinical Study on the Surgical Treatment of Double Chambered Right Ventricle Associated with Ventricular Septal Defect (VSD 를 합병한 DCRV 의 외과적 수술에 대한 임상적 고찰)

  • Son, Dong-Seop;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.241-249
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    • 1985
  • Twenty-one patients with Double Chambered Right Ventricle [DCRV] associated with Ventricular Septal Defect [VSD] were treated by open heart surgery under cardiopulmonary bypass with moderate hypothermia in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital between June 1982 and October 1984. The following results were obtained 1. The symptoms and physical signs, specific for DCRV, could not be identified. 2. The radiologic findings on simple chest X-ray, specific for DCRV, could not be identified. 3. Electrocardiographic findings, specific for DCRV, could not be identified. 4. Cardiac catheterization was found to be the most important diagnostic method, revealing pressure gradient between proximal chamber and distal chamber in the right ventricle. The average pressure gradient between two chambers showed 48.1523.29 mmHg[varying from 15mmHg to 94mmHg]. 5. Cardiac angiography was found to visualize the anomalous muscle bundles in right ventricle [in 17 cases, 81%] but the evidence of pressure gradient between two chambers within right ventricle is considered necessary for the diagnosis of DCRV. 6. Via surgical observation, anatomical and pathologic findings of the anomalous muscle bundles, associated DCRV were identified. 7. As the direct pressure was measured on the operating table before and after surgery, the average pressure gradient across the muscle bundles showed 40.5219.75mmHg [varying from 16 to 89mmHg] preoperatively and 8.909.72mmHg [varying from 0 to 32mmHg] postoperatively, indicating significant surgical correction of the obstruction present. 8. The presence of anomalous muscle bundles, dividing the right ventricle into two separated chambers, and the presence of the pressure gradient over 15mmHg are considered necessary for the diagnosis of DCRV.

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Neuroblastoma : Computed Tomographic Finding (신경아세포종의 전산화단층촬영 소견)

  • Kim, Jae-Woon;Choi, Jong-Oh;Cho, Jae-Ho;Hwang, Mi-Soo;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.134-140
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    • 1996
  • Recently many studies have shown the usefulness of computed tomogram in diagnosing abdominal mass when clinical and conventional radiologic examinations fail to reveal the nature of abdominal mass or the cause of abdominal distension. To evaluate the usefulness of CT in diagnosing neuroblastoma, we retrospectively analyzed computed tomographic findings of 16 neuroblastoma patients, who pathologically proved in Yeungnam University Hospital from 1986 to 1995. The age range of the patients studied were from 8months to 18years. The most frequent sith of origin was adrenal gland and the next was retroperitioneum. The presenting symptoms were palpable mass, abdominal distension, and abdominal pain. The viewpoints of this analysis were turnoral calcifications, midline cross, shape, margin, internal structure, contrast enhancement patterns, major vessel involvement, and lymph node involvement. Characteristic CT findings were as follows: Fine dense curvillinear calcification within the tumor(56%), midline cross(50%), lobulation(75%), well-circumscribed margin(56%), cystic degeneration(56%), heterogeneous contrast enhancement(69%). encasement of major vessels such as aorta, IVC and celiac trunk(50%), and paraaortic lymphadenopathy(87%). We conclude that these CT findings were very common and could be helpful in diagnosting and differentiation neuroblastoma in infant and children.

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Juxtacortical Osteogenic Sarcoma of Chondroblastic Type on the Maxilla (상악골에 발생된 연골형성현 측피질골육종)

  • Choi Sun-Young;Choi Eun-Suk;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.2
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    • pp.539-563
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    • 1998
  • 39-year-old female had been treated for the exophytic mass on buccal aspect of the left, maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical. radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical. radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of /sup 99m/Tc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sunray appearace, and coincided with benign characters as follows; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.

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The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients (2세 미만 소아의 경도 두부 외상 후 두개골 골절 및 두개내 병변의 위험 인자)

  • Jeong, Jong Il;Kim, Ah Jin;Shin, Dong Wun;Rho, Jun Young;Kim, Kyung Hwan;Kim, Hong Yong;Park, Jun Seok
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.83-89
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    • 2007
  • Purpose: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. Methods: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. Results: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. Conclusion: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted.

Strategy for Management of Giant Invasive Pituitary Adenoma

  • Yang, Hee-Seok;Kim, Oh-Lyong;Kim, Min-Soo;Kim, Sang-Woo;Chang, Chul-Hun;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.25-28
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    • 2005
  • Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

Usefulness of Three Dimensional Proset MR Images for Diagnosis of Symptomatic L5-S1 Foraminal and Extraforaminal Stenosis

  • Kim, Sang Woo;Kim, Chang Hwan;Kim, Min Su;Jung, Young Jin;Byun, Woo Mok
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.30-33
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    • 2013
  • Objective : To suggest a new useful diagnostic technique, principles of the selective excitation technique-magnetic resonance images (Proset-MRI), and to know the precise radiologic findings that can prove symptomatic foraminal and extraforaminal stenosis at L5-S1. Methods : Nineteen patients with symptomatic L5-S1 stenosis were checked by Proset-MRI. Four patients were performed decompressive surgery and 15 patients were performed selective nerve root block (SNRB) at L5. The pain scale of patients was checked by Visual Analogue Scale (VAS) scores at the pre- and post-treatment state. Results : Proset-MRI findings of patients with symptomatic stenosis are root swelling (RS) and indentation. The comparisons with VAS scores had a meaningful statistical result at each RS (p<0.01) and indentation (p<0.01). However, the findings of RS combined with indentation lacked statistical significance (p=0.0249). In addition, according to a comparison with the treatment modalities, reducing of VAS scores had statistical meaningful significance in decompressive surgery cases (p<0.01), and also in SNRB cases (p<0.01) after a 3-month follow-up period. Conclusion : The three dimensional Proset-MRI is very useful and sensitive technique to diagnose the symptomatic foraminal and extraforaminal stenosis at L5-S1.