• Imaging Science in Dentistry
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• 제45권3호
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• pp.181-185
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• 2015

Numerous cases of enamel renal syndrome have been previously reported. Various terms, such as enamel renal syndrome, amelogenesis imperfecta and gingival fibromatosis syndrome, and enamel-renal-gingival syndrome, have been used for patients presenting with the dental phenotype characteristic of this condition, nephrocalcinosis or nephrolithiasis, and gingival findings. This report describes a case of amelogenesis imperfecta of the enamel agenesis variety with nephrolithiasis in a 21-year-old male patient who complained of small teeth. The imaging modalities employed were conventional radiography, cone-beam computed tomography, and renal sonography. Such cases are first encountered by dentists, as other organ or metabolic diseases are generally hidden. Hence, cases of amelogenesis imperfecta should be subjected to advanced diagnostic modalities, incorporating both dental and medical criteria, in order to facilitate comprehensive long-term management.

• Korean Journal of Radiology
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• 제22권5호
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• pp.735-741
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• 2021

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter²). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001). The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion: Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.

• Korean Journal of Radiology
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• 제25권1호
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• pp.33-42
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• 2024

Focal enhancement typically suggests local tumor progression (LTP) after renal cell carcinoma is percutaneously ablated. However, evaluating findings that are false positive or negative of LTP is less familiar to radiologists who have little experience with renal ablation. Various imaging features are encountered during and after thermal ablation. Ablation procedures and previous follow-up imaging should be reviewed before determining if there is LTP. Previous studies have focused on detecting the presence or absence of focal enhancement within the ablation zone. Therefore, various diagnostic pitfalls can be experienced using computed tomography or magnetic resonance imaging examinations. This review aimed to assess how to read images during or after ablation procedures, recognize imaging features of LTP and determine factors that influence LTP.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.66-70
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• 2021

Isolated head and neck metastasis of renal cell carcinoma (RCC) is relatively rare and metastasis to the temple area is very rare. Here, we present the case of a 51-year-old man who was diagnosed with RCC 2 years earlier and had a contralateral metastatic temple area lesion. The patient who was diagnosed with renal cell cancer and underwent a nephrectomy 2 years ago was referred to the plastic surgery department for a temple mass on the contralateral side. In the operative field, the mass was located in the temporalis muscle with a red-to-purple protruding shape. Biopsy of the mass revealed a metastatic RCC lesion. Computed tomography imaging showed a lobulated, contoured enhancing lesion. Positron emission tomography/computed tomography imaging showed high-fluorodeoxyglucose uptake in the right temporalis muscle. The patient underwent wide excision of the metastatic RCC including the temporalis muscle at the plastic surgery department. Skeletal muscle metastasis of head and neck lesions is extremely rare in RCC. Isolated contralateral temporalis muscle metastasis in RCC has not been previously reported in the literature. If a patient has a history of malignant cancer, plastic surgeons should always consider metastatic lesions of head and neck tumors. Because of its high metastatic ability and poor prognosis, it is very important to keep this case in mind.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.90-97
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• 2015

Background: Contrast-induced nephropathy (CIN) can cause serious adverse effects. To reduce the occurrence of CIN related computed tomography (CT) in emergency patients, we assessed the respective roles of serum creatinine (SCr) alone and estimated glomerular filtration rate (eGFR) as an early predictor for CIN related CT. Methods: For patients with SCr <1.5 mg/dL who underwent CT in emergency department (ED) between September 2012 and October 2013, we assessed the prevalence of CIN and its adverse effects. The Modification of Diet in Renal Disease Study (MDRD) and Cockcroft-Gault (CG) formula was used for the calculation of eGFR. Practical calculation was performed by electronic medical record (EMR) system for MDRD and internet calculating service for CG. And we investigated the prevalence of CIN in eGFR $<60mL/min/1.73m^2$ before CT. Results: A total of 1,555 patients were enrolled. The prevalence of CIN after CT was 4.6% and it showed correlation with renal deterioration, increased in-hospital mortality, and prolonged hospitalization. Despite baseline SCr <1.5 mg/dL, among enrolled patients, 11.3% as MDRD equation and 29.5% as CG formula were $<60mL/min/1.73m^2$ and in this condition, the prevalence of CIN was significantly high (odds ratio was 2.87 [1.64-5.02] as MDRD equation and 2.03 [1.26-3.29] as CG formula). Conclusion: Just SCr <1.5mg/dL was not appropriate to recognize preexisting renal insufficiency, but eGFR using MDRD equation was useful in predicting the risk of CIN related CT in ED. Using EMR, calculation of eGFR can be easier and more convenient.

• Childhood Kidney Diseases
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• 제17권1호
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• pp.25-28
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• 2013

분절형 다낭성 이형성신은 PubMed의 자료 수집에 따르면 산전에 발견된 19명을 포함해 35명의 소아 환자와 1명의 성인 환자의 증례가 보고 되었다. 분절형 다낭성 이형성신에 대한 기록은 부족하며 비전형적으로 나타날 수 있어 진단이 어렵다. 본 연구에서는 분절형 다낭성 이형성신의 37번째 케이스를 보고하는 바다. 본 연구에서 환아의 산전 초음파에서 발견된 다낭성 복부 종양은 신장 초음파와 컴퓨터 단층촬영에 의해 분절형 다낭성 이형성신으로 진단되었다. 영상 검사를 통해 분절형 다낭성 이형성신의 최종 진단이 내려진다면 진단적 생검을 위한 수술은 불필요할 것이다.

• 대한수의학회지
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• 제55권1호
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• pp.65-69
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• 2015

A 14-year-old, 7.4 kg, neutered male mongrel dog presented with vomiting, anorexia, and hematuria starting 3 days prior to admission. Serum biochemical profiles indicated severe azotemia. Computed tomography revealed loss of normal left kidney structure. The organ was 1.5 to 2 times larger than the right kidney with mixed attenuation. Histopathologic examination was performed after nephrectomy. The renal mass and mesenteric membrane were positive for vimentin and stained blue with Masson's trichrome. In conclusion, this was a rare occurrence of primary renal fibrosarcoma, most likely originated from the renal capsule, with local invasion into the mesenteric membrane.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.86-91
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• 2013

목적: 본 연구는 가와사키 질환의 신장 침범에 대하여 비교적 덜 침습적이며, 특이도와 민감도가 높은 검사인 Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT)을 통하여 밝혀보고자 한다. 방법: 2011년 3월부터 10월까지 국민건강보험 일산병원에서 가와사키로 진단된 15명의 환아들을 대상으로 진행하였다. 15명의 환아 모두 가와사키의 급성기에 DMSA renal SPECT를 시행하였다. 또한 신장 세뇨관 손상 지표인 요중 ${\beta}2$-microglobulin (${\beta}2$-MG)을 측정하여 이를 통한 가와사키 환아에서 신장 손상의 조기 진단 가능 여부를 연구해보았다. 결과: 환아 15명 모두의 신기능 검사는 정상이었다. 소변 검사상 현미경적 혈뇨와 농뇨가 각각 13%, 33%에서 관찰되었다. 요중 ${\beta}2$-MG는 46%에서 증가된 소견을 보였다. 또한 환아들을 요중 ${\beta}2$MG를 기준으로 증가되어 있는 군과 증가되지 않은 군으로 나누어 비교, 분석해 보았으며, 두군간에 임상 증상, 임상 검사, 초음파 검사 및 심초음파 검사에서 유의한 차이를 보이지 않았다. 모든 환아에서 DMSA renal SPECT는 정상 소견을 보였다. 결론: 본 연구에서 가와사키 질환의 신장 침범은 경한 소변 검사 이상 및 일부 환아에서의 요중 ${\beta}2$-MG의 상승 소견을 보였으며, DMSA renal SPECT에서 관찰될 정도의 신장 침범은 보이지 않았다.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.117-120
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• 2023

Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.408-413
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• 2010

목 적 : 소아에서 급성 신우신염 진단시 computed tomography(CT)와 비교하여 $^{99mTc}DMSA$ scintigraphy (DMSA)의 상대적 제한점이 있음을 확인하고자 하였다. 방 법 : 64채널 CT가 도입된 2006년 9월 이후 3년 동안 급성복증이나 발열성 급성병증으로 복부 CT검사를 받은 환아 중 급성 신우신염의 소견을 보였으나 후속으로 시행된 DMSA에서는 이상소견을 발견되지 않은 'DMSA 위음성 환자' 10명을 연구대상으로 선정하여 이들의 임상상과 CT 소견을 분석하였다. CT촬영에는 필립스사의 브릴리언스-64 모델을, DMSA 스캔에는 Siemens사의 Orbiter 75 기종을 사용하였다. 결 과 : 총 10명 중 남자가 8명, 영유아가 8명이었으며 내원당시 평균 1.1일간 발열이 있었고 말초혈액 백혈구 수, 적혈구침강 속도, C-반응단백 등의 급성반응표지가 증가된 상태였다. DMSA 정상 소견을 보였던 10명에서 CT 신장환부 소견은 국소적인 경우가 6례, 미만성인 경우가 4례였다. 대개 일측성이었으며 양측 신장 모두 침범된 경우는 2례였다. DMSA에서 확인되지 않은 CT상 병변 개수는 총 22개 확인되었다. DMSA 비교신기능 측정법은 신손상 정도를 가늠하는데 도움이 되지 않았다. 결 론 : 본 연구를 통하여 DMSA검사는 CT검사상 양성인 급성 신우신염의 신장환부를 밝혀내지 못하는 제한점이 있음이 확인되었다. DMSA 위음성 결과는 주로 질병초기에 영아 환자에서 흔히 발생하는 것으로 보이나, 그 정확한 이유와 발생 비율 등을 밝히기 위해서는 전향적인 추가조사가 필요하다.