• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.528-533
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• 2012

Objective : In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. Methods : One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. Results : Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was $50{\pm}45$ months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. Conclusion : In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.987-994
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• 2019

Low energy x-rays that occur in the low tube voltage radiography of general radiography are absorbed strongly in the body and do not aid image quality enhancement. This study maintains titer in general radiography while using tube current that are proportional to density and the tube voltage 15% principle according to density to reduce patient exposure doses, and area doses and entrance surface doses were measured to compare patient exposure doses. In hand, knee, abdomen, and skull radiography, kVp was increased to 115% and mAs was decreased to 50% and kVp was decreased to 85% while mAs was increased to 200% and area doses and entrance surface doses were measured to compare relative doses. Also, 5 places in each image were set, density was measured, and Kruskal wallis H test was conducted to observe significance probabilities between groups. To fix density, kVp was increased to 115% and mAs was decreased to 50% and after measurements of mean area doses and entrance surface doses were made by each part, each decreased to 58.68% and 59.85% when standard doses were set to 100%, and each increased to 147.28% and 159.9% when kVp was decreased to 85% and mAs was increased to 200%. Comparisons of density changes showed that hand, knee, abdomen, and skull radiography all displayed significance probabilities>0.05, showing no changes in concentration. Radiography that increases kVp and lowers mAs through reasonable calculations within ranges that don't affect resolution and contrast seems to be a simple way to decrease patient exposure doses.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.181-185
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• 2019

Intraosseous hemangioma is a rare, slow-growing, benign tumor of blood vessels. Primary hemangioma of the skull is a benign lesion that may appear as a palpable mass or accidentally detected during image evaluation. Simple radiography is the most commonly used technique to localize a lesion and computed tomography (CT) may help determine the effect of a lesion. We report a case of multifocal intraosseous calvarial hemangioma developed in the subgaleal plane of an elderly male patient. Ultrasonography examination revealed hyperechoic striated septae parallel to the skin and discontinuity of the focal cortex, however, the underlying bone cortex appeared relatively intact. No significant flow is observed on Doppler ultrasonography. Based on these evaluations, the mass was interpreted by a radiologist as a subgaleal lipoma. This case highlights the importance of additional CT examination in a patient presenting with a scalloping sign of the underlying calvarium. Clinicians also should be aware of the possibility of intraosseous calvarial hemangiomas in lesion. Furthermore, the proper choice of congenital vascular malformation term is still quite confusing with misconception present in the literature.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.249-251
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• 2013

Pneumocephalus is a condition characterized by the presence of air in the cranium, and it is mainly caused by trauma or a neurosurgical procedure. In the absence of head trauma or a neurosurgical procedure, meningitis is an extremely rare cause of pneumocephalus. Here, the authors present a rare case of spontaneous pneumocephalus caused by pneumococcal meningitis, in which simple lateral radiography and computed tomography (CT) findings of the skull suggested the diagnosis. Cerebrospinal fluid analysis showed bacterial meningitis which later revealed streptococcus pneumonia. The patient was treated with antibiotics and responded remarkably well. Repeat CT performed after 2 weeks of treatment showed complete resolution of the intracranial gas. Here, the authors report an unusual case of a pneumocephalus caused by meningitis in the absence of head trauma or a neurosurgical procedure.

• Imaging Science in Dentistry
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• v.46 no.1
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• pp.63-68
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• 2016

Panoramic radiographs are a relatively simple technique that is commonly used in all dental specialties. In panoramic radiographs, in addition to the formation of real images of metal objects, ghost images may also form, and these ghost images can hinder an accurate diagnosis and interfere with the accuracy of radiology reports. Dentists must understand the formation of these images in order to avoid making incorrect radiographic diagnoses. Therefore, the present study sought to present a study of the formation of panoramic radiograph ghost images caused by metal objects in the head and neck region of a dry skull, as well as to report a clinical case in order to warn dentists about ghost images and to raise awareness thereof. An understanding of the principles of the formation of ghost images in panoramic radiographs helps prevent incorrect diagnoses.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.22-29
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• 2000

Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.