• Title/Summary/Keyword: Space occupying lesions

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A Clinical Study on the Value of a Scoring System of the Scanning Images in Liver Cirrhosis (간경변증(肝硬變症)의 간주사상판독(肝走査像判讀)에 있어서의 평점제적용(評點制適用)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Chang, Ko-Chang
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.41-53
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    • 1970
  • Although the radioisotope liver scan has primarily been of use in the detection of the intra-hepatic space occupying lesions, there has been an increasing awareness of its use in evaluation of liver function. In this study, the degree of hepatomegaly, changes in shape and mottling radiodensity on each lobe and splenic visualization in the liver scans done with colloidal radiogold were numerically expressed as scores under the arbitrary standard in 210 patients with liver cirrhosis. The clinical value of this scoring system was studied with special regards to the correlation between the radiogold hepatic uptake half time and conventional liver function tests. Following were the results; 1) The normal scan appeared in 6.7% of 210 patients with liver cirrhosis. 2) The colloidal radiogold hepatic uptake half time was abnormally and progressively prolonged in parallel to severity of hepatocellular dysfunction. The mean hepatic uptake half time in cirrhosis showing normal scan was $2.76{\pm}0.73$ minutes. 3) The scoring system was well correlated with the serum albumin and globulin levels, A/G ratio and BSP retention. There was some correlative tendency in alkaline phosphatase activity. 4) There was no correlation with the thymol turbidity test, cholesterol levels, transaminase activities and bilirubin levels. 5) The spleen was visualized in 38.6% of total patients with liver cirrhosis. Excluding normal scans in liver cirrhosis, the spleen was visualized in 41.3%. 6) The scoring system appears to confirm the clinical diagnosis and to give a reliable estimate of the degree of hepatocellular dysfunction in patients with liver cirrhosis.

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Treatment of Suprascapular Cyst by Ultrasound Guided Aspiration - A Case Report - (초음파 유도 흡인을 이용한 견갑 상 낭종의 치료 - 증례보고 -)

  • Lee, Hyo-Jin;Kim, Yang-Soo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.41-45
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    • 2012
  • Among the various reasons that can cause entrapment of suprascapular nerve, suprascapular cyst is not commonly found and more often, overlooked or misdiagnosed. Authors experienced one case of suprascapular cyst causing suprascapular nerve entrapment confirmed by ultrasonography and MRI. Symptom of the patient was confined to infrascapular nerve. Percutaneous aspiration of cyst was done under the guidance of ultrasonography through Neviaser portal on out-patient department. After 8 weeks of follow-up, no recurrent lesion was found and objective functional improvement was identified. When clinicians confront with the symptoms compatible with suprascapular nerve entrapment, every effort should be put on finding lesion under ultrasonography before attempting any further cost-ineffective or time-wasting evaluation. Symptoms caused by space-occupying cyst will be soothed by simple decompression. However, always be aware of concomitant lesions that might be the reason for the cystic lesion and in some cases, further evaluation is inevitable.

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Profiles of Spinal Cord Tumors Removed through a Unilateral Hemilaminectomy

  • Yeo, Dong-Kyu;Im, Soo-Bin;Park, Kwan-Woong;Shin, Dong-Seong;Kim, Bum-Tae;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.195-200
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    • 2011
  • Objective : To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods : From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results : The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion : Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

Significance of Diffuse Lung Uptake of $^{99m}Tc-Tin$ Colloid in Liver Scanning (간스캔상 $^{99m}Tc-Tin$ Colloid의 미만성 폐섭취의 의의)

  • Sohn, In;Kwon, In-Soon;Park, Jung-Sik;Lee, Myung-Chul;Cho, Bo-Yeon;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.1
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    • pp.33-39
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    • 1983
  • Sixty-nine patients with diffuse lung uptake of $^{99m}Tc-tin$ colloid were evaluated to determine the kinds of associated diseases, the incidence of associated liver scan abnormalities, and prognosis. The results were as follows: 1) Diseases associated with diffuse lung uptake included malignancies in 31 patients, infectious diseases in 19, chronic liver diseases in 14, and others in 5. It appeared that the marked degree of lung uptake was associated with severe diseases. 2) Thirty-one of the 69 patients(45%) had abnormal liver size, 43(62%) had space occupying lesions or nonhomogeneity in liver image, 37(54%) had splenomegaly and 45(65%) had increased splenic uptake. Increased bone marrow uptake was found in 48(70%) and renal uptake in 15(22%). As the degree of lung uptake increased, there was a statistically significant (p<0.05) tendency for the incidences of the abnormal liver image and renal uptake to increase. 3) Sixty-two of the 69 patients were followed up for one to 439 days(mean 44 days) after liver scanning. Eleven(18%) were dead, 10(16%) were aggravated, and 13(21%) were improved. Most of improved patients had infectious diseases. It appeared that diffuse lung uptake of $^{99m}Tc-Tn$ colloid was found in the various diseases including malignancies, infections, and chronic liver diseases, and that it was strongly associated with other liver scan abnormalities, but was not necessarily associated with a poor prognosis, particularly when underlying diseases were infections.

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A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst

  • Yoo, Minwook;Lee, Chang-Hyun;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.226-229
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    • 2014
  • We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases.

Quantitation of Hepatic and Extrahepatic $^{99m}Tc-Tin$ Colloid Uptake in the Hepatocellular Diseases (간세포성 질환에서의 간 및 간외 $^{99m}Tc-Tin$ Colloid 섭취의 정량분석)

  • Park, Young-Ha;Kim, Choon-Yul;Kim, Sung-Hoon;Park, Seog-Hee;Park, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.9-16
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    • 1987
  • It is well-known that hepatic scintigraphv have been found to be less sensitive and specific in the detection of the diffuse hepatocellular diseases than that of the space-occupying lesions. To obtain the higher diagnostic specificity and sensitivity, we, using the computer quantitation, have attempted to analyze hepatic and extrahepatic $^{99m}Tc-tin$ colloid uptake patterns in various diffuse hepatocellular diseases retrospectively. The studied groups consisted of 116 cases of normal, 67 cases of acute hepatitis, 112 cases of chronic hepatitis, 61 cases of liver cirrhosis, 47 cases of fatty liver, 12 cases of hepatoma and 9 cases of metastasis, making total 424 cases. Scintigraphic imagings were obtained in the anterior, right lateral and posterior projections using high-resolution collimation, and simultaneously these gamma data were acquisited into the computer system. Both large region of interest (ROI) using light pen and ROI computer program were placed over right lobe, left lobe of liver, spleen and cardiac blood pool. Total counts in ROI were divided by the number of pixels in the ROI, and mean count rate per pixels calculated. Mean right-lobe counts were divded by mean-left lobe counts to determine right-to-left hepatic lobe ratio and mean spleen counts were divided by mean liver counts to determine spleen to liver ratio. The results were as follows. 1) Of 424 cases, 292 were male and 132 were female. The majority of age distribution was in $30\sim49$ (54.5%). 2) Inter-observer between two independant operators and inter-method between drawing by light-pen and ROI computer program variations were not significant. 3) The uptake count values (per pixel) determined at each area in normal group were $106.53{\pm}18.35$ in right lobe, $79.00{\pm}13.82$ in left lobe, $17.52{\pm}8.31$ in spleen and $8.09{\pm}3.43$ in cardiac blood pool. 4) In liver cirrhosis, right lobe uptake was decreased but spleen and cardiac blood pool uptakes were increased (p<0.01). 5) Right-to-left hepatic lobe uptake ratio was $1.37{\pm}0.24$ in normal group and significantly low in chronic hepatitis, liver cirrhosis and fatty liver, and more or less low in acute hepatitis. 6) Spleen-to-right hepatic lobe uptake ratio was $0.17{\pm}0.09$ in normal group and high in chronic hepatitis and liver cirrhosis. 7) The computer-quantitation of hepatic and extrahepatic uptake patterns thought to be sensitive and useful method in the interpretation of liver scintigram.

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