• Journal of Chest Surgery
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• v.28 no.5
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• pp.521-524
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• 1995

Esophageal leiomyoma is a very rare disease. We present a patient who underwent enucleation of esophageal leiomyoma through a left thoracotomy. The patient was suffered from substernal pain and chest discomfort for 4 months.The esophagogram revealed irregular ovoid smooth filling defect in just proximal portion of G-E junction with the normal mucosal folds. Chest CT demonstrated well-defined, polypoid tumor mass on the anterolateral wall of the distal esophagus. Esophagoscopy revealed normal intact mucosal patterns with swollen hard protruded tumor mass lesion from the just proximal portion of G-E junction. In June, 1993, patient underwent enucleation of esophageal leiomyoma through the left thoracotomy. A horseshoe and spiral shaped, whitish firm tumor mass was noted on the distal esophagus, and the tumor mass was enucleated by blunt dissection carefully. The esophageal leiomyoma was confirmed with histopathological examination. The postoperative course was smooth and uneventful.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.05a
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• pp.143-143
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• 2006

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.116-121
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• 1999

Unilateral hypoplasia of the pulmonary artery is an uncommon anomaly, which commonly develops in combination with congenital cardiovascular defects such as tetralogy of Fallot, patent ductus arteriosus and septal defect of atrium or ventricle, but may also present as an isolated lesion. We have recently experienced a case of the left pulmonary artery hypoplasia in adult by chance of during the general health screen, which diagnosed by chest X-ray, chest spiral CT, lung perfusion and ventilation scan, digital substraction angiogram and bronchoscopy, then presented hereby with the review of relevant literature.

• Tuberculosis and Respiratory Diseases
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• v.56 no.4
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• pp.343-347
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• 2004

Congenital bronchial atresia is a rare anomaly, which results from a congenital focal obliteration of a proximal segmental or subsegmental bronchus, with normal development of the distal structures. The short atretic segment leads to the accumulation of mucus within the distal bronchi, forming a bronchocele and air trapping of the alveoli supplied by these bronchi. The diagnostic CT features include the presence of a branching opacity and the bronchocele, which radiate from the hilum and are surrounded by an area of hyperlucency.

• Journal of Gastric Cancer
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• v.6 no.4
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• pp.263-269
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• 2006

Purpose: The aim of this study was to investigate the causes of under-staging in patients with advanced gastric cancer that was proven to be unresectable after a laparotomy. Materials and Methods: We retrospectively analyzed 25 gastric cancer patients who had undergone a diagnostic laparotomy between 2001 and 2005. For the preoperative evaluation, spiral CT and multidetector-row CT were performed. We analyzed the clinicopathologic features of patients and compared the image findings and the results of surgery. The causes of under-staging were divided into 3 groups; patient factor, CT factor, and interpretation factor. Results: Grossly, there were 12 cases of Borrmann type-III tumors and 13 cases of Borrmann type-IV tumors. The most frequent histologic type was poorly differentiated adenocarcinomas (8 cases) and signet ring cell carcinomas (7 cases). There were 13 cases of adjacent organ invasion, and the pancreas was the most frequently invaded organ (9 cases). There were 17 cases of peritoneal metastasis, and 3 cases of distant lymph node metastasis. For the cause of under-staging, there were four cases of patient factor, 19 cases of interpretation factor, and 9 cases of CT factor. In three cases, the cause of under-staging could not be identified. Conclusion: CT interpretation factor was the most frequent cause of under-staging in the preoperative diagnosis with gastric cancer patients. Therefore, more cautious CT interpretation is necessary to avoid unnecessary laparotomies in gastric cancer patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.30.1-30.7
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• 2015

Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.900-910
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• 2023

Purpose To assess normal CT scans with quantitative CT (QCT) analysis based on smoking habits and chronic obstructive pulmonary disease (COPD). Materials and Methods From January 2013 to December 2014, 90 male patients with normal chest CT and quantification analysis results were enrolled in our study [non-COPD never-smokers (n = 38) and smokers (n = 45), COPD smokers (n = 7)]. In addition, an age-matched cohort study was performed for seven smokers with COPD. The square root of the wall area of a hypothetical bronchus of internal perimeter 10 mm (Pi10), skewness, kurtosis, mean lung attenuation (MLA), and percentage of low attenuation area (%LAA) were evaluated. Results Among patients without COPD, the Pi10 of smokers (4.176 ± 0.282) was about 0.1 mm thicker than that of never-smokers (4.070 ± 0.191, p = 0.047), and skewness and kurtosis of smokers (2.628 ± 0.484 and 6.448 ± 3.427) were lower than never-smokers (2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.02). The Pi10 of COPD smokers (4.429 ± 0.435, n = 7) was about 0.4 mm thicker than never-smokers without COPD (3.996 ± 0.115, n = 14, p = 0.005). There were no significant differences in MLA and %LAA between groups (p > 0.05). Conclusion Even on normal CT scans, QCT showed that the airway walls of smokers are thicker than never-smokers regardless of COPD and it preceded lung parenchymal changes.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.53-59
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• 1999

The aim of this study is to improve the accuracy of field placement and junction between adjacent fields and block shielding through the use of a computed tomography(CT) simulator and virtual simulation. The information was acquired by assessment of Alderson Rando phantom image using CT simulator (I.Q. Xtra - Picker), determination of each field by virtual fluoroscopy of voxel IQ workstation AcQsim and colored critical structures that were obtained by contouring in virtual simulation. And also using a coronal, sagittal and axial view can determine the field and adjacent field gap correctly without calculation during the procedure. With the treatment planning by using the Helax TMS 4.0, the dose in the junction among the adjacent fields and the spinal cord and cribriform plate of the critical structure was evaluated by the dose volume histogram. The pilot image of coronal and sagittal view took about 2minutes and 26minutes to get 100 images. Image translation to the virtual simulation workstation took about 6minutes. Contouring a critical structure such as cribriform plate, spinal cord using a virtual fluoroscopy were eligible to determine a correct field and shielding. The process took about 20 minutes. As the result of the Helax planning, the dose distribution in adjacent field junction was ideal, and the dose level shows almost 100 percentage in the dose volume histogram of the spinal cord and cribriform plate CT simulation can get a correct therapy area due to enhancement of critical structures such as spinal cord and cribriform plate. In addition, using a Spiral CT scanner can be saved a lot of time to plan a simulation therefore this function can reduce difficulties to keep the patient position without any movements to the patient, physician and radiotherapy technician.

• The Journal of the Korea Contents Association
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• v.13 no.4
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• pp.290-299
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• 2013

This study included 198 patients who underwent prospectively electrocardiogram-triggered high-pitch spiral mode(FLASH mode) in cardiac CT for health check: 123 patients who underwent manual exposure control(Group A) and 75 patients who underwent automatic exposure control(Group B). Patients were classified according to BMI grades: Grade 1, Grade 2, Grade 3, Grade 4. Radiation dose, objective and subjective image quality between two groups were compared. In Group B, tube voltage were significantly decreased in all BMI grades. Both $CTDI_{vol}$ and effective dose were significantly reduced in the BMI Grade 1, 3, and 4 whereas they were slightly reduced in the Grade 2(p>0.05), SNR was significantly decreased in the Grade 1 and increased in the Grade 3(p<0.05), but there was no significant difference in the Grade 2, 4 between the two groups(p>0.05). CNR was significantly decreased in the Grade 1(p<0.05), and there was no significant difference in the Grade 2, 3, 4 between the two groups(p>0.05). The subjective image quality showed no significant difference in all BMI Grades between the two groups(p>0.05). Automatic exposure control can lead to a significant reduction of radiation exposure dose without degradation of subjective image quality.

• Journal of the Korean Society of Radiology
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• v.7 no.4
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• pp.307-311
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• 2013

This study examined the change of artifact volume by analyzing the level of image change associated with the setting of threshold through 3D imaging in scan parameter(slice thickness and helical pitch) and 3D image reconstruction to explore whether the presence of pathology was fully distinguished when CT was taken by lower dose than the existent dose to reduce exposure. Furthermore, this study attempted to investigate Scan Parameter acceptable in CT to reduce exposure dose. For materials and methods, silicon was used to produce samples. Five spherical samples were produced at 10-millimeter intervals(50, 40, 30, 20, and 10 mm) in diameter and were fixed at 120 Kvp of tube voltage and 50 mA of tube current. Varied slab thickness((1.0, 2.0, 3.0, 5.0, and 7.0mm) and Helical Pitch(1.5, 2.0, 3.0) were scanned. The image at an interval of 1.0, 2.0, 3.0, 5.0, and 7.0mm was transmitted to the workstation. Threshold(-200, -50, 50 ~ 1,000) was changed using the volume rendering technique, 3D image was reconstructed, and artifact volume was measured. In conclusion, 1.5 of Helical Pitch showed the least change of volume and 3.0 of helical pitch showed the greatest reduction of volume change. The experiment suggested that as slice thickness was increased, artifact volume was decreased more than actual measurement. Furthermore, in the 3D image reconstruction, when the range of threshold was set as -200 ~1,000, artifact volume was changed the least. Based on the results, it is expected to have an effect of reducing exposure dose.