• Title/Summary/Keyword: Thoracic radiograph

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Radiograph-based Diagnostic Methods for Thoracic and Lumbar Spine Malposition in Chuna Manual Therapy Using Biomarkers (단순 방사선 영상기반 바이오마커를 활용한 흉·요추의 추나의학적 변위 진단 방법)

  • Jin-Hyun Lee;Minho Choi;Joong Il Kim;Jun-Su Jang;Tae-Yong Park
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.18 no.2
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    • pp.1-8
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    • 2023
  • Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

Solitary Fibrous Tumor of the Diaphragmatic Pleura (횡격흉막에서 발생한 고립성 섬유성 종양)

  • Lee, Chul-Burm;Lim, Hyoun-Soo;Jee, Heng-Ok;Park, Choong-Ki;Park, Yong-Wook;Kim, Hyuck;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.568-572
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    • 2002
  • We present a case of a 47-year-old woman with benign solitary fibrous tumor of the pleura originated in the diaphragm which was discovered incidentally on a chest radiograph. Chest radiograph, sonograph, computed tomographic scan and magnetic resonance image studies proved a well circumscribed and lobulated fibrous tumor of the pleura. During the subsequent right thoracotomy, the tumor was found to be encapsulated and consisted of firm mass. It was connected to the diaphragm with $5{\times}4$cm area by pedicle. Most of the tumor was free of adhesion. It was excised completely together with attached diaphragm. The tumor measured $23.5{\times}13.5{\times}8.0$cm and the pathologic diagnosis was benign solitary fibrous tumor and the attached diaphragm was free of disease.

Surgical Removal of the Lung Lobe Metal Foreign Body in a Dog

  • Hwang, Yawon;Kang, Jihoun;Chang, Dongwoo;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.108-111
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    • 2017
  • A 4-year-old, weighing 7.6 kg, castrated male, Pug presented with ingestion of gastric cavity foreign body. Physical examination revealed panting, retching and hyper-salivation. Blood chemistry and complete blood cell count were normal, but hypophosphatemia was observed. An abdominal radiograph revealed the foreign body (FB), round shape and 2 cm length, at the pyloric region of stomach. A thoracic radiograph revealed an incidental metal FB, 3.5 cm length, at the cranial portion of the diaphragm. An upper gastrointestinal endoscopy was performed to remove the FB in the stomach and then a peach-pit was removed. However the metal FB was not found in the esophagus therefore a lateral thoracotomy was performed. A right lateral thoracotomy through the $7^{th}$ intercostal space was accomplished to expose the right caudal lung lobe. After open the thoracic cavity, foreign body was not observed by gross evaluation and caudal lung lobe was attached to the diaphragm. The FB was identified inside the lung lobe and surrounded by granulation tissue. The metal FB (sewing needle) was removed with blunt dissection and incised lung lobe was sutured using absorbable suture material PDS 4-0 with interrupted suture. A thoracotomy tube was inserted into the thoracic cavity during surgery. Patient's respiration became stable after surgery. A chest tube was removed 3 days after surgery. No complications were noted and the dog was discharged 4 days after surgery. In small animal, foreign body ingestion is a common reason for emergency. After ingestion of the FB, perforation through the esophagus and migration to inside the lung lobe is not common in small animals. In this case, thoracic metal FB was identified incidentally and removal of a thoracic FB with thoracotomy was performed successfully.

The Effect of a Chest CT Scan on the Treatment and Diagnosis of Major Blunt Chest Trauma (흉부 둔상환자에서 흉부전산화단층촬영이 진단과 치료에 미치는 영향)

  • Park, Il-Hwan;Oh, Joong-Hwan;Lee, Chong-Kook
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.226-232
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    • 2009
  • Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

Missed Traumatic Rupture of the Diaphragm

  • Ryu, Sang Woo;Chekar, Jaykey;Yi, In Ho;Seo, Bo Ra;Park, Seong Huek;Go, Seong Ju
    • Journal of Trauma and Injury
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    • v.30 no.1
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    • pp.16-20
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    • 2017
  • A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

Intracardiac Foreign Body: A Sewing Needle in Right Ventricle of Unknown Etiology (심장내 이물질: 선행 원인이 불분명한 환자에서 발견된 우심실내 봉합침)

  • Kim, Kyung-Hwan;Chang, Ji-Min;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.681-683
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    • 2000
  • A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.

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Correlation of Temporary Lateral Recumbency and Lung Opacity on Ventrodorsal Radiograph (일시적인 횡와 자세와 흉와위 영상에서 폐 불투과도의 상관관계)

  • Lee, Hyunjik;Jeong, Jiyoon;Choi, Wooshin;Lee, Donghoon;Lee, Youngjae;Chang, Jinhwa;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.313-318
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    • 2015
  • The lung opacity on radiography is influenced by various factors. The physical density of the lung and the attenuation ensured on computed tomography (CT) scans is determined by three components : lung tissue, blood, and air. Temporary right lateral recumbency may responsible for the increase of opacity on ventrodorsal projection view. Thus, our aim is to demonstrate that the effect of right lateral recumbency posture on right lung opacity using radiograph and CT scan. In this study, 62 dogs without clinical or radiologic signs of cardiopulmonary disease are selected. Thorax radiographs per 30 seconds for 2 minutes (30s, 60s, 90s, 120s) were performed for 62 dogs. After discussion of the radiographic findings of lung field by two radiologists and a student at Chungbuk national university veterinary medical center a consensus opinion was recorded. Computed tomography per a minute (1 min, 2 min) for 2 minutes were performed for 2 dogs. Mean x-ray attenuation of lung was measured quantitatively using software at two levels (aortic arch and basal level). Among 62 dogs with radiograph comparison, 9.3% of dogs showed influence by postural effect. However, all 2 dogs with computed tomography comparison, showed influence by postural effect. In conclusion, position dependent changes of lung density in CT exam are not consistent with thoracic radiograph.

Voice Change Due to Paratracheal Air Cysts

  • Rhee, Youn Ju;Han, Sung Joon;Chong, Yoo Young;Cho, Hyun Jin;Kang, Shin Kwang;Lee, Choong-Sik;Kang, Min-Woong
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.313-316
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    • 2016
  • Paratracheal air cysts are a rare entity in which cystic formation occurs adjacent to the trachea. Most patients with paratracheal air cysts are asymptomatic, and the cysts are detected incidentally on chest radiograph or computed tomography (CT) scan. Most symptomatic patients complain of pulmonary symptoms or repeated respiratory infection. Rarely, the air cysts can lead to paralysis of the recurrent laryngeal nerve as a result of direct compression. We report a case of a 59-year-old male patient who presented with voice change, and the cause was identified as paratracheal air cysts on a chest CT scan. Surgical resection via video-assisted mediastinoscopy was performed, and the voice recovered immediately after the operation.

A Sphaghetti Sign in the Abdominal Radiograph Consistent with Spleno-Systemic Shunts in a Cat

  • Oh, Donghyun;Hwang, Jaewoo;Yoon, Junghee;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.37 no.4
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    • pp.227-230
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    • 2020
  • A 8-year-old spayed female Korean short-haired cat was presented with respiratory distress. CBC, serum chemistry analysis, plain radiography, and abdominal ultrasonography were performed. Besides hypertrophic cardiomyopathy (HCM) suspected by the thoracic radiograph, a tubular, tortuous soft tissue structure was detected at the region of the left retroperitoneal cavity on the abdominal radiograph. On the abdominal ultrasonography, a shunt vessel is identified caudo-lateral to the left kidney region. These findings are consistent with spleno-systemic shunts in cats. Furthermore, portal hypertension and diffuse hepatic lesion were also identified. Although the cause of a shunt vessel is not easy to diagnose, it is important to include spleno-systemic shunt into differential diagnosis list, when convoluted, tubular soft tissue opacity is seen on the digital radiography (DR). This report will allow clinicians to raise awareness of complications of portosystemic shunt (PSS) and better treat PSS suspected feline patients when the advanced modalities such as computed tomography and magnetic resonance imaging are not available.

Clinical Implementation of Deep Learning in Thoracic Radiology: Potential Applications and Challenges

  • Eui Jin Hwang;Chang Min Park
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.511-525
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    • 2020
  • Chest X-ray radiography and computed tomography, the two mainstay modalities in thoracic radiology, are under active investigation with deep learning technology, which has shown promising performance in various tasks, including detection, classification, segmentation, and image synthesis, outperforming conventional methods and suggesting its potential for clinical implementation. However, the implementation of deep learning in daily clinical practice is in its infancy and facing several challenges, such as its limited ability to explain the output results, uncertain benefits regarding patient outcomes, and incomplete integration in daily workflow. In this review article, we will introduce the potential clinical applications of deep learning technology in thoracic radiology and discuss several challenges for its implementation in daily clinical practice.