• Title/Summary/Keyword: Ultrasound Diagnosis

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Pulmonary artery sarcoma manifesting as a main pulmonary artery stenosis diagnosed by 18F-FDG PET/CT (18F-FDG PET/CT를 통해 진단된 주폐동맥 협착 소견의 폐동맥 육종)

  • Lee, Hoonhee;Park, Han-bit;Cho, Yun Kyung;Ahn, Jung-Min;Lee, Sang Min;Lee, Jae Seung;Kim, Dae-Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.279-284
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    • 2017
  • Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

Extraction of Transverse Abdominis Muscle form Ultrasonographic Images (초음파 영상에서 복횡근 근육 추출)

  • Kim, Kwang-Baek
    • Journal of the Korean Institute of Intelligent Systems
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    • v.22 no.3
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    • pp.341-346
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    • 2012
  • In rehabilitation where ultrasonographic diagnosis is not popular, it could be subjective by medical expert's experience. Thus, it is necessary to develop an objective automative procedure in ultrasonic image analysis. A disadvantage of existing automative analytic procedure in musculoskeletal system is to designate an incorrect muscle area when the figure of fascia is vague. In this study, we propose a new procedure to extract more accurate muscle area in abdomen ultrasonic image for that purpose. After removing unnecessary noise from input image, we apply End-in Search algorithm to enhance the contrast between fascia and muscle area. Then after extracting initial muscle area by Up-Down search, we trace the fascia area with a mask based on morphological and directional information. By this tracing of mask movements, we can emphasize the fascia area to extract more accurate muscle area in result. This new procedure is proven to be more effective than existing methods in experiment using convex ultrasound images that are used in real world rehabilitation diagnosis.

Clinical application of chromosomal microarray for pathogenic genomic imbalance in fetuses with increased nuchal translucency but normal karyotype

  • Lee, Dongsook;Go, Sanghee;Na, Sohyun;Park, Surim;Ma, Jinyoung;Hwang, Doyeong
    • Journal of Genetic Medicine
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    • v.17 no.1
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    • pp.21-26
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    • 2020
  • Purpose: To evaluate the additive value of prenatal chromosomal microarray analysis (CMA) in assessing increased nuchal translucency (NT) (≥3.5 mm) with normal karyotype and the possibility of detecting clinically significant genomic imbalance, based on specific indications. Materials and Methods: Invasive samples from 494 pregnancies with NT ≥3.5 mm, obtained from the Research Center of Fertility & Genetics of Hamchoon Women's Clinic between January 2019 and February 2020, were included in this study and CMA was performed in addition to a standard karyotype. Results: In total, 494 cases were subjected to both karyotype and CMA analyses. Among these, 199 cases of aneuploidy were excluded. CMA was performed on the remaining 295 cases (59.7%), which showed normal (231/295, 78.3%) or non-significant copy number variation (CNV), such as benign CNV or variants of uncertain clinical significance likely benign (53/295, 18.0%). Clinically significant CNVs were detected in 11 cases (11/295, 3.7%). Conclusion: Prenatal CMA resulted in a 3% to 4% higher CNV diagnosis rate in fetuses exhibiting increased NT (≥3.5 mm) without other ultrasound detected anomalies and normal karyotype. Therefore, we suggest using high resolution, non- targeting CMA to provide valuable additional information for prenatal diagnosis. Further, we recommend that a genetics specialist should be consulted to interpret the information appropriately and provide counseling and follow-up services after prenatal CMA.

A Non-Invasive Ultrasonic Urinary Bladder Internal Pressure Monitoring Technique: Its Theoretical Foundation and Feasibility Test (비침습적 초음파 방광 내압 측정 기술: 이론적 기초 및 실현 가능성 평가)

  • Choi, Min Joo;Kang, Gwan Suk;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.526-539
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    • 2012
  • A new approach was proposed in this article, named, a non-invasive ultrasonic method to monitor the urinary bladder internal pressure which can resolve the shortcomings of the existing methods. The proposed method makes use of acoustic cavitation. It is based on a physical phenomenon that an extracorporeal high intensity focused ultrasonic pulse generates bubbles inside the urinary bladder and the dynamic properties of the bubbles are related to the urinary bladder internal pressure. The article presents the theoretical foundation for the proposed technique and verifies its feasibility with preliminary experimental data. The suggested ultrasonic urinary bladder internal pressure monitoring method is non-invasive and can be used any time regardless of sex and age, so that it will be of a great benefit to the diagnosis and therapy of urination related diseases.

Gastric Follicular Lymphomas Presenting as Subepithelial Tumors: Two Cases (위 상피하 종양으로 발견된 소포림프종 2예)

  • Kim, Hyeong Jin;Choi, Cheol Woong;Park, Su Bum;Kim, Su Jin
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.258-263
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    • 2018
  • Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the "watch and wait" strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.

Comparative evaluation of ultrasonography with clinical respiratory score in diagnosis and prognosis of respiratory diseases in weaned dairy buffalo and cattle calves

  • Hussein, Hussein Awad;Binici, Cagri;Staufenbiel, Rudolf
    • Journal of Animal Science and Technology
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    • v.60 no.12
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    • pp.29.1-29.11
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    • 2018
  • Background: Respiratory troubles have economic impacts in countries where livestock industry is an important segment of the agricultural sector, as well as these problems may cause significant economic losses for bovine producers. Various practical methods are used to assess diseases that affect the bovine respiratory system. Ultrasonography is a noninvasive tool that has been used frequently in diagnosis of various animal diseases. The present study was designed to establish whether thoracic ultrasonography is a diagnostic tool for detection of respiratory troubles in weaned buffalo and cattle calves, as well as to assess its prognostic value in comparison with clinical respiratory scores. Thirty five (15 buffalo and 20 cattle) calves were included. Twelve (6 buffalo and 6 cattle) clinically healthy calves were enrolled as controls. Results: Based on physical examinations, clinical respiratory scores (CRS), ultrasound lung scores (ULS) and postmortem findings, animals were classified into 4 groups as pulmonary emphysema (n = 8), interstitial pulmonary syndrome (n = 7), bronchopneumonia (n = 12), and pleurisy (n = 8). The mean values of CRS and ULS were significantly higher in diseased calves (P < 0.01). In calves with pulmonary emphysema and interstitial syndrome, thoracic ultrasonography revealed numerous comet-tail artifacts, which varied in numbers and imaging features. Furthermore, variable degrees of pulmonary consolidation with alveolograms and bronchograms were noticed in bronchopneumonic calves. In addition, thick irregular or fragmented pleura with pleural effusions and fibrin shreds were imaged in calves with pleurisy. A weak correlation was calculated between CRS and ULS (r = 0.55, P < 0.01). Hematologically, the counts of white blood cells, activities of aspartate aminotransferase and partial tensions of carbon dioxide were significantly increased in all diseased groups. Serum concentrations of total globulins were higher in claves with bronchopneumonia (P < 0.05). The partial tension of oxygen was decreased in all diseased calves (P < 0.05). Conclusions: Thoracic ultrasonography is a diagnostic tool for various lung troubles and assessment the grade and severity of pulmonary diseases, as well as it can be used as a follow-up tool for evaluating the prognosis of respiratory troubles and monitoring the efficacy of therapies.

Pre-Coronavirus Disease 2019 Pediatric Acute Appendicitis: Risk Factors Model and Diagnosis Modality in a Developing Low-Income Country

  • Salim, Jonathan;Agustina, Flora;Maker, Julian Johozua Roberth
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.30-40
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    • 2022
  • Purpose: Pediatric acute appendicitis has a stable incidence rate in Western countries with an annual change of -0.36%. However, a sharp increase was observed in the Asian region. The Indonesian Health Department reveals appendicitis as the fourth most infectious disease, with more than 64,000 patients annually. Hence, there is an urgent need to identify and evaluate the risk factors and diagnostic modalities for accurate diagnosis and early treatment. This study also clarifies the usage of pediatric appendicitis score (PAS) for children <5 years of age. Methods: The current study employed a cross-sectional design with purposive sampling through demographic and PAS questionnaires with ultrasound sonography (USG) results. The analysis was performed using the chi-square and Mann-Whitney tests and logistic regression. Results: This study included 21 qualified patients with an average age of 6.76±4.679 years, weighing 21.72±10.437 kg, and who had been hospitalized for 4.24±1.513 days in Siloam Teaching Hospital. Compared to the surgical gold standard, PAS and USG have moderate sensitivity and specificity. Bodyweight and stay duration were significant for appendicitis (p<0.05); however, all were confounders in the multivariate regression analysis. Incidentally, a risk prediction model was generated with an area under the curve of 72.73%, sensitivity of 100.0%, specificity of 54.5%, and a cut-off value of 151. Conclusion: PAS outperforms USG in the sensitivity of diagnosing appendicitis, whereas USG outperforms PAS in terms of specificity. This study demonstrates the use of PAS in children under 5 years old. Meanwhile, no risk factors were significant in multivariate pediatric acute appendicitis risk factors.

Hypoadrenocorticism in a 1-Year-Old Korean Shorthair Cat

  • Jung, Hansol;Jeong, Yunho;Kim, Yoonhwan;Choi, Sooyoung;Park, Inchul;Ahn, Jin-Ok
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.144-148
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    • 2022
  • A one-year-old spayed female Korean Shorthair cat presented to Kangwon National University Veterinary Hospital with vomiting, weight loss, lethargy, loss of appetite, and polyuria that lasted for more than two weeks. The body condition score, blood pressure, heart rate, and body temperature were abnormally low, and the physical examination findings were consistent with moderate dehydration. Hematological and biochemical tests demonstrated mild azotemia and a low Na:K ratio. Additional abdominal ultrasound imaging revealed reduced size of both adrenal glands. The adrenocorticotropic hormone (ACTH) stimulation test showed decreased post-ACTH cortisol and aldosterone levels and increased endogenous ACTH levels, confirming a diagnosis of primary hypoadrenocorticism. The cat was treated with subcutaneous injections of desoxycorticosterone pivalate (DOCP) and oral prednisolone supplementation, and subsequent electrolyte analysis showed a normal Na:K ratio. Clinical symptoms were also improved in response to treatment. Hypoadrenocorticism in cats is a very rare disease, but it should not be excluded as a potential diagnosis in favor of kidney diseases or other conditions, especially when the Na:K ratio is low. In addition, the prognosis for the disease and the response to DOCP treatment should be further evaluated in cats.

Gastrointestinal Emergencies in Neonates: What We Should Know (신생아 위장관 응급 질환: 알아야 할 영상의학적 소견)

  • Hyun-Hae Cho;So Mi Lee;Sun Kyoung You
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.770-793
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    • 2020
  • Newborn gastrointestinal tract emergency diseases include various disorders that occur anywhere along the digestive tract. Most of them are congenital malformations, not acquired diseases. Many of them cannot be confirmed on prenatal examination, and consequently, postnatal evaluation is required. Unlike adults, in newborn babies, detailed evaluations with computed tomography (CT) and magnetic resonance imaging (MRI) are often limited, so making the diagnosis based on early abdominal radiography is most important. Therefore, it is necessary to be familiar with the radiologic findings that may be seen on imaging studies. In addition, it is important to understand abdominal ultrasound and fluoroscopy findings, which can be used in addition to simple radiography and indications that can be used for further diagnosis and appropriate treatment. Therefore, this study describes and organizes the various imaging findings that may occur in neonatal gastrointestinal emergencies.

Clinical Application of the 2021 Korean Thyroid Imaging Reporting and Data System (K-TIRADS) (2021 한국 갑상선영상 판독과 자료체계의 임상적용)

  • Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.92-109
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    • 2023
  • In patients with thyroid nodules, ultrasonography (US) has been established as a primary diagnostic imaging method and is essential for treatment decision. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is a pattern-based, US malignancy risk stratification system that can easily diagnose nodules during real-time ultrasound examinations. The 2021 K-TIRADS clarified the US criteria for nodule classification and revised the size thresholds for nodule biopsy, thereby reducing unnecessary biopsies for benign nodules while maintaining the appropriate sensitivity to detect malignant tumors in patients without feature of high risk thyroid cancer. Thyroid radiology practice has an important clinical role in the diagnosis and non-surgical treatment of patients with thyroid nodules, and should be performed according to standard practice guidelines for proper and effective clinical care.