• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1057-1065
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• 2023

Non-invasive liver fibrosis diagnosis is crucial for patients with chronic liver diseases. Many patients cannot undergo liver tissue biopsy, so predicting the degree of liver fibrosis early through meaningful methods can reduce complications related to chronic liver diseases, such as liver cell carcinoma and cirrhosis. This study compared and analyzed the quantitative measurement of liver fibrosis using shear wave elastography in conjunction with liver ultrasound findings and their associations with serum biomarkers (p<0.05). The results showed that the shear wave elastography measurement in the normal group was 4.55 ± 0.69 kPa, while the abnormal contrast group with echogenic patterns had a measurement of 8.27 ± 1.83 kPa. The hepatitis B carrier group exhibited higher shear wave elastography measurements, and among serum biomarkers, AST, ALT, GGT, and PT showed statistically significant positive correlations with fibrosis severity according to SWE categories (p<0.05), while ALP and TB did not demonstrate statistically significant differences (p=0.163, p=0.567). Conversely, Albumin and PLT showed significant negative correlations (p<0.05). Clinically, utilizing shear wave elastography measurements through liver ultrasound in the tracking and repeat testing of liver fibrosis in chronic hepatitis B patients without cirrhosis can assist in achieving more objective diagnoses among healthcare providers.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.182-193
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• 2021

Purpose To identify the features that can be used for differentiating appendicitis from non-appendicitis in pediatric patients with equivocal ultrasound (US) results. Materials and Methods A total of 53 pediatric patients (≤ 18 years old) with equivocal results on US examination for suspected appendicitis between November 2012 and October 2017 were included. US evaluation was conducted based on information retrieved from a predefined structured report form. Then, the likelihood of appendicitis was prospectively classified into five categories. The equivocal results were considered as grade 3 (indeterminate) and grade 4 (probably appendicitis). Results Of the 53 patients, 25 (47.2%) and 28 (52.8%) were classified into grade 3 and 4 groups, respectively. Among the individual US findings, increased vascularity of the appendiceal wall and peri-appendiceal fat infiltration were independent findings associated with the diagnosis of appendicitis (p = 0.005, p = 0.045, respectively) in the multivariate logistic regression analysis and showed the highest diagnostic accuracy (69.8% and 62.3%, respectively). Conclusion Increased vascularity within the appendiceal wall and peri-appendiceal fat infiltration were significant predictors of appendicitis in patients with equivocal US findings.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7061-7064
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• 2014

Background: To assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of intraoperative gross examination (IGE) of uterine specimens in determining deep myometrial invasion and cervical invasion compared to final histology. Materials and Methods: The clinical, surgical and histological data of all FIGO stage I-II endometrial cancer (EC) patients who had primary surgery were reviewed. Results of the IGE for myometrial invasion and cervical invasion were compared to the final histology. The sensitivity, specificity, PPV, NPV, and accuracy of the IGE in determining deep myometrial invasion and cervical invasion were calculated. Association between clinico-pathological factors and discrepancy between IGE and final histology in the determination of myometrial invasion was also assessed. A p-value of <0.05 was considered significant. Results: From January 2007 to December 2012, 179 patients diagnosed with clinical stage I-II endometrial cancer underwent surgical staging. The sensitivity and specificity of IGE in detecting deep myometrial invasion were 42.4% and 90.0%, respectively, and the PPV and NPV were 67.6% and 76.1%. The overall accuracy of IGE was 74.3%. The sensitivity and specificity of IGE in identifying cervical invasion were 28.6% and 97.5%, respectively, while the PPV and NPV were 60.0% and 91.1%. The overall accuracy of IGE was 89.4%. Conclusions: The sensitivity of IGE for detecting deep myometrial invasion and cervical invasion in early-stage EC is too low to be used alone. Alternative methods including intraoperative frozen section analysis, preoperative three dimensional ultrasound, and preoperative magnetic resonance imaging should be strongly considered.

• Journal of Veterinary Clinics
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• v.35 no.4
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• pp.155-160
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• 2018

A 6-year-old intact female Shih-tzu dog was referred due to anorexia. Physical examination, complete blood count, serum chemical analysis, radiography, and ultrasonography were evaluated. Physical examination and hematological analysis showed normal findings. Abdominal radiographs and ultrasound revealed well-defined masses in the spleen. Other abdominal organs showed no significant abnormalities. Tissue samples taken via sono-guided fine needle aspiration of the splenic mass showed many bare nuclei, which were variable in size. Results of histopathological and immunohistochemical (IHC) analyses performed after splenectomy were consistent with paraganglioma. Based on these findings, we diagnosed this patient with a paraganglioma of splenic origin. Two months after splenectomy, abdominal ultrasonography revealed a new neoplastic lesion in the liver. The clients refused further management and the patient expired three months after initial diagnosis. Necropsy as well as histopathological and IHC examinations of other systemic organs including the liver, adrenal gland, kidney, brain, urinary bladder, lung, aortic body, carotid body, and pancreas were performed. The neoplastic tissue in the liver also demonstrated features of a paraganglioma, and there were no remarkable findings in all other organs.

• Korean Journal of Veterinary Research
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• v.47 no.1
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• pp.127-129
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• 2007

A 3-month-old male Maltese dog was presented with generalized trembling, ataxia, and seizure.The patient had traumatic injury on history takings. Physical examination revealed dome shaped craniumwith open fontanelle, nasal hemorrhage, and blepharoedema with hemorhage on the left side. On serumbiochemical profiles, creatine phosphokinase was severely elevated. There was no remarkable findingon radiography. Ultrasound images of brain were obtained via a persistence bregmatic fontanelle, andbilateraly dilated lateral ventricles with a hyperechoic mass on the left temporal lobe were detected.Based on clinical signs, history, physical examination, laboratory findings, and ultrasonographic findings,we suspected this intracranial mass to intracerebral hematoma induced by head trauma. Methylprednisoloneh after initial diagnosis. We performed necropsy and confirmed intracerebral hematoma. This case reportdescribes the identification of intracerebral hematoma using ultrasonography.

• Journal of Veterinary Clinics
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• v.37 no.2
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• pp.106-108
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• 2020

An eight-month-old, outdoor, intact male English Pointer dog weighing 23.5 kg presented to the hospital with signs of hematochezia, soft stools, and weight-loss. There were no remarkable findings on physical examination, complete blood count, serum biochemistry, electrolyte and gas analysis, and radiography. The serologic and Polymerase Chain Reaction (PCR) tests for canine parvovirus were negative. A fecal smear examination showed rod-shaped, sporeforming bacteria. Additionally, a fecal flotation test showed ova of Ancylostoma spp. The size of ova was 60 × 40 ㎛, and it was identified as Ancylostoma caninum using light microscopy. The PCR test indicated a Clostridial perfringens infection and the presence of C. perfringens alpha toxin. The diagnosis given was C. perfringens enterotoxicosis with ancylostomiasis. Treatment included antibiotics (metronidazole, trimethoprim-sulfamethoxazole) and anthelmintics (afoxolaner, milbemycin oxime). After two weeks, the clostridial infection resolved, but ancylostomiasis persisted for six weeks. The anthelmintic was changed to Drontal^â plus (praziquantel/pyrantel pamoate/febantel). After four weeks, there were no remarkable findings in the fecal samples, but the patient still presented with watery stools and hematochezia. Survey of abdominal ultrasound had performed, and a target-like sign with multiple rings was seen in the cecocolic region. The patient was diagnosed with A. caninum-induced cecocolic intussusception from the history and clinical signs. After a surgery, he recovered fully. This is the first clinical case report of Ancylostoma caninum parasitizing from the small intestine and causing an intussusception in the large intestine.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.29-32
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• 2022

Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.

• Journal of Veterinary Clinics
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• v.40 no.4
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• pp.308-313
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• 2023

A 1-year-old castrated male Korean Shorthair cat presented with dyspnea, anorexia, lethargy, and seizures. Physical examination revealed salivation, right forelimb hemiparesis, and rapid breathing. No abnormalities were detected on auscultation. Laboratory findings revealed increased levels of bilirubin, aspartate aminotransferase (AST), globulin, glucose, and a decreased albumin-to-globulin (A:G) ratio. Both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and feline serum amyloid A (fSAA) levels were significantly elevated. Thoracic radiography revealed mild cardiomegaly and diffuse increased interstitial infiltration with soft tissue opacity in the periphery of the right caudal pleural space. Echocardiography and lung ultrasonography were performed to investigate the cause of mild cardiomegaly and soft tissue opacity in the pleural space. Echocardiography revealed a mild amount of echogenic pericardial effusion, and lung ultrasonography showed an echogenic soft tissue mass with no blood signal in the right caudal pleural space, suggestive of a granulomatous lesion. After obtaining 5 mL of pericardial fluid through pericardiocentesis, cytology of the pericardial effusion sample revealed marked neutrophils and macrophages with no bacteria. IDEXX feline infectious peritonitis (FIP) virus real-time reverse transcriptase polymerase chain reaction (RT-PCR) confirmed the presence of the FIP virus biotype in the sample. This case presents a rarely reported atypical mixed form of FIP in a cat diagnosed ante-mortem using pericardial effusion analysis. In this case, ultrasound examination played a crucial role in the definitive diagnosis of FIP by PCR biotyping through pericardiocentesis. Ultrasonography can be highly beneficial in guiding the diagnosis and evaluation of cats with suspected FIP.

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.230-237
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• 2023

A 6-year-old intact male Cane Corso dog weighing 40 kg with a 2-month history of dysuria, dyschezia, anorexia, intermittent panting, and penile discharge presented to the Veterinary Medical Teaching Hospital of Jeju National University. Examination revealed a giant paraprostatic cyst (PPC) that occupied a large part of the abdomen and caused displacement of organs. Radiography, ultrasound, and computed tomography (CT) scans confirmed that the PPC had spread to the pelvic regions. Subtotal resection was performed, leaving two sites with PPC remnants. One site was the prostate gland, which communicated with, and adhered to, the PPC; the other site was the pelvic region, where the PPC had spread. The reason for leaving two remnants was that an anatomical approach for complete resection was difficult, and to avoid complications associated with prostatic urethra damage. Routine omentalization and castration were performed. Partial cystectomy was performed because of the presence of a diverticulum-like lesion in the ventral part of the urinary bladder. The patient's clinical symptoms, including dysuria, completely resolved, and voluntary urination was possible 1 day post-operatively. Histopathological examination revealed osseous metaplasia of the PPC. The patient was well-managed and had no post-operative complications or recurrence until day 180 of follow-up.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.275-279
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• 2023

Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.