• Journal of Trauma and Injury
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• v.29 no.4
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• pp.161-166
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• 2016

Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.

• Journal of Korean Neurosurgical Society
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• v.39 no.5
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• pp.355-359
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• 2006

Objective : The purpose of our study is to examine the clinical significance of vertebrobasilar artery[VBA] fenestration and duplication. In addition, we review its incidence and pathogenesis. Methods : Cerebral angiography was performed in 803 patients and magnetic resonance angiography[MRA] in 880; the patients had or were suspected to have cerebrovascular disease. We retrospectively reviewed angiography and MRA. Results : Fifteen patients [eight men, seven women, 3 to 77 years of age, median age = 58 years] had a VBA fenestration and duplication. Seven [7/803 = 0.87%] of the patients undergoing cerebral angiography revealed fenestrations and one duplication of VBA. Ten patients [10/880 = 114%] among 880 patients that underwent MRA demonstrated fenestration of basilar artery[BA]. Two of 66 patients that underwent both conventional cerebral angiography and cranial MRA showed a fenestration of BA. Twelve fenestrations were located in the proximal portion of the BA and one was in the mid portion of the BA. One vertebral artery[VA] fenestration was located in the intracranial portion of the right VA, and one VA duplication was at the level of $C_{1-2}$ in the left VA. Conclusion : In addition to medial defects, flow phenomena at the proximal end of fenestrations, where hemodynamic stress and increased turbulence are present, may contribute to aneurysm formation. And arterial fenestration is a predisposing factor in vascular injury and cerebral ischemia.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.74-78
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• 2006

Objective : We examined the incidence of fenestration in the proximal segment of the anterior cerebral artery[ACA] and reviewed its clinical significance. Methods : Cerebral angiography was performed in 843 patients and magnetic resonance angiography[MRA] in 1,787; all patients had, or were suspected to have, cerebrovascular disease. We subsequently reviewed the angiography and MRA data. Results : Fourteen patients [six men and eight women, $35{\sim}81$ years of age, median age = 67 years] had proximal ACA fenestrations. Three of the 843 patients [0.36%] undergoing cerebral angiography had fenestrations of proximal ACA as did eleven of the 1,787 MRA patients [0.62%]. Seven fenestrations were located on the right side and seven fenestrations were located on the left side. The fenestrated ACA in one patient was associated with a saccular aneurysm at its proximal end. None of the 120 patients who underwent both conventional cerebral angiography and cranial MRA showed fenestration of proximal ACA. Conclusion : Although fenestration of ACA has little clinical significance, knowledge and recognition of this condition is important in the interpretation of cerebral images, especially during neurosurgical procedures.

• Journal of radiological science and technology
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• v.45 no.4
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• pp.313-320
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• 2022

Both angiography and interventional procedures accompanied by angiography provide many diagnostic and therapeutic benefits to patients and are rapidly increasing. However, unlike general radiography or computed tomography using the same X-ray, the amount of radiation is quite high, but the dose range can vary considerably for each patient and operator. The high sensitivity of the lens to radiation during cerebral angiography and neurointervention is already well known, and although there are many related studies, it is insufficient to easily reduce radiation in diagnosis and treatment. In this situation, in particular, by adding three-dimensional rotational angiography (3D-RA) to the existing two-dimensional (2D) angiography, it is now possible to make an accurate diagnosis. However, since this 3D-RA acquires images through projection of more radiation than before, the exposure dose of the lens may be higher. Therefore, we tried to analyze whether the radiation dose of the lens can be reduced by moving the lens out of the field range by adjusting the table height and magnification ratio during the examination using 3D-RA. The surface dose was measured using a rando phantom and a radiophotoluminescent glass dosimeter (PLD) and the radiation dose was compared by adjusting the table height and magnification ratio based on the central point. As a result, it was found that the radiation dose of the lens decreased as the table height increased from the central point, that is, as the lens was out of the field of view. In conclusion, in 3D-RA, moving the table position of about 2 cm in height will make a significant contribution to the dose reduction of the lens, and it was confirmed that adjusting the magnification ratio can also reduce the surface dose of the lens.

• Journal of radiological science and technology
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• v.46 no.6
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• pp.509-517
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• 2023

This study analyzed imaging conditions and exposure index through clinical information collection and dose calculation programs in coronary angiography examinations. Through this, we aim to analyze the effective dose according to examination conditions and provide basic data for dose optimization. In this study, ALARA(As Low As Reasonably Achievable)-F(Fluoroscopy), a program for evaluating the radiation dose of patients and the collected clinical data, was used. First, analysis of imaging conditions and exposure index was performed based on the data of the dose report generated after coronary angiography. Second, after evaluating organ dose according to 9 imaging directions during coronary angiography, with the LAO fixed at 30°, dose evaluation was performed according to tube voltage, tube current, number of frames, focus-skin distance, and field size. Third, the effective dose for each organ was calculated according to the tissue weighting factors presented in ICRP(International Commission on Radiological Protection) recommendations. As a result, the average sum of air kerma during coronary angiography was evaluated as 234.0±112.1 mGy, the dose-area product was 25.9±13.0 Gy·cm², and the total fluoroscopy time was 2.5±2.0 min. Also, the organ dose tended to increase as the tube voltage, milliampere-second, number of frames, and irradiation range increased, whereas the organ dose decreased as the FSD increased. Therefore, medical radiation exposure to patients can be reduced by selecting the optimal tube voltage and field size during coronary angiography, maximizing the focal-skin distance, using the lowest tube current possible, and reducing the number of frames.

• Journal of Veterinary Science
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• v.24 no.5
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• pp.65.1-65.9
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• 2023

Background: Bone subtraction computed tomography angiography (BSCTA) is a useful alternative technique for improving visualization of vessels surrounded by skull bone. However, no studies have compared computed tomography angiography (CTA) and BSCTA for improving the visibility of canine cerebral blood vessels. Objectives: To evaluate the potential benefit of BSCTA for better delineation of brain arteries of the circle of Willis (CoW) in dogs by comparing BSCTA with non-subtraction computed tomography angiography (NSCTA). Methods: Brain CTA was performed for nine healthy beagle dogs using a bolus tracking method with saline flushing. A total dose of 600 mgI/kg of contrast agent with an iodine content of 370 mgI/mL was injected at a rate of 4 ml/s. Bone removal was achieved automatically by subtracting non-enhanced computed tomography (CT) data from contrast CT data. Five main intracranial arteries of the CoW were analyzed and graded on a scale of five for qualitative evaluation. Results: Scores of basilar artery, middle cerebral artery, and rostral cerebral artery in the BSCTA group were significantly higher than those in the NSCTA group (p = 0.001, p = 0.020, and p < 0.0001, respectively). Scores of rostral cerebellar artery (RcA) and caudal cerebral artery (CCA) did not differ significantly between the two groups. However, scores of RcA and CCA in the BSCTA group were higher than those in the NSCTA group. Conclusions: BSCTA improved visualization of intracranial arteries of the CoW with close contact to bone. Thus, it should be recommended as a routine scan method in dogs suspected of having brain vessel disease.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.669-680
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• 1999

Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

• Proceedings of the KSMRM Conference
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• 1998.03a
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• pp.77-98
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• 1998

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.10-20
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• 2010

Purpose : Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. Materials and Methods : In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. Results : The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. Conclusion : From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.2
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• pp.83-90
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• 2011

To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.