• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.41-46
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• 2010

Purpose : To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. Materials and methods : Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusionweighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. Results : At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. Conclusion : MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1067-1073
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• 2023

Breast cancer is one of the top three most common cancers in modern women, and the incidence rate is increasing rapidly. Breast cancer has a high family history and a mortality rate of about 15%, making it a high-risk group. Therefore, breast cancer needs constant management after an early examination. Among the various equipment that can diagnose cancer, ultrasound has the advantage of low risk and being able to diagnose in real time. In addition, breast ultrasound will be more useful because Asian women's breasts are denser and less sensitive. However, the results of ultrasound examinations vary greatly depending on the technology of the examiner. To compensate for this, we intend to incorporate motion tracking technology. Motion tracking is a technology that specifies and analyzes a location according to the movement of an object in a three-dimensional space. Therefore, real-time control is possible, and complex and fast movements can be recorded in real time. We would like to present the production of an ultrasound examination guide using these advantages.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.398-408
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• 2023

Purpose This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast. Materials and Methods Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision. Results All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy. Conclusion Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.106-113
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• 2021

Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.876-886
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• 2022

Purpose To evaluate the performance of MicroPure US imaging to detect and characterize microcalcifications. Materials and Methods A total of 171 lesions with suspicious microcalcifications seen on mammography and B-mode US were included and simultaneously evaluated using MicroPure US imaging. The size of microcalcifications was divided into small (punctate, amorphous, fine pleomorphic, and fine linear) and large (coarse heterogeneous), and the extent was divided into narrow (grouped) and wide (others). MicroPure US imaging visibility was divided into four types based on the number of microcalcifications on the two images: B > M (more on B-mode), B = M (similar), B < M (more on MicroPure), and negative. Triple pairwise comparison was used to evaluate the imaging features according to the MicroPure US imaging visibility. Results Among the 171 lesions examined, 157 lesions (91.8%) were detected by MicroPure US imaging. The proportion of Breast Imaging Reporting and Data System (BI-RADS) category 4A was significantly higher in the MicroPure positive group, and that of category 4B was significantly higher in the MicroPure negative group (p = 0.035). The other imaging features did not differ. Among the positive MicroPure subgroups, all features showed no significant difference. Conclusion MicroPure US imaging demonstrated 91.8% positivity in detecting microcalcifications on B-mode US. MicroPure US imaging visibility correlated with the BI-RADS category of microcalcifications.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.790-795
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• 2002

Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.

• Journal of Digital Convergence
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• v.14 no.1
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• pp.305-310
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• 2016

Recently as the ultrasonography became generalized, the annual change rate of the incidence of thyroid cancer extraordinarily grew to 24.5% in Korea. Therefore, the aim of this study was performed to identify the risk factors of thyroid cancer apart from conventional risk factors of dietary iodine and ionizing radiation. In this retrospective study, 411 patients underwent fine-needle aspiration biopsy were examined from January 2011 to March 2013. The subjects are divided into two groups which are 260 patients with benign nodule and 151 patients with malignancy nodule. We compared age, hematologic values, body mass index, waist circumference, menopausal status, breast nodules status, uterine myoma status, fatty liver status of targeted group of patients. According to the result, in thyroid cancer group with obesity, the number of case of breast nodules and myoma was higher, and their thyroid stimulating hormone values was higher than the benign nodule group. In order to establish factors influencing thyroid and thyroid cancer, there is a definite need for continuous study.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.703-706
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• 2011

Purpose: Augmentation mammoplasty by cohesive silicone gel implant is becoming more popular nowadays. Many types of complications have been reported, such as hematoma, seroma, infection, capsular contracture and etc. But there were no report of deep vein thrombosis(DVT) after augmentation mammoplasty in Korea. The authors experienced one case of DVT after augmentation mammoplasty using a cohesive silicone gel implant. Methods: A 38-year-old woman with breast cancer underwent reconstruction by tissue expander and augmentation mammoplasty by cohesive silicone gel implant, and exchange of expander to cohesive silicone gel implant. The operation was finished without any complicating event. On 4th day after the operation, the patient complained of intermittent right lower leg pain. By doppler ultrasonography, the patient was diagnosed with acute venous thrombosis of the popliteal vein, posterior tibial vein and peroneal vein. Results: Intravenous heparinization and oral warfarin were started immediately and elastic compression stocking was applied. Intravenous heparinization was continued until INR (blood coagulation unit) reached to target levels. The patient was discharged on 11th day of operation with oral warfarin. Other complication has not been reported after 10 weeks of operation. Conclusion: To our knowledge, this is the first report of DVT after silicone implant based breast augmentation.

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.177-184
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• 2002

Purpose: Ultrasonography and $^{99m}-Tc-MIBI$ scintimammography were validated as useful diagnostic tools for primary breast cancer. However, ultrasound has the problem of low specificity. We compared the diagnostic usefulness of ultrasound with $^{99m}-Tc-MIBI$ scintimammography in the diagnosis of breast cancer. Materials and Methods: This study included 174 patients who had ultrasound and $^{99m}-Tc-MIBI$ scintimammography peformed on breast masses from 1999 to 2000. The pathologic results were obtained by surgery or FNAB. Results: Among the 174 patients, malignant breast disease numbered 117 and benign breast disease numbered 57. Ultrasound revealed 88 TP, 9 FN, 8 FP, 34 TN, and 35 indeterminate cases. $^{99m}-Tc-MIBI$ scintimammography revealed 91 TP, 25 FN, 9 FP, and 48 TN. The sensitivity, specificity, positive predictive value, and negative predictive value of Ultrasound were 66.7%, 44.2%, 67.2%, and 43.6% respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}-Tc-MIBI$ scintimammography were 77.8%, 84.2%, 91%, and 64.9% respectively. Among the 35 indeterminate ultrasound cases, $^{99m}-Tc-MIBI$ scintimammography revealed 13 TP, 15 TN, and 7 FP Conclusion: $^{99m}-Tc-MIBI$ Scintimammography was more sensitive and specific than ultrasound for the detection of primary breast cancer and provided more useful information in cases of indeterminate ultrasound findings.

• Investigative Magnetic Resonance Imaging
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• v.19 no.3
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• pp.191-195
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• 2015

We present a 53-year-old woman with a large chest wall mass in the interpectoral space, which was eventually confirmed as a lipogranuloma resulting from hydrogel implant rupture. Ultrasonography (US) showed reduced implant volume with surrounding peri-implant fluid collection, suggesting the possibility of implant rupture. A heterogeneously hypoechoic mass was found between the pectoralis major and minor muscles adjacent to the ruptured implant. On magnetic resonance imaging (MRI), there was a large mass in the left interpectoral space of the upper inner chest wall. The mass showed slightly high signal intensity (SI) on pre-contrast T1-weighted image (WI) with mixed iso and high SI on T2-WI. The signal of the mass was suppressed using the water suppression technique but not with the fat suppression technique on T2-WI. The mass showed diffuse enhancement upon contrast enhancement. The enhancing kinetics showed persistent enhancement pattern. US-guided core needle biopsy revealed a lipogranuloma and removal confirmed a ruptured PIP hydrogel implant.