• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1493-1504
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• 2021

Purpose This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. Materials and Methods This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calcium-score CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. Results The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. Conclusion The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.7-11
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• 2012

Purpose : The effect of concomitant use of $^{18}F$-FDG and intravenous contrast agent (CA) on dual-energy X-ray absorptiometry (DXA), was rarely reported. We had investigated these potentially confounding effects. Materials and Methods : Twenty-two patients had undergone DXA before and immediately after $^{18}F$-FDG PET/CT scans. Two DXA and 1 PET/CT scans had performed within one-day. $^{18}F$-FDG PET/CT scans had been performed with CA in 17 patients and without CA in 5 patients. Whole body bone mineral content (BMC), whole body bone mineral density (BMD), total fat mass (TFM), and lean body mass (LBM) were measured by DXA scanner before and after the $^{18}F$-FDG PET/CT scans. Results : BMC, BMD, TFM and LBM had significantly affected by $^{18}F$-FDG PET/CT with CA (BMC, +13.7%, from $2061.3{\pm}393.7$ to $2343.4{\pm}373.3$; BMD, +9.3%, from $1.07{\pm}0.09$ to $1.17{\pm}0.08$; TFM, -34.1%, from $17052.1{\pm}4049.9$ to $11237.1{\pm}2990.3$; LBM, +13.6%, from $45834.5{\pm}5662.1$ to $52094.0{\pm}6335.4$). However, $^{18}F$-FDG PET/CT without CA had no effect on the measurement of DXA (BMC, +2.4%, from $2197.7{\pm}391.6$ to $2251.5{\pm}380.9$; BMD, +1.8%, from $1.13{\pm}0.09$ to $1.15{\pm}0.07$; TFM, -6.8%, from $14585.6{\pm}3455.9$ to $13591.3{\pm}4351.4$; LBM, +2.2%, from $47360.5{\pm}8381.8$ to $48441.1{\pm}8488.1$). Conclusion : The measurements of DXA are affected by using CA. However, DXA scans might be unaffected by the presence of $^{18}F$-FDG administered for PET/CT.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.135-142
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• 2021

The aim of this study was to evaluate the contrast effect if a saline flush following low-volume contrast medium bolus improves vascular and parenchymal enhancement using a saphenous vein in abdominal CT for small animals. Six clinically healthy beagle dogs underwent abdominal contrast-enhanced CT. They were divided into nine groups (each group, n = 6), according to the volume of contrast medium 1, 2, and 3 mL/kg, and volume of the saline solution 0, 5, and 10 mL. Dynamic CT scanning was performed at the hepatic hilum level. The maximum contrast enhancement, time to maximum enhancement, and time to equilibrium phase were calculated from the time attenuation curves. Mean attenuation values for all groups were measured in the aorta, portal vein, and liver. After contrast enhancement, grading of image quality regarding surrounding artifacts and evaluation of the hepatic hilum structures was performed. For comparison of the effect of the contrast material and saline solution doses, differences in mean attenuation values between the contrast medium 2 mL/kg without saline flush group and the remaining groups, and between contrast medium 3 mL/kg without saline flush group and the remaining groups, were analyzed for statistical significance. There were no significant differences between with and without saline flushing at the same contrast medium dose groups. There were no significant differences in peak values between the 3 mL/kg dose of contrast medium alone and the 2 mL/kg dose of contrast medium with saline solution flush. However, there was a significant difference in peak values between the 3 mL/kg dose of the contrast medium without the saline flush group and the 2 mL/kg dose of the contrast medium alone group. Grades of the artifacts were not significantly different in the saline flush regardless of the dose of the contrast medium. Using 2 mL/kg of contrast medium with saline solution flush resulted in similar liver parenchyma attenuation, compared with using 3 mL/kg of contrast medium without saline solution flush. In CT evaluation of hepatic parenchymal diseases, using 2 mL/kg of contrast medium with saline solution flush may yield decreased risk of contrast nephropathy and cost-saving.

• Journal of the Korean Institute of Intelligent Systems
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• v.17 no.3
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• pp.380-389
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• 2007

In Korea, undoubtedly, the cancer is one of the most common reasons of death, and hepatoma is the second highest fatal cancer regardless of the gender only next to the stomach cancer In the middle and prime-aged between 40 and 60 years, the incidence of hepatoma is the highest in the world, and the death rate due to hepatoma is the highest among OECD countries. In this paper, we propose a novel method for automatic identification of hepatoma from a contrast enhanced CT images, which is used in an expert system that helps medical specialists. First, consecutive $40{\sim}50$ contrail enhanced CT images are photographed by every 5mm from the upper part of the chest, and using position information on the rib, we classify the internal area including only internal organs and the external one that consists of the rib, subcutaneous fat layers, and the background from the CT images. Then, the region of the liver is extracted from the classified internal area by using information on the intensity, the distribution of brightness, and using the regions extracted from consecutive images, we restore information on the 5 mm space occurred between the consecutive two slides tty applying a shape-based interpolation method. Lastly, using the characteristics such as the brightness and the morphology, we are able to extract the regions of hepatoma. The expert system based on our method is sufficiently competitive when it is compared with the diagnoses by specialists in the diagnostic radiology.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.168-172
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• 2021

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

• Progress in Medical Physics
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• v.16 no.1
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• pp.47-51
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• 2005

We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.41-47
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• 2011

Purpose : To evaluate the cause of internal jugular vein (IJV) obstruction on contrast enhanced 3D MR angiography (CE-MRA) using contrast enhanced computed tomography (CE-CT). Materials and Methods : A total number of 30 patients were enrolled, who underwent both head and neck CE-MRA and CE-CT from 2005 to 2008. We defined obstruction group which had IJV obstruction and control group which had no IJV obstruction on CE-MRA. The following parameters were measured from axial images of CE-CT: 1) diameter of IJV; 2) distance between the styloid process and ipsilateral lateral mass of the atlas; 3) maximum area of lateral mass of the atlas. Each parameter was compared between obstruction group and control group. Results : The diameter of IJV and distance between the styloid process and lateral mass of the atlas at IJV obstruction side in obstruction group were $1.6{\pm}1.0\;mm$ and $4.1{\pm}2.1\;mm$ respectively, which resulted in statistical significance (p<0.01). The maximum area of lateral mass of the atlas at IJV obstruction side in obstruction group was $103.4{\pm}25.3\;mm^2$ which is significantly larger than in control group (p<0.05). Conclusion : We found that the cause of IJV obstruction on CE-MRA could be narrow space between the styloid process and the lateral mass of the atlas, which was related with asymmetric larger area of lateral mass of atlas.

• Korean Journal of Radiology
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• v.23 no.4
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• pp.402-412
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• 2022

Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

• Proceedings of the Korea Society for Simulation Conference
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• 2003.11a
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• pp.201-206
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• 2003

In clinical practice, CT Angiography is a powerful technique for the visualziation of blood flow in arterial vessels throughout the body. However CT Angiography images of blood vessels anywhere in the body may be fuzzy if the patient moves during the exam. In this paper, we propose a novel technique for removing global motion artifacts in the 3D space. The proposed methods are based on the two key ideas as follows. First, the method involves the extraction of a set of feature points by using a 3D edge detection technique based on image gradient of the mask volume where enhanced vessels cannot be expected to appear, Second, the corresponding set of feature points in the contrast volume are determined by correlation-based registration. The proposed method has been successfully applied to pre- and post-contrast CTA brain dataset. Since the registration for motion correction estimates correlation between feature points extracted from skull area in mask and contrast volume, it offers an accelerated technique to accurately visualize blood vessels of the brain.

• Investigative Magnetic Resonance Imaging
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• v.24 no.3
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• pp.154-161
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• 2020

Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot. Materials and Methods: From September 2014 to February 2017, we did non-contrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging. We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSC-MRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks. Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated. Conclusion: DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.