• Title/Summary/Keyword: contrast-enhanced CT

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A Case of Lemierre's Syndrome, Misdiagnosed as a Simple Deep Neck Infection on Initial Ultrasonography Followed by an Abscess Aspiration Trial (초음파에서 단순 심경부 감염증으로 오인하여 흡인치료를 시도한 내경정맥 혈전정맥염 (레미에르 증후군) 1례)

  • Lee, Dong Yun;Kim, Sang Bin;Ban, Myung Jin
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.31-34
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    • 2019
  • Lemierre's syndrome is rare disease characterized by anaerobic sepsis, internal jugular vein thrombosis, septic emboli that resulted from head and neck infection. Lemierre's syndrome has significant morbidity, so immediate, accurate diagnosis and treatment is needed. It is necessary to perform contrast-enhanced computed tomography (CT) for diagnosis. Systemic antibiotics is recommended, and surgical interventions, anticoagulation may beis considered for treatment. We report misdiagnosed case as a simple deep neck infection on initial ultrasonography with simultaneous abscess aspiration but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan. We report a case of a 45-year-old patient, who was diagnosed with a simple deep neck infection and treated with simultaneous abscess aspiration, but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.

Effect of Dietary Minerals and Ca-Regulating Hormones on Bone Enzyme Alkaline Phosphatase Activity

  • Chung, Cha-Kwon;Ha, Kyung-Sun;Sohn, Jeong-In
    • Preventive Nutrition and Food Science
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    • v.1 no.1
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    • pp.80-86
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    • 1996
  • Parathyroid hormone(PTH) is known to stimulate bone resorption and to inhibit bone collagen synthesis. In contrast, as the evidence of stimulation of bone formation by PTH has recently been observed, the study on the role of PTH involved in osteoporosis draws remarkable attention. This study has dealt with the role of alkaline phoshatase(AP), a marker enzyme for bone formation and osteoblast action, Animals(BALS/cmice) were divided into three dietary groups(high and medium Ca and Ca-free) and hormones including PTH, calcitonin(CT), cholecalciferol(citamin D) were i.p. injected. AP in the serum and liver was measured using Sigma 221 alkaline buffer solutions containing 9mM of p-nitrophenyl phoshate. Enzume was reacted at 37$^{\circ}C$ for 10 minutes and the reaction was stopped by 1.8ml of 0.1N NaOH and measured at 410nm. We found that serum and liver AP activity was increased by low dietary Ac. Compared to the control, and serum Ap activity was enhanced by PTH and vitamin D regardless of the dietary Ca. On the other hand, liver AP activity was inhibited by OTH and vitamin D at all levels of dietary Ca. CT inhibited the action of PTH and vitamin D in the serum. But, the inhibition of PTH and vitamin D action by CT was not observed in the liver, unlike in the case of serum.

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Incidentally found unicentric plasma cell variant Castleman's disease in mesentery: focus on ultrasonography and CT findings (우연히 발견된 장간막의 단중심성 형질세포형 Castleman병 1예: 초음파와 CT 소견 중심으로)

  • Kim, Hyun Min;Kim, Bong Soo;Jung, In Ho;Hyun, Chang Lim;Jung, Seung Wook;Jo, Jae Min
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.19-22
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    • 2018
  • Castleman's disease is a benign lympho-proliferative disorder that commonly occurs in mediastinum. It is known that the disease rarely occurs in mesentery. Most localized abdominal Castleman's diseases are histologically hyaline vascular type. The contrast-enhanced CT in patient with hyaline vascular type Castleman's disease shows a well-defined mass with homogenously intense enhancement. On the other hand, the patient with plasma cell variant has systemic symptoms, but not specific imaging features. We report a unicentric plasma cell variant Castleman's disease in mesentery nearby superior mesenteric artery as presenting a single mass, not accompanied by systemic symptoms with similar characteristics to hyaline vascular type.

Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma (둔상 후 복부 전산화단층촬영에서 조영제 유출로 동맥색전술을 시행받은 환자의 복강내와 후복막강/골반강내 출혈 비교)

  • Yoon, Ji Young;Kim, Sun Hyu;Ahn, Ryeok;Hwang, Jae Cheol;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.199-205
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    • 2009
  • Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report (반충손상 기전에 의한 간문맥손상에 대한 증례 보고)

  • Joonghyun Yoo;Sung-Joon Park;Seung Hwa Lee;Hwan Hoon Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1594-1599
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    • 2021
  • A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

Computed tomographic evaluation of experimental hydronephrosis treated with transarterial embolization of renal artery in Beagle dogs (신장동맥 색전술을 실시한 실험적 수신증의 전산화 단층촬영)

  • Chang, Dongwoo;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.421-427
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    • 2001
  • This study was performed to evaluate the embolized kidney and contralateral normal kidney using computed tomography (CT) and enhanced computed tomography. Experimental hydronephrosis was induced by ligation of unilateral ureter in Beagle dogs. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and repiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. There were no dogs expired after TAE-Ra and no side effects associated with regurgitation of iohexol-ehtanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. CT showed dilation of urinary collection system and ventral displacement of spleen at 14 days after TAE-RA in one dog not treated by TAE-RA and experimental group treated by TAE-Ra. CT two month after TAE-RA showed the shrunken embolized kidney in experimental group. Transverse CT with contrast enhancement demonstrated the increase of signal intensity at thinned renal cortex in control group not treated by TAE-Ra at 30 days and 60 days, however, there was no increase of signal intensity at shrunken embolized kidney at 60 days after TAE-RA. CT was useful modality for evaluation of the morphology and the size of embolized kidney and contralateral normal kidney. Enhanced CT was availabel for the detection of revascularization of renal artery after TAE-RA in dogs with hydronephrosis. It is conclued that CT is useful modality for the monitoring of the revascularization of the renal artery after TAE-RA.

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The Use of FDG PET for Nodal Staging of Non-Small-Cell Lung Cancer (비소세포폐암 환자의 국소 림프절 전이 발견을 위한 FDG PET의 이용)

  • 백희종;박종호;최창운;임상무;최두환;조경자;원경준;조재일
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.910-915
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    • 1999
  • Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

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Automatic Liver Segmentation by using Gray Value Portion in Enhanced Abdominal CT Image (조영제를 사용한 복부CT영상에서 명암값 비율을 이용한 간의 자동 추출)

  • Yu, Seung-Hwa;Jo, Jun-Sik;No, Seung-Mu;Sin, Gyeong-Suk;Park, Jong-Won
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.38 no.2
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    • pp.179-190
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    • 2001
  • In this proposed study, observing and analyzing contrast enhanced abdominal CT images, we segmented the liver automatically. We computed the ratio of each gray value from the estimated gray value range. With the average value of mesh image, we distinguished the liver from the noise parts. We divided the region based on immersion simulation. The threshold value is determined from the mesh image which is generated from each gray value portion of the liver and is used in dividing the liver to the noise region. To get the outline of the liver, we generated template image which represents the lump of the liver, and subtracted it from the binary image. With the results we use the proposed algorithm using 8-connectivity instead of the present opening algorithm, to reduce the processing time. We computed the volume from the segmented organ size and presented a clinical demonstration with the animal experiment

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Preoperative Detection of Hepatic Metastases from the colorectal Cancers: Comparison of Dual-phase CT scan, Mn-DPDP enhanced MRI, and combination of CT and MRI (대장암의 간 전이 진단: 이중시기 CT, Mn-DPDP 조영증강 MRI, 그리고 CT-MRI 종합 판독의 비교)

  • Shin, Kyung-Min;Kim, Jong-Yeol;Choi, Gyu-Seok;Kim, Hye-Jeong;Lee, Jong-Min;Chang, Yong-Min;Kim, Yong-Seon;Kang, Duk-Sik;Ryeom, Hun-Kyu
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.2
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    • pp.109-116
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    • 2005
  • Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.

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