• Title/Summary/Keyword: incidental

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Giant Intramyocardial Aneurysm in a Patient with Intercoronary Communication between the Left Circumflex Artery and Right Coronary Artery: A Case Report (우관상동맥과 좌회선지간 교통이 있는 환자에서 나타난 거대 심근내 동맥류: 증례 보고)

  • Yu Hyun Lee;Noh Hyuck Park;Ji Yeon Park;Seon-Jeong Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.213-218
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    • 2020
  • Coronary artery aneurysm is a rare disease. It occurs in the epicardial space, mostly along the course of major coronary arteries. Here, we report a case of a giant incidental aneurysm embedded in the basal posterior wall of the left ventricle. A 43-year-old woman was referred to our institution for the evaluation of cardiac palpitations that had been present from the previous 2 months. She reported no medical history (such as Kawasaki's disease or hypertension) or previous operative history. Echocardiogram and subsequent cardiac CT revealed a giant aneurysm in the left ventricle, with a direct fistulous connection to a dilated and tortuous left circumflex artery, which showed direct communication with the straight right coronary artery.

Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality (특발폐섬유증 진단의 최신 지견과 간질성폐이상)

  • Bo Da Nam;Jung Hwa Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.770-790
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    • 2021
  • Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

Adnexal Masses: Clinical Application of Multiparametric MR Imaging & O-RADS MRI (난소-자궁부속기 종괴: 다중기법 MR 영상의 임상 적용과 O-RADS MRI)

  • So Young Eom;Sung Eun Rha
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1066-1082
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    • 2021
  • Incidental adnexal masses considered indeterminate for malignancy are commonly observed on ultrasonography. Multiparametric MRI is the imaging modality of choice for the evaluation of sonographically indeterminate adnexal masses. Conventional MRI enables a confident pathologic diagnosis of various benign lesions due to accurate tissue characterization of fat, blood, fibrous tissue, and solid components. Additionally, functional imaging sequences, including perfusion- and diffusion-weighted imaging, improve the diagnostic efficacy of conventional MRI in differentiating benign from malignant adnexal masses. The ovarian-adnexal reporting and data system (O-RADS) MRI was recently designed to provide consistent interpretations in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. In this review, we describe the clinical application of multiparametric MRI for the evaluation of adnexal masses and introduce the O-RADS MRI risk stratification system.

Radical surgery for stage IV gallbladder cancers: Treatment strategies in patients with limited metastatic burden

  • Shraddha Patkar;Swapnil Patel;Mufaddal Kazi;Mahesh Goel
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.180-188
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    • 2023
  • Backgrounds/Aims: The present study looked at the role of radical surgery in gallbladder cancers (GBC) with limited metastatic disease. Methods: The retrospective observational study was conducted to screen the database from 1st January 2010 to 31st December 2019. Patients of GBC found to have low-volume metastatic disease upon surgical exploration were included. Results: Of the 1,040 patients operated for GBC, 234 patients had low-volume metastatic disease (microscopic disease in station 16b1 node or N2 disease isolated port-site metastases, or low burden peritoneal disease with deposits less than 1 cm, in adjacent omentum or adjacent diaphragm or Morrison's pouch or a solitary discontinuous liver metastasis in adjacent liver parenchyma) detected intraoperative. Of these, 62 patients underwent radical surgery for R-0 metastatic disease followed by systemic therapy, while the remaining 172 patients did not undergo radical surgery and were given palliative systemic chemotherapy. Patients who underwent radical surgery had significantly superior overall survival (19 months versus 12 months, p < 0.01) and superior progression-free survival (10 months versus 5 months, p < 0.01) when compared to the rest. This difference in survival was more significant amongst patients when operated on after neoadjuvant chemotherapy. Regression analysis showed that a sub-group of patients with incidental GBC with limited metastases showed more favorable outcomes with radical surgery. Conclusions: Authors suggest a possible role for radical treatment of advanced GBC with a limited metastatic burden. Neoadjuvant chemotherapy can be used for preferentially selecting patients of favorable disease biology for curative treatment.

Prevalence of incidental distal biceps signal changes on magnetic resonance imaging

  • Eugene Kim;Joost T.P. Kortlever;Amanda I. Gonzalez;David Ring;Lee M. Reichel
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.260-266
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    • 2023
  • Background: Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging. Methods: MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication. Results: Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training. Conclusions: The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care. Level of evidence: IV.

Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images (18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가)

  • Lee, Hyeon-Guck;Han, Man-Seok;Kim, Yong-Kyun;Seo, Sun-Youl;Jeon, Min-Cheol;Kim, Tae-Hyung;Hong, Seong-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2958-2965
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    • 2013
  • Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

Clinical Significance of Incidental Asymmetric Palatine Tonsillar Uptake on $^{18}F$-FDG PET/CT ($^{18}F$-FDG PET/CT에서 우연히 관찰되는 구개편도의 비대칭적 섭취증가의 임상적 의의)

  • Chae, Sun-Young;Baek, So-Ra;Ryu, Jin-Sook;Moon, Dae-Hyuk;Kim, Jae-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.402-410
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    • 2009
  • Purpose: The aim of this study was to determine the incidence and malignant rate of incidental asymmetric palatine tonsillar uptake (ATU) on $^{18}F$-FDG PET/CT in various clinical indications and to evaluate the clinical and PET/CT findings suggesting malignancy. Materials and Methods: We retrospectively reviewed a total of 2,901 patients ($58.4{\pm}12.3$ yrs, range 20~88 yrs, M:F = 1,841:1,060) who underwent $^{18}F$-FDG PET/CT during an 1-year period with various indications except primary tonsillar cancer and lymphoma evaluation. On $^{18}F$-FDG PET/CT, metabolic abnormality of the palatine tonsil and cervical lymph node were visually assessed. ATU was defined as increased palatine tonsillar uptake with diffuse, focal, or irregular pattern compared to contralateral side. The incidence and malignant ratio of ATU were evaluated according to clinical and PET/CT findings. Results: Of 2,901 cases, 290(10,0%) showed ATU. The incidence of ATU showed seasonal variation and was high in the winter (12.1%). Of 209 cases with ATU confirmed pathologically and/or clinically, five (2.4%) were malignant lesions. ATU with irregular uptake pattern (2/2) and in cases referred for cervical lymph node metastasis of unknown origin (3/5) were frequently associated with malignant lesion (p<0.05). Conclusion: ATU was not infrequently observed on $^{18}F$-FDG PET/CT, and the malignant risk of ATU was low. However, ATU with cervical lymph node metastasis or with irregular pattern on PET/CT would be further evaluated by the histopathologic examination.

Evaluate Utility of Thyroid Incidentaloma Discrimination by $^{18}F$-FDG PET/CT Delay Scan Images ($^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가)

  • Lee, Hyun-Kuk;Yang, Seoung-Oh;Song, Gi-Deok;Song, Chi-Ock;Lee, Gi-Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.184-191
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    • 2008
  • Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

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Evaluation of Spa Destinations' Image & Preference (국내 온천관광지 이미지 및 선호도 평가)

  • Kim, Si-Joong
    • Journal of the Economic Geographical Society of Korea
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    • v.13 no.2
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    • pp.253-269
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    • 2010
  • This study analyzed image similarity, attribute recognition, and preference by multidimensional scaling. The analyses were carried out by 10 spa destinations (Deoksan, Bugok, Onyang, Yuseong, Suanbo, Bomun, Dongrae, Asan, Dogo, Haeundae) in Korea. The results were as follows: First, according to the analyses of image similarity of spa destinations, 'Haeundae, Dongrae and Bomun,' 'Dogo, Onyang, Asan,' and 'Deoksan, Suanbo, Bugok,' made similar image groups separately. However, Yuseong had different image from the other spa destinations in the above. Second, according to the analyses of attribute recognition of spa destinations, Deoksan and Bugok had more competitive ability in terms of 'the incidental facilities of spa destinations, 'Yuseong, Onyang, Asan, and Dogo' showed high competitiveness in terms of 'accessibility of spa destination' and 'tourism conditions.' Haeundae, Dongrae, and Suanbo had weak competitiveness in terms of 'the accessibility of spa destinations.' Third, according to the analyses of preference about spa destinations based on different job groups, office workers had a preference for Yuseong and Bugok, professional workers for Bomun, the people engaged in the farming, fishing, livestock raising and housewives for Haeundae and Dongrae, government officials, students, factory workers, the people living on a pension for Onyang, Deoksan and Dogo, and the self-employed for Suanbo. In conclusion, according to the analyses of spa destination preference based on different residence groups, residents of Seoul, Incheon, Gyunggi province, Gangwon province, Daejeon, Chungcheong province and Jeolla province had a preference for Yuseong, Suanbo, Onyang, Deoksan, and Asan and the residents of Daegu, Gyungsang province, Busan, Ulsan for Bugok, Bomun, and Haeundae.

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The Effects of Operational and Mechanical Factors on the Performance of Rice-Husk Furnace (왕겨연소기(燃燒機)의 성능(性能)에 영향(影響)을 마치는 설계(設計) 및 작동인자(作動因子)에 관(關)한 연구(硏究))

  • Park, Seung Je;Noh, Sang Ha
    • Journal of Biosystems Engineering
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    • v.8 no.2
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    • pp.39-48
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    • 1983
  • This study was performed to obtain the basic data which could be used for the modification of the manual center-burner-type rice-husk furnace into a small scale automatic type for the multi-purpose use in the farm. For this purpose, first, the utilization feasibility of the rice-husk furnace in the farm was analyzed briefly in aspects of available amount of rice-husk for the fuel, annual operation time and replaceble amount of residential heating energy with rice-husk in the farm. For the experiment a prototype furnace geared with an automatic feeding device was fabricated, and feed rate, mold size and chimney height were changed to investigate the combustion efficiency of rice-husk and thermal efficiency of the furnace. Also, optimum and limiting operational factors were observed in each treatments. The results obtained are summarized as follows. 1. If the rice-husk is intensively used for residential heating in the farm for winter season, on an average 51 percent of the total heating energy can be replaced with the rice-husk. Therefore, development of a small scale automatic rice-husk furnace was recognized to be feasible. 2. The operational condition depending on husk-feed rates was very important factor for successive steady burning operation of the given furnace. When the feed-rate was 1.5 kg/hr, the top of the burning zone should be kept at the position about 55 cm from the bottom of the combustion chamber with the periodic removal of ash (termed as steady state position), which was 18 cm above the mold waist. When the feed rates were 2.4 kg/hr and 3.0 kg/hr, the steady state position was at about 4 cm above the mold waist. 3. The mold size affected inflow rate of air into the furnace and consequently CO content in the exhaust gas. The relatively bigger mold gave positive effect on the air-inflow rate. 4. When the husk-feed rates were 1.5 kg/hr, 2.4 kg/hr, 3.0 kg/hr, the combustion efficiencies of the rice-husk were 98.5%, 97.4% and 95.0%, the thermal efficiencies of the furnace were 93.4%, 93.2% and 87.6%, and CO content in the exhaust gas were 1.21%, 1.03%, and 2.43%, respectively. The air-inflow rates were decreased with the increase of feed rates. When the amount of excess air was 30-40%, the CO content in the exhaust gas was at the minimum level. 5. When the chimney height was lowered from 260 cm to 96 cm, the air-inflow rate was slightly decreased, but the average temperature in the combustion chamber, CO content in the exhaust gas and combustion and thermal efficiencies were not changed significantly. 6. The incidental problems associated with the protytype furnace were accumulation of the ash inside the mold, accumulation of the cinder between the outer-drum of the furnace and the combustion chamber wall, and accumulation of the cinder in the chimney.

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