• Title/Summary/Keyword: thoracic imaging

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Diagnostic Performance of Diffusion - Weighted Imaging for Multiple Hilar and Mediastinal Lymph Nodes with FDG Accumulation

  • Usuda, Katsuo;Maeda, Sumiko;Motono, Nozomu;Ueno, Masakatsu;Tanaka, Makoto;Machida, Yuichiro;Matoba, Munetaka;Watanabe, Naoto;Tonami, Hisao;Ueda, Yoshimichi;Sagawa, Motoyasu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6401-6406
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    • 2015
  • Background: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. Materials and Methods: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. Results: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value ($1.57{\pm}0.29{\times}10^{-3}mm^2/sec$) of malignant MHMLN was significantly lower than that ($1.99{\pm}0.24{\times}10^{-3}mm^2/sec$) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher ($10.0{\pm}7.34$ as compared to $6.38{\pm}4.31$) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). Conclusions: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.

Anomalous Origin of the Right Subclavian Artery in a Patient with D-transposition of the Great Arteries

  • Park, Hyojung;Song, Jinyoung;Huh, June;Kang, I-Seok;Jun, Tae-Gook;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.403-405
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    • 2018
  • This case report concerns a young patient with an extremely rare combination of d-transposition of the great arteries (d-TGA) and anomalous origin of the right subclavian artery. In our patient, the right subclavian artery originated from the pulmonary artery, which is why he did not show reversed differential cyanosis. We conclude that the presence of an aortic arch anomaly should be considered in patients with d-TGA who do not present with reversed differential cyanosis. A further imaging work-up, including computed tomography or magnetic resonance imaging, might be helpful.

Thoracic Splenosis after Splenic and Diaphragmatic Injury

  • Ha, You Jin;Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.47-50
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    • 2019
  • Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.190-199
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    • 2022
  • Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Pseudoaneurysm with Arteriovenous Fistula after Arthroscopic Procedure: A Rare Complication of Arthroscopy

  • Jin, Moran;Lee, Yang-Haeng;Yoon, Young Chul;Han, Il-Yong;Park, Kyung-Taek;Wi, Jin Hong
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.302-305
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    • 2015
  • Pseudoaneurysm with arteriovenous fistula is a rare complication of arthroscopy, and can be diagnosed by ultrasonography, computed tomography, magnetic resonance imaging, or angiography. This condition can be treated with open surgical repair or endovascular repair. We report our experience with the open surgical repair of a pseudoaneurysm with an arteriovenous fistula in a young male patient who underwent arthroscopy five months previously.

Successful Diagnosis and Treatment of a Pancreaticopleural Fistula in a Patient Presenting with Unusual Empyema and Hemoptysis

  • Kim, Eunji;Ahn, Hyo Yeong;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.174-177
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    • 2019
  • Pancreaticopleural fistula (PPF) is a rare complication in patients with pancreatitis. Its symptoms are similar to those of empyema or pleural effusion; therefore, it is important to consider PPF in the differential diagnosis. Herein, we describe the diagnosis and treatment of PPF in a patient presenting with unusual empyema and delayed hemoptysis.

A Case of Spontaneous Hemothorax with a Ruptured Variceal Phrenic Vein

  • Juhyun, Lee;Sung Kwang, Lee;Jinhong, Wi;Yoo Sang, Yoon;Il-Yong, Han;Yang Haeng, Lee
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.482-484
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    • 2022
  • Spontaneous hemothorax is rare, with limited data available on its etiology and treatment. We report a case of massive spontaneous hemothorax with a ruptured variceal phrenic vein during pregnancy, likely a complication of the Kasai procedure. Despite closed thoracostomy, the patient's symptoms and imaging findings did not improve. Emergent open thoracotomy and bleeding control were performed.

The Changes of Skin Temperature and Subjective Fatigue of the Thoracic Vertebrae by the Chiropractic Adjustments (흉추에 적용한 척추교정이 피부온도와 주관적 피로에 미치는 영향)

  • Yoon, Jung-Gyu;Lee, Geon-Cheol
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.102-108
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    • 2003
  • The purpose of this study was to determine the changes of skin temperature and subjective fatigue of the thoracic vertebrae by the chiropractic adjustments. Stimulation of the sympathetic nervous system will cause the changes in the skin blood flow which can be detected by measuring the skin surface temperature. This study was to see whether chiropractic adjustments could affect the activity of the sympathetic nervous system as reflected by changes in skin temperature of the thoracic. Skin temperature and subjective fatigue on 16 subjects was measured before, within 10 sec, 10min, 20min and 30 min after a thoracic adjustment with Digital Infrared Thermal Imaging(DITI) and Visual Analogue Scale(VAS). The adjustments consisted of a straight posterior-to-anterior high-speed, low-amplitude thrust to the transverse process of T3-T10 using a reinforced hypothenar contact. The average temperature and fatigue changed when the spine was considered as an entire unit. These results illustrate that the blood flow through the soft tissue can be affected by specific adjustments to the spine. This study might be served as an useful baseline data for the changes of the circulation and fatigue after the chiropractic adjustments.

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Thoracic Actinomycosis Causing Spinal Cord Compression

  • Kim, In-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.289-292
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    • 2006
  • Thoracic spinal actinomycosis causing epidural abscess and significant spinal cord compression is very rare. A case is presented of a 56-year-old woman with rapid progressive upper back pain and weakness in both legs without evidence of systemic infection. Magnetic resonance imaging revealed a thoracic epidural enhancing lesion at the T1-T5 level. After decompression by laminectomy, precise diagnosis was accomplished using specific histopathological studies of the surgical specimens. A histopathologic findings showing typical Actinomyces sulfur granules surrounded by acute inflammatory cells. The clinical radiological findings of spinal actinomycosis closely resemble metastatic tumors and other infectious processes. Delay in diagnosis and treatment can significantly worsen the condition of patient.

Cor Triatriatum Associated with Total Anomalous Pulmonary Venous Connection: A Rare but Plausible Combination

  • Lee, Jun Oh;Park, Chun Soo
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.143-145
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    • 2021
  • In a newborn in whom cor triatriatum was missed on echocardiography, infracardiac total anomalous pulmonary venous connection was successfully repaired with the aid of cardiac computed tomography (CT). In rare combinations, as in this case, an accurate diagnosis prior to surgery, which is of vital importance for successful repair, can be made through a high index of suspicion and the use of a supplemental imaging modality such as CT.