• Journal of the Korean Society of Radiology
• /
• v.82 no.1
• /
• pp.274-277
• /
• 2021

Perineal involvement by metastatic renal cell carcinoma (RCC) is very rare, and there are only few reports on its radiological findings in the literature. Here, we present a case of a 76-year old female who presented with perineal pain caused by metastatic clear cell RCC. We discuss the radiological changes of the tumor before and after targeted therapy.

• Journal of the Korean Society of Radiology
• /
• v.82 no.3
• /
• pp.626-637
• /
• 2021

Purpose To explore cerebrovascular reservoir (CVR) and arterial transit time (ATT) changes using acetazolamide-challenged multi-phase arterial spin labeling (MP-ASL) perfusion-weighted MRI in chronic cerebrovascular steno-occlusive disease. Materials and Methods This retrospective study enrolled patients with chronic steno-occlusion who underwent acetazolamide-challenged MP-ASL between June 2019 and October 2020. Cerebral blood flow, CVR, basal ATT, and ATT changes associated with severe stenosis, total occlusion, and chronic infarction lesions were compared. Results There were 32 patients (5 with bilateral steno-occlusion) in our study sample. The CVR was significantly reduced during total occlusion compared with severe stenosis (26.2% ± 28.8% vs. 41.4% ± 34.1%, respectively, p = 0.004). The ATT changes were not significantly different (p = 0.717). The CVR was marginally lower in patients with chronic infarction (29.6% ± 39.1% vs. 38.9% ± 28.7%, respectively, p = 0.076). However, the ATT was less shortened in patients with chronic infarction (-54 ± 135 vs. -117 ± 128 ms, respectively, p = 0.013). Conclusion Acetazolamide-challenged MP-ASL provides an MRI-based CVR evaluation tool for chronic steno-occlusive disease.

• Journal of the Korean Society of Radiology
• /
• v.83 no.4
• /
• pp.792-807
• /
• 2022

In children and adolescents, inguinal and scrotal diseases are relatively common, and imaging is very useful for the diagnosis and differential diagnosis of these diseases. Therefore, it is important to understand the imaging findings of these diseases. In this article, we classify these diseases into small testes, cryptorchidism, patent processus vaginalis, acute scrotum pain, trauma, testicular tumors, and others and describe their characteristic findings.

• Journal of the Korean Society of Radiology
• /
• v.83 no.5
• /
• pp.1128-1133
• /
• 2022

Common carotid artery (CCA) rupture during parathyroid cancer surgery is extremely rare and is generally life-threatening. We present a case of successful management of a ruptured CCA following the emergency placement of stent-graft in a 59-year-old male diagnosed with recurrent parathyroid cancer. During recurrent parathyroid cancer surgery, his right CCA ruptured unexpectedly, and his vital signs deteriorated rapidly despite surgical management. After stent replacement, his unstable vital signs improved and, thereafter, he was discharged without any complications.

• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.393-405
• /
• 2021

Purpose To determine the multidetector CT (MDCT) findings that differentiate adenomyoma of the ampulla of Vater (AOV) from localized adenocarcinoma of the AOV. Materials and Methods Sixteen and 30 patients with adenomyoma and localized adenocarcinoma of the AOV, respectively, were evaluated using MDCT. We analyzed the size and attenuation value and presence of uniform enhancement of the lesions, diameters of the extrahepatic bile duct (EHD) and main pancreatic duct, presence of regional lymph node enlargement, and laboratory findings. We determined the independent findings for differentiating adenomyoma from localized adenocarcinoma of the AOV using multivariate analysis. Results The size of the lesion and diameter of the EHD were significantly smaller for adenomyoma than those for localized adenocarcinoma of the AOV (all p < 0.001). In multivariate analyses, a lesion size of ≤ 1.3 cm, an EHD diameter of ≤ 1.3 cm, and an alanine transaminase level of ≤ 31 IU/L significantly differentiated adenomyoma from localized adenocarcinoma of the AOV. When all of these three findings were met, the specificity for adenomyoma of the AOV was 93.3%. Conclusion MDCT imaging may facilitate the differential diagnosis of adenomyoma and localized adenocarcinoma of the AOV based on the size of the lesion and diameter of the EHD.

• Journal of the Korean Society of Radiology
• /
• v.83 no.5
• /
• pp.1003-1013
• /
• 2022

Biliary atresia is an unknown etiology of extrahepatic bile duct obstruction with a 'fibrous ductal remnant,' which represents the obliterated ductal remnant in the porta hepatis. The sonographic 'triangular cord' (TC) sign has been reported to indicate a fibrous ductal remnant in the porta hepatis. In this review, we discuss the correlations among surgicopathological and sonographic findings of the porta hepatis and the definition, objective criteria, diagnostic accuracy, and differential diagnosis of the TC sign in biliary atresia.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.1
• /
• pp.139-144
• /
• 1996

갈륨스캔은 여러 종류의 염증성 질환 및 종양을 발견하기 위해 사용되고 있다. 특히 림프종은 갈륨스캔에서 양성율이 비교적 높은 종양으로 알려져 있다. 하지만 기존의 평면 영상만으로는 작은 크기의 종괴나 다른 장기에 의해 가려져 있는 경우에 위음성 결과를 보일 수 있었다. 최근 단일광자 방출 전산화 단층촬영(SPCET)을 도입하여 평면영상에 비해 더 나은 공간해상력으로 많은 정보를 얻고 있다. 저자들은 비호지킨 림프종 환자 30명을 대상으로 갈륨스캔 평면영상과 SPECT 영상을 얻어 비교하였다. 병변의 부위별로 두경부, 흉부, 복부에서 평면영상의 예민도는 각각 71%, 73%, 81%였으며, SPECT 영상의 예민도는 91%, 93%, 96%였다. CT 등 방사선학적 검사소견과 임상소견을 기준으로 하였을 때 위음성율은 평면영상의 경우 24%, SPECT 6.5%였다. 장의 방사능으로 인한 섭취와 폐문부 및 침샘의 비대칭적 섭취로 인한 위양성례가 4예 있었다. 결론적으로 비호지킨 림프종의 진단 및 병기를 결정하는데 있어서 갈륨스캔이 유용하며, SPCET 영상을 얻음으로써 더 나은 해부학적 위치 및 정확한 범위를 보여 줄 수 있을 것으로 생각된다.

• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.298-314
• /
• 2021

Owing to the anatomic complexity of the hepatic hilum, it has been considered difficult to diagnose and treat peri-hilar cholangiocarcinoma. Currently, imaging studies, including contrast-enhanced CT and MRI, play a crucial role in the detection, characterization, staging, and resectability assessment of peri-hilar cholangiocarcinoma. In this review, the classification of perihilar cholangiocarcinoma and proposed imaging protocol for the evaluation will be discussed. The typical imaging finding of peri-hilar cholangiocarcinoma, evaluation of longitudinal tumor extent, adjacent vascular invasion, and distant metastasis will also be mentioned. Finally, traditional concepts and recent updates for the resectability assessment of peri-hilar cholangiocarcinoma will be introduced.

• Journal of the Korean Society of Radiology
• /
• v.81 no.1
• /
• pp.81-100
• /
• 2020

Magnetic resonance neurography (MRN) has been increasingly used in recent years for the assessment of peripheral neuropathies. Fat suppression T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) have typically been used to provide high contrast MRN. Isotropic 3-dimensional (3D) sequences with fast spin echo, post-processing imaging techniques, and fast imaging methods, among others, allow good visualization of peripheral nerves that have a small diameter, complex anatomy, and oblique course within a reasonable scan time. However, there are still several issues when performing high contrast and high resolution MRN including standard sequence; fat saturation techniques; balance between resolution, field of view, and slice thickness; post-processing techniques; 2D vs. 3D image acquisition; different T2 contrasts between proximal and distal nerves; high T2 signal intensity of adjacent veins or joint fluid; geometric distortion; and appropriate p-values on DWI. The proper understanding of these issues will help novice radiologists evaluate peripheral neuropathies using MRN.

• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.423-428
• /
• 2021

Progressive transformation of germinal centers (PTGC) is a rarely diagnosed, benign disease of the lymph nodes that commonly manifests as chronic lymphadenopathy. PTGC may be characterized by single or multiple non-tender lymph nodes, and it commonly involves the cervical, axillary, and inguinal areas. Although PTGC is identified with concurrent lymphoma in some patients, it is not considered as a premalignant entity. Histopathologic diagnosis of PTGC is rarely made, and imaging findings have been reported in very few studies. We present a case of PTGC that occurred at the contralateral axillary lymph nodes and mimicked metastatic lymphadenopathy after breast cancer surgery. We also discuss its imaging findings.