• Title/Summary/Keyword: 컴퓨터단층촬영검사

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Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Alveoloar Rhabdomyosarcoma of Tongue Base in an Infant : A Case Report (영아의 설근부에 발생한 폐포성 횡문근육종 1예)

  • Kim, Jisung;Yeon, Je Yeob;Park, Jae-Hong;Lee, Yong-Moon;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.75-78
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    • 2013
  • 영아의 설근부에 발생하는 악성 종양은 매우 드물다. 저자들은 연하곤란과 폐쇄성 수면 무호흡증으로 의뢰된 17개월 남아의 설근부에 발생한 횡문근육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 외래에서 실시한 이학적 검사 상 설근부 전체가 돌출되어 있었으며 단단한 종괴가 촉지 되었다. 조직검사와 기관절개술을 시행하였으며 컴퓨터단층촬영, 양전자 방출 단층 촬영 그리고 뼈 스캔과 함께 염색체 분석을 실시하였다. 조직검사 결과 폐포성 횡문근육종이 확인되었으며 전이의 증거는 없었다. 염색체 분석상 폐포성 횡문근육종에 상응하는 PAX7-FKHR 유전자 전좌가 발견되었다. 8 회의 항암화학요법과 방사선 치료 후 촉지되는 설근부의 종괴는 없었으며 환자가 호소하는 증상도 개선되었다. 추적 관찰 시 시행된 자기공명영상 결과 확연한 종괴 크기의 감소를 확인할 수 있었다. 횡문근육종은 매우 드문 악성 종양으로 수술과 함께 항암화학요법, 방사선치료 등 여러 치료 방법이 동원되지만 전이나 재발이 있을 시 예후는 매우 불량하다. 그러므로 영아에서 연하곤란, 호흡 곤란 등의 증상이 있을 시에는 설근부를 포함한 상부호흡소화관을 적극적으로 검사하여야 하며 악성 종양의 가능성을 염두에 두어야 하겠다.

Comparison of Cervical Lymphadenitis as First Presentation of Kawasaki Disease and Acute Unilateral Cervical Lymphadenitis (경부 림프절염로 발현된 가와사키병과 급성 편측 경부 림프절염의 비교)

  • Lee, Hoon Sang;Kim, Ji Yong;Song, Bo Kyung;Kim, Yong-Woo;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.217-222
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    • 2016
  • Purpose: This study aimed to identify the differential clinical, laboratory, and imaging characteristics between patients with cervical lymphadenitis as first presentation of Kawasaki disease (CLKD) and those with acute unilateral cervical lymphadenitis (AUCL). Methods: We surveyed 372 patients who visited Pusan National University Children's Hospital because of fever and cervical lymph node enlargement, and underwent neck computed tomography (CT) from January 2010 to December 2014. We compared 28 confirmed cases of Kawasaki disease and 28 cases of AUCL based on a retrospective review of the medical records of the patients. Results: Patients with CLKD and AUCL showed no differential clinical characteristics in terms of the duration of fever, antibiotic use, or the size of lymph nodes. Patients with CLKD had higher white blood cell count, absolute neutrophil count, erythrocyte sedimentation rate, and C-reactive protein levels (P<0.05) than those of patients with AUCL. The presence of retropharyngeal edema on neck CT was similar between the groups (64% vs. 33%, P=0.686). Conclusions: CLKD and AUCL showed no differentiating clinical and radiological characteristics; hence, Kawasaki disease should be the presumptive diagnosis in patients with fever and cervical lymph node enlargements who fail to respond to antibiotic treatment.

Evaluation and Comparison of Contrast to Noise Ratio and Signal to Noise Ratio According to Change of Reconstruction on Breast PET/CT (Breast PET CT 영상 재구성 변화에 따른 대조도 대 잡음비와 신호 대 잡음비의 비교평가)

  • Lee, Jea-Young;Lee, Eul-Kyu;Kim, Ki-Won;Jeong, Hoi-Woun;Lyu, Kwang-Yeul;Park, Hoon-Hee;Son, Jin-Hyun;Min, Jung-Whan
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.79-85
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    • 2017
  • The purpose of this study was to measure contrast to noise ratio (CNR) and signal to noise ratio (SNR) according to change of reconstruction from region of interest (ROI) in breast positron emission tomography-computed tomography (PET-CT), and to analyze the CNR and SNR statically. We examined images of breast PET-CT of 100 patients in a University-affiliated hospital, Seoul, Korea. Each patient's image of breast PET-CT were calculated by using ImageJ. Differences of CNR and SNR among four reconstruction algorithms were tested by SPSS Statistics21 ANOVA test for there was statistical significance (p<0.05). We have analysis socio-demographical variables, CNR and SNR according to reconstruction images, 95% confidence according to CNR and SNR of reconstruction and difference in a mean of CNR and SNR. SNR results, with the quality of distributions in the order of PSF_TOF, Iterative and Iterative-TOF, FBP-TOF. CNR, with the quality of distributions in the order of PSF_TOF, Iterative and Iterative-TOF, FBP-TOF. CNR and SNR of PET-CT reconstruction methods of the breast would be useful to evaluate breast diseases.

Diagnostic Value of Thoracography in Pneumothorax (기흉에서 흉강조영술(Thoracography)의 진단적 가치)

  • 박영식;한재열;장지원
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.730-734
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    • 1998
  • Background: It is important to know the location, number, size and shape of bullae before thoracotomy or VATS bullectomy. Chest X-ray and chest CT may be used but with some limitation. The purpose of this study was to compare the diagnostic value of thoracography with that of chest X-ray in preoperative detection of bullae. Meterial and Method: Thoracography was performed by injection of non-ionic water-soluble dye into pleural space in 22 primary spontaneous pneumothoraces, which underwent thoracotomy or VATS bullectomy. Chest X-ray and thoracography were compared through operative finding. Results: Sensitivity and accuracy of thoracography(75% and 72.7%) were higher than those of chest X-ray(30% and 36.4%). However, specificity of thoracography(50%) was lower than that of chest X-ray (100%). There were no complications during or after thoracography. Conclusion: Thoracography is a safer and more useful method for preoperative detection of bullae when compared with chest X-ray.

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Medical Imaging of Well-differentiated Liposarcoma Arising from the Falciform Fat in a Dog (개에서 겸상인대에서 유래된 분화지방육종의 영상의학증례)

  • Jung, Dong-In;Kim, Jae-Hwan;Ha, Ji-Young;Park, Ki-Tae;Yeon, Seong-Chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.186-189
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    • 2012
  • A 7-year-old castrated male Cocker spaniel dog was referred to Gyeongsang National University Veterinary Medical Teaching Hospital with a severe abdominal distension. A huge, inhomogeneous fat opacity mass was identified on the abdomen radiographic survey. From the abdominal ultrasonographic examination, the mass was found to have irregular marginated hyperechoic capsule with cellular hypoechoic fluids inside. On the computed tomography, an encapsulated inhomogeneous mass was identified with fat attenuation peripheral and soft tissue attenuation inside. The origin of the mass was confirmed as falciform fat by surgical excision. The resected mass appeared to be a firm reddish-brown color with a smooth surface. The histopathological appearance was a well-differentiated liporsarcoma. The patient has no recurrent signs 1 month after surgery.

Renal Cell Carcinoma in a Pekingese Dog (페키니즈견에서 신장세포암종)

  • Lee Ki-chang;Jung Joo-hyun;Byeon Ye-eun;Oh Sun-kyung;Seo Eun-jung;Song Kyung-jin;Kweon Oh-kyeong;Yoon Jung-hee;Choi Min-cheol
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.148-152
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    • 2005
  • An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.

Pulmonary Paragonimiasis Misdiagnosed with Pulmonary Tuberculosis (객혈과 공동 폐병변으로 폐결핵으로 오인된 폐흡충증 1예)

  • Park, Su Eun;Song, Bokyung;Hwang, Jae-Yeon
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.178-182
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    • 2017
  • Paragonimiasis was one of the most common causes of cavitary lung lesions until the 1960s, but now it has become a very rare disease in Korea. A 16-year-old boy presented with hemoptysis and several days of cough. His plain chest radiograph showed nodular opacity with a cavity in the left upper lung region. Although his symptoms disappeared after taking antituberculous drugs, his plain chest radiograph and computed tomography images after completion of therapy showed a new nodule with a cavity in the left lung field. Through video-assisted thoracoscopic wedge resection, Paragonimus eggs were found in the lung tissues.

Unusual Presentation of a Testicular Lymphoma Mimicking a Missed Testicular Torsion: A Case Report (계류 고환염전으로 오인된 드문 형태의 고환 림프종: 증례 보고)

  • Mi Jin Kim;Young Hwan Lee;Youe Ree Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1287-1291
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    • 2021
  • Testicular lymphoma is an uncommon testicular tumor that usually presents as a painless mass. It usually shows hypervascularity on color Doppler ultrasound (US) and a mild enhancement on enhanced CT or MRI. We present an unusual case of a testicular lymphoma mimicking a missed testicular torsion in a 67-year-old male patient with right scrotal swelling and intermittent pain for 2 months. Color Doppler US demonstrated the absence of vascularity in the enlarged right testis, and the initial diagnosis was a missed testicular torsion. CT demonstrated a poorly enhancing mass rather than a missed testicular torsion with enhanced small nodular foci at the periphery. The final pathological diagnosis was testicular lymphoma.

Two Cases of Perforated Typhlitis in Acute Lymphocytic Leukemia (급성 림프구성 백혈병에 합병된 천공성 typhlitis)

  • Park, Woo-Hyun;Ahn, Keun-Soo;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.59-63
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    • 2001
  • The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.

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