• Journal of Trauma and Injury
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• 제22권1호
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• pp.24-28
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• 2009

Purpose: This was conducted to assess the need for conventional radiographs of the thoracolumbar spine for routine screening of trauma patients who revealed no spinal trauma on chest and abdominal computed tomography (CT). Methods: We performed a retrospective review of the medical records of trauma patients who underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. Results: Two hundred seventy-five trauma patients underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. In 274 of the cases, the thoracolumbar spine series was also negative. Conclusion: CT of the chest and abdomen is an adequate evaluation of the thoracolumbar spine in trauma patients who require routine thoracolumbar spine screening, making subsequent conventional radiographs of the thoracolumbar spine unnecessary.

• Korean Journal of Radiology
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• 제24권6호
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• pp.541-552
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• 2023

Objective: Detection of pneumoperitoneum using abdominal radiography, particularly in the supine position, is often challenging. This study aimed to develop and externally validate a deep learning model for the detection of pneumoperitoneum using supine and erect abdominal radiography. Materials and Methods: A model that can utilize "pneumoperitoneum" and "non-pneumoperitoneum" classes was developed through knowledge distillation. To train the proposed model with limited training data and weak labels, it was trained using a recently proposed semi-supervised learning method called distillation for self-supervised and self-train learning (DISTL), which leverages the Vision Transformer. The proposed model was first pre-trained with chest radiographs to utilize common knowledge between modalities, fine-tuned, and self-trained on labeled and unlabeled abdominal radiographs. The proposed model was trained using data from supine and erect abdominal radiographs. In total, 191212 chest radiographs (CheXpert data) were used for pre-training, and 5518 labeled and 16671 unlabeled abdominal radiographs were used for fine-tuning and self-supervised learning, respectively. The proposed model was internally validated on 389 abdominal radiographs and externally validated on 475 and 798 abdominal radiographs from the two institutions. We evaluated the performance in diagnosing pneumoperitoneum using the area under the receiver operating characteristic curve (AUC) and compared it with that of radiologists. Results: In the internal validation, the proposed model had an AUC, sensitivity, and specificity of 0.881, 85.4%, and 73.3% and 0.968, 91.1, and 95.0 for supine and erect positions, respectively. In the external validation at the two institutions, the AUCs were 0.835 and 0.852 for the supine position and 0.909 and 0.944 for the erect position. In the reader study, the readers' performances improved with the assistance of the proposed model. Conclusion: The proposed model trained with the DISTL method can accurately detect pneumoperitoneum on abdominal radiography in both the supine and erect positions.

• 한국임상수의학회지
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• 제13권1호
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• pp.87-92
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• 1996

A hemangiosarcoma in a 30 kg, 6-year-old German Shepherd dog showing signs of abdominal distension, anorexia and depression was diagnosed with clinicopathologic examination, abdominal radiographs and ultrasonographic assessmint. In abdominal radiographs, overall abdominal distension was seen. Stomach and some parts of small intestines were deviated caudo-ventrally by enlarged liver. The splenomegaly was also identified and descending colon was dislocated laterally by splenic mass. In ultrasonographic findings, abdominal fluid was identified. Hepatomegaly was seen and it was consisted of multiple, anechoic cysts. The spleen was enlarged and a large round mass with mixed echo pattern at the mid to tail portion of spleen was identified. Grossly, at necropsy, multi-sized cysts in which contained blood and fibrpus materials and some blood were seen in the cross section and it showed hard consistency. Also, lots of small red tumor nodules were dispersed on the serosal surface of the bladder, omentum, mesentery, diaphragm and peritoneum. In abdominal paracentesis, fluid having almost the same properties as circulating blood was identified. The hemoperitoneum was thought to be resulted from the bleeding into peritoneum owing to the rupture of cystic lesions located on the superficial liver area.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권2호
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• pp.130-136
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• 2011

Plain X-ray radiographs are the first line of investigation taken in the diagnosis of abdominal pathology and are considered an important diagnostic tool to provide guidelines for further imaging studies and comprehensive therapeutic management. Although most abdominal pathology demonstrates non-specific radiologic findings, the plain abdominal radiography is very useful in specific diseases, including certain gastrointestinal anomalies. This review provides image findings of normal plain abdominal radiography and some common abdominal pathology in infants and children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권1호
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• pp.44-50
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• 2007

목 적: 소아에서 기능성 변비는 소화기 증상 중 가장 흔한 증상이나 각 개인이 호소하는 증상이 다양하여 쉽게 정의하기 어렵다. 단순 복부 X-선 사진을 이용한 점수체계(scoring system)는 간단하고 비용이 적게 들어 변비의 정도를 평가하는데 사용하고 있다. 그러나 소아변비의 정도를 평가하는데 어떤 점수체계가 임상적으로 더 유용한지에 대한 연구는 매우 드물다. 따라서 저자들은 소아 변비 환자에서 단순 복부 방사선사진을 이용하여 Barr, Blethyn과 Leech 점수를 측정하여 유용성을 비교 연구하였다. 방 법: 2006년 1월부터 8월까지 조선대학교 병원 소아과 외래를 방문하거나 입원한 4세에서 15세 사이의 환아 77명(변비군 38명, 대조군 39명)을 대상으로 하였다. 네 명의 전공의가 77매의 동일한 단순 복부 X-선 사진을 보고 Barr, Blethyn과 Leech 점수체계를 사용하여 1주 간격으로 각각 2회 점수를 매겼으며 점수 측정시에 환자의 대한 사전 정보를 배제하였다. 각 점수체계 방법에 대한 검사자들의 유의성은 ${\kappa}$ 상수을 계산하여 평가하였다. 결 과: 대상아 77명 중 남자는 41명(53.2%), 여자는 36명(46.8%)이었고 변비군은 38명(49.4%), 대조군은 39명(50.6 %)이었다. 네 명의 검사자가 측정한 Barr 점수로 계산한 ${\kappa}$ 상수는 각각 0.75, 0.66, 0.68, 0.71이었고, Blethyn 점수로 계산한 ${\kappa}$ 상수는 0.61, 0.58, 0.55, 0.63이며, Leech 점수로 계산한 ${\kappa}$ 상수는 0.88, 0.92, 0.86, 0.89이었다. Barr 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정 시에 각각 0.66, 0.67, 0.69, 0.66이었으며, 1주후에 두 번째 측정 시에는 각각 0.68, 0.65, 0.71, 0.68로 측정 시기에 따라 유의한 차이가 없었다(p>0.05)(Fig. 1). 네명의 검사자가 측정한 Blethyn 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정 시에 각각 0.44, 0.55, 0.48, 0.33이었으며, 1주 후에 두 번째 측정 시에는 0.65, 0.34, 0.39, 0.46으로 측정 시기에 따라 유의한 차이가 있었으며(p<0.05), Leech 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정시에 각각 0.88, 0.91, 0.92, 0.86이고 두 번째 측정 시에 각각 0.81, 0.88, 0.89, 0.84로 측정 시기에 따라 유의한 차이가 없었다(p>0.05). Barr 점수의 평균치는 변비군은 $9.68{\pm}3.55$, 대조군은 $5.32{\pm}3.45$로 두 군 사이에 유의한 차이가 없었다(p>0.05). Leech 점수의 평균치는 변비군은 $10.42{\pm}3.12$, 대조군은 $6.28{\pm}3.56$으로 두 군 사이에 유의한 차이가 있었다(p<0.05). 네 명의 검사자가 측정한 Barr 점수의 특이도는 각각 0.51, 0.55, 0.54, 0.71이었고 민감도는 각각 0.68, 0.61, 0.69, 0.61이었다. Leech 점수의 특이도는 각각 0.88, 0.91, 0.92, 0.86이었고 민감도는 각각 0.90, 0.89, 0.91, 0.84였다. 결 론: 단순 복부 X-선 사진을 이용한 점수체계는 소아 변비의 정도를 평가하는 데 있어서 검사자의 경력과는 무관하게 사용할 수 있으며 그 중 Leech 점수체계가 임상적으로 가장 유용하다.

• 한국임상수의학회지
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• 제24권1호
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• pp.46-50
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• 2007

A 7-year-old female, Jindo dog was referred to the Veterinary Teaching Hospital with mild dyspnea and anorexia due to a gunshot trauma. The dog was wounded in the thoracic region 3 days ago. Plain radiographs showed the left 8th rib fracture, interstitial pattern in the left caudal lung field and pleural effusion. Abdominal radiographs showed the lead bullet. Computed tomographs(CT) showed the size of pulmonary contusion, laceration, lung parenchymal injuries, hemothorax and perforation of abdominal wall. The therapeutic plan was based on abnormalities seen on CT scans but not clearly seen in survey radiographs. Thoracic CT significantly provides even more informations compared with the corresponding radiographs in thoracic gunshot trauma. Although thoracic survey radiographs are useful as a screening tool, CT is highly sensitive in detecting thoracic injuries after thoracic trauma and is superior to routine thoracic survey radiographs in visualizing lung contusion, pneumothorax and hemothorax. Therefore, we recommend CT in the initial diagnostic work-up of patients with thoracic injuries and with suspected chest trauma because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications.

• 한국임상수의학회지
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• 제25권1호
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• pp.52-57
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• 2008

An intact male, 3-year old, Sapsari, weighing 29 kg with a history of respiratory distress, anorexia, abdominal distension, and depression for 1 day was referred. Radiographic findings included a C-shaped soft tissue mass in the mid-abdominal cavity and loss of serosal detail. Ultrasonographs showed splenomegaly with hypoechoic coarse parenchyma, loss of venous flow in the dilated splenic veins, and thrombi. Based on image findings, acute isolated splenic torsion was diagnosed. Splenectomy and prophylactic gastropexy was performed. Another case was a spayed female, 8-year old, Shih-tzu, weighing 3.7 kg with a history of intermittent abdominal pain and a palpable abdominal mass for 1 year. Radiographic findings showed splenomegaly characterized by a soft tissue round mass. Ultrasonographs revealed displaced splenic hilum and absence of venous flow in the dilated splenic vein. Chronic isolated splenic torsion was diagnosed and also splenectomy and gastropexy was performed. Two dogs were recovered normally after surgery without any complications. Acute form of isolated splenic torsion showed acute systemic clinical signs, severe C-shaped splenomegaly on radiographs, and loss of all of splenic venous flow, perivenous hyperechoic triangle sign, and thrombi on ultrasonographs. Chronic form of isolated splenic torsion showed chronic obscure clinical signs, moderate splenomegaly on radiographs, and partial loss of splenic venous flow on ultrasonographs.

• 한국임상수의학회지
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• 제31권4호
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• pp.333-336
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• 2014

An 1-year-old, intact female Yorkshire Terrier weighing 1.83 kg was referred for vomiting and anorexia. Survey abdominal radiographs revealed marked gastric distention. Ultrasonography showed a hyperechoic material with acoustic shadowing near the pylorus. A foreign body and ulceration were identified during gastroscopic examination. After endoscopic retrieval of gastric foreign body, unexpectedly abdominal distention was developed. Abdominal radiographs revealed pneumoperitoneum, but no leakage of contrast media was observed in gastrointestinal contrast study. Three days after hospitalization with supportive care, no abnormal findings were detected, and then the dog was discharged. This case describes the development of peumoperitoneum during endoscopic retrieval of gastric foreign body.

• 한국임상수의학회지
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• 제14권1호
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• pp.131-135
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• 1997

Nutritional secondary hyperparathyroidism in a seven-month old male kitten showing signs of paraparesis (ataxia, dragging the pelvic limbs), abdominal distention, aconuresis was diagnosed with clinical signs, radiographs and serum biochemical tests. In radiographs, bones were abnormally radiolucent and cortices were thin. Serum biochemical tests were performed, but had normal values. The treatment was directed at the suspected dietary calcium and phosphorus imbalance. Oral calcium supplement and a commercial cat food were introduced. On clinical evaluation 3 months later, this case showed no clinical signs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.238-243
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• 2021

Caudal regression syndrome (CRS) is a rare neural tube defect that affects the terminal spinal segment, manifesting as neurological deficits and structural anomalies in the lower body. We report a case of a 31-month-old boy presenting with constipation who had long been considered to have functional constipation but was finally confirmed to have CRS. Small, flat buttocks with bilateral buttock dimples and a short intergluteal cleft were identified on close examination. Plain radiographs of the abdomen, retrospectively reviewed, revealed the absence of the distal sacrum and the coccyx. During the 5-year follow-up period, we could find his long-term clinical course showing bowel and bladder dysfunction without progressive neurologic deficits. We present this case to highlight the fact that a precise physical examination, along with a close evaluation of plain radiographs encompassing the sacrum, is necessary with a strong suspicion of spinal dysraphism when confronting a child with chronic constipation despite the absence of neurologic deficits or gross structural anomalies.