• Title/Summary/Keyword: CT, MRI

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Delayed Transfer of Major Trauma Patients Under the Current Emergency Medical System in Korea (현재의 국내 응급의료체계에서 중증외상환자의 이송 지연)

  • Jung, Kyoung-Won;Jang, Jeong-Moon;Kim, Ji-Young;Baek, Suk-Ja;Song, Seo-Young;Gang, Chan-Suk;Lee, Kug-Jong
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.25-30
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    • 2011
  • Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

Influence of Iodinated Contrast Media and Paramagnetic Contrast Media on Changes in Uptake Counts of 99mTc

  • Cho, Jae-Hwan;Lee, Jin-Hyeok;Park, Cheol-Soo;Lee, Sun-Yeob;Lee, Jin;Moon, Deog-Hwan;Lee, Hae-Kag
    • Journal of Magnetics
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    • v.19 no.3
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    • pp.248-254
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    • 2014
  • The purpose of this study is to figure out how uptake counts of technetium ($^{99m}Tc$) among radioisotopes in the human body are affected if computed tomography (CT), magnetic resonance imaging (MRI) and isotope examination are performed consecutively. $^{99m}Tc$ isotope material, iodinated contrast media for CT and paramagnetic contrast media for magnetic resonance (MR) were used as experimental materials. First, $^{99m}Tc$ was added to 4 cc normal saline in a test tube. Then, 2 cc of CT contrast media such as $Iopamidol^{(R)}$ and $Dotarem^{(R)}$ were diluted with 2 cc normal saline, and 2cc of MRI contrast media such as $Primovist^{(R)}$ and $Gadovist^{(R)}$ were diluted with 2 cc normal saline. Each distributed contrast media was a total of 4 cc and included 10m Ci of $^{99m}Tc$. A gamma camera, a LEHR (Low energy high resolution) collimator and a pin-hole collimator were used for image acquisition. Image acquisition was repeated a total of 6 times and 120 frames were obtained and uptake counts of $^{99m}Tc$ were measured (from this procedure). In this study, as a result of measuring the uptake counts of $^{99m}Tc$ using the LEHR collimator, the uptake counts were less measured in all contrast media than normal saline as a reference. In particular, the lowest uptake counts were measured when $Gadovist^{(R)}$, contrast media for MRI, was used. However, the result of measuring the uptake counts of $^{99m}Tc$ using the pin-hole collimator showed higher uptake counts in all contrast media, except for $Iopamidol^{(R)}$, than normal saline as a reference. The highest uptake counts were measured particularly when $Primovist^{(R)}$, contrast media for MRI, was used. In performing the gamma camera examination using contrast media and $^{99m}Tc$, it is considered significant to check the changes in the uptake counts to improve various diagnosis values.

Vertebral Osteosarcoma Causing Compression of the Lumbar Spinal Cord in a Dog (개에서 요추부 척수를 압박하는 척추 골육종 발생례)

  • Kang, Byung-Jae;Ryu, Hak-Hyun;Park, Sung-Su;Rahman, Md. Mizanur;Sung, Gyu-Jin;Kim, Yong-Sun;Park, Jun-Won;Kim, Wan-Hee;Yoon, Jung-Hee;Kim, Dae-Yong;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.588-592
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    • 2010
  • A 15-year-old neutered male Yorkshire terrier was presented with a gait disorder of the pelvic limbs. For differential diagnosis of neural disease, magnetic resonance imaging (MRI) and computed tomography (CT) scan were performed. CT showed bone defect in the 4th lumbar vertebra and adjacent soft tissue mass. MRI revealed a mass in left side of the 4th lumbar vertebra. The mass was uniformly enhanced on contrast-enhanced T1-weighted imaging (T1W1). Excision of the mass alleviated back pain. Vertebral osteosarcoma was identified by the histopathological examination. Therefore, CT and MRI were helpful to diagnose vertebral osteosarcoma in the dog and to plan surgical excision of the mass.

Signal Change of Iodinated Contrast Agents in MR Imaging (요오드화 조영제가 MR영상에 미치는 신호 변화)

  • Jeong, HK;Kim, Seongho;Kang, Chunghwan;Lee, Suho;Yi, Yun;Kim, Mingi;Kim, Hochul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.131-138
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    • 2016
  • In this study, we tried to analyze the influence of ICM(Iodinated Contrast Media) in MR imaging compare to GBCA(Gadolinium Based Contrast Agent), and as this result we discussed whether resonable or not the protocol which is MRI scan after enhanced CT scan without proper time interval in clinical field. For this research, we assembled two phantoms. which one was iodine and another one was gadolinium. We did test two phantoms in conventional MRI scan which is T1, T2, T2 FLAIR and 3D angio. After that, quantitative analysis was progressed. The results of study were as follow : SSI(Saline's Signal Intensity) was shown as each sequences 175, 1231, 333, 37 [a.u] at iodine. and 1297, 123, 757, 232 [a.u] was recorded at gadolinium. BDEPS(the Biggest Difference of EPS) was shown as each sequences 1297, 123, 757, 232 [a.u] at iodine and 793, 6, 1495, 365 [a.u] was recorded at gadolinium. At this time, EPS(Enhancement Percentage to Saline) was shown 641.1, -90.0, 127.3, 527% at iodine and 685.1, 99.4, 365.7, 1077.4% was recorded at gadolinium. BP(BDEPS's point) was shown 900, 900, 477, 900 mmol at iodine and 4, 0.2, 0.2, 40 mmol was recorded at gadolinium. CPSS(Change Point of SI to SSI) was shown 63, 423, 63, 29 mmol at iodine and each [50, 30], [4, 0.2], [4, 1], 0.2 mmol was recorded at gadolinium. According to this research, we could not only discover the fact that was iodine could effect on MR signal, but also the pattern is different as various sequences compare to gadolinium. Therefore, we expect useful diagnostic MR image in clinical field with this quantitative data for deciding protocol regarding MRI and CT scan order.

임상가를 위한 특집 3 - 구강악안면영역에서 악성종양의 영상진단 : 상악골의 파괴를 동반한 악성종양의 영상진단

  • Heo, Gyeong-Hoe
    • The Journal of the Korean dental association
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    • v.47 no.10
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    • pp.647-655
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    • 2009
  • 지면의 한계 상 다양한 악성종양을 모두 다룰 수가 없어, 주로 상악에 발생하여 골 파괴를 야기하고 있는 증례들의 영상 소견을 소개하고자 한다. 악성종양의 진단 과정에는 보통 CT, MRI, PET/CT 등의 특수 장치들이 필요하지만, 개원의들이 일반 환자들의 진단과 치료 과정에서 흔히 접하게 되는 파노라마 방사선사진을 중심으로 하여, 악성종양들의 병인이나 기본적인 악성종양에 대한 설명 보다는 실제 임상 증례들을 통해 악성종양의 공통된 영상 소견 특징을 찾아보고자 한다.

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Impact of the Liver Imaging Reporting and Data System on Research Studies of Diagnosing Hepatocellular Carcinoma Using MRI

  • Yura Ahn;Sang Hyun Choi;Jong Keon Jang;So Yeon Kim;Ju Hyun Shim;Seung Soo Lee;Jae Ho Byun
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.529-538
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    • 2022
  • Objective: Since its introduction in 2011, the CT/MRI diagnostic Liver Imaging Reporting and Data System (LI-RADS) has been updated in 2014, 2017, and 2018. We evaluated the impact of CT/MRI diagnostic LI-RADS on liver MRI research methodology for the diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: The MEDLINE, EMBASE, and Cochrane databases were searched for original articles reporting the diagnostic performance of liver MRI for HCC between 2011 and 2019. The MRI techniques, image analysis methods, and diagnostic criteria for HCC used in each study were investigated. The studies were classified into three groups according to the year of publication (2011-2013, 2014-2016, and 2017-2019). We compared the percentage of studies adopting MRI techniques recommended by LI-RADS, image analysis methods in accordance with the lexicon defined in LI-RADS, and diagnostic criteria endorsed by LI-RADS. We compared the pooled sensitivity and specificity between studies that used the LI-RADS and those that did not. Results: This systematic review included 179 studies. The percentages of studies using imaging techniques recommended by LI-RADS were 77.8% for 2011-2013, 85.7% for 2014-2016, and 84.2% for 2017-2019, with no significant difference (p = 0.951). After the introduction of LI-RADS, the percentages of studies following the LI-RADS lexicon were 0.0%, 18.4%, and 56.6% in the respective periods (p < 0.001), while the percentages of studies using the LI-RADS diagnostic imaging criteria were 0.0%, 22.9%, and 60.7%, respectively (p < 0.001). Studies that did not use the LI-RADS and those that used the LIRADS version 2018 showed no significant difference in sensitivity and specificity (86.3% vs. 77.7%, p = 0.102 and 91.4% vs. 89.9%, p = 0.770, respectively), with some difference in heterogeneity (I2 = 94.3% vs. 86.7% in sensitivity and I2 = 86.6% vs. 53.2% in specificity). Conclusion: LI-RADS imparted significant changes in the image analysis methods and diagnostic criteria used in liver MRI research for the diagnosis of HCC.

A Case of Xanthogranulomatous Pyelonephritis with Nephropleural Fistula Formation: Role of MRI in Diagnosis and Treatment (황색육아종성 신우신염의 신장-흉강 누공 형성의 증례: 진단과 치료에서의 자기공명영상의 역할)

  • Geon Yang Lee;Sung Kyoung Moon;Myung-Won You;Joo Won Lim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.475-480
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    • 2021
  • Xanthogranulomatous pyelonephritis (XGP) is a rare type of chronic bacterial nephritis, which rarely involves the invasion of adjacent organs or the formation of fistulas due to tissue-destructive granulomatous reactions. Although the invasions of various adjacent organs have been reported in several cases of XGP, MRI data on their features are limited. MRI has a better soft-tissue resolution than CT. Thus, it can identify the extent of extrarenal involvement in advanced XGP, and the findings can be used in treatment planning. Herein, we report a rare case of XGP with nephropleural fistula formation diagnosed using CT and MRI.

Tuberculous Pericarditis Mimicking a Malignant Pericardial Tumor: A Case Report (악성 심막 종양으로 오인한 결핵성 심막염: 증례 보고)

  • Ji Young Park;Ji-Yeon Han;Jinyoung Park;Gi Won Shin;Su Young Yun;Mi Seon Kang;Da Som Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.197-203
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    • 2024
  • Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

Developments of Small Animal Imaging Systems in Korea (소동물 영상시스템의 국내 개발 현황)

  • Lee, Soo-Yeol
    • Journal of Biomedical Engineering Research
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    • v.30 no.1
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    • pp.1-9
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    • 2009
  • Many types of small animal imaging modalities, like micro-CT, micro-PET, and micro-SPECT, have been recently developed worldwide. Small animal imaging systems are now recognized as indispensable tools to validate efficacy and safety of new drugs or new therapeutic methods using the animal disease models. With increasing demands for small animal imaging in biomedical research, multimodal small animal imaging systems, like micro-PET/CT or micro PET/MRI, are now also being developed. Small animal imaging with spatial resolution and sensitivity comparable to human imaging is quite challenging since laboratory small animals are much smaller than human beings. Research activities in Korea on small animal imaging systems are reviewed in this paper. In the field of micro-CT and micro-PET, many world-class technologies have been developed successfully in Korea. It is expected that the developed animal imaging system technologies can be used in the development of clinical imaging systems in Korea in the near future.

Clinical Application of $^{18}F-FDG$ PET in Malignant Mesothelioma (악성중피종에서 $^{18}F-FDG$ PET의 임상응용)

  • Lee, Eun-Jeong
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.157-161
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    • 2008
  • Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multi modality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with $^{18}F-FDG$ comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.