• International journal of advanced smart convergence
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• 제7권2호
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• pp.1-6
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• 2018

In this paper, we propose an automatic left ventricle segmentation method in computed tomography angiography (CTA) using separating energy function. First, we smooth the images by applying anisotropic diffusion filter to remove noise. Secondly, the volume of interest (VOI) is detected by using k-means clustering. Thirdly, we divide the left and right heart with split energy function. Finally, we extract only left ventricle from left and right heart with optimizing cost function including orientation term.

• Journal of Chest Surgery
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• 제26권7호
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• pp.548-551
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• 1993

Calcified right ventricular thrombi are very rare.One case of large clacified thrombus in right ventricle being seen in a 65-year old man, is presented. He had dyspnea and generalized edema.The chest film showed a large calcified mass in cardiac shadow especially in lateral view.On echocardiography and chest computed tomography, large calcified mass density occupied nearly entire right ventricular outflow tract.The mass removal was performed through right ventriculotomny.The mass was whitish, stony hard, measured 4 cm x 4.5 cm x 8 cm, tightly attached to right ventricular infundibular septum and ventriculoinfundibular fold.

• Journal of Chest Surgery
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• 제54권2호
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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.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.435-441
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• 2023

Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient's body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient's inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

• 대한방사선기술학회지:방사선기술과학
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• 제39권4호
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• pp.535-541
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• 2016

심장혈관검사에서 전산화단층검사(cardiac computed tomography; CCTA)와 혈관조영검사(coronary angiography; CAG)의 입사표면선량을 후향적 방법으로 분석하여 선량의 저감화 방안을 알아보고 조영제 사용량을 실제 측정하여 신기능 저하 환자 및 부작용 발생 확률이 높은 환자 등의 검사 선택 결정에 대한 역할을 확인하고자 하였다. 양 검사의 입사표면선량인 전산화단층촬영지수($CTDI_{vol}$)값과 공기 커마(air kerma)값, 그리고 프레임 수에 따른 조영제 사용량 등을 비교 분석하였다. 실험 대상으로는 2014년 5월부터 2016년 5월까지 본원에서 CCTA와 CAG를 시행한 21명(남11, 여10)을 대상으로 하였고 연령대는 48~85세(평균 $65{\pm}10$세)이고, 몸무게는 37.6~83.3 kg(평균 $63{\pm}6kg$)였다. CAG보다 CCTA를 이용한 심장혈관 검사가 선량의 감소를 기대할 수 있고 조영제 사용량에 있어서는 CCTA보다 CAG가 더 적은 양을 사용한다는 것을 알 수 있었다. 특히 CAG에서 프레임 수가 증가함에 따라 조영제 사용량이 늘어나므로 촬영범위에 적합한 프레임 수를 선택하여 검사 할수록 조영제 사용량을 더욱 감소시킬 수 있을 것으로 사료된다.

• Journal of Magnetics
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• 제17권3호
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• pp.229-232
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• 2012

This study examined the correlation between MR cine and myocardium Single-photon emission computed tomography (SPECT) by comparing the measured cardiac ejection fractions. The usefulness of cardiac MRI was also evaluated. Ten patients (8 men, 2 women and average age of 58.6 years), who underwent a myocardium SPECT scan and cardiac cine MRI scan among patients who visited the hospital for the chief complaint of cardiac disorder from June 1, 2010 to February 10, 2011, were enrolled in this study. The cardiac ejection fraction was calculated from the images obtained in both scans. The data was used to examine the correlation. The regression equation the cardiac ejection fraction values of the 10 patients obtained in myocardium SPECT and MRI cine was Y = 1.12X-8.91 ($R^2$ = 0.78, significance of F = 0.001639, and confidence level of 95%). The results were significant when the cardiac ejection fraction obtained from MRI cine was compared with that obtained from myocardium SPECT. Overall, a cardiac examination using MRI enables an investigation of not only the ejection fraction but also the ED and ES volumes, stroke volume, wall thickness, and wall thickening in a higher spatial resolution despite the examination being conducted once. This examination is believed to be very useful for diagnosing patients with cardiac disease.

• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.237-244
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• 2017

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

• Journal of Chest Surgery
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• 제55권1호
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• pp.95-97
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• 2022

A cardiac calcified amorphous tumor (CAT) is a rare non-neoplastic mass of the heart with histological characteristics comprising calcification and amorphous fibrous material. Little is known regarding the incidence, symptoms, and therapeutic strategies for CAT. Echocardiography and computed tomography were performed on a 48-year-old man who had a cardiac mass that was accidentally discovered on admission to a local hospital for a fracture related to a trauma that occurred 1 month prior. After surgery, a histological examination resulted in the diagnosis of a cardiac CAT. The patient was discharged without postoperative complications on the 12th day after surgery.

• 대한영상의학회지
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• 제85권1호
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• pp.210-214
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• 2024

심실간 막 중격류는 드문 질환이다. 이 동맥류는 우심실 유출 폐색이나 혈전색전증과 같은 합병증을 유발할 수 있으므로 이 동맥류를 발견하는 것은 임상적으로 의의가 있다. 우리는 뇌경색의 원인으로 생각되는 심실간 막 중격류에 생긴 혈전을 보고하고자 한다.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1764-1776
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• 2021

Objective: This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods: We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1-10, 11-100, 101-400, > 400) was evaluated. Results: In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion: The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.