• Title/Summary/Keyword: Chest CT scan

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An Extra-adrenal Pheochromocytoma Presenting with Spontaneous Intracerebral Hematoma

  • Park, Seong-Keun;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.61-64
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    • 2005
  • We report a 18-year-old man, who has been taking antihypertensive medication for 1month in a local clinic, presented with a sudden onset headache followed by left blindness. He experienced palpitation and chest discomfort during physical exertion since 2years before admission, but unfortunately has been ignored. Brain CT showed intracerebral hemorrhage in the left temporoparietal area, but cerebral angiogram and magnetic resonance image revealed no vascular anomaly. He was managed conservatively, and headache and visual loss were improved over time. Subsequently, on the evaluation of hypertension, he was diagnosed as having extra-adrenal pheochromocytoma on left paraaortic area from the results of endocrinological evaluations, abdominal CT scan, and $^{131}I$-MIBG scintigraphy.

Validation of Deep-Learning Image Reconstruction for Low-Dose Chest Computed Tomography Scan: Emphasis on Image Quality and Noise

  • Joo Hee Kim;Hyun Jung Yoon;Eunju Lee;Injoong Kim;Yoon Ki Cha;So Hyeon Bak
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.131-138
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    • 2021
  • Objective: Iterative reconstruction degrades image quality. Thus, further advances in image reconstruction are necessary to overcome some limitations of this technique in low-dose computed tomography (LDCT) scan of the chest. Deep-learning image reconstruction (DLIR) is a new method used to reduce dose while maintaining image quality. The purposes of this study was to evaluate image quality and noise of LDCT scan images reconstructed with DLIR and compare with those of images reconstructed with the adaptive statistical iterative reconstruction-Veo at a level of 30% (ASiR-V 30%). Materials and Methods: This retrospective study included 58 patients who underwent LDCT scan for lung cancer screening. Datasets were reconstructed with ASiR-V 30% and DLIR at medium and high levels (DLIR-M and DLIR-H, respectively). The objective image signal and noise, which represented mean attenuation value and standard deviation in Hounsfield units for the lungs, mediastinum, liver, and background air, and subjective image contrast, image noise, and conspicuity of structures were evaluated. The differences between CT scan images subjected to ASiR-V 30%, DLIR-M, and DLIR-H were evaluated. Results: Based on the objective analysis, the image signals did not significantly differ among ASiR-V 30%, DLIR-M, and DLIR-H (p = 0.949, 0.737, 0.366, and 0.358 in the lungs, mediastinum, liver, and background air, respectively). However, the noise was significantly lower in DLIR-M and DLIR-H than in ASiR-V 30% (all p < 0.001). DLIR had higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) than ASiR-V 30% (p = 0.027, < 0.001, and < 0.001 in the SNR of the lungs, mediastinum, and liver, respectively; all p < 0.001 in the CNR). According to the subjective analysis, DLIR had higher image contrast and lower image noise than ASiR-V 30% (all p < 0.001). DLIR was superior to ASiR-V 30% in identifying the pulmonary arteries and veins, trachea and bronchi, lymph nodes, and pleura and pericardium (all p < 0.001). Conclusion: DLIR significantly reduced the image noise in chest LDCT scan images compared with ASiR-V 30% while maintaining superior image quality.

Assessment of Treatment Response in Patients With Severe Asthma Using Visual and Quantitative Analysis of Chest CT

  • Han Na Lee;Jin An;Miji Lee;Hye Jeon Hwang;Jooae Choe;Jihye Yoon;Ji-Hyang Lee;Min-Hye Kim;Young-Joo Cho;Sang Min Lee;Tae-Bum Kim;Joon Beom Seo
    • Korean Journal of Radiology
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    • v.25 no.7
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    • pp.673-683
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    • 2024
  • Objective: To evaluate the role of visual and quantitative chest CT parameters in assessing treatment response in patients with severe asthma. Materials and Methods: Korean participants enrolled in a prospective multicenter study, named the Precision Medicine Intervention in Severe Asthma study, from May 2020 to August 2021, underwent baseline and follow-up chest CT scans (inspiration/expiration) 10-12 months apart, before and after biologic treatment. Two radiologists scored bronchiectasis severity and mucus plugging extent. Quantitative parameters were obtained from each CT scan as follows: normal lung area (normal), air trapping without emphysema (AT without emph), air trapping with emphysema (AT with emph), and airway (total branch count, Pi10). Clinical parameters, including pulmonary function tests (forced expiratory volume in 1 s [FEV1] and FEV1/forced vital capacity [FVC]), sputum and blood eosinophil count, were assessed at initial and follow-up stages. Changes in CT parameters were correlated with changes in clinical parameters using Pearson or Spearman correlation. Results: Thirty-four participants (female:male, 20:14; median age, 50.5 years) diagnosed with severe asthma from three centers were included. Changes in the bronchiectasis and mucus plugging extent scores were negatively correlated with changes in FEV1 and FEV1/FVC (ρ = from -0.544 to -0.368, all P < 0.05). Changes in quantitative CT parameters were correlated with changes in FEV1 (normal, r = 0.373 [P = 0.030], AT without emph, r = -0.351 [P = 0.042]), FEV1/FVC (normal, r = 0.390 [P = 0.022], AT without emph, r = -0.370 [P = 0.031]). Changes in total branch count were positively correlated with changes in FEV1 (r = 0.349 [P = 0.043]). There was no correlation between changes in Pi10 and the clinical parameters (P > 0.05). Conclusion: Visual and quantitative CT parameters of normal, AT without emph, and total branch count may be effective for evaluating treatment response in patients with severe asthma.

Coarctation of the Aorta Associated with Chronic Thoracic Aortic Aneurysm -A case report - (만성 흉부 대동맥류를 동반한 대동맥 축착증 - 1예 보고 -)

  • 구자홍;김경화;김민호;김공수
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.691-694
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    • 2003
  • A 49-year-old woman had thoracic back pain for several years. Chest CT scan and MRI angiography revealed descending thoracic aortic aneurysm with a maximum diameter of 69 mm. Thoracic aortography showed not only the aortic aneurysm, but also coarctation of descending thoracic aorta at the level of aortic hiatus of the diaphragm. Intercostal artery arising Adamkiewicz artery was found in descending thoracic aortic aneurysm just above the coarctation, The aneurysm with coarctation of the aorta was successfully repaired with prosthetic graft replacement under left atrio-femoral bypass.

Primary Malignant Lymphoma of Lung -A Case Report- (원발성 악성 폐 임파종 -수술 치험 1례-)

  • 전홍주;김병훈;류지윤
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.820-822
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    • 1998
  • Primary malignant lymphoma of lung is a very rare disease, only 0.34% of all malignant lymphomas. In our case, a 76 year old male patient had a solitary mass without lympha- denopathy at chest CT scan. He underwent right middle lobectomy through a posterolateral thoracotomy incision. Pathologic study confirmed a diagnosis of malignant lymphoma and chemotherapy was started by an oncologist.

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Localized Fibrous Tumor of the Pleura (흉막에 발생한 국소성 섬유성 종양)

  • 김대영;손제문
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.112-114
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    • 1996
  • Localized fibrous tumor of the pleura (LFTP) is of submesothelial fibrous origin, which has been called pleural fibroma and has been confused with mesothelioma. We experienced a case of LFTP in a twenty nine year old man. The tumor arose from the right parietal pleura with long stalk. Chest X-ray and CT scan showed a 6$\times$5$\times$4cm well-defined mass in the right costophrenic angle. Wo evidence of metastasis was noted. Exploratory thoracotomy with enbloc excision of 6$\times$5$\times$4cm mass was done. The fine needle aspiration cytology and histopathologic features indicated the tumor to be malignant, and biologic behavior was discussed.

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Acquired Pulmonary Arteriovenous Fistula -A Case Report- (후천성 폐 동정맥루 -1례 보고-)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.495-498
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    • 1995
  • Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

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Circumferential Resection and End to End Anastomosis of Mediastinal Trachea for Long Tracheal Stenosis (주기관 긴 협착증 환자의 수술 치험)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.588-592
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    • 1992
  • Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

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Surgical Resection of Tracheal Leiomyoma; A cas report (기관 평활근종의 수술적 절제;1례 보고)

  • 심재천
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.965-968
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    • 1993
  • Primary benign tracheal tumors are exceedingly rare and leiomyoma has the least frequency among them. It is important to recognize early without misdiagnosis such as asthma because it is curable. A 41 year-old female was admitted for dyspnea and choking since November 1991. Under the impression of asthma, she received medication. Symptom was not improved and thus chest CT scan was performed. There was endotracheal tumor mass which was located just above the carina and arose from the right lateral tracheal wall with broad base. We successfully resected the tumor mass including trachea and the defected area of trachea was reconstructed with autologous graft using pericrdium & rib cartilage. During the follow up period, no complication was developed.

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A case Report of Tracheal Lipoma (기관내 지방종-1례 보고-)

  • 문석환;조민섭
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.441-444
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    • 1997
  • Pure lipoma, originating from the trachea is a very rara disease entity A-37-ycar-old-male patient had suf'leered from intermittent episodes of dyspnea and has been treated under the diagnosis of bronchial asthma for 6 months. On chest CT scan and bronchofiberscopic examination, a round mass with the pedunculated neck was found in the mid-portion of the membranous portion of the intrathoracic trachea. Under the guide of fiberoptic bronchoscope, the mass was extirpated using polypectomy w re loop and eletrocauterization . He was discharged without any events on third postoperative day of operation and has been well without recurrence for 6 months.

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