• Korean Journal of Radiology
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• 제22권8호
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• pp.1416-1435
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• 2021

Non-infectious granulomatous lung disease represents a diverse group of disorders characterized by pulmonary opacities associated with granulomatous inflammation, a relatively nonspecific finding commonly encountered by pathologists. Some lesions may present a diagnostic challenge because of nonspecific imaging features; however, recognition of the various imaging manifestations of these disorders in conjunction with patients' clinical history, such as age, symptom onset and duration, immune status, and presence of asthma or cutaneous lesions, is imperative for narrowing the differential diagnosis and determining appropriate management of this rare group of disorders. In this pictorial review, we describe the pathologic findings of various non-infectious granulomatous lung diseases as well as the radiologic features and high-resolution computed tomography imaging features.

• 대한방사선기술학회지:방사선기술과학
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• 제40권4호
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• pp.567-573
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• 2017

본 연구의 목적은 흉 복부 다중검출기전산화단층촬영(multi-detector computed tomography; MDCT)에서 상지를 머리 위로 위치 잡이 할 수 없는 경우 흉 복부에서 거리에 따른 인공유무를 평가하고자 하였다. 128-채널 MDCT로 흉 복부 CT를 위한 인체대상과 흉부 팬텀을 현재 임상에서 검사하고 있는 조건(120 kVp, 110 mAs, standard algorithm)으로 검사하였다. 인체 검사 시 한번은 팔을 머리 쪽으로 올리고 검사하고, 팔을 내린 후 동일한 조건으로 한 번 더 검사하였다. 흉부 팬텀 실험은 환자와 동일한 조건으로 검사를 하고, 상지팬텀을 흉 복부에서 일정한 거리(0, 3, 7 cm)를 두고 검사하였다. 목적하는 부위에 관심영역을 설정하여 CT 값, 노이즈, 신호 대 잡음비, 대조도 대 잡음비를 측정하여 평가하였다. 인체를 대상으로 획득한 영상에서 노이즈는 팔을 올렸을 때와 비교하여 팔을 내렸을 때 지방, 갈비뼈, 근육 모두에서 증가하였다(0.79, 47.8, 27%). 팬텀 영상에서도 상지를 아래로 내렸을 경우 근육, 폐 실질에서 노이즈가 증가하였다(31.2, 9.4%). 또한 상지의 위치가 흉 복부에서 멀어질수록(0, 3, 7 cm) 노이즈가 감소하였다. 근육에서 노이즈는 상지가 흉부와 붙어있을 경우(0 cm)를 기준으로 3 cm, 7cm 떨어졌을 때 5, 25.12% 감소하였고, 폐실질에서 5.6, 15.35% 감소하였다. 흉 복부 CT 촬영 시 갠트리 내 검사 이외의 부위(상지 등)가 위치할 경우 흉 복부로부터 약 3 cm 이상 거리를 유지시킨 후 검사를 진행하면 발생할 수 있는 인공음영을 최소화시킬 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제50권6호
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• pp.424-429
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• 2017

Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.218-222
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• 2012

Pulmonary artery intimal sarcoma is a rare tumor with no characteristic symptoms. It is frequently misdiagnosed as pulmonary embolism. We report a case of pulmonary artery intimal sarcoma in a 48-year-old man with dyspnea, cough and blood-tinged sputum. He was initially suspected and treated as a pulmonary embolism. Computed tomography of the chest showed filling defects occupying the entire luminal diameter of the right and left pulmonary artery as well as extraluminal extension of the intraluminal mass. Surgical resection of the tumor confirmed pulmonary artery intimal sarcoma. After surgery, he received 8 cycles of combined chemotherapy consisting of doxorubicin and ifosfamide. After 8 cycles, Computed tomography of the chest showed interval regression of the residual tumor. Radiotherapy was done as total 6,000 cGy for 5 weeks, following the 8th chemotherapy. The patient's condition was successfully stabilized with chemotherapy and radiotherapy.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.52-55
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• 2010

Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

• 방사선산업학회지
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• 제12권4호
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• pp.365-372
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• 2018

The use of CT examinations is increasing rapidly and radiation dose from CT examinations is much higher than other diagnostic radiography examinations including general radiography and mammography. DRLs used to optimize the radiation dose of patients by diagnostic radiology in each country. The objective of this study was to investigate and to analyze the status of DRLs from CT examinations in domestic and other countries. In other countries, DRLs were set for each age group and each examination considering the medical situation of each country. In Korea, DRLs were set for adults and children in 2017. For adults, DRLs were set for 13 examinations. Reported DLP values were 1119, 297, $472mGy{\cdot}cm$ for head, chest and abdomen pelvis examination, respectively. For children, DRLs were set for head examinations. Reported DLP values were 298 (0~1 years), 404 (2~5 years), 494 (6~10 years), 1,088 (11~15 years) $mGy{\cdot}cm$. DRLs of Korea were similar to other countries for head examinations. For chest examinations and abdomen pelvis examinations were relatively lower than other countries. As a major reason for relatively low radiation dose, it is considered to contribute the activity and management of medical radiation safety at national level.

• Korean Journal of Radiology
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• 제1권3호
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• pp.135-141
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• 2000

Objective: To compare the clinical utility of the different imaging techniques used for the evaluation of tracheobronchial diseases. Materials and Methods: Forty-one patients with tracheobronchial diseases [tuberculosis (n = 18), bronchogenic carcinoma (n = 10), congenital abnormality (n = 3), post-operative stenosis (n = 2), and others (n = 8)] underwent chest radiography and spiral CT. Two sets of scan data were obtained: one from routine thick-section axial images and the other from thin-section axial images. Multiplanar reconstruction (MPR) and shaded surface display (SSD) images were obtained from thin-section data. Applying a 5-point scale, two observers compared chest radiography, routine CT, thin-section spiral CT, MPR and SSD imaging with regard to the detection, localization, extent, and characterization of a lesion, information on its relationship with adjacent structures, and overall information. Results: SSD images were the most informative with regard to the detection (3.95±0.31), localization (3.95±0.22) and extent of a lesion (3.85±0.42), and overall information (3.83±0.44), while thin-section spiral CT scans provided most information regarding its relationship with adjacent structures (3.56±0.50) and characterization of the lesion (3.51±0.61). Conclusion: SSD images and thin-section spiral CT scans can provide valuable information for the evaluation of tracheobronchial disease.

• Journal of Chest Surgery
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• 제32권2호
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• pp.194-197
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• 1999

지질성 폐렴이란 폐포나 간질에 존재하는 지질에 대한 폐조직의 반응을 의미하며 내인성과 외인성으로 구분된다. 내인성은 지질이 폐실질에서 생성된 경우를 말하며 외인성은 지질을 흡인하거나 흡입한 경우를 말한다. 본 증례의 경우 53세 남자가 오한과 혈담을 주소로 내원하여 경피적 흉막 및 폐생검을 시행후 내인성 지질성폐렴 진단하에 좌하엽절제술 및 늑막박피술을 치험하였기에 보고하고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제73권6호
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• pp.320-324
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• 2012

A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.

• Tuberculosis and Respiratory Diseases
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• 제69권2호
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• pp.103-107
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• 2010

Background: The aim of the present study was to evaluate whether findings on initial chest computed tomography (CT) of influenza pneumonia can help predict clinical outcome. Methods: We reviewed all adult patients admitted to the Emergency Department (ED) with a confirmed diagnosis of novel influenza A H1N1 virus (2009 H1N1) pneumonia, who underwent chest CT upon admission between Aug 26, 2009 and Jan 31, 2010. Radiologic findings were characterized by type and pattern of opacities and zonal distribution. Clinical outcome measures were intensive care unit (ICU) admission, mechanical ventilation, and inhospital death. Results: Of 59 patients diagnosed with 2009 H1N1 pneumonia, 41 (69.5%) underwent chest CT on admission into ED. Nine (22%) of these patients developed adverse clinical outcomes requiring the following treatments: 9 (22.0%) ICU admissions, 5 (12.2%) mechanical ventilation, and 3 (7.3%) inhospital deaths. Counting the number of patients with more than 4 involved lobes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of adverse clinical outcome were 67%, 84%, 55% and 80%, respectively. Conclusion: Extensive involvement of both lungs (over 4 lobes) is related to ICU admission, mechanical ventilation, and inhospital death. Initial chest CT may help predict an adverse clinical outcome of patients with 2009 H1N1 influenza pneumonia.