• Title/Summary/Keyword: Chest computed tomography

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A Phantom Study for the Optimal Low-dose Protocol in Chest Computed Tomography Examination (흉부 전산화단층촬영검사를 위한 최적의 저선량 프로토콜에 관한 팬텀연구)

  • Kim, Young-Keun;Yang, Sook;Wang, Tae-uk;Kim, Eun-Hye
    • Journal of radiological science and technology
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    • v.44 no.2
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    • pp.101-107
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    • 2021
  • The purpose of this study was to evaluate optimal CT scan parameters to minimize patient dose to the irradiation and maintain satisfactory image quality in low-dose chest computed tomography (CT) scans. In a chest anthropomorphic phantom, chest CT scans were performed at different kVp and mA within reference of 3.4mGy in volume CT Dose Index (CTDIvol). The following quantitative parameters had been statistically evaluated: image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM). Nine radiographers conducted the blind test to select the optimal kVp-mA combination. Results indicated that the kVp-mA combination of 80kVp-90mA, 100kVp-50mA, 120kVp-30mA and 140kVp-30mA were obtained high SNR and CNR. The 120kVp-30mA combination offered good compromise in the FOM, which showed the quality and dose performance. In the blind test, an image of 80kVp-90mA obtained a high score with 4.7 points, and 120kVp-10mA or 140kVp-10mA with a low tube current were observed severe noise and poor image quality, thus resulting in decreased diagnostic accuracy. On the other hand, in the combination of high kVp and high mA(140kVp-90mA), the image quality was improved, but the radiation dose was also increased. the FOM value of 140kVp-90mA was lower than 120kVp-30mA. The application of appropriate scan parameters in low-dose chest CT scans produced satisfactory results in dose and image quality for the accuracy of the clinical diagnosis.

Primary leiomyosarcoma of the chest wall in a child : a case report (소아의 흉벽에서 진단된 평활근육종 1례)

  • Choi, Jae Hyuk;Chung, David Chanwook;Lee, Mee Jeong
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.98-101
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    • 2008
  • Leiomyosarcoma is an uncommon soft tissue sarcoma of mesenchymal cell origin, which shows smooth muscle differentiation. Leiomyosarcoma is seldom found in the pediatric population, and accounts for fewer than 2% of all soft tissue sarcomas. Leiomyosarcoma of the chest wall is extremely rare in children. We report here a case of an 8-year-old boy with a primary leiomyosarcoma that was incidentally found as a rib mass. The patient underwent a complete resection for a suspected osteochondroma diagnosed by a three-dimensional chest computed tomography examination. Pathological findings of the mass revealed intersecting fascicles of spindle cells showing cigar-shaped nuclei, inconspicuous nuclear pleomorphism and occasional mitotic figures in the background of a suspected osteochondroma of the rib. This report documents the first description of a leiomyosarcoma possibly arising in an osteochondroma of the rib in a child.

Pulmonary Bone Cement Embolism Following Percutaneous Vertebroplasty (요추 압박 골절의 골 시멘트를 이용한 척추성형술 치료 후 발생한 폐동맥 시멘트 혈전증: 증례보고)

  • Cha, Yong Han
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.202-205
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    • 2015
  • Purpose: Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable. Case description: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. Literature Reviews: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces. Conclusion: Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

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Surgical Treatment of Pulmonary Actinomycosis Mimicking Pulmonary tuberculosis (폐결핵으로 오인된 폐방선균증의 수술적 치험 1례)

  • 백효채;이진구;강정한;정경영;구자승
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.315-317
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    • 2002
  • Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

Radiation Dose Reducing Effect during the AEC System in the Chest and Abdomen of the MDCT Scanning (흉부 및 복부에서 AEC 적용에 따른 MDCT의 선량 감소 효과)

  • Lee, Jong-Seok;Kweon, Dae-Cheol;You, Beong-Gyu
    • The Journal of the Korea Contents Association
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    • v.9 no.3
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    • pp.225-231
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    • 2009
  • The purpose of the current study was to compare radiation dose of 64MDCT performed with automatic exposure control (AEC) with manual selection fixed tube current. We evaluated the CT scans of phantom of the chest and abdomen using the fixed tube current and AEC technique. Objective image noise shown as the standard deviation of CT value in Hounsfield units was measured on the obtained images. Compared with fixed tube current, AEC resulted in reduction of the chest and abdomen in the CTDIvol (35.2%, 5.9%) and DLP (49.3%, 3.2%). Compared with manually selected fixed tube current, AEC resulted in reduced radiation dose at MDCT study of chest and abdomen.

Bronchogenic Cyst of the Right Hemidiaphragm Presenting with Pleural Effusion

  • Kim, Jae-Bum;Park, Chang-Kwon;Kum, Dong-Yoon;Lee, Deok-Heon;Jung, Hye-Ra
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.86-88
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    • 2011
  • Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum or lung parenchyma. An isolated bronchogenic cyst of the diaphragm is very rare. Our case was a 56-year-old female patient who presented with pleuritic chest pain in her right chest. Chest and abdominal computed tomography revealed a large lobulated cystic mass that was accompanied with pleural effusion in the right lower hemithorax. The tumor showed focally calcified areas in the wall and abutted against the diaphragm. We performed complete excision of the cyst including a portion of the diaphragm attached to it. The pathological diagnosis was established as the bronchogenic cyst originating from the diaphragm. We report this case with a review of the literature.

Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest

  • Seok, Junepill;Wang, Il Jae
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.284-287
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    • 2021
  • We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.

Diaphragmatic Hernia with Stomach Rupture after Blunt Chest Trauma at a Short Interval: A Case Report

  • Lee, Seung Hyong;Lee, Sun-Geun;Kim, Dae Hyun;Cho, Sang-Ho;Song, Jae Won;Park, Won Kyoun
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.85-87
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    • 2022
  • Diaphragmatic hernias have been reported in 0.8%-1.6% of patients who experience blunt chest trauma. The hernia is assumed to form as a result of direct diaphragmatic violation or significant intraabdominal or intrathoracic pressure caused by the trauma. Some reports have described cases of delayed diaphragmatic hernia and subsequent stomach perforation that occurred a few days to several years after an accident. We report an extremely rare case of diaphragmatic herniation in which the process from initial blunt trauma to visceral organ perforation took only 2 days, without any evidence of herniation on the initial X-ray or computed tomography. Delayed diaphragmatic herniation and subsequent visceral organ perforation should not be missed during the period immediately after blunt chest trauma.

Missed Lung Cancers on Chest Radiograph: An Illustrative Review of Common Blind Spots on Chest Radiograph with Emphasis on Various Radiologic Presentations of Lung Cancers (놓치기 쉬운 폐암: 흉부 X선 진단의 함정에 대한 이해와 다양한 폐암 영상 소견의 중요성)

  • Goun Choi;Bo Da Nam;Jung Hwa Hwang;Ki-Up Kim;Hyun Jo Kim;Dong Won Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.351-364
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    • 2020
  • Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

Synovial Sarcoma of the Anterior Chest Wall: A Case Report (앞가슴벽에 생긴 윤활막육종: 증례 보고)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1227-1233
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    • 2020
  • Synovial sarcoma is a malignant soft tissue tumor that usually involves the extremities, particularly near the knees; a synovial sarcoma originating in the chest wall is extremely rare. We describe a 26-year-old woman diagnosed with a synovial sarcoma originating in the chest wall, based on CT and MRI findings. Contrast-enhanced CT images revealed a small, well-defined enhancing mass with calcification, in the subpleural area. This lesion was initially diagnosed as a benign tumor; however, the patient developed sudden severe pain with spontaneous bleeding and hemothorax, suggesting the possibility of malignancy. MRI revealed a multilobulated mass with a fluid-fluid level, which characterizes a synovial sarcoma.