• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.43-47
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• 2010

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.278-283
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• 2004

The incidence of a pulmonary leiomyosarcoma as a primary lung tumor is quite rare. We report a case of primary leiomyosarcoma with a cardiac invasion in a 76 year old man. He was admitted due to left anterior chest wall pain for one month. Chest computed tomography showed a $9{\times}8{\times}10cm$ sized, large round mass in the left upper and lower lobes, and an amorphous low density lesion within the left atrium. Chest magnetic resonance imaging showed a large round mass in the left upper and lower lobes with growth into the left atrium. A diagnosis of leiomyosarcoma with prominent osteoclast-like giant cells was made based on the microscopic and immunohistochemical findings of a permanent specimen by explothoracotomy. The pathologic features of the tumor showed round mononuclear hyperchromatic cells and multinucleated giant cells that resembled osteoclasts. The immunohistochemical staining showed that the giant cells are positive for CD68 but negative for the muscle markers while the round cells were positive for the muscle marker. The patient refused further treatment and died after two months.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.383-387
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• 1999

Background: We analysed simple chest PA and high-resolution CT findings in patients with spontaneous pneumothorax in order to help selecting the kind of treatment, provide a guidline during surgical treatment, and to recognize the bulla which may not be detected by simple radiographs or may be a potential cause of recurrence. Material and Method: We retrospectively analysed the presence and number of bulla in each side, combined pulmonary disease on simple chest films and high-resolution CT, and methods and frequency of the treatment in 70 patients with spontaneous pneumothorax excluing traumatic origin. Result: 45 patients were revealed primary spontaneous pneumothorax, and the remaining 25 patients were revealed secondary spontaneous pneumothorax. All secondary spontaneous pneumothorax were from the longstanding sequelle of pulmonary tuberculosis. The patients with primary spontaneous pneumothorax group was younger(mean:26.0 years old) than secondary group (mean: 44.1 years old). On simple radiography, bulla was detected in 16 patients(30.2%). On HRCT, the bulla was detected in 53 patients(75.7%) of the total 70 patients. In 48 patients(68.6%), the bulla or bleb was noted in ipsilateral side to the pneumothorax, and 34 patients(48.6%) of them showed bulla or bleb bilaterally. 39 patients(55.7%) showed bulla or bleb in contralateral side. The number of bulla or bleb was variable. In secondary spontaneous pneumothorax group, the incidence of multiple(more than 10) bulla or bleb was higher than primary type. Most of the patients were treated by thoracostomy(36 patients) or bullectomy( 7 patients). Conclusion: HRCT was superior to detect bulla and analyse the combined pulmonary disease than simple radiography. Therefore, HRCT can help to determine the mothod of treatment, provide a guidline during surgical treatment, and notify the bulla as a possible cause of recurrent pneumothorax.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.765-769
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• 2006

Background: Nuss procedure is a minimally invasive technique for correcting the pectus excavatum. But there are some limitations of correcting the complex anomaly or grown-up patients. Material and Method: we retrospectively reviewed 135 consecutive patients who underwent repair of pectus excavatum by the Nuss procedure and its modifications between November 1999 and December 2004. We analyzed the computed tomography, age on operation, operative technique, and complications. Result: We operated 135 patients of pectus excavatum during 62 months. Total number of operations about Nuss procedure is 216, including bar removal procedure of 64 cases, redo Nuss procedures of 47 cases. We modified the point of bar insertion to the hinge point, made a shoulder in the bar to prevent a displacement. And then we changed the fixation material from Vicryl to steel wire. If the patients are old, we retract the sternum during bar rotation and fixation. Until 2002, the number of redo Nuss operations were 17, complications were 23. but, after modifications, the number of redo Nuss operation were 0, complications were 2. Conclusion: This result indicates that our modifications of Nuss operation is effective, and could decrease the number of redo Nuss operation and complications.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.55-60
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• 1997

We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.305-314
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• 2011

The purpose of this study was to compare the findings on the chest low-dose CT (LDCT) images between the negative and positive groups for pneumoconiosis in the group exposed to inorganic dust. From May 30, 2007 to August 31, 2008, total 328 subjects were examined by a LDCT. LDCT images were read by a chest radiologist who has much experience for reading of pneumoconiosis. All subjects were classified into two groups based on digital images after consensus reading of two radiologists according to the ILO 2000 guidelines; negative group (87, 26.5%) without pneumoconiosis and positive group (241, 73.5%). Statistical analysis was performed using a SPSS 14.0. There were significant differences in age (60.9 vs. 65.0, p<0.001), and in dust expose duration (17.0 vs. 19.2, p=0.024) between two groups, but no significant difference in smoking (p=0.784). Of the 328 subjects, 13 diagnosis were extracted from 245 subjects (74.7%). Coronary artery calcification (CAC) was significantly higher in positive group than that in negative group (36.9% vs. 25.3%, p=0.049). Honeycombing showed higher frequency in positive group than in negative group (6.2% vs. 1.2%, p=0.079). Pneumoconiosis findings caused by inorganic dusts exposure showed the significant relation with CAC on LDCT images. Future studies need to prove that pneumoconiosis finding is independent risk factor for CAC using a coronary artery angiography.

• Korean Journal of Digital Imaging in Medicine
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• v.16 no.2
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• pp.9-14
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• 2014

Purpose: The purpose of this study has attempted to evaluate and compare the image evaluation and exposure dose by respectively applying Filtered Back Projection(FBP), the existing test method, and Adaptive Statistical Iterative Reconstruction(ASIR) with different values of tube voltage during the Low Dose Computed Tomography(LDCT). Materials and Methods: With the image reconstruction method as basis, Chest Phantom was utilized with the FBP and ASIR set at 10%, 20% respectively, and the change of Tube Voltage (100kVp, 120kVp). For image evaluation, Back ground noise, Signal to Noise ratio(SNR) and Contrast to Noise ratio(CNR) were measured, and, for dose evaluation, CTDIvol and DLP were measured respectively. The statistical analysis was tested with SPSS(ver. 22.0), followed by ANOVA Test conducted after normality test and homogeneity test. (p<0.05). Results: In terms of image evaluation, there was no outstanding difference in Ascending Aorta(AA) SNR and Infraspinatus Muscle(IM) SNR with the different values of ASIR application(p<0.05), but a significant difference with the different amount of tube voltage(p>0.05). Also, there wasn't noticeable change in CNR with ASIR and different amount of Tube Voltage (p<0.05). However, in terms of dose evaluation, CTDIvol and DLP showed contrasting results(p<0.05). In terms of CTDIvol, the measured values with the same tube voltage of 120kVp were 2.6mGy with No-ASIR and 2.17mGy with 20%-ASIR respectively, decreased by 0.43mGy, and the values with 100kVp were 1.61mGy with No-ASIR and 1.34mGy with 20%-ASIR, decreased by 0.27mGy. In terms of DLP, the measured values with 120kVp were $103.21mGy{\cdot}cm$ with No-ASIR and $85.94mGy{\cdot}cm$ with 20%-ASIR, decreased by $17.27mGy{\cdot}cm$(about 16.7%), and the values with 100kVp were $63.84mGy{\cdot}cm$ with No-ASIR and $53.25mGy{\cdot}cm$ with 20%-ASIR, a decrease by $10.62mGy{\cdot}cm$(about 16.7%). Conclusion: At lower tube voltage, the rate of dose significantly decreased, but the negative effects on image evaluation was shown due to the increase of noise. For the future, through the result of the experiment, it is considered that the method above would be recommended for follow-up patients or those who get health checkup as long as there is no interference on the process of diagnosis due to the characteristics of Low Dose examination.

• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.303-310
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• 2018

Purpose: To evaluate the CT features of incidental breast lesions on chest CT and to suggest useful criteria for referral to a specialized breast unit. Materials and Methods: Between May 2009 and April 2014, enhanced chest CT examination reports containing the key word 'breast' were reviewed retrospectively. Patients who had incidental breast lesion and were referred to a specialized breast unit and then underwent pathological confirmation or follow-up over a 1-year period were included. Finally, 86 patients (all female, mean age, $48.9{\pm}12.6years$) were enrolled. Two radiologists evaluated lesion characteristics, including size, shape, margins, and enhancement. The correlations between the CT features and pathologies were evaluated, and the diagnostic accuracy of CT features in various combinations was assessed. Results: Among the CT features, irregular shape, non-circumscribed margin, and high contrast enhancement were different between malignant and benign lesions (p < 0.05). The combination of non-circumscribed margin and high contrast enhancement had the highest accuracy (97.7%). Conclusion: Reliable CT features for incidental malignant breast masses are irregular shape, non-circumscribed margin, and high contrast enhancement. The combination of non-circumscribed margin and high contrast enhancement could help distinguish incidental malignant breast lesions and indicate referral to a specialized breast unit.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.324-336
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• 2020

Cardiovascular calcifications can occur in various cardiovascular diseases and can serve as a biomarker for cardiovascular event prediction. Advances in CT have enabled evaluation of calcifications in cardiovascular structures not only on ECG-gated CT but also on non-ECG-gated CT. Therefore, many studies have been conducted on the clinical relevance of cardiovascular calcifications in patients. In this study, we divided cardiovascular calcifications into three classes, i.e., coronary artery, thoracic aorta, and cardiac valve calcifications, which are closely associated with cardiovascular events. Further, we briefly described pericardial calcifications, which can be found incidentally. Since the start of lung cancer screening in Korea in the second half of 2019, the number of non-enhanced, non-ECG-gated, low-dose chest CT has been increasing, and the number of incidentally found cardiovascular calcifications has also been increasing. Therefore, understanding the relevance of cardiovascular calcifications on non-enhanced, non-ECG-gated, low-dose chest CT and their proper reporting are important for radiologists.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1524-1533
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• 2021

Purpose To investigate the incidence of tuberculosis (TB) in healthcare workers (HCWs) with positive interferon-gamma release assay (IGRA) results based on chest X-ray (CXR) and CT findings and determine the role of imaging in the diagnosis of TB. Materials and Methods Among 1976 hospital personnel screened for TB using IGRA, IGRApositive subjects were retrospectively investigated. Clustered nodular and/or linear streaky opacities in the upper lung zone were considered positive on CXR. The CT findings were classified as active, indeterminate, inactive, or normal. The active or indeterminate class was considered CT-positive. Results IGRA was positive in 255 subjects (12.9%). CXR and CT were performed in 249 (99.2%) and 113 subjects (45.0%), respectively. CXR- and CT-positive findings were found in 7 of 249 (2.8%) and 9 of 113 (8.0%) patients, respectively. Among the nine CT-positive subjects, active and indeterminate TB findings were found in 6 (5.3%) and 3 (2.7%) patients, respectively. Microbiological tests, including acid-fast bacilli staining, culture, and polymerase chain reaction for TB, were negative in all nine CT-positive subjects. Empirical anti-TB medications were administered to 9 CT-positive subjects, and 3 of these nine subjects were CXR-negative for pulmonary TB.