• Title/Summary/Keyword: Chest computed tomography

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Surgical Experience of Funnel Chest (누두흉의 임상적 고찰)

  • Ahn, Byoung-Hee;Hur, Sun
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.316-324
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    • 1990
  • This study is a review of the early postoperative results in fifteen patients who diagnosed funnel chest and underwent the corrective surgical procedure by the sternal turnover[STO] or the sternocostal elevation[SCE] between January 1988 and February 1990. Thirteen among fifteen patients were male. Early eight patients were corrected by the STO and late seven patients by the SCE. Cosmetic result was excellent in one, fair in five, poor in two patients who received the STO and excellent in all patients corrected by the SCE. This unfavorable postoperative result in the STO group was due to the protrusion of inverted xiphisternal joint, the depression along the rejoined costal cartilages and forward tilting of the distal sternum. The lower vertebral indices measured on the lateral chest film were improved postoperatively from 0.42\ulcorner0.08 to 0.30\ulcorner0.05 in the STO group and from 0.31\ulcorner0.05 to 0.24\ulcorner0.03 in the SCE group. There was significant improvement in lower vertebral index in both groups, but it was difficult to compare the postoperative improvement between groups due to the different preoperative status. In the SCE group, the funnel index and the degree of depression measured on the computed tomography were significantly improved from 5.29\ulcorner1.72 and 3.11\ulcorner0.71 to 2.77\ulcorner0.46 and 1.63\ulcorner0.19[P<0.05], but there was no significant change in the degree of flatness postoperatively. This results suggest that sternocostal elevation is more cosmetic procedure than sternal turnover in children and in young adolescents whose funnel index measured on the computed tomography is low.

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Early Detection of the Acute Exacerbation of Interstitial Pneumonia after the Surgical Resection of Lung Cancer by Planned Chest Computed Tomography

  • Oyama, Kunihiro;Kanzaki, Masato;Kondo, Mitsuko;Maeda, Hideyuki;Sakamoto, Kei;Isaka, Tamami;Tamaoki, Jun;Onuki, Takamasa
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.177-183
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    • 2017
  • Background: To improve postoperative outcomes associated with interstitial pneumonia (IP) in patients with lung cancer, the management of the postoperative acute exacerbation of IP (PAEIP) was investigated. Methods: Patients with primary lung cancer were considered to be at risk for PAEIP (possible PAEIP) based on a preoperative evaluation. The early phase of this study was from January 2001 to December 2008, and the late phase was from January 2009 to December 2014. In the early phase, chest computed tomography (CT) was performed for patients for whom PAEIP was suspected based on their symptoms, whereas in the late phase, chest CT was routinely performed within a few days postoperatively. The numbers of possible PAEIP cases, actual PAEIP cases, and deaths within 90 days due to PAEIP were compared between both phases. Results: In the early and late phases, surgery was performed in 712 and 617 patients, 31 and 72 possible PAEIP cases were observed, nine and 12 actual PAEIP cases occurred, and the mean interval from the detection of PAEIP to starting treatment was $7.3{\pm}2.3$ and $5.0{\pm}1.8$ days, respectively. Five patients died in the early phase, and one patient died in the late phase. Significantly fewer PAEIP-related deaths were observed in the late phase (p<0.05). Conclusion: Identifying patients at risk for PAEIP by routine postoperative CT examinations led to the early diagnosis and treatment of PAEIP, resulting in the reduction of PAEIP-related mortality.

Lung Cancer Screening with Low-dose Computed Tomography (저선량 CT를 이용한 폐암의 선별 검사)

  • Hwang, Jung Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.118-124
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    • 2004
  • Lung cancer is the leading cause of cancer death for men and women in the industrialized world. It is desirable to detect disease at a stage when it is not causing symptoms and when control or cure is possible. If the screening test detects patients with the disease at an early stage, they can be examined to confirm the diagnosis and intervention can alter the natural history of the disease. The results of screening programs designed to detect early lung cancer using either conventional chest radiograph or sputum cytology are disappointing for a diagnostic screening test. Because of advances in helical CT imaging techniques, screening for lung cancer has been suggested as a possible method of improving outcome. Findings in recent publications suggest that substantial dose reduction is possible in chest CT. The advantages of low-dose CT are more sensitive than chest radiograph for detecting small pulmonary nodules that may be lung cancers, shorter scanning time than conventional chest CT scan without intravenous contrast injection, cheaper cost than standard CT, low radiation dose. However, the true clinical significance of the small tumors found by screening is still unknown, and their effect on mortality awaits future investigation. Furthermore, in addition to detecting an increased number of lung cancers, low-dose CT found at least one indeterminate nodule in many of all screened patients. The majority should be benign but evaluation of all these indeterminate nodules is not a trivial problem in routine practice. In conclusion, lung cancer screening with low-dose CT is a complex subject. The true effectiveness of lung cancer screening (a reduction in mortality from lung cancer) with low-dose CT can be determined through well-designed randomized control trials with enrolment of appropriate subjects.

A Deep Learning Model for Judging Presence or Absence of Lesions in the Chest X-ray Images (흉부 디지털 영상의 병변 유무 판단을 위한 딥러닝 모델)

  • Lee, Jong-Keun;Kim, Seon-Jin;Kwak, Nae-Joung;Kim, Dong-Woo;Ahn, Jae-Hyeong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.2
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    • pp.212-218
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    • 2020
  • There are dozens of different types of lesions that can be diagnosed through chest X-ray images, including Atelectasis, Cardiomegaly, Mass, Pneumothorax, and Effusion. Computed tomography(CT) test is generally necessary to determine the exact diagnosis and location and size of thoracic lesions, however computed tomography has disadvantages such as expensive cost and a lot of radiation exposure. Therefore, in this paper, we propose a deep learning algorithm for judging the presence or absence of lesions in chest X-ray images as the primary screening tool for the diagnosis of thoracic lesions. The proposed algorithm was designed by comparing various configuration methods to optimize the judgment of presence of lesions from chest X-ray. As a result, the evaluation rate of lesion presence of the proposed algorithm is about 1% better than the existing algorithm.

Cerebral Toxoplasmosis Combined with Disseminated Tuberculosis

  • Hwang, Eui-Ho;Ahn, Poong-Gi;Lee, Dong-Min;Kim, Hyeok-Su
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.316-319
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    • 2012
  • A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

Accuracy of Preoperative Computed Tomography in Comparison with Histopathologic Findings in Staging of Lung Cancer (폐암의 병기결정시 임파절의 조직학적 소견과 전산화단층활영의 정확도에 관한 고찰)

  • 박기진;김대영
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.52-58
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    • 1996
  • Sixty six patients who were operated as lung cancer during the period from Mar. 1991 to Sep. 1993 at the department of Thoracic and cardiovascular surgery, were reviewed retrospectively and the accuracy of regional lymph node in preoperative CT were compared with histopathologlc report obtained from operation. The age ranged from 30 to 72 years old (mean age : 56.5), and 51 patients were male and 15 patients were female. The author analysed the true positive, true negative, false positive and false negative and sensitivity, specificity, positive predictive index, negative predictive index and accuracy of each nodes. The result is that there were differences between seven nodal groups in specificity, sensitivity, positive predictive Index, negative predictive index and accuracy. The range of each nodal group is from 81.7 to 98.3% The nodes of the most poor accuracy are aortopulmonary area and hilar area.

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Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

  • Kim, Hak Ju;Kwak, Jae Gun
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.298-299
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    • 2017
  • We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient's rhythm disturbances improved.

Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion

  • Ryu, Dae Woong;Lee, Sam Youn;Lee, Mi Kyung
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.443-446
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    • 2015
  • A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up.

A Case of Pulmonary Capillary Hemangiomatosis-Like Lesion Followed for Seven Years

  • Rhee, Chin-Kook;Yim, Nam-Yeol;Shim, So-Yeon;Kim, Hui-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.3
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    • pp.242-246
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    • 2011
  • Pulmonary capillary hemangiomatosis (PCH) is a rare disease of unknown etiology that is characterized by nodules composed of infiltrating capillary blood vessels. Herein, we describe a case of a PCH-like lesion that was detected by chest computed tomography. Transthoracic needle aspiration resulted in life-threatening hemorrhage. The patient was followed for seven years. He remained in good health and a follow up image showed little interval change.

A Case of Tracheal Diverticulum that is an Incidental Finding at Preoperative Computed Tomography (수술전 컴퓨터 단층 촬영에서 우연히 발견된 기관 게실 1예)

  • Lee, Dong-Hoon;Jo, Si-Young;Lee, Chang-Joon;Lee, Joon-Kyoo
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.77-79
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    • 2011
  • Tracheal diverticulum is very rare, that is usually an incidental finding at routine chest computed tomography scan. Differential diagnosis of tracheal diverticulum includes pharyngocele, laryngocele, Zenker diverticulum, apical lung hernia, blebs and bulla, and pneumomediastinum. Treatment options can be devided into medical and surgical. The majority of patients is asymptomatic and requires no specific intervention. We experienced one case of tracheal diverticulum in patient with tongue cancer and report it with reviews of literature.