• Title/Summary/Keyword: Contrast-enhanced computed tomography

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A Giant Hydatid Cyst in the Interventricular Septum with Papillary Muscle Involvement

  • Sabzi, Feridoun;Faraji, Reza
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.349-352
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    • 2013
  • We present here a 44-year-old male patient with hydatid disease who was referred to our hospital due to dyspnea and chest pain for the last 2 month before admission. Using echocardiography and contrast-enhanced computed tomography the heart hydatid was diagnosed. However, hydatid disease of the interventricular septum is rare; particularly, the involvement of mitral apparatus with mitral regurgitation (MR) is an exceptionally rare presentation. Early diagnosis and an integrated treatment strategy are crucial. Surgical excision was performed and the patient had an uneventful recovery and follow-up at 3 months.

Splenic Infarction due to Torsion of Wandering Spleen - A Case Report - (유주 비장의 염전에 의한 비장 경색 - 1예 보고 -)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.183-188
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    • 2008
  • Wandering spleen is very rare condition in children characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. We experienced a case of splenic infarction due to torsion of a wandering spleen in a 6-year-old boy who presented with fever, vomiting, and abdominal pain of 2 day's duration. On physical examination, there was severe tenderness in the left upper quadrant of the abdomen. The plain abdominal radiograph showed marked colonic gaseous distension. Contrast-enhanced abdominal computed tomography scan showed decreased density of spleen in the normal position, consistent with infarction. At emergency laparotomy, a wandering spleen twisted $360^{\circ}$ on its pedicle was found. Despite splenic detorsion, blood flow could not be restored. Splenectomy was therefore performed. The child was discharged 7 days after surgery without any complications.

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Portal cavernoma cholangiopathy: Update and recommendations on diagnosis and management

  • Ruchir Bhavsar;Amitabh Yadav;Samiran Nundy
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.298-307
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    • 2022
  • Portal cavernoma cholangiopathy is defined as an obstruction of the biliary system due to distended veins surrounding bile ducts that mainly occur in patients with extrahepatic portal venous obstruction. The periductal venous plexuses encircling the ducts can cause morphological changes which may or may not become symptomatic. Currently, non-invasive techniques such as ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and dynamic contrast enhanced magnetic resonance images are being used to diagnose this disorder. Only a few patients who have symptoms of biliary obstruction require drainage which might be accomplished using endoscopic stenting, decompression of the portal venous system usually via a lienorenal shunt, a difficult direct hepaticojejunostomy, and rarely a liver transplant.

Renal embolization for trauma: a narrative review

  • Peter Lee;Simon Roh
    • Journal of Trauma and Injury
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    • v.37 no.3
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    • pp.171-181
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    • 2024
  • Renal injuries commonly occur in association with blunt trauma, especially in the setting of motor vehicle accidents. Contrast-enhanced computed tomography is considered the gold-standard imaging modality to assess patients for renal injuries in the setting of blunt and penetrating trauma, and to help classify injuries based on the American Association for the Surgery of Trauma injury scoring scale. The management of renal trauma has evolved in the past several decades, with a notable shift towards a more conservative, nonoperative approach. Advancements in imaging and interventional radiological techniques have enabled diagnostic angiography with angiographic catheter-directed embolization to become a viable option, making it possible to avoid surgical interventions that pose an increased risk of nephrectomy. This review describes the current management of renal trauma, with an emphasis on renal artery embolization techniques.

Metastatic Brain Neuroendocrine Tumor Originating from the Liver

  • Lee, Guk Jin;Jo, Kwang Wook;Kim, Jeana;Park, Il Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.550-553
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    • 2015
  • A 67-year-old male presented with left temporal hemianopsia and left hemiparesis. A contrast-enhanced magnetic resonance image revealed a $4.5{\times}3.5{\times}5.0cm$ rim-enhancing mass with central necrosis and associated edema located in the left occipital lobe. Of positron emission tomography and abdominal computed tomography, a 9-cm mass with poor enhancement was found in the right hepatic lobe. Craniotomy and right hemihepatectomy was performed. The resected specimen showed histological features and immunochemical staining consistent with a metastatic neuroendocrine tumor (NET). Four months later, the tumors recurred in the brain, liverand spinal cord. Palliative chemotherapy with etoposide and cisplatin led to complete remission of recurred lesions, but the patient died for pneumonia. This is the first case of a metastatic brain NET originating from the liver. If the metastatic NET of brain is suspicious, investigation for primary lesion should be considered including liver.

Unusual Peritoneal Metastasis of Late Recurrent Uterine Cervical Cancer: A Case Report and Literature Review (후기 재발성 자궁 경부암의 비전형적인 복막 전이: 증례 보고 및 문헌 고찰)

  • Sangmin Park;Hee Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.904-909
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    • 2022
  • Uterine cervical cancer is one of the most common malignancies of the female genital tract. Most recurrent cases of uterine cervical cancer are diagnosed within two years after primary treatment, and late recurrence after a disease-free interval of more than five years is rare. In addition, peritoneal metastases usually present as multifocal discrete nodules in the peritoneal cavity with nodular or diffuse peritoneal thickening. Herein, we report an extremely rare case of late recurrent cervical cancer peritoneal metastasis with an unusual manifestation of a large, solitary necrotic mass in the right subphrenic space on contrast-enhanced CT.

Image Quality and Lesion Detectability of Lower-Dose Abdominopelvic CT Obtained Using Deep Learning Image Reconstruction

  • June Park;Jaeseung Shin;In Kyung Min;Heejin Bae;Yeo-Eun Kim;Yong Eun Chung
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.402-412
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    • 2022
  • Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

Intraosseous neurofibroma of the mandible involving masticator space (저작근 공간을 침범한 하악골내 신경섬유종)

  • Kim, Eun-Kyung;Han, Won-Jeong;Choi, Jin-Woo;Kim, Hak-Sun
    • The Journal of the Korean dental association
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    • v.58 no.9
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    • pp.556-562
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    • 2020
  • Neurofibroma is a benign, heterogenous peripheral nerve sheath tumor arising from the connective tissue of peripheral nerve sheaths, especially the endoneurium. Its intraoral occurrence is uncommon and its occurrence within mandible is extremely rare. A case of solitary intraosseous neurofibroma of the mandible involving masticator space in a 8-year-old male is reported. He was referred from a private local clinic with a chief complaint of limitation in opening of the mouth. Panoramic and cone-beam computed tomographic images showed unilocular radiolucent lesion with scalloped border at the right mandibular ramus, connected posteriorly to the enlarged mandibular foramen and anteriorly to the mandibular canal. T1-weighted magnetic resonance images showed soft tissue mass of isointensity compared with muscles. Contrast-enhanced T1-weighted images showed peripheral enhancement and T2-weighted images showed the heterogeneous hyperintense mass with extension between lateral and medial pterygoid muscles. The tumor was surgically removed under general anesthesia and diagnosed to be neurofibroma at the biopsy.

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Giant plunging ranula: a case report

  • Kim, Seong-Ha;Huh, Kyung-Hoe;An, Chang-Hyeon;Park, Jin-Woo;Yi, Won-Jin
    • Imaging Science in Dentistry
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    • v.43 no.1
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    • pp.55-58
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    • 2013
  • A ranula is a bluish, transparent, and thin-walled swelling in the floor of the mouth. They originate from the extravasation and subsequent accumulation of saliva from the sublingual gland. Ranulas are usually limited to the sublingual space but they sometimes extend to the submandibular space and parapharyngeal space, which is defined as a plunging ranula. A 21-year-old woman presented with a complaint of a large swelling in the left submandibular region. On contrast-enhanced CT images, it dissected across the midline, and extended to the parapharyngeal space posteriorly and to the submandibular space inferiorly. Several septa and a fluid-fluid level within the lesion were also demonstrated. We diagnosed this lesion as a ranula rather than cystic hygroma due to the location of its center and its sublingual tail sign. As plunging ranula and cystic hygroma are managed with different surgical approaches, it is important to differentiate them radiologically.

Synthesis of contrast CT image using deep learning network (딥러닝 네트워크를 이용한 조영증강 CT 영상 생성)

  • Woo, Sang-Keun
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2019.01a
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    • pp.465-467
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    • 2019
  • 본 논문에서는 영상생성이 가능한 딥러닝 네트워크를 이용하여 조영증강 CT 영상을 획득하는 연구를 수행하였다. CT는 고해상도 영상을 바탕으로 환자의 질병 및 암 세포 진단에 사용되는 의료영상 기법 중 하나이다. 특히, 조영제를 투여한 다음 CT 영상을 획득되는 영상을 조영증강 CT 영상이라 한다. 조영증강된 CT 영상은 물질의 구성 성분의 영상대비를 강조하여 임상의로 하여금 진단 및 치료반응 평가의 정확성을 향상시켜준다. 하지많은 수의 환자들이 조영제 부작용을 갖기 때문에 이에 해당되는 환자의 경우 조영증강 CT 영상 획득이 불가능해진다. 따라서 본 연구에서는 조영증강 영상을 얻지 못하는 환자 및 일반 환자의 불필요한 방사선의 노출을 최소화 하기 위하여 영상생성 딥러닝 기법을 이용하여 CT 영상에서 조영증강 CT 영상을 생성하는 연구를 진행하였다. 영상생성 딥러닝 네트워크는 generative adversarial network (GAN) 모델을 사용하였다. 연구결과 아무런 전처리도 거치지 않은 CT 영상을 이용하여 영상을 생성하는 것 보다 히스토그램 균일화 과정을 거친 영상이 더 좋은 결과를 나타냈으며 생성영상이 기존의 실제 영상과 영상의 구조적 유사도가 높음을 확인할 수 있다. 본 연구결과 딥러닝 영상생성 모델을 이용하여 조영증강 CT 영상을 생성할 수 있었으며, 이를 통하여 환자의 불필요한 방사선 피폭을 최소하며, 생성된 조영증강 CT 영상을 바탕으로 정확한 진단 및 치료반응 평가에 기여할 수 있을거라 기대된다.

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