• Title/Summary/Keyword: Diagnostic X-ray

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A method of bedside urethrography before catheterization in pelvic trauma in Korea: a case report

  • Hojun Lee;Sung Yub Jeong;Kun Hwang
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.451-453
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    • 2023
  • We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.

Radiologic Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease (비결핵마이코박테륨 폐질환의 영상의학진단)

  • Eun-Young Kang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.838-850
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    • 2021
  • The incidence and prevalence of nontuberculous mycobacterial pulmonary disease (NTM-PD) is increasing worldwide, including in Korea, and the clinical importance of NTM-PD is also rapidly increasing. The diagnosis and management of NTM-PD is difficult. Radiologic evidence is mandatory to diagnose NTM-PD, and the radiologic findings may be the first evidence of the disease in many patients. Traditionally, NTM-PD demonstrates two different radiologic forms: fibrocavitary and nodular bronchiectatic. However, the disease also shows non-specific and a wide spectrum of radiologic features. Radiologists must be aware of the radiologic features of NTM-PD and should include them in the differential diagnosis. This review focuses on the epidemiology in Korea, diagnostic criteria, and radiological features of NTM-PD for radiologists.

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.

Temporomandibular joint ankylosis suspected to be associated with ankylosing spondylitis based on cervical computed tomography images: A pictorial essay

  • Ikuho Kojima;Shinnosuke Nogami;Shin Hitachi;Yusuke Shimada;Yushi Ezoe;Yuka Yokoyama-Sato;Masahiro Iikubo
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.201-206
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    • 2024
  • This report showed a case of temporomandibular joint (TMJ) ankylosis suspected to be associated with ankylosing spondylitis based on the observation of bony ankylosis of the cervical spine on computed tomography (CT) images. A 53-year-old man presented with a chief complaint of difficulty in opening his mouth. His medical history indicated that in his 20 s, he became aware of the difficulty in moving his neck. CT revealed marked osteoarthritic changes in the right mandibular condyle, suggesting fibrotic TMJ ankylosis. In addition, bony ankylosis of the cervical vertebral body and facet joints from the axis (C2) to C5 in continuity was observed. CT of the entire spine also showed bony deformity of the sacroiliac joints and bony ankylosis. Based on these findings, ankylosing spondylitis was suspected. The possibility of an ankylosing spondylitis complication should be considered in cases of TMJ ankylosis if bony ankylosis of the cervical spine is observed.

A rare case report of ameloblastic fibrodentinoma with imaging features in a pediatric patient

  • Youjin Jung;Kyu-Young Oh;Sang-Sun Han;Chena Lee
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.207-210
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    • 2024
  • Ameloblastic fibrodentinoma (AFD) is a rare benign odontogenic tumor that resembles an ameloblastic fibroma with dysplastic dentin. This report presents a rare case of mandibular AFD with imaging features in a young patient. Panoramic radiography and computed tomography revealed a well-defined lesion with internal septa and calcified foci, causing inferior displacement of the adjacent molars as well as buccolingual cortical thinning and expansion of the posterior mandible. The lesion was surgically removed via mass excision, and the involved tooth was extracted under general anesthesia. During the 5-year follow-up period, no evidence of recurrence was observed. Radiologic features of AFD typically reveal a moderately to well-defined mixed lesion with varying degrees of radiopacity, reflecting the extent of dentin formation. Radiologists should consider AFD in the differential diagnosis when encountering a multilocular lesion with little dense radiopacity, particularly if it is associated with delayed eruption, impaction, or absence of involved teeth, on radiographic images of young patients.

A Case of Idiopathic Bronchiolitis Obliterans Organizing Pneumonia (원발성 Bronchiolitis Obliterans Organizing Pneumonia 1예)

  • Lee, Cheol-Whan;Koh, Youn-Suck;Kim, Woo-Sung;Gong, Kyeong-Yub;Song, Kun-Sik;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.536-541
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    • 1992
  • Bronchiolitis obliterans organizing pneumonia (BOOP) is a type of diffuse interstitial lung disease that primarily affects the small conducting airways and characterized by the presence of granulation tissue plugs within the lumen of small airways often extending into alveolar ducts. It is associated with a number of different causes, including a variety of infections, fume exposures, drugs, collagen diseases and idiopathic. Recently we have experienced one patient with idiopathic BOOP. The patient was a 58 year old man presented with 2 months' history of dry cough and exertional dyspnea. The phyical examination showed inspiratory crackles at both lower lung field. Chest X-ray showed bilateral multiple patchy alveolar density. Pulmonary function studies showed a moderate degree of restrictive lung disease. Open lung biopsy carried out and revealed findings characteristic of BOOP. There was a dramatic response clinically and radiologically to high dose predinisolone therapy. Chest X-ray and pulmonary function test under-taken one year later showed marked improvement. New lesion on chest PA was developed during the period of tapering of prednisolone dose, but it was soon disappeared after increasing of prednisolone dose. One year later, he is well without steroid therapy.

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Quality Improvement on Upper Gastrointestinal Series (위장조영검사에서 화질 개선 방법)

  • Lim, Byung-Hak;Chon, Kwon Su
    • Journal of the Korean Society of Radiology
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    • v.10 no.6
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    • pp.395-401
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    • 2016
  • Upper gastrointestinal series is a diagnostic test that X-ray passes through the stomach after administering contrast media such as barium or gastrografin. Upper gastrointestinal series with an advantage of no side effect except temporary constipation or abdominal pain has been widely used to diagnose diseases of the gastrointestinal system. However, image degradation and diagnostic accuracy frequently occurred when improper movement and breath control were carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. The movie of the upper gastrointestinal series was made for improving inspection accuracy and image quality. The examinees encouraged to see the movie for waiting time before doing upper gastrointestinal series. In this study, image quality and diagnostic accuracy was examined for the effect of the movie about upper gastrointestinal series. 60 patients composed of each 10 people from 30s to 80s were selected randomly among both 2,940 examinees in 2014 and 3,076 examinees in 2015. Image quality was evaluated by the full width at half maximum of profile for each image using the Image J. The measurement of the full width at half maximum showed 0.208 mm and 0.133 mm for after and before seeing the movie. Thus it was verified that the movie education could improve the image quality and diagnostic accuracy for upper gastrointestinal series.

Radiologic Analysis of Congenital Origin Intestinal Obstruction in Neonate and Childhood (선천성 장관폐쇄의 방사선학적 분석)

  • Hwang, Mi-Soo;Byun, Woo-Mok;Kim, Sun-Yong;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.4 no.1
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    • pp.33-42
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    • 1987
  • Congenital origin intestinal obstruction are important disease due to required emergency operation. So accurate and rapid diagnosis is needed for decreased mortality and morbidity. Radiologist must detect to accurate obstruction site and also associated other congenital anomalies. And also embriological bases are very important role to the diagnosis of theses diseases. We were analysed radiologically and clinically 25 cases with congenital origin intestinal obstruction with review of literature. 1. Hypertrophic pyloric stenosis 6 cases, midgut malrotation 4 cases, congenital megacolon 8 case, imperforated anus 5 cases, ileal atresia 1 case and duodenal atresia 1 case. 2. Male and female radio were 16:9. Especially on hypertrophic pyloric stenosis, 5 cases were male infants. 3. All cases of hypertrophic pyloric stenosis represented string sign and also pyloric beak sign shoulder sign on UGI. 4. I case duodenal atresia showed double bubble sign on simple abdomen x-ray and ileal atresia showed mechanical small bowel obstruction sign with microcolon. 5. On midgut malrotation, cecum was located in right upper abdomen on 4 cases. And 2 cases were associated with Ladd's band. I case with volvulus and 1 case with mesenteric defect. 6. Involved site of all congenital megacolon were localized to rectosigmoid colon. 7. On 5 cases imperforated anus, 3 cases were low type and 2 case high type. Rectoperineal and rectourogenital fistula were demonstrated on 4 cases.

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The Ratio of Descending Aortic Enhancement to Main Pulmonary Artery Enhancement Measured on Pulmonary CT Angiography as a Finding to Predict Poor Outcome in Patients with Massive or Submassive Pulmonary Embolism

  • Park, Chi-Young;Yoo, Seung-Min;Rho, Ji-Young;Ji, Young-Geon;Lee, Hwa-Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.352-359
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    • 2012
  • Background: The purpose of this study was to evaluate whether measuring the ratio of descending aortic enhancement (DAE) to main pulmonary artery enhancement (MPAE) on pulmonary computed tomography angiography (PCTA) can predict poor outcome in patients with acute massive or submassive pulmonary embolism (PE). Methods: We retrospectively, reviewed computed tomgraphy findings and charts of 37 patients with acute PE and right ventricular dysfunction. We divided the enrolled patients into 3 groups; group Ia (n=8), comprised of patients with major adverse event (MAE); group Ib (n=5), consisted of those with PE-related MAE; and group II (n=29), those without MAE. We analyzed the right ventricular diameter (RVD)/left ventricular diameter (LVD) and DAE/MPAE on PCTA. Results: For observer 1, RVD/LVD in group Ia ($1.9{\pm}0.36$ vs. $1.44{\pm}0.38$, p=0.009) and group Ib ($1.87{\pm}0.37$ vs. $1.44{\pm}0.38$, p=0.044) were significantly higher than that of group II. For observer 2, RVD/LVD in group Ia ($1.71{\pm}0.18$ vs. $1.41{\pm}0.47$, p=0.027) was significantly greater than that of group II, but RVD/LVD of group Ib was not ($1.68{\pm}0.2$ vs. $1.41{\pm}0.47$, p=0.093). For both observers, there was a significant difference of DAE/MPAE between group Ib and group II ($0.32{\pm}0.15$ vs. $0.64{\pm}0.24$, p=0.005; $0.34{\pm}0.16$ vs. $0.64{\pm}0.22$, p=0.004), but no significant difference of DAE/MPAE between group Ia and group II ($0.51{\pm}0.3$ vs. $0.64{\pm}0.24$, p=0.268; $0.53{\pm}0.29$ vs. $0.64{\pm}0.22$, p=0.302). Intra-class correlation coefficient (ICC) for the measurement of DAE/MPAE (ICC=0.97) was higher than that of RVD/LVD (ICC=0.74). Conclusion: DAE/MPAE measured on PCTA may predict PE-related poor outcomes in patients with massive or submassive PE with an excellent inter-observer agreement.

Radiology Residents' Independent Diagnosis of Appendicitis Using 2-mSv Computed Tomography: A Secondary Analysis of a Large Pragmatic Randomized Trial

  • Jungheum Cho;Hae Young Kim;Seungjae Lee;Ji Hoon Park;Kyoung Ho Lee
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.529-540
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    • 2023
  • Objective: To compare the diagnostic performance and clinical outcomes of 2-mSv computed tomography (CT) and conventional-dose CT (CDCT), following radiology residents' interpretation of CT examinations for suspected appendicitis. Materials and Methods: Altogether, 3074 patients with suspected appendicitis aged 15-44 years (28 ± 9 years, 1672 females) from 20 hospitals were randomly assigned to the 2-mSv CT (n = 1535) or CDCT (n = 1539) groups in a pragmatic trial from December 2013 and August 2016. Overall, 107 radiology residents participated in the trial as readers in the form of daily practice after online training for 2-mSv CT. They made preliminary CT reports, which were later finalized by attending radiologists via addendum reports, for 640 and 657 patients in the 2-mSv CT and CDCT groups, respectively. We compared the diagnostic performance of the residents, discrepancies between preliminary and addendum reports, and clinical outcomes between the two groups. Results: Patient characteristics were similar between the 640 and 657 patients. Residents' diagnostic performance was not significantly different between the 2-mSv CT and CDCT groups, with a sensitivity of 96.0% and 97.1%, respectively (difference [95% confidence interval {CI}], -1.1% [-4.9%, 2.6%]; P = 0.69) and specificity of 93.2% and 93.1%, respectively (0.1% [-3.6%, 3.7%]; P > 0.99). The 2-mSv CT and CDCT groups did not significantly differ in discrepancies between the preliminary and addendum reports regarding the presence of appendicitis (3.3% vs. 5.2%; -1.9% [-4.2%, 0.4%]; P = 0.12) and alternative diagnosis (5.5% vs. 6.4%; -0.9% [-3.6%, 1.8%]; P = 0.56). The rates of perforated appendicitis (12.0% vs. 12.6%; -0.6% [-4.3%, 3.1%]; P = 0.81) and negative appendectomies (1.9% vs. 1.1%; 0.8% [-0.7%, 2.3%]; P = 0.33) were not significantly different between the two groups. Conclusion: Diagnostic performance and clinical outcomes were not significantly different between the 2-mSv CT and CDCT groups following radiology residents' CT readings for suspected appendicitis.