• Title/Summary/Keyword: Enhanced CT

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Utility of Acetazolamide-Enhanced Brain Perfusion SPECT in Predicting Outcome of the Patients with Aneurysmal Subarachnoid Hemorrhage (뇌동맥류파열에 의한 지주막하 출혈환자의 예후평가에 있어서 아세타졸아미드 부하 뇌혈류 SPECT의 유용성)

  • Choi, Yun-Young;Kim, Jae-Min;Kim, Kwang-Myung;Choe, Il-Seung;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.241-250
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    • 2001
  • Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

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Analysis of Mediatinal Lymph Nodes with Internal Low Density on Contrast Enhanced CT Scan (조영종강 전산화단층촬영상 내부 저밀도 음영을 보이는 종격동 림프절의 분석)

  • Ryu, Young-Hoon;Choe, Kyu-Ok;Hong, Yong-Kook;Kim, Sung-Kyu;Chang, Joon;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.264-279
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    • 1997
  • Background : To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan. Method : A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n=4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated : location, size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. Results : In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1 cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. Conclusion : Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.

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Epipericardial Fat Necrosis in a Pediatric Patient Diagnosed Using Contrast-Enhanced MRI Findings: A Case Report and Literature Review (소아 심장막 주위 지방 괴사 환자에서의 조영증강 자기공명영상 소견: 증례 보고 및 문헌고찰)

  • Seong Ju Kim;Byoung Hee Han;Youngjong Cho;Dae Shick Ryu;Ga Young Yoon;Wooyul Paik;Young Rae Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1160-1167
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    • 2022
  • Epipericardial fat necrosis (EPFN) is a relatively rare cause of acute chest pain, with only five pediatric cases having been reported in the English-language medical literature to date. EPFN can be diagnosed based on the clinical symptoms of acute pleuritic chest pain and classic CT features of typically ovoid fatty lesions surrounded by a rim or capsule in the mediastinal or pericardial areas. Previous studies have reported that contrast-enhanced MRI can detect typical fat signal changes in adults with EPFN. We report a pediatric EPFN case diagnosed using gadolinium-enhanced MRI. Thus, contrast-enhanced MRI may be used to confirm EPFN in the differential diagnoses of the causes of acute chest pain.

Metastatic thyroid follicular carcinoma of masticator space (저작근극에서 발생한 전이된 갑상선 여포상암)

  • Gang Tae-In;Heo Min-Suk;An Chang-Hyeon;Choi Mi;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won
    • Imaging Science in Dentistry
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    • v.32 no.3
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    • pp.175-179
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    • 2002
  • Follicular carcinomas are the second most common form of thyroid cancer, accounting for 10 to 20% of all thyroid cancers. Follicular carcinomas have a propensity to metastasize via the bloodstream, spreading to bone, lungs, liver, and elsewhere. We described the case of a 48-year-old woman who presented with swelling of the left preauricular area, which was a consequence of a metastatic follicular carcinoma of the masticator space. Plain films showed illdefined erosive bony changes from the left condylar head to the mandibular notch. Contrast-enhanced CT images showed a well circumscribed round mass with well enhancement within left masticator space. On MR images, the mass was heterogenously hyperintense to the muscle on T2-weighted images and isointense or hyperintense to the muscle on Tl-weighted images, and showed good enhancement on contrast-enhanced Tl-weighted images. Upon microscopic examination, the metastatic mass was found to be composed of fairly uniform cells forming small follicles containing colloid, showing capsular and vascular invasion.

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IgG4 Related Disease Misdiagnosed to Carotid Body Tumor (경동맥소체종양으로 오인된 IgG4 연관 질환)

  • Lee, Gun Hyuk;Song, Ji-Sun;Yoon, So Yeon;Cho, Youn Jin;Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.27-31
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    • 2020
  • Neck mass has various etiologies, including inflammatory, congenital, neoplastic causes. The IgG4-related disease can cause symptoms in the head and neck areas with an inflammatory neck mass. It also shows clinical and pathological findings from inflammation caused by immune reactions, such as lymphocyte and plasma cell infiltration, storiform fibrosis, obliteration phlebitis, and invigorated serum IgG4 levels. The treatment guideline has not been established and still under debate, but systemic glucocorticoid seems to be effective in the most cases. In this brief report, a 48-year-old male patient presented with voice change for 3 weeks. Left side paramedian vocal fold palsy was observed in the flexible laryngoscopy. About 2.5×2.0×1.2cm size, heterogeneously enhanced neck mass with irregular margin encasing left carotid artery was noted on preoperative contrast enhanced neck CT scan, and it was suspicious of left carotid body tumor. The pathology shows IgG4-related disease rather than carotid body tumors. We report this case of IgG4-related disease, which can be misdiagnosed to carotid body tumors.

The Effects of Partial Vibration on Tibia of Osteoporosis Induced Rat (골다공증이 유발된 쥐 정강이뼈에 적용한 부분 진동자극 효과)

  • Park, Ji-Hyung;Seo, Dong-Hyun;Jung, Young-Jin;Ko, Chang-Yong;Kim, Han-Sung
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.5
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    • pp.578-583
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    • 2012
  • The pharmacological therapies and whole body vibration as non-pharmacological therapies were known to have adverse side effects. Therefore, partial stimulation was suggested and its effects were evaluated. This study aimed to evaluate the site-specific effects of partial stimulator for treatment of osteoporosis induced by estrogen deficiency. Sixteen virginal Sprague-Dawley rats (12 weeks old) were divided into 2 groups(no stimulation, stimulation groups). All rats were ovariectomised to induce osteoporosis. After 3 weeks of operation, the right tibiae in rats of stimulation group (frequency: 10Hz, cycle: 1500, strain on bone surface: $2000{\mu}{\varepsilon}$) were stimulated perpendicularly at right tibia by using partial stimulator for 6 weeks (3days/week). The right tibiae in rats were scanned, before stimulation (0 week) and at 6 weeks after stimulation by using in-vivo micro computed tomography. For investigation of changes in morphological characteristics, structural parameters were measured and calculated. At 6 weeks the morphological characteristics (relative value) in stimulation group were significantly enhanced than those in no stimulation group (p<0.05). In this study, we find that after 6 weeks of partial stimulation, the morphological characteristics of tibia trabecular bone were enhanced. Thus, we concluded that partial stimulation could be used to treat osteoporosis.

Classification of Surface Defects on Cold Rolled Strips by Probabilistic Neural Networks (확률신경회로망에 의한 냉연 강판 표면결함의 분류)

  • Song, S.J.;Kim, H.J.;Choi, S.H.;Lee, J.H.
    • Journal of the Korean Society for Nondestructive Testing
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    • v.17 no.3
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    • pp.162-173
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    • 1997
  • Automatic on-line surface inspection systems have been applied for monitoring a quality of steel strip surfaces. One of the important issues in this application is the performance of on-line defect classifiers. Rule-based classification table methods which are conventionally used for this purpose have been suffered from their low performances. In this work, probabilistic neural networks and the enhanced classification tables which are newly proposed here are applied as alternative on-line classifiers to identify types of surface defects on cold rolled strips. Probabilistic neural networks have shown very excellent performance for classification of surface defects.

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Gold nanoparticles enhance anti-tumor effect of radiotherapy to hypoxic tumor

  • Kim, Mi Sun;Lee, Eun-Jung;Kim, Jae-Won;Chung, Ui Seok;Koh, Won-Gun;Keum, Ki Chang;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.230-238
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    • 2016
  • Purpose: Hypoxia can impair the therapeutic efficacy of radiotherapy (RT). Therefore, a new strategy is necessary for enhancing the response to RT. In this study, we investigated whether the combination of nanoparticles and RT is effective in eliminating the radioresistance of hypoxic tumors. Materials and Methods: Gold nanoparticles (GNPs) consisting of a silica core with a gold shell were used. CT26 colon cancer mouse model was developed to study whether the combination of RT and GNPs reduced hypoxia-induced radioresistance. Hypoxia inducible $factor-1{\alpha}$ ($HIF-1{\alpha}$) was used as a hypoxia marker. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were conducted to evaluate cell death. Results: Hypoxic tumor cells had an impaired response to RT. GNPs combined with RT enhanced anti-tumor effect in hypoxic tumor compared with RT alone. The combination of GNPs and RT decreased tumor cell viability compare to RT alone in vitro. Under hypoxia, tumors treated with GNPs + RT showed a higher response than that shown by tumors treated with RT alone. When a reactive oxygen species (ROS) scavenger was added, the enhanced antitumor effect of GNPs + RT was diminished. Conclusion: In the present study, hypoxic tumors treated with GNPs + RT showed favorable responses, which might be attributable to the ROS production induced by GNPs + RT. Taken together, GNPs combined with RT seems to be potential modality for enhancing the response to RT in hypoxic tumors.

Case report of acute lymphoblastic leukemia with multiple soft tissue mass (다발성 연조직 종괴를 동반한 급성 림프구성 백혈병의 증례 보고)

  • Jang Jung-Yong;Huh Kyung-Hoe;Yi Won-Jin;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.35 no.2
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    • pp.111-114
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    • 2005
  • A 15-year-old patient, who had been diagnosed and treated as Burkitt cell type acute lymphoblastic leukemia (ALL-L3) already, visited our department. He complained of gingival enlargement and loosening teeth 1 month ago. The clinical examination revealed anterior open bite, gingival enlargement, and nontender swelling particularly in molar regions of both jaws. Deep periodontal pockets and severe mobility was shown on most of the teeth. The panoramic radiographs showed severe bone destruction and extrusion of the molars. The contrast enhanced CT showed multiple enhanced mass and bone marrow obliteration in both jaws. Chemotherapy was done and the swelling was subsided at 1 month later. In conclusion, radiologic findings of leukemia with soft tissue mass, known as chloroma or granulocytic sarcoma, mimic those of lymphoma, so blood test may be needed for the final diagnosis.

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Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma (둔상 후 복부 전산화단층촬영에서 조영제 유출로 동맥색전술을 시행받은 환자의 복강내와 후복막강/골반강내 출혈 비교)

  • Yoon, Ji Young;Kim, Sun Hyu;Ahn, Ryeok;Hwang, Jae Cheol;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.199-205
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    • 2009
  • Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.