This study was conducted on 101 patients who visited hospital for abdominal ultrasonography from May 2020 to December 2020. The purpose of this study was to find out the elasticity according to the ultrasound images (echo pattern, splenomegaly, hepatitis) during the ultrasound examination using the shear wave elastography. The shear wave elastography value of the normal group of the echo pattern was 5.75±1.58 kPa, and the group with the abnormal echo pattern was 8.84±4.94 kPa, and the shear wave elastography value of the abnormal group was high (p<0.05). In normal spleen size, hepatic elasticity value was 6.33±2.54 kPa, and hepatic elasticity value of splenomegaly was 13.73±5.48 kPa. In the case of splenomegaly, the liver elasticity value was high, and there was a statistically significant difference (p<0.05). As the spleen size increased, the liver elasticity value increased by 1.485 times, and as hepatitis progressed, the liver elasticity value increased by 1.573 times (p<0.05). As a result of analysis of concordance between ultrasound imaging findings and shear wave elastography, the Kappa value was found to be as high as 0.922 (p<0.05), which showed high concordance between the two test methods. Additional comparisons of liver elasticity values in shearwave elastography tests along with liver ultrasound findings are thought to be of great help in diagnosing liver fibrosis.
The aim of this study was to achieve optimal portal phase while reducing contrast medium by applying weight-based dose protocol compared to standard fixed dose protocol to performing of pediatric abdominal CT examination. Discovery 750HD (General Electric Medical Systems, Milwaukee, USA) was used, and a total of 167 children consisting of 85 men and 82 women under the age of 18 were studied. The group in which the 300 mgI/ml(Xenetix, Guerbet, France) contrast medium was fixedly injected at twice body weight and the group injected with physiological saline while gradually decreasing the injection amount by 10% while applying the weight-based protocol were distinguished. Also, the CT number and SNR of abdominal organs were compared and evaluated while changing the scan delay time. Subjective image quality of enhancement and beam-hardening artifacts of around the heart was assessed with five-point criterion. The group adapted weight-based protocol with 20% reduction in contrast medium was most similar in contrast enhancement in the group with fixed injection at twice body weight. Furthermore, the group with a delay time of 20% had the highest contrast enhancement effect, and the difference in CT attenuation coefficient from the group scanned immediately after injection of the contrast media. Therefore, the appropriate delay time after injection of the contrast agent increased the contrast enhancement of the parenchymal organ. In addition, the weight-based injection protocol with normal saline reduced artifacts around the heart, and the effect of contrast enhancement could be maintained. In conclusion, it is possible to reduce dosage of contrast media through the application of weight-based injection protocols and appropriate latency, and to characterize optimal portal phase imaging on pediatric abdominal CT.
Kim, Kwang Yeon;Kim, Sae Yun;Park, Su Eun;Lee, Jina;Lee, Hyunju;Lee, Soyoung;Kim, Joong Gon
Pediatric Infection and Vaccine
/
v.25
no.3
/
pp.113-122
/
2018
Purpose: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. Methods: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. Results: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Conclusions: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.
In this study, we intend to develop a granulation tissue formation model. As a pilot experiment, a contrast agent was injected into the pylorus in 3 rats, the normal pylorus lumen size was confirmed, and a stent was placed. Stent migration was confirmed in to the duodenum within 1 week. In this experiment, stent was sutured and fixed to induce granulation tissue formation after gastrostomy under a fluoroscopic guidance. Twenty rats were divided into Healthy Group / Gastrostomy Group. After anesthesia of the Gastrostomy Group, an abdominal incision was performed, and gastrostomy was performed under a fluoroscopic guidance, and a stent was placed into the pylorus. In order to prevent stent migration due to peristalsis, suture between the pylorus and the proximal end of the stent was performed. Postoperative behavior and weight changes were monitored daily. Four weeks after surgery, gastrointestinal fluoroscopy imaging was performed and rats were sacrifices. To evaluate the degree of granulation formation, the stent was sectioned transversely. Gastrostomy group was statistically significantly higher than Healthy Group in granulation area ratio (all p<.001). In conclusion, it is considered that the level of tissue overgrowth formation for preclinical evaluation of the pylorus stricture model through gastrostomy is appropriate as a research evaluation tool.
Soong Moon Cho;Ho Kyun Kim;Hye Kyung Lee;Byungmo Lee;Ki Hwan Kim;Kyoung Eun Lee;Jae-Chan Shim;Dae Hyun Hwang;Ghi Jai Lee
Journal of the Korean Society of Radiology
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v.81
no.1
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pp.190-196
/
2020
Xanthogranulomatous inflammation is a rare inflammatory reaction, characterized by lipid-laden macrophages, known as xanthomas, in histopathologic examination. Aggressive xanthogranulomatous inflammation often manifests as local infiltration but does not affect distant organs unless combined with rare systemic diseases. We report a case of focal xanthogranulomatous pyelonephritis (XGP) associated with severe xanthogranulomatous cholecystitis. Focal XGP was suspected in radiologic examination that showed a cystic lesion with an infiltrative margin, which were surgically resected and confirmed in pathologic examination. To our knowledge, this is the first report of focal xanthogranulomatous pyelonephritis associated with xanthogranulomatous cholecystitis. Moreover, we found peripheral hypointensity around the cystic lesion in the T2-weighted image, probably reflecting hemorrhage and fibrosis of the xanthogranulomatous inflammation.
Jiyun Lim;Seong Sook Hong;Jiyoung Hwang;Hyun-joo Kim;So-Young Jin
Journal of the Korean Society of Radiology
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v.83
no.2
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pp.432-438
/
2022
Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.
Mohamed A. Abdallah;Kimberlee Bohy;Ashwani Singal;Chencheng Xie;Bhaveshkumar Patel;Morgan E. Nelson;Jonathan Bleeker;Ryan Askeland;Ammar Abdullah;Khalil Aloreidi;Muslim Atiq
Annals of Hepato-Biliary-Pancreatic Surgery
/
v.26
no.1
/
pp.91-97
/
2022
Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.
Purpose : We studied the correlation between urinalysis and radiologic findings in infants and children with urinary tract infection. Method : Urine Dipstick test and unstained urine microscopic examination were carried out in 56 infants and children who were hospitallized with the diagnosis of urinary infection by pocitive urine culture at Seoul Adventist from September 1996 through August 1998. Urine was collected by midsream, catheter, urine bag after cleansing or bladder puncture. Renal sonography and $^{99m}Tc-DMSA$ renal scan or voiding cystoureterography were studied. Results : 1)In dipstick analysis, leukocyte esterase(LE) were positive in 30 cases of 56 patients(54%) and Nitrite were positive in 20 cases of 56 patients(36%) and LE or Nitrite were positive in 38 cases of 56 children with UTI(68%). 2)In microscopic analysis, WBC were positive in 38 cases of patients(68%) and bacteria were positive in 23 cases of 56 patients(41%) and WBC or bacteria were positive in 41 cases of 56 children with UTI(71%). 3)Ten cases of 56 UTI patients(18%) showed negative finding in Dipstick and microscopic analysis. 4)There was no significant difference in positive rate of dipstick(71% vs 66%) and microscopia analysis(83% vs 66%) between two group with or without renal scar on $^{99m}Tc-DMSA$ scan (P=0.117). 5)There was no significnt difference in positive rate of dipstick(100% vs 91%) and microscopic analysis(100% vs 100%) between two groups with or without vesicoureteral reflux on VCUG. Conclusion : There was no specific relationships between the abnormal urinalysis and the abnormal findings on $^{99m}Tc-DMSA$ scan or VCUG.
Ha, Kee Soo;Moon, Il Hong;Lee, Hee Sun;Shin, Dong Han;Eun, So Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
Clinical and Experimental Pediatrics
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v.49
no.11
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pp.1194-1201
/
2006
Purpose : The comatose mentality can be catastrophic, especially if the condition is severe or the duration is prolonged. Therefore, delayed diagnosis can result in a poor outcome or death. The best radiologic modality to differentiate from cerebral lesions in patients suffering from cerebral diseases is magnetic resonance imaging (MRI) rather than computed tomography (CT). Special apparatuses with metal materials such as ventilators, and cardiac pacemakers belonging to patients cannot be located in the magnetic field. We aimed to exhibit the possibility of examining MRI, maintaining ventilation at a relative long distance by means of modified $Ambu^{(R)}$. Methods : Self-inflating bags as a sort of a manual ventilator, connected with relatively long extension tubes instead of mechanical ventilators, were adopted to obtain MRI. PVC (polyvinyl chloride) extension tubes had different lengths and diameters. Lengths were 1, 2, and 3 cm and diameters were 15, and 25 mm. The work of breathing and expiratory changes of expiratory tidal volume (TVe), minute volume of expiration (MVe), peak inspiratory pressure (PIP) were measured by use of the mechanical ventilator, $Servoi^{(R)}$, as the alteration of TVi (inspiratory tidal volume), extension tube lengths and diameters with other values fixed. Results : Measured TVe and MVe by ventilator were the same values with control at every TVi, regardless of extension tube lengths and diameters, but PIP were increased with the rise of TVi, tube lengths, with decline of tube diameters, these were statistically significant. Conclusion : MRI examination can be carried out with a self-inflating bag connected with an extension tube at a long distance in patients who need artificial ventilation.
With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.
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