• Title/Summary/Keyword: Radiology science department

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Diagnostic Imaging of Biliary Atresia (담도폐쇄증의 영상 진단)

  • Haesung Yoon;Hyun Ji Lim;Jisoo Kim;Mi-Jung Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.991-1002
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    • 2022
  • Biliary atresia is a rare but significant cause of neonatal cholestasis. An early and accurate diagnosis is important for proper management and prognosis. To diagnose biliary atresia, various imaging studies using ultrasonography, MRI, hepatobiliary scans, and cholangiography can be performed, although ultrasonography is more important for initial imaging studies. In this article, we review the findings of biliary atresia from various imaging modalities, including ultrasonography, MRI, hepatobiliary scans, and cholangiography. The known key imaging features include abnormal gallbladder size and shape, periportal thickening visible as a 'triangular cord' sign, invisible common bile duct, increased hepatic arterial flow, and combined anomalies. Aside from the imaging findings of biliary atresia, we also reviewed the diagnostic difficulty in the early neonatal period and the role of imaging in predicting hepatic fibrosis. We hope that this review will aid in the diagnosis of biliary atresia.

Delayed Cancer Diagnosis in Thyroid Nodules Initially Treated as Benign With Radiofrequency Ablation: Ultrasound Characteristics and Predictors for Cancer

  • Myoung Kyoung Kim;Jung Hee Shin;Soo Yeon Hahn;Haejung Kim
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.903-911
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    • 2023
  • Objective: Regrowth after radiofrequency ablation (RFA) of symptomatic large thyroid nodules, initially treated as benign, sometimes turns out to be malignancies. This study aimed to assess the ultrasound (US) characteristics of thyroid nodules initially treated as benign with RFA and later diagnosed as cancers, predictive factors for cancers masquerading as benign, and methods to avoid RFA in these cancers. Materials and Methods: We reviewed the medical records of 134 consecutive patients with 148 nodules who underwent RFA between February 2008 and November 2016 for the debulking of symptomatic thyroid nodules diagnosed as benign using US-guided biopsy. We investigated the pre-RFA characteristics of the thyroid nodules, changes at follow-up after RFA, and the final surgical pathology. Results: Nodule regrowth after RFA was observed in 36 (24.3%) of the 148 benign nodules. Twenty-two of the 36 nodules were surgically removed, and malignancies were confirmed in seven (19.4% of 36). Of the 22 nodules removed surgically, pre-RFA median volume (range) was significantly larger for malignant nodules than for benign nodules: 22.4 (13.9-84.5) vs. 13.4 (7.3-16.8) mL (P = 0.04). There was no significant difference in the regrowth interval between benign and malignant nodules (P = 0.49). The median volume reduction rate (range) at 12 months was significantly lower for malignant nodules than for benign nodules (51.4% [0-57.8] vs. 83.8% [47.9-89.6]) (P = 0.01). The pre-RFA benignity of all seven malignant nodules was confirmed using two US-guided fine-needle aspirations (FNAs), except for one nodule, which was confirmed using US-guided core-needle biopsy (CNB). Regrown malignant nodules were diagnosed as suspicious follicular neoplasms by CNB. Histological examination of the malignant nodules revealed follicular thyroid carcinomas, except for one follicular variant, a papillary thyroid carcinoma. Conclusion: Symptomatic large benign thyroid nodules showing regrowth or suboptimal reduction after RFA may have malignant potential. The confirmation of these nodules is better with CNB than with FNA.

Quantitative T1 Mapping for Detecting Microvascular Obstruction in Reperfused Acute Myocardial Infarction: Comparison with Late Gadolinium Enhancement Imaging

  • Jae Min Shin;Eui-Young Choi;Chul Hwan Park;Kyunghwa Han;Tae Hoon Kim
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.978-986
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    • 2020
  • Objective: To compare native and post-contrast T1 mapping with late gadolinium enhancement (LGE) imaging for detecting and measuring the microvascular obstruction (MVO) area in reperfused acute myocardial infarction (MI). Materials and Methods: This study included 20 patients with acute MI who had undergone 1.5T cardiovascular magnetic resonance imaging (CMR) after reperfusion therapy. CMR included cine imaging, LGE, and T1 mapping (modified look-locker inversion recovery). MI size was calculated from LGE by full-width at half-maximum technique. MVO was defined as an area with low signal intensity (LGE) or as a region of visually distinguishable T1 values (T1 maps) within infarcted myocardium. Regional T1 values were measured in MVO, infarcted, and remote myocardium on T1 maps. MVO area was measured on and compared among LGE, native, and post-contrast T1 maps. Results: The mean MI size was 27.1 ± 9.7% of the left ventricular mass. Of the 20 identified MVOs, 18 (90%) were detected on native T1 maps, while 10 (50%) were recognized on post-contrast T1 maps. The mean native T1 values of MVO, infarcted, and remote myocardium were 1013.5 ± 58.5, 1240.9 ± 55.8 (p < 0.001), and 1062.2 ± 55.8 ms (p = 0.169), respectively, while the mean post-contrast T1 values were 466.7 ± 26.8, 399.1 ± 21.3, and 585.2 ± 21.3 ms, respectively (p < 0.001). The mean MVO areas on LGE, native, and post-contrast T1 maps were 134.1 ± 81.2, 133.7 ± 80.4, and 117.1 ± 53.3 mm2, respectively. The median (interquartile range) MVO areas on LGE, native, and post-contrast T1 maps were 128.0 (58.1-215.4), 110.5 (67.7-227.9), and 143.0 (76.7-155.3) mm2, respectively (p = 0.002). Concordance correlation coefficients for the MVO area between LGE and native T1 maps, LGE and post-contrast T1 maps, and native and post-contrast T1 maps were 0.770, 0.375, and 0.565, respectively. Conclusion: MVO areas were accurately delineated on native T1 maps and showed high concordance with the areas measured on LGE. However, post-contrast T1 maps had low detection rates and underestimated MVO areas. Collectively, native T1 mapping is a useful tool for detecting MVO within the infarcted myocardium.

Molecular Imaging of Arthritis in the Angiogenic Vasculature Using A 123I-Vascular Endothelial Growth Factor Receptor Antibody

  • Kim, Sung-Min;Choi, Na-Eun;Song, Young-Kyu;Cho, Gyung-Goo;Bang, Jeong-Kyu;Kim, Sang-Mi;Lee, Sang-Hoon;Ryu, Eun-Kyoung
    • Bulletin of the Korean Chemical Society
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    • v.33 no.6
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    • pp.1890-1894
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    • 2012
  • Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) have been implicated in the pathogenesis of rheumatoid arthritis, which is angiogenesis dependent. Antibody-based molecular imaging improves targeting, and antibody radiolabeling is useful for monitoring biological events $in$ $vivo$ $via$ PET or SPECT. We investigated the potential of molecular imaging to diagnose arthritis with VEGFR-2 $in$ $vivo$. The $^{123}I$-VEGFR-2 antibody was prepared by the iodogen tube method. The radioligand was injected into arthritic mice, and micro SPECT/CT was performed. The arthritic mice were examined by 4.7-T MRI and immunohistochemistry. The $^{123}I$-VEGFR-2 antibody showed high uptake in the arthritic region at 1 h postinjection on SPECT/CT but no uptake in the control animals after radioligand injection. In MR images, the arthritic tissue of the mice was correlated with regions labeled by the $^{123}I$-VEGFR-2 antibody. Immunohistochemical localization showed markedly increased expression of VEGFR-2 in the endothelial cells, fibroblasts, and macrophages of the arthritic mice.

A repeatedly recurrent desmoplastic ameloblastoma after removal and allobone graft: Radiographic features compared with histological changes

  • Kim, Jae-Duk;Jang, Hyun-Seon;Seo, Yo-Seob;Kim, Jin-Soo
    • Imaging Science in Dentistry
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    • v.43 no.3
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    • pp.201-207
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    • 2013
  • A 40-year-old man suffered from a repeatedly recurrent desmoplastic ameloblastoma in the right maxillary anterior and premolar regions. During the first visit, the patient was provisionally histopathologically diagnosed with a developmental cyst, and it was confirmed to be unicystic ameloblastoma and resected. Four years later, the lesion recurred, and was diagnosed as a desmoplastic type of ameloblastoma and removed again. Then, 5 years after the second surgery, the lesion recurred again, and was diagnosed as a type containing a follicular pattern, recurrent ameloblastoma. A panoramic radiograph showed a multilocular and mixed radiolucent/radiopaque expansile lesion at the first visit, a unilocular cystic lesion confined to the premolar area at the second visit, and a small soap bubble appearance in the molar area in the final visit. Cone-beam computed tomographic images of the final recurrence of the tumor revealed multiple small cyst-like structures in the right maxillary anterior and posterior regions.

Diagnostic ability of panoramic radiography for mandibular fractures (하악골 골절에 대한 파노라마방사선사진의 진단능)

  • Lee, Ji-Hyun;Jung, Yun-Hoa;Cho, Bong-Hae;Hwang, Dae-Seok
    • Imaging Science in Dentistry
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    • v.40 no.1
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    • pp.33-38
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    • 2010
  • Purpose : The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. Materials and Methods : The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral & maxillofacial radiologists (observer A&B), two oral & maxillofacial surgeons (observer C&D), and two general dentists (observer E&F). Results : Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A&B, 93.5% in observer C&D and 80.4% in observer E&F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Conclusion : Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

Calcifying Odontogenic Cyst Associated with an Impacted Upper Cuspid (상악 매복 견치와 관련된 석회화 치성낭)

  • Yoon Suk-Ja;Kim Young-Hee;Yi Jae-Seo
    • Imaging Science in Dentistry
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    • v.30 no.3
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    • pp.223-227
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    • 2000
  • A 35-year-old man was referred to the department of Oral and maxillofacial surgery of Chonnam university hospital for the chief complaint of asymptomatic swelling on the buccal vestibule of upper right canine area. Radiographs revealed that the upper right canine was impacted and there was a well-circumscribed pericoronal radiolucency related with the canine. Multiple radiopaque foci were scattered in the radiolucent lesion, and the roots of the lateral incisor and the first premolar related to the lesion showed external resorption. The radiographic features of this lesion were typical of adenomatoid odontogenic tumor, but considering the gender and age of the patient, the tentative diagnosis was made as calcifying odontogenic cyst. Microscopically this lesion was diagnosed as calcifying odontogenic cyst. Because calcifying odontogenic cyst has no pathognomonic feature of radiographs, to consider radiographic features with clinical findings is necessary in order to establish more correct diagnosis.

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Dose Comparison Analysis of Temporal bone CT scan to conventional scan method during helical scan method (Temporal bone CT 검사 시 conventional scan 방식과 helical scan방식에 따른 선량 비교분석)

  • Gang, Su-hong;Park, Yong-Seong;Lee, Rae-Gon;Hwang, Seon-Kwang
    • Korean Journal of Digital Imaging in Medicine
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    • v.17 no.1
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    • pp.49-56
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    • 2015
  • Temporal bone CT scan side skull fracture. In addition to the confirmation of the ossicles, such as fractures and dislocations, temporomandibular facial fractures, deformities surgery helps to establish a science plan. Cochlear implant surgery has been performed in the state before and after identifying purposes. Test methods are being implemented by the Conventional direct axial and Direct coronal scan, the basic method of Temporal bone CT. Helical scan is a fast Volumetric data obtained compared with the Conventional scan, the patient reduced the dose, and there are some advantages, such as reduced Beam hardening streak artifacts caused by dental fillings. This study is a comparative analysis by dose reduction for patients with a dose according to the conventional scan method and then effective from 2015 by helical scan method performed in 2014 through the retrospective survey, which was then optimized for the purpose of inspection.

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Ameloblastic carcinoma of the mandible (하악에 발생된 법랑모세포 암종)

  • Kim Keun-Min;Hwang Eui-Hwan;Cho Jae-O;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.31 no.2
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    • pp.109-115
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    • 2001
  • The ameloblastic carcinoma is an extremely rare, aggressive odontogenic neoplasm of the jaws. It is described as an ameloblastoma in which there is histologic evidence of malignancy in the primary or recurrent tumors, regardless of whether it has metastasized. We report an aggressive case of ameloblastic carcinoma of the mandible. A 68-year-old man with the complaint of the left facial swelling and intermittent pain was referred to our hospital. Serial images of panoramic radiograph, computed tomograph, and magnetic resonance imaging showed an ill-defined destructive radiolucent lesion of the left mandible. The lesion had typically aggressive behavior with extensive local destruction of bone and extended to the adjacent soft tissues. Bone scan revealed increased uptakes in the left mandibular body and ramus regions. Histological features were generally resembled with those of an ameloblastoma but with cytologic features of epithelial malignancy.

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Metal artifact production and reduction in CBCT with different numbers of basis images

  • Queiroz, Polyane Mazucatto;Santaella, Gustavo Machado;Groppo, Francisco Carlos;Freitas, Deborah Queiroz
    • Imaging Science in Dentistry
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    • v.48 no.1
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    • pp.41-44
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    • 2018
  • Purpose: To evaluate the effect of different numbers of basis images and the use of metal artifact reduction (MAR) on the production and reduction of artifacts in cone-beam computed tomography images. Materials and Methods: An acrylic resin phantom with a metal alloy sample was scanned, with 450 or 720 basis images and with or without MAR. Standard deviation values for the test areas (around the metal object) were obtained as a way of measuring artifact production. Two-way analysis of variance was used with a 5% significance level. Results: There was no significant difference in artifact production among the images obtained with different numbers of basis images without MAR (P=.985). MAR significantly reduced artifact production in the test areas only in the protocol using 720 basis images (P=.017). The protocol using 450 basis images with MAR showed no significant difference in artifact production when compared to the protocol using 720 basis images with MAR (P=.579). Conclusion: Protocols with a smaller number of basis images and with MAR activated are preferable for minimizing artifact production in tomographic images without exposing the patient to a greater radiation dose.