• Title/Summary/Keyword: Vascular malformation

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The Analysis of Incidental Findings on Temporomandibular Joint Magnetic Resonance Imaging

  • Choi, Yoon Joo;Lee, Chena;Jeon, Kug Jin;Han, Sang-Sun
    • Journal of Korean Dental Science
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    • v.13 no.1
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    • pp.21-27
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    • 2020
  • Purpose: The aim of this study was to investigate the types and frequency of the various incidental findings (IFs) on magnetic resonance images (MRI) taken from the patients with temporomandibular disorder (TMD) symptoms. Materials and Methods: Temporomandibular joint (TMJ) MRI taken from 1,013 patients with TMD symptoms were evaluated retrospectively. IF was defined as imaging features that were accidentally or unexpectedly found, rather than degenerative bony changes of TMJ complex or disc derangement. They were classified into two groups as TMJ site-specific findings and unexpected findings at other regions. The frequency of the sub groups was analyzed. Result: A total of 26 (2.57%) cases with IFs were classified into 13 cases with TMJ site-specific findings and 13 cases with unexpected findings at other region. TMJ site-specific findings included synovial chondromatosis in 6 cases, synovial cyst in 6 cases and osteochondroma in one case. Unexpected findings included salivary gland tumor in 3 cases, developmental cyst in 3 cases, vascular malformation in 2 cases, mastoiditis in 4 cases and sialadenitis on parotid gland in one case. Conclusion: When diagnosing TMD through TMJ MRI, clinicians should carefully read the image, considering the possibility of IFs because TMJ MRI can provide pathologic information in TMJ region and other oral and maxillofacial region.

OK-432 Intralesional Injection Therapy for Lymphangioma in Children (소아 림프관종의 OK-432 병변내 주사요법)

  • Kim, Kyung-Hun;Kim, Hyun-Hahk;Lee, Suk-Koo;Seo, Jeong-Meen;Chang, Weon-Young;Lee, Byung-Boong
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.142-146
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    • 2001
  • Lymphangioma is a congenital malformation of the lymphatic system, commonly seen in the neck. Operation was the treatment of choice but it is difficult to resect the lymphangiomas completely. The aim of this study is to evaluate the result of intralesional injection of OK-432 as a treatment strategy of lymphangioma in children. Medical records of 51 cases of lymphangioma from March 1996 to February 2001 were reviewed retrospectively. Intralesional injection of 0.1mg OK-432 in 10ml normal saline was performed after the aspiration of as much fluid as possible. The location of the lesion was the face and neck in 26 patients, the chest wall in 14, the extremities in 9, and the abdominal wall in 2. The cystic type was present in 45 patients and the cavernous type in 6. Four postoperative recurrent cases were included. Fluid aspiration from the lesion was impossible in 5 patients. Development of fever after injection was observed in 27 patients and local inflammatory reaction was in 5 patients. There was no scar formation at injection sites. Complete shrinkage was observed in 20 patients, remarkable shrinkage in 23, slight shrinkage in 3, and no response in 5. Cystic type or aspiration-possible cases showed better outcome than cavernous type or aspiration-impossible cases. All of four recurrent cases after surgical excision showed at least remarkable shrinkage. These results indicate that intralesional injection of OK-432 is a safe and satisfactory treatment modality of lymphangiomas in children and might be considered as a treatment of choice, even in recurrent cases.

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Persistent Proatlantal Artery in Magnetic Resonance Angiography: A Case Report (자기공명혈관조영술로 진단된 제2형 전환추동맥(Proatlantal Artery): 증례 보고)

  • Jeon, Seong Woo;Chang, Hyuk Won;Kim, Mi Jung;Cho, Jihyoung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.55-58
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    • 2013
  • Persistent proatlantal artery (PPA) is a rare embryologically remnant carotico-vertebrobasilar anastomoses. There are two types of PPA according to embryological considerations, origin and anatomic course. Type I PPA usually originate from internal carotid artery and not traversing transverse foramen. Type II PPA traverses from external carotid artery to C1 transverse foramen. The PPA is usually found incidentally without clinical symptoms, but can be related to several clinically significant vascular lesions, such as hypoplastic vertebral artery, intracranial arteriovenous malformation and in a case of carotid endarterectomy or external carotid artery embolization. So, thorough understanding of this anomaly is needed and we report a case of type II PPA diagnosed by MR angiography.

Hereditary Hemorrhagic Telangiectasia (유전성출혈모세혈관확장증의 증례 및 문헌 고찰)

  • Kwon, Jeong-Seung;Ahn, Hyung-Joon;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.135-139
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    • 2012
  • Hereditary hemorrhagic telangiectasia is a rare autosomal dorminant disease that features abnormal and fragile vascular dilations of terminal vessels in skin and mucous membranes, as well as arteriovenous malformations of internal organs, particularly lungs, brain, and liver. Often patients have not been diagnosed with HHT for a long time, and undiagnosed HHT patients unnecessarily develop serious complications such as severe life-threatening hemorrhage, stroke or brain abscess. Therefore, early detection and appropriate screening is very important. Early detection of HHT allows the appropriate screening for the presence of silent disease such as AVMs in the lungs, liver, or brain, and preventive treatment in the patient and their affected family members. Dentists should be familiar with HHT because the telangiectases on skin and oral mucosa are often the most dramatic and most easily identified component of HHT. Recently, we experienced a case of HHT. We present the case with a review of the literature.

Systemic Pulmonary Arteriovenous Fistula - 1 Case Report - (체동맥 폐동정맥루 치험례의 보고 -1례 보고-)

  • 허재학;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.409-412
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    • 1998
  • This is a case report of an operation for the pulmonary arteriovenous fistula supplied from the systemic arteries instead of the pulmonary artery. The operation of systemic arteriovenous pulmonary fistula has formidable technical challenges due to its extensive collateral circulations. A 16 year-old female patient, diagnosed as systemic arteriovenous fistula with multiple tortuous feeding vessels and with hereditary hemorrhagic telangiectasia, was initially managed with arterial embolization before the operation. A 15${\times}$8cm sized huge vascular malformation was removed by RML and RLL bilobectomy. During the operation, we encountered annoying massive bleeding and pulmonary congestion originated in its extensive collateral circulation. The patient was discharged after conservative management without specific problem on the 15th postoperative day. For the safe operation as well as good operative result, it seemed that meticulous ligation of the multiple collateral vessels should be performed prior to that of pulmonary veins.

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Usefulness of Computed Tomographic Angiography in the Detection and Evaluation of Aneurysms of the Circle of Willis (Willis환 내 뇌동맥류 진단시 전산화단층촬영 뇌혈관 조영술의 유용성)

  • Lee, Hyuk Gi;Cho, Jae Hoon;Lee, Sung Lak;Kang, Dong Gee;Kim, Sang Chul
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.345-352
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    • 2000
  • Objective : The purpose of this study was to compare computed tomographic angiography(CTA) with conventional cerebral angiography(CCA) and to assess usefulness of CTA in detection and anatomic definition of intracranial aneurysms of the circle of Willis in subarachnoid hemorrhage. Patients and Methods : Fifty consecutive patients with known or suspected intracranial saccular aneurysms underwent CTA with preoperative CCA from 1997 to 1999. Using surface shaded display post-processing technique, CTA was interpreted for the presence, location of aneurysms and anatomic features. The image obtained with CTA was then compared with CCA image. Results : In 47 patients, CCA revealed 57 cerebral aneurysms and CTA revealed 54 aneurysms. Two of the 57 cerebral aneurysms were located outside of the imaging volume of CTA and one case was misdiagnosed. The sensitivity of CTA was 94.7% and the specificity was 100%. The results obtained with CTA were, compared with the results obtained with CCA, equal in determining dome shape, direction and lobularity. However, CTA provided a 3-dimensional representation of aneurysmal lesion very useful for surgical planning. Moreover, CTA was useful for rapid and relatively noninvasive detection of aneurysms in the circle of Willis. Conclusion : CTA can be a diagnostic tool for the patients with acute subarachnoid hemorrhage due to a ruptured aneurysm of the circle of Willis and provides adequate anatomic detail for surgical planning, especially to complex cerebral aneurysms. However, we think CCA is necessary because of CTA limitations including its difficulty in detecting unusually located aneurysms(including those in cavernous sinus or distal artery) and combined vascular lesion (including arteriovenous malformation) and acquiring dynamic flow information.

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Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.

Transvaginal Direct Puncture and Ethanol Sclerotherapy for Cervicovaginal Venous Malformations: A Case Report and Literature Review (자궁경부 및 질에 발생한 정맥기형에 대한 질 경유 직접 천자 및 에탄올 경화요법: 증례 보고 및 문헌 고찰)

  • Gu Seong Jeong;Suk Hyun Bae;Young Soo Do;Hyoung Nam Lee;Sang Joon Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.688-692
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    • 2021
  • Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

The Oriental and Occidental bibliographic Study of Psoriasis (乾癬에 對한 東.西醫 文獻的 硏究)

  • Kim, Nam-Kwen;Hwang, Chung-yeon;Lim, Gye-sang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.1
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    • pp.154-178
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    • 1999
  • Psoriasis is the recurrent disease of skin and till now its mechanism, pathogenesis and treatment are not clearly discovered. So, like these papers, we must investigate more safety and effective treatment of psoriasis. And I obtained the following condusions from the Oriental and Occidental bibliographic investigation. 1. In Oriental medicine. Baikbi, Pungsun, Eunselbyong, Songpisun, Baikselpung were the other names of Psoriasis. 2. In Occidental medicine, genetic factors, aggravation and inducible factors, biochemical factors, immunologic factors, disorder of epidermal kinetics, vascular malformation of dermis were cosidered to the pathogenic factors of psoriasis. 3. In Oriental medicine, the pathogenic factors of psoriasis were divided two parts. One is exogenous pathogenic factors which including the blood-heat, blood dryness, blood stasis, deficiency of liver and kidney, inharmony of impulsive and appointed pulsation, deficiency of blood. The other is exogenous pathogenic factors which including the wind-evil, wind-wetness, wind-heat, wind-cold, wetness-heat, cold-wetness, heat-evil. 4. In Occidental medicine, external applicative medicine, internal medicine, ultraviolet therapy, ultraviolet - external applicative medicine compound therapy and etc. were used the therapy of psoriasis. 5. In Oriental medicine, clean away heat and cooling blood, aliment the blood and moisturize, activating blood and expelling blood stasis, harmonize and invigorate the liver and kidney, invigorate the kidney, aliment the blood and moisturize the skin, aliment the blood and expelling the wind, expelling the wind and wetness, clean away heat and expelling wind, expelling the wind and scatter the cold, clean away heat and expelling the wetness, heat up the meridian and scatter the cold, clean away heat and remove the toxin and etc. were used the method of internal therapy of psoriasis. 6. Until Qing dynasty, wind expelling effective prescriptions like Bangpungtongsungsan, Sopungsan. Supungsunkisan and etc. were used and recently Yanghyelgeupungtang, Hwalhyelgeupungtang, Samultanggagam and etc. were used the internal therapy of psoriasis. 7. In the external therapy of psoriasis, Yuhonggo, Pungyugo, Sekryupiyeongo were used the plaster therapy and Folium Rerillae, Camphora, Fructus, Xanthii, Herba Spirodelae compound prescription were used the cleansing therapy, Okgisan, Chiunsan, Galmyogo, Hobunsan, Muisan, Madugo, Jeyugohengin were used the rubbing skin therapy. Rangdok Radix Aconiti, Bijeonilchoalkwang were used the attaching therapy, the extract of Rhizoma Et Radix Veratri was used the spreading pouder therapy. 8. In the acupuncture therapy of psoriasis, the Jelgol, chok Samni(S36), Kansa(P5), Haegye(S41), Wijung(B40) and etc. were used the acupuncture point, and the angle of helix incision threapy that disinfect and cut the angle of helix and plaster the Semen Glycine and Squama Manitis were used.

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Diagnosis and Post-Therapeutic Evaluation of Arteriovenous Malformations in Extremities Using Transarterial Lung Perfusion Scintigraphy (경동맥 폐관류 신티그라피를 이용한 상하지 동정맥 혈관기형의 진단과 치료 평가)

  • Chung, Hyun-Woo;Choi, Joon-Young;Kim, Young-Wook;Kim, Dong-Ik;Do, Young-Soo;Lee, Eun-Jeong;Lee, Su-Jin;Cho, Young-Seok;Hyun, Seung-Hyup;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.316-321
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    • 2006
  • Purpose: Differential diagnosis between arteriovenous (AVMs) aud non-arteriovenous malformations (nAVMs) is important in patients with congenital vascular malformations, because AVMs can cause hemodynamic alteration and require immediate treatment. We investigated whether transarterial lung perfusion scintigraphy (TLPS) was useful for the diagnosis and post-therapeutic evaluation of AVMs in extremities. Materials and Methods: Fifty-seven patients (M:F=26:31, $21{\pm}13$ yr, 9 upper and 48 lower extremities) suspected of congenital vascular malformations in extremities underwent TLPS using $^{99m}Tc-MAA$ before embolization/sclerotherapy. Dose-corrected shunt fraction (SF) was calculated from time-activity curve of the lung. Final diagnosis of AVMs was determined by angiography. in patients with AVMs, follow-up TLPS was done for post-therapeutic evaluation. Results: Sixteen patients (8 upper and 8 lower extremities) had AVMs, while the remaining 41 had nAVMs (1 upper and 40 lower extremities). The mean SF of AVMs on TLPS was significantly higher than that of nAVMs ($66.4{\pm}25.8%\;vs.\;2.8{\pm}4.3%$), p=0.003). The sensitivity, specificity, and accuracy of TLPS (cut-off of SF = 20.0%) in diagnosis of AVMs before treatment were 93.8% (15/16), 100% (41/41) and 98.2% (56/57), respectively. The follow-up TLPS and angiography for post-therapeutic evaluation showed concordant results in 13 of 16 patients (81.3%) with AVMs. The mean SF of TLPS was significantly decreased after embolization/sclerotherapy ($69.5{\pm}24.0%\;vs.\;41.0{\pm}34.7%$, p=0.01). Conclusion: TLPS provides hemodynamic information of AVMs in extremities semiquantitatively. Furthermore, the results of TLPS showed a high concordance rate with angiographic findings. Therefore, TLPS is useful for the diagnosis and post-therapeutic evaluation of AVMs in extremities.