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Prediction of Necrotizing Pancreatitis on Early CT Based on the Revised Atlanta Classification (개정된 아틀란타 분류법에 근거한 초기 CT에서의 괴사성 췌장염의 예측)

  • Yeon Seon Song;Hee Sun Park;Mi Hye Yu;Young Jun Kim;Sung Il Jung
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1436-1447
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    • 2020
  • Purpose To investigate the clinical and CT features at admission to predict the progression to necrotizing pancreatitis (NP) in patients initially diagnosed with interstitial edematous pancreatitis (IEP). Materials and Methods Patients with IEP who underwent contrast-enhanced CT at admission and follow-up CT (< 14 days) were included (n = 178). Two radiologists performed a consensus review of follow-up CT scans and diagnosed the type of acute pancreatitis as IEP or NP. Laboratory findings at admission were recorded. Clinical, CT, and laboratory findings were compared between the IEP-IEP group and IEP-NP group using the chi-square test and the t-test. Multivariate analysis was also performed. Results There were 112 and 66 patients in the IEP-IEP and the IEP-NP groups, respectively. The proportion of patients with alcohol etiology was significantly larger in the IEP-NP group. Among the CT findings, the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were more frequently observed in the IEP-NP group. Among the laboratory variables, serum C-reactive protein levels and white blood cell counts were significantly higher in the IEP-NP group. Multivariate analysis revealed that the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were significant findings distinguishing the two groups. Conclusion CT findings, such as the presence of peripancreatic fluid and heterogeneous pancreatic parenchymal enhancement, may be helpful in predicting the progression to NP in patients initially diagnosed with IEP.

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings (대동맥판막치환술 후 발생한 판막하 판누스(Pannus): 시간에 따른 변화 및 심초음파 소견)

  • Mi Yeon Park;Hyun Jung Koo;Hojin Ha;Joon-Won Kang;Dong Hyun Yang
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1151-1163
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    • 2020
  • Purpose This study aimed to evaluate changes of subprosthetic pannus on cardiac CT and determine its relationship to echocardiographic findings in patients with mechanical aortic valve replacement (AVR). Materials and Methods Between April 2011 and November 2017, 17 AVR patients (56.8 ± 8.9 years, 12% male) who showed pannus formation on CT and had undergone both follow-up CT and echocardiography were included. The mean interval from AVR to the date of pannus detection was 10.5 ± 7.1 years. In the initial and follow-up CT and echocardiography, the pannus extent and echocardiographic parameters were compared using paired t-tests. The relationship between the opening angle of the prosthetic valve and the pannus extent was evaluated using Pearson correlation analysis. Results The pannus extent was significantly increased on CT (p < 0.05). The peak velocity (3.9 ± 0.8 m/s vs. 4.2 ± 0.8 m/s, p = 0.03) and mean pressure gradient (36.4 ± 15.5 mm Hg vs. 42.1 ± 15.8 mm Hg, p = 0.03) were significantly increased. The mean opening angles of the mechanical aortic leaflets were slightly decreased, but there was no statistical significance (73.1 ± 8.3° vs. 69.4 ± 12.1°, p = 0.12). The opening angle of the prosthetic leaflets was inversely correlated with the pannus extent (r = -0.57, p < 0.001). Conclusion The pannus extent increases over time, increasing transvalvular peak velocity and the pressure gradient. CT can be used to evaluate the pannus extent associated with hemodynamic changes that need to be managed by surgical intervention.

Early Recurrence of Breast Cancer after the Primary Treatment: Analysis of Clinicopathological and Radiological Predictive Factors (유방암 일차치료 후 조기 재발: 임상병리학적 및 영상의학적 예측인자 분석)

  • Sun Geun Yun;Yeong Yi An;Sung Hun Kim;Bong Joo Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.395-408
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    • 2020
  • Purpose To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

Adaptive Image Rescaling for Weakly Contrast-Enhanced Lesions in Dedicated Breast CT: A Phantom Study (약하게 조영증강된 병변의 유방 전용 CT 영상의 대조도 개선을 위한 적응적 영상 재조정 방법: 팬텀 연구)

  • Bitbyeol Kim;Ho Kyung Kim;Jinsung Kim;Yongkan Ki;Ji Hyeon Joo;Hosang Jeon;Dahl Park;Wontaek Kim;Jiho Nam;Dong Hyeon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1477-1492
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    • 2021
  • Purpose Dedicated breast CT is an emerging volumetric X-ray imaging modality for diagnosis that does not require any painful breast compression. To improve the detection rate of weakly enhanced lesions, an adaptive image rescaling (AIR) technique was proposed. Materials and Methods Two disks containing five identical holes and five holes of different diameters were scanned using 60/100 kVp to obtain single-energy CT (SECT), dual-energy CT (DECT), and AIR images. A piece of pork was also scanned as a subclinical trial. The image quality was evaluated using image contrast and contrast-to-noise ratio (CNR). The difference of imaging performances was confirmed using student's t test. Results Total mean image contrast of AIR (0.70) reached 74.5% of that of DECT (0.94) and was higher than that of SECT (0.22) by 318.2%. Total mean CNR of AIR (5.08) was 35.5% of that of SECT (14.30) and was higher than that of DECT (2.28) by 222.8%. A similar trend was observed in the subclinical study. Conclusion The results demonstrated superior image contrast of AIR over SECT, and its higher overall image quality compared to DECT with half the exposure. Therefore, AIR seems to have the potential to improve the detectability of lesions with dedicated breast CT.

Utility of the 16-cm Axial Volume Scan Technique for Coronary Artery Calcium Scoring on Non-Enhanced Chest CT: A Prospective Pilot Study (비 조영증강 흉부 CT에서 관상동맥 칼슘스코어 측정을 위한 16 cm 축상 촬영 기법의 유용성: 전향적 탐색적 연구)

  • So Jung Ki;Chul Hwan Park;Kyunghwa Han;Jae Min Shin;Ji Young Kim;Tae Hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1493-1504
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    • 2021
  • Purpose This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. Materials and Methods This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calcium-score CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. Results The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. Conclusion The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.

CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

The effect of listening to music on cardiovascular and autonomic reactivity to sympathoexcitation in young adults (음악 청취가 교감신경 활성화에 대한 심혈관 및 자율신경 반응 완화에 미치는 영향)

  • Jeong In Kwon;Hyun Jeong Kim;Min Jeong Cho;Yoo Sung Oh;Sae Young Jae
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.4
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    • pp.674-684
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    • 2023
  • The purpose of this study was to investigate the effect of acute listening to music on the cardiovascular reactivity to sympathoexcitation. In this crossover design study, 15 healthy adults(23.1±1.94(yrs) were randomized to either (1)acute listen to the subject's preferred music for 30 minutes and (2)sat as a time control by an experiment coordinator. After completing each trial, the cold pressor test(CPT) was conducted. Heart rate(HR) and blood pressure(BP) were measured for 4 times at baseline, during and after the CPT. Heart rate variability(HRV) were measured for 3 times at baseline, prior and after the CPT. HR and BP increased during the CPT in both trial and returned to baseline after CPT(time effect, p < .001). After CPT, brachial systolic BP reactivity to the CPT was attenuated in listening to music trial compared to control trial(p = . 008). As a result of heart rate variability(HRV), the difference values between the baseline and prior to the CPT showed a significant increase in standard deviation of the NN intervals(SDNN), total power(TP) and high frequency(HF) only in the music trial (p = .001, p = .002, p = .011). The difference value between prior to and after the CPT did not show significance. But compared with the control trial, the music trial was confirmed that SDNN, TP and HF were more activated. Therefore, listening to music alleviated anxiety and tension before the CPT, and it is estimated that it had a favorable effect on stability after the CPT. This findings showed that listening to music may have a positive effect on brachial systolic BP and HRV to sympathoexcitation.

Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology (확산강조영상에서 미만성 대뇌 백질의 이상을 보이는 신생아 경련 환자에서 구조적 이상이나 대사와 관련된 원인이 없을 경우 임상적 소견과 영상 소견의 특징)

  • Maeran Kim;Jae-Yeon Hwang;Yeoun Joo Lee;Yong-Woo Kim;Shin Yun Byun;Yun-Jin Lee;Jeong A Yeom;Ung Bae Jeon;Ki Seok Choo;Kyung Jin Nam;Storm Nicholas Shaun Reid
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1412-1423
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    • 2020
  • Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

Study on the Effect of Self-Disclosure Factor on Exposure Behavior of Social Network Service (자기노출 요인이 소셜 네트워크 서비스의 노출행동에 미치는 영향에 관한 연구)

  • Do Soon Kwon;Seong Jun Kim;Jung Eun Kim;Hye In Jeong;Ki Seok Lee
    • Information Systems Review
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    • v.18 no.3
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    • pp.209-233
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    • 2016
  • Internet companies that utilize social network have increased in number. The introduction of diverse social media services facilitated innovative changes in e-business. Social network service (SNS), which is a domain of social media, is a web-based service designed to strengthen human relations in the Internet and build new social relations. The remarkable growth of social network services and the profit generation and perception of this service are the new growth engines of this digital age. Given this development, many global IT companies views SNS as the most powerful form of social media. Thus, they invest efforts to develop business models using SNS.2) This study verifies the impact of privacy exposure in SNS as a result of privacy invasion. This study examines the purpose of using the SNS and user's awareness of the significance of personal information, which are key factors that affect self-disclosure of personal information. This study utilizes theory of reasoned action (TRA) to provide a theoretical platform that describes the specific behavior and emotional response of individuals. This study presents a research model that considers negative attitude (negatude). In this model, self-disclosure in SNS is considered a TRA. TRA is a subjective norm, a behavioral intention, and a key variable of exposure behavior. A survey was conducted on college students at Y university in Seoul to empirically verify the research model. The students have experiences in using SNS. A total of 198 samples were collected. Path analysis was applied to analyze the relations of factors. The results of path analysis show the statistically insignificant impact of privacy invasion on negatude, subjective norm, behavioral intention, and exposure behavior. The impact of unrecognized privacy invasion was also considered insignificant. The impacts of intention to use SNS on negatude, subjective norm, behavioral intention, and exposure behavior was significant. A significant impact was also found for the significance of personal information on subjective norm, behavioral intention, and exposure behavior, whereas the impact on negatude was insignificant. The impact of subjective norm on behavioral intention was significant. Lastly, the impact of behavioral intention on exposure behavior was insignificant. These findings are significant because the study examined the process of self-disclosure by integrating psychological and social factors based on theoretical discussion.

A Study on the Continuous Usage Intention Factors of O2O Service (O2O 서비스의 지속사용의도에 미치는 영향요인 연구)

  • Sung Yong Jung;Jin Soo Kim
    • Information Systems Review
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    • v.20 no.4
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    • pp.1-23
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    • 2018
  • A smart phone has been widely spread around world and makes people enjoy online shopping in any time and any place. Recently it also changes the distribution environment. O2O (Online-to-Offline) service becomes new normal due to its convenience of ease shopping of product and services. O2O service market shows steady and steep growth, It is reported that, however, 80% of the businesses has been discontinued within the first year because of unstable business models, customer dissatisfaction and distrust of service. Therefore, it is very important research issue to find out influential factors promoting continuous usage intention of O2O service. Previous study shows that it only considers online characteristics and lack of analysis about offline characteristics and social impact factors. The purpose of this paper is to find out continuous usage intention factors of O2O services by literature review, case analysis, and empirical test. A comprehensive research model and related hypothesis are developed and tested by using a structural equation, Survey was carried out among users who have used O2O service including payment service for at least once. Finally 611 samples are selected out of total 813 surveys. The result shows that the model is theoretically proved and 12 out of 17 hypotheses are accepted. The contribution of this paper is that it provides a new theoretical research model about continuous usage intention factors as well as practical guidelines about promoting continuous usage and growth strategies of O2O service.