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ABSTRACT: OBJECTIVES: To evaluate the feasibility of diagnosing recurrence of HCC after TACE color-coded iodine CT (CICT) based on arterial phase scans obtained by a dual-energy CT (DECT) scanner. METHODS: A CICT scan was acquired from an iodine map after applying material decomposition of the liver tissue and setting a threshold attenuation level for viable tumors. Two radiologists reviewed both conventional and CICT sets in 31 patients who had a history of TACE for HCC. The performances in detecting local tumor progression (LTP) were evaluated by alternative free-response receiver operating characteristics. The rate of uncertain diagnosis and interobserver agreement of the diagnosis were explored. Additionally, the reading time and radiation dose were also investigated. RESULTS: The mean figures of merit of the conventional and CICT sets for LTP were 0.818 and 0.847, respectively (p=0.459). The rate of uncertain diagnosis was significantly decreased in CICT sets (34.5% vs. 0%), and interobserver agreement was improved (k=0.527 vs. 0.718). On the CICT set, mean reading time was reduced by 49s and mean radiation dose was also decreased by 18.3% when replacing the non-contrast CT with CICT. CONCLUSIONS: CICT is comparable to conventional liver CT protocol in demonstrating viable HCCs, while it allows a reduction in radiation dose.
European journal of radiology 12/2012; · 2.65 Impact Factor
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ABSTRACT: Inflammatory pseudotumor (IPT) is a pseudoneoplastic lesion that most commonly involves lung. We report a case of IPT of kidney associated with hepatocellular carcinoma. CT and PET/CT showed the features of renal cell carcinoma. After radical nephrectomy, histologic examination demonstrated acute pyelonephritis associated with papillary necrosis, and IPT involving renal parenchyma and capsule. Although renal IPT is a very rare tumor, awareness of its existence in the differential diagnosis of a renal mass is critical to avoid misdiagnosis. Clinician should carefully consider differential diagnosis and complications associated with acute or chronic pyelonephritis and papillary necrosis in diabetic patients, particularly.
Clinical nuclear medicine 07/2012; 37(7):699-701. · 3.92 Impact Factor
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ABSTRACT: Bleeding jejunal varices are rare and could be life threatening. They are usually found in the presence of portal hypertension and prior history of gastrointestinal surgery. They can be effectively managed by radiological interventions such as transjugular intrahepatic portosystemic shunt or transhepatic embolization of varices. However, in patients with portal vein obstruction, an alternative access is necessary. We report a case of bleeding jejunal varices associated with postoperative adhesion in a patient with portal vein thrombosis which was successfully managed by percutaneous transsplenic embolization.
Abdominal Imaging 04/2012; · 1.73 Impact Factor
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ABSTRACT: Hepatic masses detected by ultrasonography and computed tomography in a young woman showed increased radioactivity on F-18 fluorodeoxyglucose positron tomography. Those multiple hepatic lesions were investigated under suspicion of malignancy. Liver enzymes, viral markers, and tumor markers were in normal range. Ultrasonography-guided needle biopsy revealed to be focal fatty infiltration in the liver.
Clinical nuclear medicine 12/2011; 36(12):1146-8. · 3.92 Impact Factor
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Jong Heon Jeong,
Hang Lak Lee,
Jin Ok Kim,
Hye Jin Tae,
Suk Hyun Jung,
Kang Nyeong Lee,
Dae Won Jun,
Oh Young Lee,
Byung Chul Yoon,
Ho Soon Choi,
Joon Soo Hahm, Soon Young Song
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ABSTRACT: The aim of this study was to examine the relationship of complications related to diverticulitis and visceral obesity. The study was based on a retrospective case note review conducted at the Hanyang University Hospital. Patients were diagnosed with diverticulitis based on clinical symptoms and abdominal computed tomography (CT) findings and divided into two groups: those admitted with complicated diverticulitis and those with a simple diverticulitis episode. We compared the body mass index (BMI) and degree of visceral obesity, measured by abdominal CT. The study included 140 patients, 87 (62.1%) were simple diverticulitis and 53 (37.9%) were complicated diverticulitis. In the complicated diverticulitis group, 9 (6.4%) cases were recurrent, 29 (20.7%) were perforation or abscess patients, and 28 (20%) were patients with systemic inflammatory response syndrome (SIRS). Of the SIRS patients, 13 were involved in other complication groups. When comparing in the two groups, the complicated diverticulitis group had a significantly higher visceral fat area (128.57 cm(2) vs 102.80 cm(2), P = 0.032) and a higher ratio of visceral fat area/subcutaneous fat area (0.997 vs 0.799, P = 0.014). Visceral obesity is significantly associated with complications of diverticulitis.
Journal of Korean medical science 10/2011; 26(10):1339-43. · 0.84 Impact Factor
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ABSTRACT: To investigate the clinical benefits of F18-fluorodeoxyglucose-positron emission tomography and computed tomography ((18)F-FDG-PET/CT) over multi-detector row CT (MDCT) in preoperative staging of gastric cancer.
FDG-PET/CT and MDCT were performed on 78 patients with gastric cancer pathologically diagnosed by endoscopy. The accuracy of radiologic staging retrospectively was compared to pathologic result after curative resection.
Primary tumors were detected in 51 (65.4%) patients with (18)F-FDG-PET/CT, and 47 (60.3%) patients with MDCT. Regarding detection of lymph node metastasis, the sensitivity of FDG-PET/CT was 51.5% with an accuracy of 71.8%, whereas those of MDCT were 69.7% and 69.2%, respectively. The sensitivity of (18)F-FDG-PET/CT for a primary tumor with signet ring cell carcinoma was lower than that of (18)F-FDG-PET/CT for a primary tumor with non-signet ring cell carcinoma (35.3% vs. 73.8%, P < 0.01).
Due to its low sensitivity, (18)F-FDG-PET/CT alone shows no definite clinical benefit for prediction of lymph node metastasis in preoperative staging of gastric cancer.
Journal of the Korean Surgical Society. 08/2011; 81(2):104-10.
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ABSTRACT: Nonalcoholic steatohepatitis (NASH) is the progressive form of non-alcoholic fatty liver disease (NAFLD), and its prevalence is increasing worldwide. Liver biopsy remains the best way to diagnose NASH and establish the presence of fibrosis, but has not been performed easily in children because of its invasiveness. We analyzed the ultrasonographic and histopathologic findings of pediatric NAFLD patients, and studied to find their association with clinical characteristics and laboratory findings.
The study involved 18 obese children ranging from 7 to 15 years of age, who were diagnosed with NASH by liver biopsy. We performed the abdomen ultrasonography before the liver biopsy. We reviewed their pathology slides and classified them by NASH CRN (Clinical Research Network) scoring system. We also reviewed the abdomen ultrasonographic findings of the patients and classified them into grade of 1, 2, and 3. We reviewed the medical records of the patients and investigated their clinical characteristics and laboratory findings.
The ultrasonographic grades had significant association with NAFLD activity score, grade of steatosis amount, ballooning change, and portal inflammation. Serum triglyceride level was significantly higher in patients who showed high grade steatosis and high NAFLD activity score.
This study showed that serum triglycerides and ultrasonographic findings are highly correlated with pathologic findings in children with NAFLD.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 03/2011; 57(3):158-65.
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ANZ Journal of Surgery 03/2011; 81(3):200-1. · 1.25 Impact Factor
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ABSTRACT: The extent of coronary artery calcification (CAC) is closely related to total atherosclerotic plaque burden. However, the pathogenesis of CAC is still unclear. Conditions such as diabetes mellitus, renal failure, smoking, and chronic inflammation have been suggested to link vascular calcification and bone loss. In the present study, we hypothesized that bone loss can contribute to the pathogenesis of CAC in patients with the chronic inflammatory condition that accompanies metabolic syndrome (MetS). The objective of this study was to investigate the relationship between CAC and bone mineral density (BMD) in patients with MetS and in patients without MetS, by using coronary multidetector-row computed tomography (MDCT).
Data from 395 consecutive patients was analyzed retrospectively. From the MDCT database, only those patients who underwent both coronary MDCT and dual-energy X-ray absorptiometry within an interval of one month, were selected. The presence of MetS was determined by the updated criteria as defined by the Third Adult Treatment Panel Report of the National Cholesterol Education Program.
In patients with MetS, a significant correlation was found between CAC and age {odds ratio (OR)=1.139, 95% confidence interval (CI) 1.080 to 1.201, p<0.001}, CAC and male sex (OR=3.762, 95% CI 1.339 to 10.569, p=0.012), and CAC and T-score of L-spine (OR=0.740, 95% CI 0.550 to 0.996, p=0.047) using a forward multiple logistic regression analysis model including clinical variables of gender, age, lipid profile, body mass index, diabetes mellitus, hypertension, smoking, and BMD. But in patients without MetS, BMD by itself was not found to contribute to CAC.
BMD was inversely correlated with CAC only in patients with MetS. This finding suggests that low BMD accompanied by MetS, may have significant clinical implications.
Korean Circulation Journal 02/2011; 41(2):76-82.
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Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 10/2010; 9(3):e20. · 5.64 Impact Factor
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ABSTRACT: To identify and evaluate the spectrum and prevalence of celiac axis (CA) and common hepatic artery (CHA) variations by using spiral computed tomography (CT) and digital subtraction angiography (DSA).
Institutional review board approval was obtained, and the requirement for informed patient consent was waived. The findings in 5002 patients who underwent spiral CT and DSA were retrospectively evaluated. CHA was defined as an arterial trunk containing at least one segmental hepatic artery and the gastroduodenal artery. The pattern of the aortic origin of the branches of the CA and superior mesenteric arteries was analyzed. The CHA anatomy was then investigated.
Of 15 possible types of CA variation, 13 types were identified. A normal CA was noted in 4457 (89.1%) of the 5002 patients. Twelve types of CA variation were identified in 482 (9.64%) patients. In the remaining 63 (1.26%) patients, the CA anatomy was classified as ambiguous because the CHA was absent owing to separate origins of the hepatic arteries and the gastroduodenal artery (n = 55) or because the origin of the CHA could not be determined owing to persistent anastomotic channels (n = 8). Seven CHAs originating from the normal CA had a retroportal (n = 6) or transpancreatic (n = 1) course. All eight CHAs originating from the left gastric artery passed the fissure of the ligamentum venosum. The 148 CHAs originating from the superior mesenteric artery showed diverse relationships with the pancreas--being supra-, trans-, or infrapancreatic--and the superior mesenteric-portal venous axis--being pre- or retroportal. The 20 CHAs originating from the aorta had a normal suprapancreatic preportal course.
Known or newly found CA and CHA variations could be systematically described in detail. The authors propose a hypothetical anatomic model for summarizing the observed CHA variations.
Radiology 04/2010; 255(1):278-88. · 5.73 Impact Factor
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ABSTRACT: Although digital ulceration frequently occurs in patients with systemic sclerosis, there have been few reports on macrovascular involvement. Macrovascular disease in systemic sclerosis has recently been described. We retrospectively reviewed the medical records and brachial angiographic findings of 19 systemic sclerosis patients, who exhibited Raynaud's phenomenon and digital ulceration. We found that ulnar artery involvement is frequent in systemic sclerosis, although the precise mechanism is not known. There was no significant difference in risk factors of macrovascular disease between ulnar artery-involved patients and not-involved subjects. Thirteen patients underwent surgical intervention; five of the 13 patients had vascular graft performed due to ulnar artery involvement. We suggest that angiographic screening and early surgical intervention such as revascularization should be considered in patients with systemic sclerosis who manifest a severe form of Raynaud's phenomenon and/or digital ulceration and especially in patients with diffuse sclerosis.
Rheumatology International 05/2009; 29(9):1081-6. · 1.88 Impact Factor
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ABSTRACT: Carcinoid tumors are slow growing submucosal tumors with metastatic potential that arise from enterochromaffin cell. The annual incidence of carcinoid tumor is 2 to 3 per 100,000. Carcinoid tumor of duodenum is very rare with an incidence of about 8% among gastrointestinal carcinoid tumor. As a endoscopic examination and immunohistochemical stain are developed, an rate of detection is increasing. Among the possible factor of metastatic prediction, tumor size >10 mm, central depression or ulcer, invasion below submucosa, lymphatic or venous invasion are associated with higher metastatic potential. Specially, in case of tumor size <10 mm, in duodenum, there is no report of metastasis to liver in Korea. But, recently, we experienced a rare care of duodenal carcinoid measured by less than 10 mm with liver metastasis. Thus, we report here this case with a review of literature.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 05/2009; 53(4):246-50.
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ABSTRACT: Monckeberg’s sclerosis (MS) is one of the non-inflammatory vascular diseases characterized by calcification of the media of small and medium-sized muscular arteries, but is distinct from atherosclerosis. We present a case of MS that was incidentally detected by plain X-ray in a patient with systemic sclerosis. We took CT angiographs of the patient's lower extremities for the differential diagnosis of vascular calcification, which was confirmed. To determine if systemic sclerosis is a risk factor for MS, we reviewed plain X-rays from 43 well-documented systemic sclerosis patients, but we did not detect any cases of MS. We therefore conclude that systemic sclerosis may not be a risk factor for MS.
Rheumatology International 04/2009; 30(1):105-7. · 1.88 Impact Factor
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ABSTRACT: To evaluate the prevalence and image characteristics of perihepatitis, as well as the relationship with some computed tomography (CT) manifestations of pelvic inflammatory disease (PID).
Between January 2006 and December 2007, 93 consecutive patients examined with three-phase abdominal CT scans and clinically diagnosed and treated for PID were included. Three radiologists retrospectively reviewed CT scans with consensus, and examined the location (12 areas) and thickness (four grades) of enhancement of the hepatic surface. Several CT manifestations of PID were also evaluated and statistical analysis was performed to determine the relationship of these findings.
Out of the 93 patients, 55 (59%) showed enhancement of the hepatic surface. The right anteroinferior hepatic surface was the most common site (89%) and lower hepatic division showed thicker parenchymal enhancement. Oophoritis (P = 0.020) and extension of mesenteric infiltration (P < 0.001) were revealed as statistically significant factors associated with the presence of perihepatitis in PID.
Perihepatits commonly occurs in PID; 59% of PID patients in this study had perihepatitis. The predominant site was the right anteroinferior hepatic surface. Perihepatitis seems not to be associated with various CT findings of PID reflecting disease severity, except oophoritis and upper extension of mesenteric infiltration.
Abdominal Imaging 11/2008; 34(6):737-42. · 1.73 Impact Factor
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Journal of vascular and interventional radiology: JVIR 11/2008; 19(12):1795-6. · 1.81 Impact Factor
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Rheumatology International 10/2007; 27(11):1097-8. · 1.88 Impact Factor
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ABSTRACT: Variceal bleeding from enterostomy site is an unusual complication of portal hypertension. The bleeding, however, is often recurrent and may be fatal. The hemorrhage can be managed with local measures in most patients, but when these fail, surgical interventions or portosystemic shunt may be required. Herein, we report a case in which recurrent bleeding from stomal varices, developed after a colectomy for rectal cancer, was successfully treated by placement of transjugular intrahepatic portosystemic shunt (TIPS) with coil embolization. Although several treatment options are available for this entity, we consider that TIPS with coil embolization offers minimally invasive and definitive treatment.
Journal of Korean Medical Science 07/2007; 22(3):583-7. · 0.99 Impact Factor
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Rheumatology International 07/2007; 27(8):789-90. · 1.88 Impact Factor
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Rheumatology International 05/2007; 27(8):789-790. · 1.88 Impact Factor
