1.Helical CT Cholangiography with Multiplanar Reformation: Utility in Patients with Extrahepatic Biliary Obstruction.
Heoung Keun KANG ; Jae Kyu KIM ; Hyon De CHUNG ; Woong YOON ; Heoung Kil KIM ; Yun Hyun KIM ; Yong Yeon JEONG
Journal of the Korean Radiological Society 1995;33(6):939-944
PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic
;
Cholangiography*
;
Choledochal Cyst
;
Common Bile Duct
;
Head
;
Humans
;
Retrospective Studies
;
Tomography, Spiral Computed*
2.Percutaneous Transluminal Angioplasty of Subclavian Artery: Case Report.
Heoung Keun KANG ; Jae Kyu KIM ; Hyon De CHUNG ; Yun Hyeon KIM ; Tae Woong CHUNG
Journal of the Korean Radiological Society 1994;30(6):1035-1038
Percutaneous transluminal angioplasty(PTA) were performed in three patients with atherosclerotic stenosis of subclavian arteries. The arteries were successfully dilated without complications during the procedure. All patients were asymptomatic during follow-up periods ranging from eight months to fifteen months after PTA.
Angioplasty*
;
Arteries
;
Constriction, Pathologic
;
Follow-Up Studies
;
Humans
;
Subclavian Artery*
3.Recanalization of Superficial Femoral Artery By Retrograde Approach Via Popliteal Artery.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIRN ; Hyung Kil KIM ; Ung YUN
Journal of the Korean Radiological Society 1995;33(3):357-360
PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty
;
Arteries
;
Cardiac Output
;
Catheters
;
Coronary Artery Disease
;
Endarterectomy
;
Femoral Artery*
;
Follow-Up Studies
;
Humans
;
Popliteal Artery*
;
Punctures
;
Stethoscopes
4.Left cervical aortic arch and persistent left superior vena cava in the SAME patient: case report.
Jae Kyu KIM ; Jae Sook MA ; Heoung Keun KANG ; Hyon De CHUNG
Journal of the Korean Radiological Society 1991;27(1):82-86
No abstract available.
Aorta, Thoracic*
;
Humans
;
Vena Cava, Superior*
5.Anterolateral Subluxation of the Tibia Associated with Combined Anterior Cruciate and IVledial Collateral Ligament Tears: IVIR Imaging of the Knee.
Heoung Keun KANG ; Jin Gyoon PARK ; Joong K LEE ; Carlton T PHELPS
Journal of the Korean Radiological Society 1995;33(3):423-428
PURPOSE: To evaluate the passive subluxation of the tibia on MR' images in patient with both anterior cruciate ligament (ACL) and medial collateral ligament (MCL) tears and to demonstrate the usefulness of its measurement. MATERIALS & METHODS: The authors performed a retrospective study of 123 knees with tears of both ACL (complete, n=70, partial, n=53) and MCL (complete, n=10, partial, n=113). ACL tears were documented at arthroscopy and MCL tears were interpreted by abnormal MR findings. One hundred normal knees were also studied for comparison. Using new internal landmarks, anterior subluxation was measured on an intercondylar sagittal image and lateral subluxation was measured on a mid-coronal image. RESULTS: Anterior subluxation of 3 mm or more was seen in 45/123(37%) abnormal knees, lateral subluxation of 3 mm or more in 20/123 (16%), and anterolateral subluxation in 15/123 (12%). Anterior subluxation of 5mm or more was seen in 25/70 (36%) complete ACL tears, and no knees with partial ACL tears showed anterior subluxation of 5 mm or more. CONCLUSION: Static anterolateral subluxation of the tibia occurs in knees with combined ACL and MCL tears, as measured on routine MR imaging. These measurements may help confirm the presence of ligament injuries and differentiate complete from partial ACLtear.
Anterior Cruciate Ligament
;
Arthroscopy
;
Collateral Ligaments*
;
Humans
;
Knee*
;
Ligaments
;
Magnetic Resonance Imaging
;
Retrospective Studies
;
Tibia*
6.Percutaneous abdominal abscess drainage
Jae Kyu KIM ; Jin Gyoon PARK ; Heoung Keun KANG ; Hyun De CHUNG
Journal of the Korean Radiological Society 1986;22(5):647-654
Conventional radiologic methods had given the limited informations about itraabdominal abscesses. Today,however, CT and ultrasongraphy provide detailed anatomic location, number and dimension of intraabdominal abscessand also permit percutaneous placement of catheter large enough to effect drainage. Percutaneous catheter drainageof intraabdominal abscess now offers an alternative to surgery. This simple method of mechanical drainage, whenemployed with systemic antibiotics, can be successful in treating the majority of intraabdominal abscesses.Authors analysed 24 cases of percutaneous abdominal abscess drainage performed at chonnam Natinal UniverstiyHospital from May 1985 to June 1986. The results were as follows: 1. The sites of abscesses; liver in 14cases(58.3%), psoas muscle in 3 cases(12.5%), subphrenic space in 3 cases (12.5%), pelvic cavity in 2 cases(8.3%),perirenal space in 2 cases(8.3%). 2. Complications during or after procedures were minor in the majority of cases.3. Average duration of drainage was as follows: 7.8days in liver abscess, 15.3 days in psoas abscess, 6 days inpelvic abscess, 7 days in subphrenic abscess.
Abdominal Abscess
;
Abscess
;
Anti-Bacterial Agents
;
Catheters
;
Drainage
;
Jeollanam-do
;
Liver
;
Liver Abscess
;
Methods
;
Psoas Abscess
;
Psoas Muscles
;
Subphrenic Abscess
7.CT and angiographic findings in ruptured intracranial aneurysms
Jae Gyu KIM ; Seon Kwan JHUNG ; Bang Eun LIM ; Heoung Keun KANG ; Hyon De CHUNG
Journal of the Korean Radiological Society 1985;21(6):893-904
CT has become the most useful, non-invasive diagnostic method as the initial exmination in the diagnosis ofruptured intracranial aneurysm with intracranial hemorrhage(subarachnoid, intracerebral and intraventricularhemorrhage), hydrocephalus and infarction. Furthermore, high resolution CT can demonstrate aneurysm itself. Butangiography is the last and conclusive method as yet, for better evaluation of vascular anatomic structure ofaneurysm for surgery. Authors analyzed 40 cases of ruptured intracranial aneurysm confirmed by CT, angiographyand/or surgery at Chonnam National University Hospital from July, 83' to July, 85'. The results were as follows:1. The most prevalent age group was the 5th decade(35%), and female patient(57.5%) was more comon than male. 2.Angiographic findings were as follows: 1) Multiple aneurysm was found in 8 patients (20%): the one of thesepatients is tripple, the others are double. 2) The location of aneurysm, in order ot frequency, were : ACA andA-com aneurysm in 23 cases(47%). ICA and P-com aneurysm in 17 cases(35%), basilar tip aneurysm in 4 cases(8%), MCAaneurysm in 3 cases(6%) and PCA aneurysm in 1 case(2%). 3) Hydrocephalus was detected in 22 cases (55%): 21 cases(95%) of these cases were demonstarated within the first 3 weeks after attack. 4) Detection of aneurysm itseslfwas 20 cases(50%). 5) Cerebral infarction was 5 cases(12.5%). 6) Subarachnoid enhancement on post-contrast scanwas 8 cases(20%).
Aneurysm
;
Cerebral Infarction
;
Diagnosis
;
Female
;
Humans
;
Hydrocephalus
;
Infarction
;
Intracranial Aneurysm
;
Jeollanam-do
;
Male
;
Methods
;
Passive Cutaneous Anaphylaxis
8.Ultrasonographic findings of pediatric abdominal masses
Seon Kwan JUHNG ; Jae Gyu KIM ; Jin Gyoon PARK ; Heoung Keun KANG ; Hyun De CHUNG
Journal of the Korean Radiological Society 1986;22(1):92-110
Ultrasonography is a very useul diagnostic modality for the evaluation of clinically suspicious abdominalmasses in infants and children, especially in assessing their existence, size,location, origin and internalconsistency. Authors analyzed and present ultrasonographic findings of 92 pathologically and/or clinically provenpediatric abdominal masses that were studied and treated in Chonnam University Hospital during recent 4 years. Theresults were as follows: 1. The most common originating site was kidney(26 cases: 28.3%), followed bygastrointestinal tract (21 cases: 22.8%), genital organ(17 cases: 18.5%), non-renal retroperitoneum (13cases:18.5%), hepatobilary tract (12 cases:13.0%), and anterior abdominal wall (3 cases: 3.3%) in ordre offrequency. 2. The most common mass was hydonephrosis(18 cases: 19.6%). Neuroblastoma(7 cases:7.6%),hepatoblastoma, ovarian teratoma, periappendiceal abscess and abdominal tuberculosis(6 cases: 6.5%, respectively),Wilms tumor(5 cases: 5.4%) were next in order of frequency. 3. The sex distribution is rather similar, that is ,male 42(45.7%) and female 50(54.3%), but characteristically choledochal cyst(2 cases) and genital mass(17 cases)were found only in females. Considering age distribution, 78 cases(84.8%) were found within the range of one to 15years of age. The rest, 14 cases(15.2%), were under the age of one year. 4. With ultrasonography, the diagnosis ofhydronephrosis could be made easily in every case and we could evaluate its severity and level of obstruction withhigh accuracy. 5. All Wilms tumor were large, round or oval, sharply marginated and relatively homogenous solidmasses. 6. All neuroblastomas were irregular shaped, poorly defined, heterogeneous solid masses. Tumorcalcification and extension across the midline were noted in 6 cases(85.7%) and 5 cases(71.4%), respectively. 7.All periappendiceal abscesses had irregular thickened wall and posterior acoustic enhancement: 4 cases (66.7%)among them were mixed echo pattern and 2 cases(33.3%) ehco free. 8. Among the 6 abdominal tuberculoses, 2 wereseen as irregularly defined solid masses, 1 as conglomeration of multiple hypoechoic nodulles and 3 as mixedpatterns. 9. All hepatoblastomas were seen to be poorly marginated solid masses with more echogenicity thanadjacent normal hepatic echo in 5 cases except one. 10. Among the 6 ovarian teraomas, 4 cases were cystic and 2cases solid. Acoutic shadowing was seen in 3 cases. 11. Choledochal cyst (2 cases), hydrops of gallbladder(1cases) and cyst of pancreas head(1 cases) had similar ultrasonic appearance as a large elliptical systic mass,but, it was important in differential diagnosis to ascertain the existence of gallblader and the connectionbetween the cyst and bile duct.
Abdominal Wall
;
Abscess
;
Acoustics
;
Age Distribution
;
Bile Ducts
;
Child
;
Choledochal Cyst
;
Diagnosis
;
Diagnosis, Differential
;
Edema
;
Female
;
Hepatoblastoma
;
Humans
;
Infant
;
Jeollanam-do
;
Male
;
Neuroblastoma
;
Pancreas
;
Sex Distribution
;
Shadowing (Histology)
;
Teratoma
;
Tuberculosis
;
Ultrasonics
;
Ultrasonography
;
Wilms Tumor
9.Injury of Renal Artery Branches by Blunt Trauma: Arteriographic Findings and Transarterial Embolotherapy.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIM ; Woong YOON ; Seong Nam CHU ; Yun Hyeun KIM ; Kwang Seong PARK
Journal of the Korean Radiological Society 1995;32(5):783-787
PURPOSE: The purpose of this study was to describe the anglographic finding and clinical result of transarterial embolotherapy(TAE) in patients with injuries of renal artery branches by blunt trauma. MATERIALS AND METHODS: The study was based on retrospective analysis of seven cases, in which TAE was attempted for the control of traumatic renal arterial bleeding. All procedures were performed via the transfemoral approach. TAE was performed with stainless steel coil in two cases, Gelfoam in one case, and Gelfoam and stainless steel coil in four cases. RESULTS: Angiographic findings of vascular injuries were pseudoaneurysm in four cases, extravasation in two cases and arteriocalyceal fistula in one case. All procedures were performed successfully without complication. CONCLUSION: Pseudoaneurysm is a common anglographic finding in patients with injury of renal artery branches and TAE is considered a safe and effective method for treating such cases.
Aneurysm, False
;
Embolization, Therapeutic*
;
Fistula
;
Gelatin Sponge, Absorbable
;
Hemorrhage
;
Humans
;
Renal Artery*
;
Retrospective Studies
;
Stainless Steel
;
Vascular System Injuries
10.Usefulness of Magnetic Resonance Angiography in Intracranial Arteriovenous Malformation.
Heoung Keun KANG ; Youn Hyeun KIM ; Jeong Jin SEO ; Jae Kyu KIM ; Woong Jae MOON ; Hyon De CHUNG
Journal of the Korean Radiological Society 1994;30(1):7-14
PURPOSE: To evaluate clinical usefulness of magnetic resonance angiography(MRA) as a diagnostic modality and for treatment planning of intracranial arteriovenous malformations(AVM). METHODS AND MATERIALS: In 14 patients with intracranial AVM which were confirmed by operations, radiologic studies and clinical evaluations, magnetic resonance imaging(MRI), MRA and conventional angiography(CA) were retrospectively reviewed with specific regards to nidus depiction, detectability of feeding arteries and draining veins, and number and anatomic consistency of these vessles. MRA was obtained by 3 D TOF, 2 D PC, and 3 D methods with adequate VENC selection. RESULTS: Nidus of AVM was well demonstrated in MRI and MRA, and no remarkable difference in detection and size estimation of nidus among MRI, MRA and CA except 2 cases of associated intracranial hemorrhage, in which 3 D PC MRA well depicted nidus that were not visualized on MRI because of subacute hemorrhage. Feeding arteries were well demonstrated on 3 D TOF and 3 D PC MRA. Dilated draining veins were well depicted on 3 D PC MRA by scannig with adequate VENC selection, and the results were no remarkable difference compared with the ones on CA. CONCLUSION: MRA of a consecutive scan after MRI is a excellent modality for evaluation and treatment planning of intracranial AVM, and possible substitutive method for CA except for radiotherapy or transarterial embolization.
Arteries
;
Hemorrhage
;
Humans
;
Intracranial Arteriovenous Malformations*
;
Intracranial Hemorrhages
;
Magnetic Resonance Angiography*
;
Magnetic Resonance Imaging
;
Radiotherapy
;
Retrospective Studies
;
Veins