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.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
7.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
8.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
9.3 Dimensional Volume MR Imaging of Intratemporal Facial Nerve.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIM ; Woong Jae MOON ; Hyun Ju KIM ; Hymn Ung JUNG
Journal of the Korean Radiological Society 1994;31(4):615-619
PURPOSE: To evaluate the usefulness of 3 dimensional-volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. MATERIALS AND METHODS: We reviewed the MR images of facial nerves obtained with 3 Dimensional-volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectabilty of anatomical segments of intratemporal facial nerves and facial nerve enhancement. RESULTS: When the 3 Dimensional-volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 Dimensional-volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastold segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. CONCLUSION: MR findings of facial nerve paralysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 Dimensional-volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.
Acoustics
;
Administration, Intravenous
;
Facial Nerve Diseases
;
Facial Nerve*
;
Facial Paralysis
;
Gadolinium DTPA
;
Geniculate Ganglion
;
Humans
;
Magnetic Resonance Imaging*
;
Paralysis
10.MR Imaging of Intracranial Calcification; Experimental and Clinical Studies.
Heoung Keun KANG ; Jeong Jin SEO ; Yun Hyeon KIM ; Jong Hoon YOON ; Byung Jin KIM ; Sung Yeul YANG
Journal of the Korean Radiological Society 1995;32(5):703-710
PURPOSE: This study was performed to evaluate MR signal intensity(SI) of calcification and to assess the capability of MRI in detection of various intracranial calcifications. MATERIALS AND METHODS: The MR findings and ROI value of experimental model of calcium carbonate suspension according to each concentration (20, 35, 50%) and diameter (1-10 mm) and hydroxyapatite suspension according to each concentration (10, 20, 30, 40, 50%) were analyzed. A specimen of calcification in cranio-pharyngioma was analyzed for its composition by XRD(X-ray diffractometer) and ICP(inductively coupled plasma) methods. MRI of 34 patients with intracranial calcifications were retrospectively analyzed for signal intensity of the calcification and its capability to detect calcifications according to size, location, and contrast with adjacent lesion. RESULTS: The calcium carbonate phantom with larger diameter and low concentration showed lower signal intensity on T2 than TlWl. Hydroxyapatite phantom showed high signal intensity in 10-30% concentration and low signal intensity in 40-50% concentration on T1 weighted image. The 5 cases of 34 intracranial calcifications showed high signal intensity on T1 weighted image. The capability of MRI in the detection of intracranial calcifications decreased in the circumstances such as small size(<2.5mm) and intraventricular location. Although the size of calcification was small, the detection was easy in the good contrast with adjacent lesion. However, the detection of the small sized calcification was easy if the contrast with adjacent lesion was good. CONCLUSION: lntracranial calcification shows generally low signal intensity on T1 and T2 weighted image with the exception of occasional high SI on TlWl. Detection of intracranial calcification in MRI is affected by its composition, size, location, and contrast with adjcent lesion.
Calcium Carbonate
;
Durapatite
;
Humans
;
Magnetic Resonance Imaging*
;
Models, Theoretical
;
Retrospective Studies