1.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
2.Colonic wall abnormalities on enhanced CT:Differentiation between inflammatory and neoplastic diseases.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIM ; Jin Gyoon PARK ; Byung Lan PARK ; Hyon De CHUNG
Journal of the Korean Radiological Society 1993;29(6):1253-1259
The computed tomographic(CT) findings of fourteen patients with inflammatory disease and 28 with neoplasm who had an abnormal colonic wall thickening, were retrospectively studied to establish CT criteria for each disorder in differentiating inflammatory from neoplastic lesions. According to homogeneity, density and contour of mural thickening and pericolic inflammatory change in enhanced CT scans, we classified colonic wall abnormalities into 6 patterns: I) multilayering with inner and outer hyper- and middle hypodensities, II) homogeneously hyperdense with pericolic inflammatory change, III) heterogeneously hyperdense with pericolic inflammatory change, IV) homogeneously heperdense with lobulated contour, V) heterogeneously hypodense with lobulated contour and VI) heterogeneously mixed densities with irregular lobulated contour. Type I, II and III were distinctively identified in inflammatory disease, type IV, V in neoplasm, and type VI in boty diseases. We conclude that enhanced CT could be helpful in the initial diagnosis and/or suggestion of abnormal colonic wall disease and differentiation of inflammatory from neoplastic diseases.
Colon*
;
Diagnosis
;
Humans
;
Retrospective Studies
;
Tomography, X-Ray Computed
3.Comparison of CO2 DSA and Conventional Angiography Using Non-ionic Contrast IVledia in Lower Extremity Angiography.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIM ; Hyon De CHUNG ; Sung Jae PARK ; Seok Wan KOH
Journal of the Korean Radiological Society 1994;31(5):825-830
PURPOSE: The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. MATERIALS AND METHODS: Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n:9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. RESULTS: In atherosclerosis;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occuring in 4 out of 16 patients. CONCLUSION: CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention reguiring large amount of contrast media CO2 could effectively replace nonionic contrast media.
Angiography*
;
Atherosclerosis
;
Catheters
;
Contrast Media
;
Diagnosis
;
Humans
;
Incidence
;
Leg
;
Lower Extremity*
;
Risk Factors
4.High resolution CT of cervical disk herniation: the value of intravenous contrast enhancement.
Heoung Keun KANG ; Yong Yeun JEONG ; Won Jee LEE ; Jae Kyu KIM ; Jin Gyoon PARK ; Hyon De CHUNG
Journal of the Korean Radiological Society 1991;27(2):213-219
No abstract available.
5.Role of Gd-DTPA Enhanced Fat-Suppression MR Imaging in Ovarian Tumors.
Heoung Keun KANG ; Jeong Jin SEO ; Jae Kyu KIM ; Woong Jae MOON ; Ho Sun CHOI ; Jin Gyoon PARK
Journal of the Korean Radiological Society 1995;32(2):315-320
PURPOSE: To determine the value of Gd-DTPA enhanced fat-suppression(GEFS) MR imaging in the characterization and differentiation of benign from malignant ovarian tumors. MATERIALS AND METHODS: MRI findings of thirty-seven patients with surgically proved 44 ovarian tumors (30 benign, 14 malignant) were studied retrospectively. MR imaging with conventional spin echo (CSE;Tl-weighted image TR/TE 450/20, T2-weighted image TR/TE 3500/30, 90) and GEFS were performed with a 1.5T GE signa. MRI findings of tumors including cystic or solid, wall and septal thickness, necrosis, invasion to adjacent organ, ascites and lymphadenopathy were assessed separately by using CSE and GEFS images, and then tumors were characterized as benign or malignant. RESULTS: Compared with CSE image, GEFS MR image showed better visualization of solid component in 5 malignant lesions, wall thickness in 5 malignant and 1 benign lesions, septal thickness in 3 malignant and 1 benign lesions, necrosis in 1 malignant lesion, and adjacent soft tissue invasion in 5 malignant lesions. Correct characterization of malignant tumors was increased from 71% on CSE image to 93% on GEFS image. However, correct characterization of benign tumors was 93% on both images. CONCLUSION: GEFS MR imaging could be useful for characterization of ovarian tumors, especially in malignant cases, and employed for differentiation of benign from malignant tumors.
Ascites
;
Gadolinium DTPA*
;
Humans
;
Lymphatic Diseases
;
Magnetic Resonance Imaging*
;
Necrosis
;
Retrospective Studies
6.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
7.Percutaneous Drainage of Abscess in the Treatment of Emphysematous Pyelonephritis.
Jin Yong JUNG ; Yong Yeon JEONG ; Jae Kyu KIM ; Seung Jei PARK ; Jin Gyoon PARK ; Heoung Keun KANG ; Byung Suk ROH
Journal of the Korean Radiological Society 1997;36(2):319-324
PURPOSE: To assess the usefulness of percutaneous drainage of abscess in the treatment of emphysematous pyelonephritis. MATERIALS AND METHODS: Ten cases of nine patients with emphysematous pyelonephritis were percutaneously drained. All were suffering from diabetes mellitus. The procedure was performed under fluoroscopic guidance in nine cases and US guidance in one case in which bilateral multiloculated abscesses were present in the perirenal spaces. The results were classified as cure, partial success, recurrence, or failure. The mean drainage period and complication were analyzed. RESULTS: Eight cases were cured, and there was one partial success. In one case, who had diffuse renal parenchymal destruction without perirenal fluid collection, the treatment failed. The longest drainage period was 45 days, in a case of re-insertion due to incidental catheter removal ; the mean was 23 days. Bacteremia in one case was cured with antibiotic therapy which lasted two days. CONCLUSION: In diabetic patients, percutaneous drainage of abscess is thought to be a safe and effective method for the treatment of emphysematous pyelonephritis, and is one that does not involve diffuse destruction of renal parenchyma.
Abscess*
;
Bacteremia
;
Catheters
;
Diabetes Mellitus
;
Drainage*
;
Humans
;
Pyelonephritis*
;
Recurrence
8.Multidetector-row CT Angiography of Hepatic Artery: Comparison with Conventional Angiography.
Jin Woong KIM ; Yong Yeon JEONG ; Woong YOON ; Jae Kyu KIM ; Jin Gyoon PARK ; Jeong Jin SEO ; Heoung Keun KANG
Journal of the Korean Radiological Society 2003;48(3):241-247
PURPOSE: To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MDCT) for delineating the arterial anatomy of the liver. MATERIALS AND METHODS: Hepatic arterial three-dimensional CT angiography was performed using MDCT (Lightspeed Qx/I; GE Medical Systems, Milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. RESULTS: Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. CONCLUSION: Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regarding a patient's hepatic arterial anatomy.
Angiography*
;
Hepatic Artery*
;
Humans
;
Liver
9.Percutaneous Transluminal Angioplasty of Chronic Arterial Occlusive Disease below the Knee Joint.
Woong YOON ; Jae Kyu KIM ; Soo Min PARK ; Yun Hyeon KIM ; Heoung Keun KANG
Journal of the Korean Radiological Society 1996;34(2):209-215
PURPOSE: The purpose of this study was to determine the safety and efficacy of the percutaneous transluminal angioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. MATERIALS AND METHODS: We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged 57-75 years(mean, 62 years). Indications were disabling claudication(SVS/ISCVS grade 1, category 3) in five cases, rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade 3, category 5) ineight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheterin tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combined thrombolytic therapy with Urokinase was performed in 14 patients. RESULTS: Involved infrapopliteal vessels werefour distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibialarteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than 30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearance of claudication or rest pain, and healing of ulceration. Technical success was achieved in 30 of 36 arteries(83%). Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46 months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and 63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vessel thrombosis, and one occluding intimal flap. CONCLUSION: PTA was an effective method for treatment of chronicarterial occlusive disease below the knee joint and considered as the procedure of first choice. Severe claudicant(grade 1) should be included in the indication of the tibioperoneal PTA.
Angioplasty*
;
Arterial Occlusive Diseases*
;
Arteries
;
Catheters
;
Constriction, Pathologic
;
Female
;
Follow-Up Studies
;
Humans
;
Knee Joint*
;
Knee*
;
Male
;
Popliteal Artery
;
Retrospective Studies
;
Rupture
;
Tibial Arteries
;
Ulcer
;
Urokinase-Type Plasminogen Activator
10.Bronchial Artery and Non-bronchial Systemic Artery Embolization for the Treatment in Patients with Hemoptysis: Analysis of Efficacy of Gelfoam Single Use.
Seok Kyun CHUNG ; Jae Kyu KIM ; Woong YOON ; Yun Hyeon KIM ; Jin Gyoon PARK ; Heoung Keun KANG
Journal of the Korean Radiological Society 2003;49(1):15-22
PURPOSE: To investigate the efficacy of Gelfoam single use for the management of hemoptysis by analyzing patients with recurrence in embolized artery and other artery, respectively. MATERIALS AND METHODS: Between 1992 and 2000, 131 patients (104 men and 27 women, mean age: 54.4 years) with hemoptysis underwent BAE using gelatin sponge only. After puncturing the femoral artery using the Seldinger method, angiographies of the thoracic aorta, the bronchial arteries, the intercostal arteries, and the systemic collaterals which were suspected of bleeding focus and embolization were performed. Gelfoam was used 1x3 mm and 2x3 mm or 2x5 mm by the diameter of feeding arteries. The cumulative hemoptysis control rate and recurrence rate were analyzed from the previously embolized vessels. RESULTS: Hemoptysis were recurred among 34 of 131 patients. Twenty-two patients had a recurrence from the same vessels and 12 from the different ones. Using the Kaplan-Meier method, the cumulative hemoptysis control rate was obtained in the patients with a recurrence from the same vessels: 88.8% in 1 month, 79.9% in 1 year, and 77.3% in 2 year. The reasons for recurrences of the same lesions are as follows; due to the tortuosity of the vessel (n=3); partial embolization through the common trunk formation between bronchial and anterior spinal artery (n=3); by vessel spasms or autogenous thrombus (n=2); due to the contrast media hypersensitivity (n=1). These 9 patients were not treated successfully. In the remaining 13 cases, hemoptysis were recurred due to recanalization of embolized vessels. Among 161 procedure, complications consisted of fever (n=8), dyspnea (n=8), mild chest discomfort (n=7), lower back pain (n=1), and transient lower leg paralysis (n=1), which were improved within several days. There was no serious complication in this study. CONCLUSION: Bronchial artery embolization using Gelfoam alone maybe effective and safe to control hemoptysis.
Angiography
;
Aorta, Thoracic
;
Arteries*
;
Bronchial Arteries*
;
Contrast Media
;
Dyspnea
;
Female
;
Femoral Artery
;
Fever
;
Gelatin
;
Gelatin Sponge, Absorbable*
;
Hemoptysis*
;
Hemorrhage
;
Humans
;
Hypersensitivity
;
Leg
;
Low Back Pain
;
Male
;
Paralysis
;
Porifera
;
Recurrence
;
Spasm
;
Thorax
;
Thrombosis