PURPOSE: Differential diagnosis of solitary pulmonary nodule with cavity includes lung abscess, tuberculoma, bronchogenic carcinoma, metastasis and trauma, etc. We analyzed the CT appearance of tubercuioma presenting as a solitary pulmonary nodule with cavity and describe the findings which suggest tuberculoma in the differential dignosis of soliary pulmonary nodule with cavity. MATERIALS AND METHODS: 25 patients with solitary pulmonary nodule(diameter less than 4 cm) without surrounding parenchymal consolidation on chest radiograph, who had a cavity within the nodule on CT, were included in our study. Density of the nodule, maximal wall thickness, the character of inner and outer wall margin, location of cavity within the nodule, location of the nodule, presence or absence of satellite lesions and calcification were analyzed. RESULTS: Solitary tuberculoma with cavity showed maximal wall thickness more than 15 mm in 40%(10/25) and 5-14 mm in 56%(14/25), eccentric cavitation in 84%(21/25) and concentric cavitation in 16%(4/25), spiculated outer wall margin in 56%(14/15) and Iobulated margin in 32%(8/25), smooth inner wall margin in 60%(15/25) and nodular margin in 40%(10/25). CT density of the cavity wall compared with the chest wall muscle was low in 84%(21/25) and isodense in 16%(4/25). Accompanying satellite lesions were seen in 84% (21/25) and calcification was visible in 28%(7/25). CONCLUSION: The CT findings of solitary tuberculoma with cavity are relative peripheral location, eccentric cavitation, finely spiculated outer wall margin, and mean maximal wall thickness of 13.2 mm, which are also the common features of malignant nodule. However, relative low density of the nodule compared to the chest wall muscle and surrounding satellite lesions can be additional clues favoring solitary tuberculoma with cavity on CT.
Carcinoma, Bronchogenic ; Diagnosis, Differential ; Humans ; Lung Abscess ; Neoplasm Metastasis ; Radiography, Thoracic ; Solitary Pulmonary Nodule ; Thoracic Wall ; Tuberculoma*

Thanks to the benefits of 3 tesla (T) magnetic resonance imaging (MRI), its clinical use is increasing in pediatric patients. However, technical considerations and clinical applications of 3T MRI have not been comprehensively reviewed. Potential advantages of 3T imaging over 1.5T imaging include a higher signal-to-noise ratio, higher contrast-to-noise ratio, higher spatial resolution, and shorter scan time. These merits are easily achieved in neuroimaging, musculoskeletal imaging, and pelvic imaging, while body imaging is substantially limited by dielectric shading and an increased specific absorption rate (SAR) owing to B1 inhomogeneity and increased susceptibility artifacts. T1 and T2 relaxation times as well as chemical shifts are influenced by the higher magnetic field strength. SAR issues and dielectric shading of 3T body MRI are less problematic in pediatric patients having a smaller body size. Improved image quality can be achieved by using parallel imaging, the shortest echo time or echo train length, the highest receiver bandwidth, and improved local shimming. Potential reduction of scan time at 3T should be emphasized for pediatric patients. Three-dimensional MRI with post-processing can improve the image quality in a short acquisition time and, therefore, has become a clinical reality at 3T. A dual-source parallel radiofrequency excitation system can reduce dielectric shading, SAR, and scan time by increasing B1 homogeneity, which eventually improves the image quality of 3T body MRI. The usefulness of 3T MRI in pediatric patients can be maximized by further technical developments and optimization.
Absorption ; Artifacts ; Body Size ; Child ; Humans ; Magnetic Fields ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Neuroimaging ; Relaxation ; Signal-To-Noise Ratio

The number of CT examinations is dramatically increasing due to recent technical advances including multi-slice spiral CT. Although the benefits of CT outweigh the risks of radiation exposure of CT, radiologists should alert to the potential harmful effects of CT and avoid unnecessarily high CT dose, especially for pediatric CT examinations. To accomplish this, we should understand CT radiation dose and be familiar with imaging techniques of reducing CT dose without degrading diagnostic image quality. In addition, it is important to spread this balanced and useful information into CT referring clinicians, radiologists in training, and medical students.
Humans ; Students, Medical ; Tomography, Spiral Computed

No Abstract available.
Heart Defects, Congenital* ; Humans

Reversible splenial lesion syndrome can be caused by viral infection. Rubella generally occurs in childhood, and it is rarely accompanied by neurological complications in adulthood. A 35-year-old man visited our hospital due to conjunctival injection, mild fever, and headache 3 days after experiencing skin rash. Brain magnetic resonance imaging (MRI) revealed distinct lesions involving white matter in the splenium of the corpus callosum approximately 3 days following the onset of symptoms. Enzyme immunoassay performed on serum and CSF samples was positive for rubella virus IgM. A follow-up brain MRI was performed 24 days after the onset of symptoms, and reduced lesion size with decreased signals were observed on diffusion weighted image. This case showed that rubella infection can result in reversible splenial lesion accompanied by only mild neurological symptoms.
Rubella

BACKGROUND: Selecting the appropriate patients and reducing stroke onset to endovascular recanalization therapy (ERT) time are essential elements of a successful ERT. Since ERT is available only in large hospitals, proper patients transfer is important. The purpose of study is to examine the suitability of the transfer of acute stroke patients. METHODS: We retrospectively reviewed the medical records of patients who diagnosed as acute ischemic stroke from January to December in 2017. Patients were divided into two groups based on transfer (direct visit vs. transfer) and Alberta Stroke Program Early computed tomography (ASPECT) score (≥8 vs. <8) respectively. Each group was assessed by demographics, type and rate of reperfusion therapy, onset to reperfusion therapy time, stroke risk factors and neurological deficit severity. Interhospital distance and transfer time was calculated in transferred patients. RESULTS: Among the 455 patients, the 228 (50.2%) patients underwent interhospital transfer. The ratio of reperfusion therapy was not significant different between direct visit and transferred group (34.8% vs. 37.3%, p=0.397). The transferred patients tended to be older (p=0.003), female (p=0.001), more hypertension (p=0.019), less transient ischemic attack (p=0.001), longer onset to ERT time (178.55±85.92 vs. 131.48±82.89; p=0.001) lower ASPECT score (6.72±2.04 vs. 8.01±1.65; p<0.001) and higher National Institute of Health Stroke Scale (NIHSS) (p<0.001) and modified Rankin Scale (mRS) (p<0.001). High ASPECT score (≥8) patients were more direct visited (63.9%), shorter onset to ERT time (p=0.047), lower initial NIHSS and mRS (p<0.001), and greater in differences between mRS at admission and 3 months later (p=0.016). CONCLUSIONS: This study suggests emergency and interhospital transfer of acute stroke patients is inefficient, and systematization of transfer is necessary.
Alberta ; Demography ; Emergencies ; Endovascular Procedures ; Female ; Humans ; Hypertension ; Ischemic Attack, Transient ; Medical Records ; Neuroimaging ; Patient Transfer ; Reperfusion ; Retrospective Studies ; Risk Factors ; Stroke

Congenital heart disease is often associated with severe clinical presentations demanding prompt imaging diagnosis and appropriate treatment. Therefore, radiologists, particularly radiology residents, should be familiar with essential cardiac anatomy in order to diagnose congenital heart disease. In our clinical practice, cardiac anatomy is commonly depicted on CT images acquired with state-of-the art CT imaging techniques; however, the related imaging findings may be overlooked due to lack of attention, experience, or knowledge. It is partly due to the fact that CT-based illustration of cardiac anatomy to help understand congenital heart disease is currently scarce. In this article, cardiac imaging planes; crucial anatomical landmarks; morphological features of cardiac chambers, septa, and valves; and connections of cardiac segments are illustrated using cardiac CT images to facilitate understanding of congenital heart disease.

Horseshoe adrenal gland is a rare congenital abnormality associated with multiple congenital anomalies that may involve the cardiovascular, central nervous, and genitourinary systems. In this report, we describe the sonographic findings of horseshoe adrenal gland in a newborn with right isomerism a frequently associated cardiovascular anomaly.
Adrenal Glands* ; Congenital Abnormalities ; Humans ; Infant, Newborn* ; Isomerism* ; Ultrasonography ; Urogenital System

Generalized lymphangiomatosis is a rare disease that is characterized by widespread bony and soft tissue involvement of lymphangioma. Radiological evaluation is crucial because the site and extent of the lymphangioma are important prognostic factors. We reported here on three cases of generalized lymphangiomatosis and all three cases showed similar radiologic findings, but a different clinical course. The CT, US and MR images showed sharply defined, non-enhanced cystic lesions involving the mediastinum, bones, spleen, lung and lower neck. The whole body MR imaging with the short tau inversion recovery (STIR) sequence showed good capability for evaluating the extent of disease.
Tomography, X-Ray Computed ; Male ; Magnetic Resonance Imaging ; Lymphangioma/*diagnosis/radiography/ultrasonography ; Humans ; Diagnosis, Differential ; Contrast Media ; Child, Preschool ; Child

PURPOSE: To assess the prevalence of various radiological reduction methods for childhood intussusception in training hospitals by means of a nationwide phone survey, and to demonstrate recent trends in this area by comparing the findings with those obtained in a survey conducted six years earlier. MATERIALS AND METHODS: Forty-seven radiologists and 36 residents in 83 (university, 54; general, 29) of 91 nationwide training hospitals were asked by telephone 1) to identify their currently used radiological reduction method, and to state 2) whether sedation was used for patient preparation, 3) how many times they had experienced bowel perforation during the previous six years, 4) whether ultrasonography was used for diagnostic purposes and 5) the grade of resident involved in night duty. The results were compared with those obtained during a 1993 survey of training hospitals in Seoul. RESULTS: 1) Air and barium reduction were used with equal frequency (40%, 33/83). Gastrografin reduction was used in six, hospitals (7%) barium reduction and ultrasonography-guided hydrostatic reduction in five (6%), and ultrasonography-guided hydrostatic reduction in four (5%), while in two (2%), air and barium reduction were used to an equal extext. Compared with the results of the 1993 survey, the use of barium reduction had decreased from 62 to 40%, though the use of air reduction showed an increase, from 5 to 40%. The frequency with which other methods were used showed no significant change. 2) In 82% of cases (68/83), patients were not sedated during preparation; the 1993 figure of 87% was thus not significantly different. 3) With regard to the incidence of perforation during the last six years, between one and three cases had been encountered at each of 30 hospitals. Air reduction was used at 17 of these (57%), and barium reduction at ten (33%). At each of five hospitals at which 3 -5 cases had occurred, air reduction had been used in all cases. 4) Ultrasonography was employed for the diagnosis of intussusception at 78/83 hospitals (94%); among these 83, this mode was always employed at 26 (31%). 5) At the majority of hospitals (42%), night duty residents were grade two, while grade one were employed at 30%, grade three at 23%, and grade four at 5%. CONCLUSION: For radiological reduction air and barium are currently used with equal frequency at training hospitals in Korea. Compared with 1993, air reduction is being used more but barium reduction less.
Barium ; Child* ; Diagnosis ; Diatrizoate Meglumine ; Humans ; Incidence ; Intussusception* ; Korea* ; Prevalence ; Seoul ; Telephone ; Ultrasonography