1.A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney.
Seung Chai JUNG ; Seung Hyup KIM ; Jeong Yeon CHO
Korean Journal of Radiology 2011;12(6):714-721
OBJECTIVE: To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. MATERIALS AND METHODS: A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. RESULTS: The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). CONCLUSION: The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan.
Animals
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Aortography
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Artifacts
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Contrast Media/*chemistry
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Iodine/*analysis/*diagnostic use
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Iopamidol/chemistry/*diagnostic use
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Kidney/*radiography
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Kidney Cortex/radiography
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*Multidetector Computed Tomography
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Rabbits
2.Endovascular Treatment of a Ruptured Pulmonary Artery Aneurysm in a Patient with Behcet's Disease Using the Amplatzer Vascular Plug 4.
Andrea IANNIELLO ; Gianpaolo CARRAFIELLO ; Paolo NICOTERA ; Adriano VAGHI ; Alberto CAZZULANI
Korean Journal of Radiology 2013;14(2):283-286
A pulmonary artery aneurysm is a common manifestation and the leading cause of mortality in Behcet's disease. We describe a case of spontaneous rupture of a pulmonary artery aneurysm that, due to the inadequacy of medical therapy and the disadvantages of surgery, became the ideal candidate for endovascular management and was successfully performed by using the Amplatzer Vascular Plug 4.
Adult
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Aneurysm, Ruptured/*radiography/*surgery
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Behcet Syndrome/*complications
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Humans
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Iopamidol/analogs & derivatives/diagnostic use
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Male
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*Pulmonary Artery
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Radiography, Thoracic
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*Septal Occluder Device
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Tomography, X-Ray Computed
3.Recurrent Pulmonary Capillary Hemangioma: Dynamic Contrast-Enhanced CT and Histopathologic Findings.
Eun Young KIM ; Tae Sung KIM ; Joungho HAN ; Hojoong KIM ; Yong Soo CHOI
Korean Journal of Radiology 2012;13(3):350-354
We report the dynamic contrast-enhanced CT and histopathologic findings of a rare case of recurrent pulmonary capillary hemangiomas. The findings consisted of peripheral nodular enhancement at the early arterial phase and a subsequent "central filling-in" enhancement pattern on the delayed scans, which was identical to the well-known enhancement pattern of hemangiomas of the liver. Although there was no evidence of histological malignancy, pulmonary capillary hemangiomas manifested as multiple nodular lesions and showed postoperative recurrence.
Contrast Media/diagnostic use
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Diagnosis, Differential
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Female
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Hemangioma, Capillary/pathology/*radiography/surgery
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Humans
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Iopamidol/diagnostic use
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Lung/*blood supply
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Lung Neoplasms/pathology/*radiography/surgery
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Recurrence
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Tomography, X-Ray Computed/*methods
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Young Adult
4.Coronary Vasospastic Angina: Assessment by Multidetector CT Coronary Angiography.
Koung Mi KANG ; Sang Il CHOI ; Eun Ju CHUN ; Jeong A KIM ; Tae Jin YOUN ; Dong Ju CHOI
Korean Journal of Radiology 2012;13(1):27-33
OBJECTIVE: We aimed to describe the imaging findings of multidetector CT coronary angiography (MDCTA) in cases of vasospastic angina (VA) and to determine the accuracy of MDCTA in the identification of VA as compared with invasive coronary angiography with an ergonovine provocation test (CAG with an EG test). MATERIALS AND METHODS: Fifty-three patients with clinically suspected VA were enrolled in this study. Two radiologists analyzed the stenosis degree, presence or absence of plaque, plaque composition, and a remodeling index of the related-segment in CAG with an EG test, which were used as a gold standard. We evaluated the diagnostic performances of MDCTA by comparing the MDCTA findings with those of CAG with an EG test. RESULTS: Among the 25 patients with positive CAG with an EG test, all 12 patients with significant stenosis showed no definite plaque with the negative arterial remodeling. Of the six patients with insignificant stenosis, three (50%) had non-calcified plaque (NCP), two (33%) had mixed plaque, and one (17%) had calcified plaque. When the criteria for significant stenosis with negative remodeling but no definite evidence of plaque as a characteristic finding of MDCTA were used, results showed sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of 48%, 100%, 100%, and 68%, respectively. CONCLUSION: Significant stenosis with negative remodeling, but no definite evidence of plaque, is the characteristic finding on MDCTA of VA. Cardiac MDCTA shows good diagnostic performance with high specificity and PPV as compared with CAG with an EG test.
Angina Pectoris/*radiography
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Chi-Square Distribution
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Comorbidity
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Contrast Media/diagnostic use
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Coronary Angiography/*methods
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Electrocardiography
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Ergonovine/diagnostic use
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Female
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Humans
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Iopamidol/analogs & derivatives/diagnostic use
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Male
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Middle Aged
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Oxytocics/diagnostic use
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Predictive Value of Tests
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Radiographic Image Interpretation, Computer-Assisted
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Retrospective Studies
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Sensitivity and Specificity
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Tomography, X-Ray Computed/*methods
5.CT Diagnosis of Fitz-Hugh and Curtis Syndrome: Value of the Arterial Phase Scan.
Seung Ho JOO ; Myeong Jin KIM ; Joon Seok LIM ; Joo Hee KIM ; Ki Whang KIM
Korean Journal of Radiology 2007;8(1):40-47
OBJECTIVE: We wanted to evaluate the role of the arterial phase (AP) together with the portal venous phase (PP) scans in the diagnosis of Fitz-Hugh-Curtis syndrome (FHCS) with using computed tomography (CT). MATERIALS AND METHODS: Twenty-five patients with FHCS and 25 women presenting with non-specifically diagnosed acute abdominal pain and who underwent biphasic CT examinations were evaluated. The AP scan included the upper abdomen, and the PP scan included the whole abdomen. Two radiologists blindly and retrospectively reviewed the PP scans first and then they reviewed the AP plus PP scans. The diagnostic accuracy of FHCS on each image set was compared for each reader by analyzing the area under the receiver operating characteristic curve (Az). Weighted kappa (wk) statistics were used to measure the interobserver agreement for the presence of CT signs of the pelvic inflammatory disease (PID) on the PP images and FHCS as the diagnosis based on the increased perihepatic enhancement on both sets of images. RESULTS: The individual diagnostic accuracy of FHCS was higher on the biphasic images (Az = 0.905 and 0.942 for reader 1 and 2, respectively) than on the PP images alone (Az = 0.806 and 0.706, respectively). The interobserver agreement for the presence of PID on the PP images was moderate (wk = 0.530). The interobserver agreement for FHCS as the diagnosis was moderate on only the PP images (wk = 0.413), but it was substantial on the biphasic images (wk = 0.719). CONCLUSION: Inclusion of the AP scan is helpful to depict the increased perihepatic enhancement, and it improves the diagnostic accuracy of FHCS on CT.
Tomography, X-Ray Computed/*methods
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Syndrome
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Retrospective Studies
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ROC Curve
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Pelvic Inflammatory Disease/*radiography
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Middle Aged
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Iopamidol/diagnostic use
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Humans
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Hepatitis/*radiography
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Female
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Diagnosis, Differential
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Contrast Media
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Adult
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Adolescent
6.Preoperative Imaging of Sentinel Lymph Nodes in Gastric Cancer Using CT Lymphography.
Woo Jin HYUNG ; Yong Soo KIM ; Joon Seok LIM ; Myeong Jin KIM ; Sung Hoon NOH ; Ki Whang KIM
Yonsei Medical Journal 2010;51(3):407-413
PURPOSE: Preoperative identification of the sentinel lymph node (SLN) in gastric cancer (GC) patients may have great advantages for the minimally invasive treatment. This study was performed to evaluate the possibility of preoperative SLN detection using CT lymphography. MATERIALS AND METHODS: Fourteen patients with early GC were enrolled. CT images were obtained before and at 1, 3, and 5 minutes after endoscopic submucosal peritumoral injection of 2 mL iopamidol. For patients with clearly identified SLNs, to make comparisons with the CT lymphography results, intraoperative SLN detection was performed using subserosally injected Indocyanine green (ICG) lymphography and ex vivo ICG and iopamidol lymphography using mammography was also performed. RESULTS: CT lymphography clearly visualized draining lymphatics and SLNs in 4 (28.6%) out of 14 patients. All clearly visualized SLNs (one to three SLNs per patient) under preoperative imaging were detected in the same location by intraoperative ICG lymphography and ex vivo ICG and iopamidol lymphography using mammography. All preoperative SLN detections were observed with the primary tumors in the lower third of the stomach. CONCLUSION: Although our study demonstrated a SLN detection rate of less than 30%, CT lymphography with radio-contrast showed potential as a method of preoperative SLN detection for GC.
Adult
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Aged
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Female
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Humans
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Iopamidol/diagnostic use
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Lymph Nodes/pathology/*radiography
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Lymphography/*methods
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Male
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Middle Aged
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Models, Biological
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Preoperative Care
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Sentinel Lymph Node Biopsy
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Stomach Neoplasms/pathology/*radiography
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Tomography, X-Ray Computed/*methods