Asthma is the most common disease of the lungs, and one that poses specific challenges for the physicians including radiologist. This article reviews for the clinical diagnosis, Radiologic features, and differential diagnosis of asthma, and outlines the radiologic features of the complications of asthma. Bronchial wall thickening and hyperinflation characterize the chest radiograph of the patients with asthma. On CT scan one may see airway wall thickening, thickened centrilobular structures, and focal or diffuse hyperlucency. Apparent bronchial dilatation may be seen, but the diagnosis of bronchiectasis should be made with caution. Quantification of changes in the airway wall and lung parenchyma may be valuable in understanding the mechanisms of asthma and in evaluating the effects of treatment. The challenge for the physician evaluating the images of a patient with asthma is to find complications.
Asthma* ; Bronchiectasis ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Humans ; Lung ; Radiography, Thoracic ; Tomography, X-Ray Computed

No abstract available.
Idiopathic Interstitial Pneumonias*

Vertebral pedicle screws have been widely used for secure posterior spinal fixation. When postoperative CT scan films were made, the blurring of pedicle screws were observed and we could not figure nut the exact diameter of screw and canal encroachment. There is no information in the difference hetween actual diameter and measured diameter of pedcile screws in CT yet. In this study, we try to find out partial voiume averaging artifact of pedicle screws made of stainless steel and titanium. Partial volume averaging artifact occurs when the shape of an object changes within the thickness of the CT slice or when a relatively small object is only partially included within the slice. Four pig cadaveric spinal column including 6 vertebrae each were prepared and CT scans were performed after insertion of C-D screws(stainless steel) to the left and TSRH screws(titanium) to the right pedicle. Another CT scans were performed after insertion of C-D screws to the right and TSRH screws to the left pedicle. The third CT scans were made after removal of all the pedicle screws. Actual C-D screw diameter was 6mm and CT scanned diameter was 8. I 6+/-0.66mm. Actual TSRH diameter was 6.5 mm and CT scanned diameter was 6.59+/-0.34mm. In conclusion, stainless steel has more partial volume averaging artifact than titanium. Safety margin of pedicle screw made of stainless steel is about 2mm and that of titanium is about 1 mm.
Artifacts ; Cadaver ; Nuts ; Spine ; Stainless Steel* ; Titanium* ; Tomography, X-Ray Computed*

PURPOSE: To evaluate the effectiveness of pelvic arterial embolization (PAE) for intractable postpartum hemorrhage (PPH) after hysterectomy. MATERIALS AND METHODS: From March 2011 to December 2017, 14 patients who received PAE for PPH that persisted after total abdominal hysterectomy were included (mean age, 33.6 years; range, 26–37 years). The delivery type, cause of PPH, and angiographic findings were investigated. The technical and clinical success rates and clinical outcomes were evaluated. RESULTS: Of 14 patients, 8 patients (57%) had positive angiographic findings for bleeding; contrast extravasation (n = 6), and pseudoaneurysm (n = 2). Remnant uterine artery (UA) was the most common bleeding focus (n = 4), followed by vaginal artery (n = 2), left lateral sacral artery (n = 1), and left internal pudendal artery (n = 1). Technical and clinical success rates were 100% and 93% (13/14), respectively. In 1 patient, bleeding was not controlled after initial selective embolization and the entire anterior divisions of both internal iliac arteries were embolized with gelfoam. CONCLUSION PAE for persistent PPH after hysterectomy is a safe and effective treatment. Remnant UA was the most common bleeding site and all patients recovered without any significant sequelae after embolization.

PURPOSE: To evaluate airway changes in ovalbumin-induced asthmatic mice in terms of postmortem micro-CT images and pathological findings. METHODS: Asthma was induced in mice by intraperitoneal injection and nasal instillation of ovalbumin aluminium hydroxide into mice (experimental group, n=6), and another group of mice received intraperitoneal injection and nasal instillation of distilled phosphate-buffered saline (control group, n=6). Bronchial lumen area was measured in the main bronchial lumen of the distal third bronchial branch level (6 parts per each mouse) on axial scans of Micro-CT, using a Lucion's smart pen (semi-automated) and a curve pen (manual). Bronchial wall thickness was obtained in 4 sections (2 levels on either side) after the third bronchial branch by measuring the diameter which was perpendicular to the longitudinal axis of the main bronchus on curved Multi-planar reconstruction (MPR) images. Histologic slides were obtained from the lesion that was matched with its CT images, and bronchial wall thicknesses were determined. RESULTS: The mean bronchial lumen area was 0.196+/-0.072 mm2 in the experimental group and 0.243+/-0.116 mm2 in the control group; the difference was significant. Bronchial wall thickness on micro-CT images (mean, 0.119+/-0.01 vs. 0.108+/-0.013 mm) and in pathological specimens (mean, 0.066+/-0.011 vs. 0.041+/-0.009 mm) were thicker in the experimental group than in the control group; bronchial wall thickness on micro-CT images correlated well with pathological thickness (for the experimental group, r=0.712; for the control group, r=0.46). The thick bronchial wall in the experimental group demonstrated submucosal hypertrophy along with goblet cell hyperplasia and smooth muscle hyperplasia. CONCLUSIONS: The results of this study suggest that asthma may induce thickening of bronchial wall and narrowing of the lumen area on micro-CT images and that these results may significantly correlate with pathological findings.
Airway Remodeling ; Animals ; Asthma* ; Axis, Cervical Vertebra ; Bronchi ; Case-Control Studies ; Evaluation Studies as Topic ; Goblet Cells ; Hyperplasia ; Hypertrophy ; Injections, Intraperitoneal ; Mice* ; Muscle, Smooth ; Ovalbumin ; X-Ray Microtomography

Malignant Peripheral Nerve Sheath Tumor is a neoplasm that most often arises in anatomically discernible peripheral nerves or neurofibroma. This rare tumor usually has a strong association with neurofibromatosis type 1. Nearly half of these malignant tumors arise in individuals affected with neurofibromatosis type 1. Neurofibromas often first appear around the time of puberty, increase in size and number during pregnancy, and shrink after giving birth. Because growth hormone (GH) concentration increases during puberty and pregnancy, it is possible that GH influences the growth of these tumors. A 33-year-old pregnant woman presented with a 4-month history of a painful, huge mass growing on the right breast. She suffered from neurofibromatosis type 1, with multiple cafe au lait spots and neurofibromas. The clinical and histopathological findings showed a malignant peripheral nerve sheath tumor. We report a case of malignant peripheral nerve sheath tumor on the right breast in a pregnant woman with neurofibromatosis type 1.
Adolescent ; Adult ; Breast ; Cafe-au-Lait Spots ; Female ; Growth Hormone ; Humans ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Parturition ; Peripheral Nerves* ; Pregnancy* ; Pregnant Women ; Puberty

PURPOSE: To observe sequential changes of acute and subacute hypersensitivity pneumonitis in high resolution CT and to correlate the findings with pulmonary function test and bronchoalveolar lavage. MATERIALS AND METHODS: This study includes 11 patients with pathologically (n=10) and clinically(n=1) proved acute and subacute hypersensitivity pneumonitis. The extent of ground glass attenuation and nodules on high resolution CT scan was correlated with pulmonary function test and bronchoalveolar lavage. We also evaluated serial changes of the lesion in high resolution CT scans. RESULTS: The extent of parenchymal abnormalities on high-resolution CT scans were significantly correlated with diffusing capacity (GGA & DLco:r=0.95, p<0.003, Nodule & DLco:r=-0.94, P<.005) and FEV1 (GGA & FEV1: r=-0.57, p<.05, Nodule & FEV1: r=-0.56, P<.05) on pulmonary function test and relatively correlated with total count of cells (GGA & total count of cells: r=0.86, P<.03, Nodule & total count of cells: r=0.71, p<0. 11) on bronchoalveolar lavage. The order in disappearance of abnormal findings were poorly defined centrilobular nodule, ground glass attenuation, and well defined small centrilobular nodule on sequential CT scans. CONCLUSION: The authors conclude that HRCT is useful for diagnosis and follow up evaluation of the acute and subacute hypersensitivity pneumonitis. Quantitative analysis of extent of disease on HRCT is useful for evaluation of clinical status.
Alveolitis, Extrinsic Allergic* ; Bronchoalveolar Lavage* ; Diagnosis ; Follow-Up Studies ; Glass ; Humans ; Hypersensitivity* ; Respiratory Function Tests* ; Tomography, X-Ray Computed

We developed the standard digital images (SDIs) to be used in the classification and recognition of pneumoconiosis. From July 3, 2006 through August 31, 2007, 531 retired male workers exposed to inorganic dust were examined by digital (DR) and analog radiography (AR) on the same day, after being approved by our institutional review board and obtaining informed consent from all participants. All images were twice classified according to the International Labour Office (ILO) 2000 guidelines with reference to ILO standard analog radiographs (SARs) by four chest radiologists. After consensus reading on 349 digital images matched with the first selected analog images, 120 digital images were selected as the SDIs that considered the distribution of pneumoconiosis findings. Images with profusion category 0/1, 1, 2, and 3 were 12, 50, 40, and 15, respectively, and a large opacity were in 43 images (A = 20, B = 22, C = 1). Among pleural abnormality, costophrenic angle obliteration, pleural plaque and thickening were in 11 (9.2%), 31 (25.8%), and 9 (7.5%) images, respectively. Twenty-one of 29 symbols were present except cp, ef, ho, id, me, pa, ra, and rp. A set of 120 SDIs had more various pneumoconiosis findings than ILO SARs that were developed from adequate methods. It can be used as digital reference images for the recognition and classification of pneumoconiosis.
Adult ; Aged ; Aged, 80 and over ; Dust ; Humans ; Lung/*pathology/*radiography ; Male ; Middle Aged ; Occupational Exposure ; Pleura/radiography ; Pneumoconiosis/*radiography ; Radiographic Image Enhancement/*standards

PURPOSE: The purpose of this study was to determine the relation between quantitative magnetic resonance imaging biomarkers, and clinical performances in chronic phase of carbon monoxide intoxication. MATERIALS AND METHODS: Eighteen magnetic resonance scans and cognitive evaluations were performed, on patients with carbon monoxide intoxication in chronic phase. Apparent diffusion coefficient (ADC) ratios of affected versus unaffected centrum semiovale, and corpus callosum were obtained. Signal intensity (SI) ratios between affected centrum semiovale, and normal pons in T2-FLAIR (fluid-attenuated inversion recovery) images were obtained. The Mini-Mental State Exam, and clinical outcome scores were assessed. Correlation coefficients were calculated, between MRI and clinical markers. Patients were further classified into poor-outcome and good-outcome groups based on clinical performance, and imaging parameters were compared. T2-SI ratio of centrum semiovale was compared, with that of 18 sex-matched and age-matched controls. RESULTS: T2-SI ratio of centrum semiovale was significantly higher in the poor-outcome group, than that in the good-outcome group and was strongly inversely correlated, with results from the Mini-Mental State Exam. ADC ratios of centrum semiovale were significantly lower in the poor outcome group than in the good outcome group, and were moderately correlated with the Mini-Mental State Exam score. CONCLUSION: A higher T2-SI and a lower ratio of ADC values in the centrum semiovale, may indicate presence of more severe white matter injury and clinical impairment. T2-SI ratio and ADC values in the centrum semiovale, are useful quantitative imaging biomarkers for correlation with clinical performance in individuals with carbon monoxide intoxication.
Biomarkers ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Corpus Callosum ; Diffusion ; Humans ; Magnetic Resonance Imaging ; Pons ; White Matter

OBJECTIVE: To assess the current practice patterns of radiologists who perform transthoracic needle biopsy (TNB). MATERIALS AND METHODS: An email survey of 71 questions on TNB was sent to 240 members of the Korean Society of Thoracic Radiology. The answers to multiple-choice questions (n = 56) were analyzed. RESULTS: Of 60 respondents, 45% had 10 or more years of experience in chest radiology, and 70% had 5 or more years of experience in TNB. For the question on the most frequently used diagnostic method for lesions with high probability of being resectable-stage lung cancer, 70% of respondents answered that TNB is initially used, with or without bronchoscopy. In patients at high-risk of TNB-related complications, the proportion of the respondents who consistently declined TNB was only 5%. The number of rebiopsies was said to be increased; molecular analysis for an established target therapy (43.6%) and clinical trial of a new drug (28.2%) were the two most common reasons for it. The most popular needle type was the coaxial cutting needle (55%), and the popular guiding modality was conventional computed tomography (CT) (56.7%). In addition, 15% of respondents have encountered air embolism. CONCLUSION: Despite high variation in how TNB is being performed in Korea, some patterns were noted. It is common for patients with resectable-stage lung cancer to undergo TNB prior to surgery. Rebiopsy is now more common than before, with personalized medicine as the most important reason for it. The most popular type of needle is the coaxial system; the most popular modality for guidance is still CT.
Biopsy, Needle* ; Bronchoscopy ; Electronic Mail ; Embolism, Air ; Humans ; Korea ; Lung Neoplasms ; Methods ; Needles* ; Precision Medicine ; Surveys and Questionnaires ; Thorax