2.Kikuchi-Fujimoto Disease Masquerading as Bilateral Lymph Node Metastasis in a Patient With Papillary Thyroid Carcinoma: A Case Report and Literature Review
Dong Hyuk JANG ; Won Mi LEE ; Ra Gyoung YOON ; Ah Ra JUNG
Korean Journal of Otolaryngology - Head and Neck Surgery 2021;64(11):829-833
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is common in young Asian women under the age of 30, and is usually characterized by fever, myalgia, fatigue, and cervical lymphadenopathy. Because patients with KFD often present with necrotic lesions that are also features of lymph node metastasis, ipsilateral or bilateral lymph node enlargement in head and neck cancer patients can be disguised as lymph node metastasis. We present an unusual case of KFD mimicking bilateral metastatic papillary carcinoma of the thyroid. This study emphasizes that KFD should be considered when diagnosing lymph nodes with necrotic lesions but without malignant cells in young women.
3.Superficially Palpable Masses of the Scalp and Face: A Pictorial Essay
Hyoung Seop KIM ; Jin Kyung AN ; Jeong Joo WOO ; Ra Gyoung YOON
Journal of the Korean Radiological Society 2019;80(2):283-293
Palpable lesions of the scalp and face are common in clinical practice. They are usually small and benign, and the lesions tend to be treated simply according to the clinical symptoms. However, radiologic evaluation is often performed to determine the exact type and location of a lesion to ensure appropriate management. Ultrasonography is useful as a primary and definitive modality for evaluating small superficial lesions. CT and MRI are better for characterizing soft tissue features and provide superior soft tissue resolution. This article discusses various lesions and their imaging findings of the scalp and face that may present as superficially palpable masses.
4.Transient Cortical Blindness Following Cervical Transforaminal Epidural Injection
Michelle YOUN ; Jeong Hyun SEO ; Byung-Kun KIM ; Ra Gyoung YOON ; Eun Hye JUNG
Journal of the Korean Ophthalmological Society 2022;63(11):953-957
Purpose:
To report a case of transient cortical blindness following cervical transforaminal epidural injection.Case summary: A 58-year-old diabetic and hypertensive male was referred to the ophthalmology department with sudden-onset bilateral visual disturbances after cervical transforaminal epidural injection for neck pain. During the procedure, an intravascular contrast medium was injected into the left vertebral artery. Immediately after the injection, the patient complained of bilateral visual disturbances, mild headache, and dizziness. Twelve hours after the procedure, his visual acuity was reduced to hand motion perception in both eyes. Anterior segment and fundus examinations were unremarkable. Pupillary light reflexes and extraocular muscle movements were normal. Brain magnetic resonance imaging, magnetic resonance angiography, and fluorescein angiography showed no significant findings. There were no other neurological abnormalities. The patient was treated conservatively with intravenous dexamethasone and nimodipine based on a provisional diagnosis of transient cortical blindness. The symptoms gradually improved 2 days after the procedure; visual acuity recovered to 20/20 by the third day.
Conclusions
Although contrast-induced transient cortical blindness is rare, it should be considered in patients with bilateral visual loss after transforaminal epidural injection. It is a benign and reversible condition but requires a prompt diagnosis.
5.High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report
Yongsang KIM ; Ra Gyoung YOON ; Ji Ye LEE ; Jong-Moo PARK
Journal of the Korean Radiological Society 2021;82(1):261-266
Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.
6.Ultrasonographic Features and the Diagnostic Role of Core Needle Biopsy at Metastatic Breast Cancer in the Thyroid gland: A Case Report
Dong Hyun LEE ; Ra Gyoung YOON ; Jin Kyung AN ; Jeong Joo WOO
Journal of the Korean Radiological Society 2020;81(3):719-725
Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.
7.Radiographic Analysis of Scoliosis Using Convolutional Neural Network in Clinical Practice
Ha Yun OH ; Tae Kun KIM ; Yun Sun CHOI ; Mira PARK ; Ra Gyoung YOON ; Jin Kyung AN
Journal of the Korean Society of Radiology 2024;85(5):926-936
Purpose:
To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times.
Materials and Methods:
ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1’s measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman’s rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated.
Results:
ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman’s rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001).
Conclusion
ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.
8.Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma
Jung Ho CHOI ; Yong-Hwi AN ; Ra Gyoung YOON ; Hyun Joon SHIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(10):525-531
Background and Objectives:
This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.
Results:
When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.
Conclusion
Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.
9.Comprehensive Analysis of the Contributing Factors to the Hearing Abilities of Patients With Vestibular Schwannoma
Jung Ho CHOI ; Yong-Hwi AN ; Ra Gyoung YOON ; Hyun Joon SHIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(10):525-531
Background and Objectives:
This study aimed to comprehensively assess the factors influencing hearing ability in patients with vestibular schwannoma, focusing on tumor size, location, primary complaint, and contralateral hearing threshold.Subjects and Method This was a retrospective analysis of 50 patients diagnosed with vestibular schwannoma by magnetic resonance imaging (MRI) at Nowon Eulji Medical Center. Tumor size and location were evaluated using a 3-T MRI system, and pure-tone threshold and speech discrimination were retrieved. To investigate the relationship between tumor size and hearing, we conducted a multiple regression analysis with several variables, including tumor size, tumor location, patient age, and gender.
Results:
When patients were categorized into groups according to their primary complaint at initial presentation, no significant differences were observed in pure tone thresholds but different speech discrimination were detected among the groups. When patients were classified according to the tumor location, the extrameatal group exhibited lower pure-tone thresholds and higher speech discrimination scores than the intrameatal group. Multiple regression analysis indicated that differences in pure tone thresholds and speech discrimination scores between affected and unaffected sides were more pronounced in cases with smaller tumor sizes and extrameatal tumor locations, emphasizing the greater impact of location over size.
Conclusion
Using both tumor size and location, it is possible to predict the differences in pure-tone thresholds and speech discrimination between the affected and unaffected sides. Extrameatal invasion of the tumor appears to be the most important factor among them.
10.Radiographic Analysis of Scoliosis Using Convolutional Neural Network in Clinical Practice
Ha Yun OH ; Tae Kun KIM ; Yun Sun CHOI ; Mira PARK ; Ra Gyoung YOON ; Jin Kyung AN
Journal of the Korean Society of Radiology 2024;85(5):926-936
Purpose:
To assess the reliability and accuracy of an automated Cobb angle measurement (ACAM) using a convolutional neural network (CNN) for scoliosis evaluation and to compare measurement times.
Materials and Methods:
ACAM was applied to spine radiographs in 411 patients suspected of scoliosis. Observer 1 (consensus of two musculoskeletal radiologists) and observer 2 (a radiology resident) measured Cobb angle (CA). CA measurements were categorized using observer 1’s measurements as the reference standard. Inter-observer reliability and correlation were assessed using intraclass correlation coefficient (ICC) and Spearman’s rank correlation coefficient, respectively. Accuracy and measurement time of ACAM and observers were evaluated.
Results:
ACAM demonstrated excellent reliability and very high correlation with observer 1 (ICC = 0.976, Spearman’s rank correlation = 0.948), with a mean CA difference of 1.1. Overall accuracy was high (88.2%), particularly in mild (92.2%) and moderate (96%) scoliosis. Accuracy was lower in spinal asymmetry (77.1%) and higher in severe scoliosis (95%), although the CA was lower compared to the observers. ACAM significantly reduced measurement time by nearly half compared to the observers (p < 0.001).
Conclusion
ACAM using CNN enhances CA measurement for assessing mild or moderate scoliosis, despite limitations in spinal asymmetry or severe scoliosis. Nonetheless, it substantially decreases measurement time.