1.Pitfalls and sources of error of color duplex ultrasonography in detecting deep vein thrombosis of proximal lower extremities
Jing GAO ; Lianhua YI ; Ho Yong Auh
Chinese Journal of Medical Imaging Technology 2004;20(3):472-476
Purpose To analyze the sources of errors and discuss the techniques to eliminate pitfalls in detecting deep vein thrombosis (DVT) of the proximal lower extremities with color duplex ultrasonography (CDUS). Methods Sixty-eight cases with initial and repeat venous CDUS of the proximal lower extremities were retrospectively reviewed. The repeat was done within 24 hours after initial CDUS scanning. Comparing repeated images to initial ones, the pitfalls and sources of error in CDUS of the proximal lower extremities were discussed. Results In total 68 repeat studies, there were 62 results as same as initials and 4 cases of false negative DVT and 2 cases of false positive DVT. Conclusion Venous CDUS in detecting DVT is observer dependent. Some pitfalls and errors can be eliminated and corrected with proper scan techniques. CDUS is the most valuable imaging modality for assessing suspected DVT in the proximal lower extremities.
2.Hepatic Microabscess with Ascending Cholangitis Complicated by Endoscopic Retrograde Cholangiopancreatogram (ERCP): A Case Report.
Mi Young KIM ; Moon Gyu LEE ; Yong Ho AUH
Journal of the Korean Radiological Society 1994;31(1):131-133
Complicated hepatic microabscess secondary to ascending cholangitis following ERCP (Endoscopic retrograde cholangiopancreatogram) is rare, and needs to be differentiated from other microabscesses, metastasis or Caroli's disease. We experienced a case of hepatic microabscess associated with septic cholangitis following ERCP. Cholangiogram showed multiple sac-like abscess pockets with characteristic biliary communication, and CT scan revealed multiple low attenuated lesions. At the resolving stage of chotangitic microabscess, CT scan showed partial rim enhancement of the abscesses and disproportional dilatation of intrahepatic ducts. The residual parenchymal enhancement surrounding the resolved microabscess pockets and dilatated biliary ducts, however, remained even after clinical recovery.
Abscess
;
Caroli Disease
;
Cholangiopancreatography, Endoscopic Retrograde
;
Cholangitis*
;
Dilatation
;
Neoplasm Metastasis
;
Tomography, X-Ray Computed
3.Diagnosis of Budd-Chiari Syndrome by Measuring the Diameter of Azygos-hemiazygos Vein on CT.
Moon Gyu LEE ; Yong Ho AUH ; Cheol Min PARK ; Gi Young KO ; Sang Hee CHOI
Journal of the Korean Radiological Society 1995;32(5):763-767
PURPOSE: The diagnosis of Budd-Chiari syndrome on CT is difficult if CT do not demonstrate obstruction of the IVC or hepatic vein and other parameter is needed for the correct diagnosis. The purpose of our study was to determine the usefulness of measuring the diameter of azygos-hemiazygos vein on CT to differentiate Budd-Chiari syndrome from advanced liver cirrhosis. MATERIALS AND METHODS: Fourteen patients who were proven as Budd-Chiari syndrome on vena cavography were studied for analysis. All patients showed evidence of liver cirrhosis on CT. As a control group fifteen cases of advanced liver cirrhosis who underwent endoscopic sclerotheraphy due to esophageal variceal bleeding were also included for comparison. The largest short axis diameter of azygos-hemiazygos vein was measured in all patients at the level of diaphragm on axial CT and the results were compared in both groups. RESULTS: In patients with Budd-Chiari syndrome the largest short axial diameter of azygos-hemiazygos vein ranged from 0.5cm to 2.5cm(mean ;1.5cm). Only one patient who showed hepatic venous obstruction demonstrated a diameter of less than 1 cm(0. Scm). In contrast, the diameter in patients with advanced liver cirrhosis without obstruction of IVC or hepatic vein was less than 1 cm with a range from 0.2cm to 1 cm(mean ;0.6cm). CONCLUSION: The short axis diameter of azygos-hemiazygos vein was an indicator of IVC obstruction (Budd-Chiari syndrome).
Axis, Cervical Vertebra
;
Budd-Chiari Syndrome*
;
Diagnosis*
;
Diaphragm
;
Esophageal and Gastric Varices
;
Hepatic Veins
;
Humans
;
Liver Cirrhosis
;
Veins*
4.MR Features of Common Hepatic Duct Cholangiocarcinoma.
Mi Young KIM ; Yong Ho AUH ; Moon Gym LEE ; Dong Erk GOO ; Hyeon Kweun HA
Journal of the Korean Radiological Society 1994;30(4):687-691
PURPOSE: The role of MRI in the detection of cholangiocarcinoma of the common hepatic duct has rarely been described. This study was attempted to ascertain characteristic MR features of cholangiocarcinoma. MATERIALS AND METHODS: The T1(500/30, TRs/TEs) and T2 weighted(200/80, TRs/TEs) MR images were obtained from nine patients with cholangiocarcinoma of the common hepatic duct. The common hepatic lesions were detected in seven cases. MR features of cholangiocarcinoma were analysed according to the signal intensity and associated findings. RESULTS: The seven cases showed lower signal intensity than the surrounding normal liver parenchyma on T1 weighted image. On T2 weighted image, the tumor showed isosignal intensity and hyperintensity in four and three patients, respectively. T2 image also revealed diffusely increased signal intensity in some hepatic lobe or segment in four cases, and Intrahepatic periductal high signal intensity in one case. Other associated MR findings were intrahepatic metastasis, and intratumoral hemorrhage, each noted in a different case. CONCLUSION: T2 weighted Image appears to be effective in the detection of cholangiocarcinoma of the common hepatic duct and evaluation of its associated intrahepatic lesions.
Cholangiocarcinoma*
;
Hemorrhage
;
Hepatic Duct, Common*
;
Humans
;
Liver
;
Magnetic Resonance Imaging
;
Neoplasm Metastasis
5.Clinical Results of the Transjugular Intrahepatic Portosystemic Shunt.
Yong Joo KIM ; Auh Whan PARK ; Jae SIM ; Hun Kyu RYEOM
Journal of the Korean Radiological Society 1994;30(4):665-672
PURPOSE: To evaluate the cilinical results of transjugular intrahepatic portosystemicshunt(TIPS) for the control of variceal bleeding. MATERIALS AND METHODS: TIPS creation was attempted in 23 patients with endoscopically confirmed variceal bleeding. Most patients had multiple episodes of bleeding in the past and have been treated with multiple endoscopic sclerotherapies. Pre- and post-procedural hepatic and portal vein pressures were measured. After creation of TIPS patients were followed up at regular intervals. RESULTS: TIPS has been successfully accomplished in 22 of 23 patients using Wallstent(n=21 ) and Strecker stent(n=1 ). Immediate bleeding control was achieved in all patients with shunt creation. No procedure-related complication was noted. Portal vein pressure was reduced from 30.7+/-5.8 mmHg to 20.8+/-4.7 mmHg. The mean pressure gradient of portosystemic shunt dropped from 22.8+/-6.0 prior to TIPS to 12.2+/-4.1 immediately after. During the follow-up period (6-556 days, mean; 10months), seven patients died; progressive hepatic failure (n=4), variceal rebleeding(n=2), and respiratory failure(n=1). Hepatic encepha-Iopathy after TIPS was noted in 7 patients(31.8%). Variceal rebleeding occurred in 3 patients(13.6%). The remaining 15 patients have survived an average of 11 months. CONCLUSION: This results suggest that TIPS is a safe and effective method for lowering portal pressure and controlling variceal bleeding. Furthermore if these initial results are encourged by further long-term observation, TIPS could replace endoscopic and risky surgical intervention.
Esophageal and Gastric Varices
;
Follow-Up Studies
;
Hemorrhage
;
Humans
;
Liver Failure
;
Portal Pressure
;
Portal Vein
;
Portasystemic Shunt, Surgical*
;
Sclerotherapy
6.Acupuncture needles in the abdominal organs: features on plain radiography, US and CT.
Seung Yon BAEK ; Moon Gyu LEE ; Hye Young CHOI ; Kyoung Sik CHO ; Yong Ho AUH
Journal of the Korean Radiological Society 1992;28(4):589-592
Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture*
;
Medicine, East Asian Traditional
;
Needles*
;
Radiography*
7.Percutaneous transheptic removal of biliary stones:clinical analysis of 16 cases.
Hun Kyu RYEOM ; Jae In SIM ; Auh Whan PARK ; Yong Joo KIM ; Hee Jin KIM
Journal of the Korean Radiological Society 1993;29(6):1234-1239
Percutaenous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre-or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliay stones are combined intrahepatic and extrahepatic in 8 cases (50%), only extrahepati in 7 cases (44%), and only intrahepatic in 1 case (6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 cases, complete stone removal was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre-or post-procedure complication was occured. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the menagement of biliary tract stones.
Biliary Tract
;
Cholangiopancreatography, Endoscopic Retrograde
;
Cholangitis
;
Drainage
;
Jaundice
;
Methods
;
Sepsis
8.CT feature of bile duct invasion in hepatocellular carcinoma.
Mi Young KIM ; Moon Gyu LEE ; Yong Ho AUH ; Jae Hoon LIM ; Ki Whang KIM
Journal of the Korean Radiological Society 1992;28(5):739-743
Intra- and extrahepatic bile duct can be invaded by hepatocellular carcinoma (HCC). This is infrequent in HCC, but it can directly affect the clinical manifestation and prognosis. We present eight cases of HCCs with emphasis on the incidence and features of bile duct invassion on computed tomography (CT). Over a period of 22 months, abdominal CT was performed in 186 with HCC patients. Out of these, five cases of bile duct invasion by HCC were confirmed in our hospital and three in other hospitals. The eight cases were evaluated for the type, size and location. CT features of intraductal mass and ductal dilatation were evaluated. The incidence of bile duct invasion in HCC was 2.6%. Infiltrative type of HCC was seen in seven cases and six of these had mass 5-11 cm in size. The characteristic CT findings of bile duct invasion in HCC are mass in common hepatic duct with bulging contour(8/80, multiple intraductal masses in the intrahepatic ducts (5/8), and diffuse dilatation of intrahepatic ducts (7/8).
Bile Ducts*
;
Bile Ducts, Extrahepatic
;
Bile*
;
Carcinoma, Hepatocellular*
;
Dilatation
;
Hepatic Duct, Common
;
Humans
;
Incidence
;
Prognosis
;
Tomography, X-Ray Computed
9.Transcatheter Embolization Therapy of the Gastrointestinal Hemorrhage.
Yong Joo KIM ; Auh Whan PARK ; Jae In SIM ; Hun Kyu RYEOM
Journal of the Korean Radiological Society 1994;30(5):823-828
PURPOSE: To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. MATERIALS AND METHODS: The study was based on retrospective analysis of twelve cases(8 men, 4 women) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(I), typhoid fever(I), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). RESULTS: Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 reguired surgery and none showed serious complication. CONCLUSION: Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding.
Accidents, Traffic
;
Aneurysm, False
;
Arteries
;
Diagnosis
;
Drainage
;
Gastrointestinal Hemorrhage*
;
Hemobilia
;
Hemorrhage
;
Humans
;
Male
;
Retrospective Studies
;
Stomach
;
Typhoid Fever
10.Insulinoma: nonvisualization on MR.
Seung Yon BAEK ; Moon Gyu LEE ; Kyu Bo SUNG ; Kyoung Sik CHO ; Yong Ho AUH
Journal of the Korean Radiological Society 1991;27(6):817-820
No abstract available.
Insulinoma*