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Nodular Fasciitis on the Nasolabial Fold in a 5-month-old Infant: A Case Report.

Kyung Sik AHN ; Bo Kyung JE ; Young Sik KIM ; Taik Kun KIM ; Baek Hyun KIM ; Sang Hoon CHA

Journal of the Korean Radiological Society.2006;55(6):623-627. doi:10.3348/jkrs.2006.55.6.623

We report the case of a 5-month-old infant with a rapidly growing mass on the right nasolabial fold; to our knowledge, this is the youngest infant diagnosed with nodular fasciitis in the literature. Based on the anatomic location, this was a subcutaneous type of nodular fasciitis and it had a mixed cellular and fibrous histologic composition, which is rare in infancy. Here we present periodic ultrasonographic images and MR images, as well as a detailed comparison of the pathologic and radiologic findings.
Fasciitis* ; Humans ; Infant* ; Nasolabial Fold*

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Cervical Spondylolysis in Child with Four Levels of Simultaneous Involvement: A Case Report.

Gang Deuk KIM ; Hye Won KIM ; Sung Jo JANG ; Jung Taek OH

Journal of the Korean Radiological Society.2006;55(6):619-622. doi:10.3348/jkrs.2006.55.6.619

Cervical spondylolysis is a rare condition, and less than 100 cases have been reported in the world literature. Cervical spondylolysis is defined as a well corticated defect in the posterior element of a cervical vertebra. Although the etiology of cervical spondylolysis is unknown, its association with dysplastic changes and spina bifida occulta suggest that the lesion is congenital. Here, we describe the radiographs and CT images of cervical spondylolysis involving four levels in a 9 year old boy.
Child* ; Humans ; Male ; Spina Bifida Occulta ; Spine ; Spondylolysis*

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Superior Labrum Anterior to Posterior Lesion Type II with Accompanied Findings: Assessment of Shoulder MR Arthrographic Findings.

Sun Young CHOI ; Kyung Ah CHUN ; Oh Soo KWON ; Ki Tae KIM

Journal of the Korean Radiological Society.2006;55(6):613-618. doi:10.3348/jkrs.2006.55.6.613

PURPOSE: To describe the pattern of various shoulder abnormalities with an associated superior labrum anterior to posterior (SLAP) lesion type II using magnetic resonance (MR) arthrography, and to assess the clinical significance of the associated abnormalities. MATERIALS AND METHODS: A retrospective review of the MR arthrographic findings of 92 cases of a shoulder with an arthroscopically confirmed SLAP lesion type II was performed. The MR arthrography images were reviewed and analyzed. MR arthrographic analysis noted the presence of a rotator cuff abnormality, acromioclavicular arthritis, adhesive capsulitis, glenohumeral arthritis, a labral abnormality besides the SLAP lesion, and a paralabral cyst. The patients with SLAP lesions were divided into two age groups: those over 40 years of age and those forty years old or younger. Statistical analysis was performed to evaluate the influence of age on the various shoulder abnormalities with associated SLAP lesion. RESULTS: Of the 92 SLAP lesions type II, there were 7 cases (8%) of isolated SLAP lesions without any associated any shoulder abnormality. Eighty-five (92%) SLAP lesions were associated with various shoulder abnormalities including rotator cuff tendinosis (30/92, 33%), partial-thickness tear (36/92, 39%), full-thickness tear (2/92, 2%), acromioclavicular arthritis (46/92, 50%), adhesive capsulitis (7/92, 8%), glenohumeral arthritis (15/92, 16%), labral abnormality (26/92, 28 %) and paralabral cyst (7/92, 8%). The SLAP lesions (60/92, 65%) in patients over forty years of age were accompanied by a significantly high number of rotator cuff abnormalities (p < 0.001), glenohumeral osteoarthritis (p = 0.001), and acromioclavicular osteoarthritis (p < 0.001). In contrast, the SLAP lesions (32/92, 35%) in patients forty years old or younger had a significantly high number of anterior or posterior labral lesions (p < 0.001). CONCLUSION: Isolated SLAP lesions type II without other associated shoulder abnormalities are uncommon, and the age of the patient influences the prevalence of other shoulder abnormalities associated with SLAP lesions. In addition, MR arthrography can help detect shoulder abnormalities accompanying the SLAP lesions.
Arthritis ; Arthrography ; Bursitis ; Humans ; Osteoarthritis ; Prevalence ; Retrospective Studies ; Rotator Cuff ; Shoulder* ; Tendinopathy

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Comparison of CT Urography and Intravenous Urography in Patients with Hematuria.

Guen Young LEE ; Byung Chul KANG ; Ji Young HWANG

Journal of the Korean Radiological Society.2006;55(6):607-612. doi:10.3348/jkrs.2006.55.6.607

PURPOSE: We wanted to compare CT urography (CTU) with using multi-detector row CT (MDCT) and intravenous urography (IVU) for diagnosing the causes of hematuria. MATERIALS AND METHODS: From January 2003 to March 2004, IVU and CTU were obtained in 48 patients. We evaluated the causes of hematuria in 34 of 48 patients. The IVU images were obtained by the conventional method. The CTU images were routinely obtained before intravenous contrast injection, and at 2 and 5 minutes after intravenous contrast injection. In case of delayed excretion of contrast by the kidneys, the delayed CT scans were obtained at 120 minutes after contrast injection. All the CT images, including the axial and 3D coronal reformatted CTUs with using software as well as conventional IVU images, were reviewed by two radiologists working in consensus. We decided if urinary stone existed or not and we looked for the indirect signs such as hydronephrosis or delayed excretion, etc. We also observed if it was possible to determine the mass, ureteral stricture and enhancement of the ureteral wall, etc. We calculated sensitivity, specificity, positive predictive value and negative predictive value for each modality to diagnose urinary stone. We compared the detection rate according to the phases of CTU. RESULTS: We confirmed the presence of urinary tract stones in 27 of 34 patients who had undergone both IVU and CTU. We diagnosed ureteritis in 1, transitional cell carcinoma in 5 and acute pyelonephritis in 1 of the remaining 7 patients. The urinary stones were detected in fifteen patients on both IVU and CTU (15/27, 55.6%). We detected the urinary stones on CTU, but not IVU, in twelve patients (12/27, 44.5%). The sensitivity to detect the urinary stones was 100% (27/27) on CTU and 55.6% (12/27) on IVU respectively. The specificity was 100% (7/7) on IVU and CTU, respectively. The positive predictive value was 100% (15/15) on IVU and 100% (27/27) on CTU, respectively. The negative predictive value was 36.8% (7/19) on IVU and 100% (7/7) on CTU. Precontrast CTU demonstrated the urinary stones in all 27 patients (100%, 27/27). On the other hands, urinary stones were detected in 19 patients (19/27, 70.4%) and 8 patients (8/27, 29.6%) at 2 and 5 minutes on CTU, respectively. CONCLUSION: CTU is superior to IVU to diagnose the causes of hematuria such as urinary tract stone or extrarenal lesion. Precontrast CTU is the most useful modality for the detection of the urinary tract stone of the other enhanced CTUs.
Carcinoma, Transitional Cell ; Consensus ; Constriction, Pathologic ; Hand ; Hematuria* ; Humans ; Hydronephrosis ; Kidney ; Pyelonephritis ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ureter ; Urinary Calculi ; Urography*

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Paradoxical Response During Antituberculous Treatment for Abdominal Tuberculosis.

Ji Young KIM ; Jung Hyeok KWON ; Mi Jeong KIM ; Hyuk Won CHANG ; Jae Seok HWANG ; Kwang Bum CHO ; Kyung Sik PARK ; Byoung Kuk JANG ; Woo Jin CHUNG

Journal of the Korean Radiological Society.2006;55(6):599-605. doi:10.3348/jkrs.2006.55.6.599

PURPOSE: The purpose of our study was to evaluate clinical and CT findings of paradoxical response during treatment for abdominal tuberculosis. MATERIALS AND METHODS: Authors reviewed the patient records of 138 patients with abdominal tuberculosis during a recent 6-year period and we selected 11 patients with a paradoxical response. The CT findings and pathologic findings of the initial lesions and new lesions were reviewed. The intervals between initiation of therapy and the detection of new lesions, improvement of new lesions and the final follow-up were evaluated. RESULTS: At the initial presentation, we identified tuberculous peritonitis in 8 patients, tuberculous lymphadenitis in 3 patients and ileocolic tuberculosis in two patients. New lesions were identified at 2-10 months (mean: 3.8 months) after the initiation of therapy and following improvement of the initial lesions. The new lesions were perihepatic caseous abscess (n=4), hepatic tuberculoma (n=3), hepatic caseous abscess (n=1), tuberculous lymphadenitis (n=3), ileocolic tuberculosis (n=3), and splenic tuberculoma (n=1). Improvement of new lesions was noted at 4-14 months (mean: 7.6 months). At the final follow-up of seven patients, the new lesions disappeared and four patients still had small residual lesions. CONCLUSION: New lesions that develop in a patient with initial improvement should be considered a paradoxical response that will ultimately improve with continuation of the original medication.
Abscess ; Follow-Up Studies ; Humans ; Peritonitis, Tuberculous ; Tuberculoma ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Lymph Node

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Comparison of Two-dimensional CT with Virtual Gastrography Using Multi-detector CT in the Diagnosis of Early Gastric Cancer.

Jee Eun LEE ; Hyo Won EUN ; Jung Hoon KIM

Journal of the Korean Radiological Society.2006;55(6):591-597. doi:10.3348/jkrs.2006.55.6.591

PURPOSE: We compared the performance of virtual gastrography (VG) using multi-detector (MDCT) with two-dimensional (2D) CT in the diagnosis of early gastric cancer (EGC). MATERIALS AND METHODS: We performed conventional gastroscopy and MDCT examination after gaseous distension of the stomach in 50 consecutive patients who were confirmed as EGC by surgery and endoscopic mucosal resection. Unenhanced images were obtained in the prone position and contrast enhanced images were obtained in the supine position. Contrast enhanced imaging was done 70 seconds after intravenous injection of 150 mL of ionic contrast material at the rate of 3 mL/sec. 2D CT and VG images were analyzed by two radiologist with consensus to assess the location and gross morphologic type of EGC. Crosstabs were used to determine the diagnostic accuracy of EGC on 2D CT and VG. RESULTS: The diagnostic specificity for 50 patients with EGC was significantly higher with VG (72%) than with 2D CT (88%) (p<0.05). VG depicted EGC in eight patients (type I = 1; type IIa = 3; type IIb = 1; type IIc = 2; type IIa + IIc = 1) that were missed on the 2D CT. The lesions were located in the antrum (n = 6), angle (n = 1), and body (n = 1). However, VG frequently misdiagnosed EGCs of type IIb (n = 4), IIc (n = 1), and III (n = 1), as well as the location at the angle (n = 3), antrum (n = 1), and body (n = 1). CONCLUSION: VG showed excellent result in the detection of EGC compared with 2D CT. However, it had limitations in the diagnosis of EGC type IIb or gastric angle tumor.
Consensus ; Diagnosis* ; Gastroscopy ; Humans ; Injections, Intravenous ; Neuroma, Acoustic ; Prone Position ; Sensitivity and Specificity ; Stomach ; Stomach Neoplasms* ; Supine Position

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Imaging Findings of Abdominal Extraosseous Plasma Cell Neoplasm.

Yang Sin PARK ; Jae Ho BYUN ; Kyungsoo BAE ; Hyung Jin WON ; Ah Young KIM ; Yong Moon SHIN ; Pyo Nyun KIM ; Hyun Kwon HA ; Moon Gyu LEE

Journal of the Korean Radiological Society.2006;55(6):579-589. doi:10.3348/jkrs.2006.55.6.579

PURPOSE: To evaluate the imaging findings of abdominal extraosseous plasma cell neoplasm. MATERIALS AND METHODS: From April 2000 to January 2005, eight patients (four men, four women; mean age, 50.6 years) with pathologically proved, extraosseous plasma cell neoplasm involving the abdominal organs were included in this study. The diagnoses were based on consensus agreement between two radiologists who retrospectively reviewed CT, ultrasonography, and enteroclysis findings. We evaluated the findings by focusing on the location, size, margin, and enhancement pattern of the lesion, and lymphadenopathy on each image. RESULTS: There were multiple myeloma in four patients and extramedullary plasmacytoma in the remaining four. Involved abdominal organs were the liver (n = 4), spleen (n = 4), lymph node (n = 3), stomach (n = 1), small bowel (n = 1), and colon (n = 1). The hepatic involvement of plasma cell neoplasm presented as a homogeneous, well-defined, solitary mass (n = 1), multiple nodules (n = 1), and hepatomegaly (n = 2). Its involvement of the spleen and lymph node appeared as splenomegaly and lymphadenopathy, respectively. Its involvement of the gastrointestinal tract including the stomach, small bowel, and colon, presented as a homogeneous, diffuse wall thickening or mass in the gastrointestinal tract. CONCLUSION: Abdominal extraosseous plasma cell neoplasm involves occasionally the liver, spleen, and lymph node, and rarely the gastrointestinal tract. When we encounter a well-defined, homogeneous lesion of the abdominal organs in patients diagnosed or suspected as having plasma cell neoplasm, we should consider its involvement of the abdominal organs.
Colon ; Consensus ; Diagnosis ; Female ; Gastrointestinal Tract ; Hepatomegaly ; Humans ; Liver ; Lymph Nodes ; Lymphatic Diseases ; Male ; Multiple Myeloma ; Neoplasms, Plasma Cell* ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Retrospective Studies ; Spleen ; Splenomegaly ; Stomach ; Ultrasonography

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Hepatic Hemangiomas with Peritumoral Sparing of Fatty Infiltration in Hepatic Steatosis: Findings on Contrast-enhanced MR Imaging and on Sonography.

Min Jeong KIM ; Kyoung Won KIM ; Hyung Jin WON ; Ah Young KIM ; Yong Moon SHIN ; Jae Ho BYUN ; Seong Ho PARK ; Pyo Nyun KIM ; Moon Gyu LEE ; Hyun Kwon HA

Journal of the Korean Radiological Society.2006;55(6):571-577. doi:10.3348/jkrs.2006.55.6.571

PURPOSE: We wanted to determine the frequency of peritumoral sparing of fatty infiltration (PTSF) around hepatic hemangioma in hepatic steatosis and to evaluate the finding of these tumors on dynamic contrast-enhanced MR imaging and on sonography. MATERIALS AND METHODS: This study included 76 hemangiomas in 67 patients suffering with hepatic steatosis. A diagnosis of hemangioma was based on the histologic findings, hemangioma SPECT or a compatible enhancement pattern on the dynamic contrast-enhanced MR study. For chemical shifting, PTSF was defined when there wasn't any decrease in signal intensity of the liver parenchyma on the opposed-phase images as compared with the in-phase images, and this intensity appeared as a hyperintense area around the tumor. We evaluated the frequency of PTSF and we analyzed if the presence of PTSF was related to the tumor size, the rapidity of enhancement or an associated arterioportal shunt. Among those, sonographic images were available in 55 hemangiomas. We also evaluated the sonographic appearances of hemangiomas with PTSF. RESULTS: Of the 76 hemangiomas, PTSF was noted on the MR chemical-shift images in 57 hemangiomas (75%). There was no significant relationship between tumor size and the presence of PTSF (p=.578). However, this finding was more frequently found in high-flow hemangiomas than in the slow-flow ones (p=.0038) and it was also related to the presence of associated arterioportal shunt (p=.0158). Sonographically, hemangiomas with PTSF were commonly surrounded by a peritumoral low-echoic area (28/41, 68%); these tumors more frequently showed a thin high-echoic rim on sonography than did the tumors without this finding (p=.0055). CONCLUSION: PTSF is commonly seen in hemangiomas in hepatic steatosis patients. Hepatic hemangiomas with PTSF tend to show rapid enhancement on dynamic MR imaging and this is accompanied by arterioportal shunt. They tend to be seen as an iso- or low-echoic mass with a thin high-echoic rim on sonography, and the mass is commonly surrounded by a peritumoral low-echoic area.
Diagnosis ; Fatty Liver ; Hemangioma* ; Humans ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography

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1024 Matrix Image Reconstruction: Usefulness in High Resolution chest CT.

Sun Young JEONG ; Myung Jin CHUNG ; Semin CHONG ; Yon Mi SUNG ; Kyung Soo LEE

Journal of the Korean Radiological Society.2006;55(6):565-569. doi:10.3348/jkrs.2006.55.6.565

PURPOSE: We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. MATERIALS AND METHODS: Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each arrowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. RESULTS: The average and standard deviation of image quality were 3.09 (+/-.92) for the 0.625 mmx512 matrix, 3.16 (+/-.84) for the 0.625 mmx1024 matrix, 2.49 (+/-1.02) for the 1.25 mmx512 matrix, and 2.35 (+/-1.02) for the 1.25 mmx1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (p < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (p = 0.678). The interobserver variation between the two observers was not significant (p = 0.691). CONCLUSION: We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinically useful.
Emphysema ; Fibrosis ; Humans ; Image Processing, Computer-Assisted* ; Masks ; Observer Variation ; Thorax* ; Tomography, X-Ray Computed*

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Usefulness of Abdominal Aortic Calcification for Screening of Peripheral Vascular Disease.

Chul Hi PARK ; Jeong Ho KIM ; Soo Jin CHOI ; Wook JIN ; Dal Mo YANG ; Hyung Sik KIM

Journal of the Korean Radiological Society.2006;55(6):557-564. doi:10.3348/jkrs.2006.55.6.557

PURPOSE: We wanted to evaluate the value of abdominal aortic calcification (AAC), as detected on CT, as a predictor of atherosclerotic stenotic disease of the lower extremity arteries. MATERIALS AND METHODS: One hundred three patients who had CT angiography performed for the evaluation of peripheral vascular disease were enrolled in this retrospective study. The volume (mm3) of the AAC was measured on CT. Each lower extremity was divided into 8 segments. The extent of stenosis of the lower extremity artery was manifested as the sum of the stenosis scores for 16 segments (total stenosis score: TSS). The significant stenosis scores (SSS-50 and SSS-75) were defined as the sum of scores for the lower extremity artery segments that had significant stenosis of more than 50% and 75%, respectively. AAC was correlated to the TSS, SSS-50 and SSS-75 with using Spearman's correlation coefficient. The diagnostic performance of AAC for stenosis of a lower extremity artery of more than 50% and 75%, respectively, was evaluated by using the receiver operating characteristic (ROC) curve RESULTS: The Spearman's correlation coefficients were 0.728 (AAC vs. TSS), 0.662 (AAC vs. SSS-50), and 0.602 (AAC vs. SSS-75), respectively. For significant stenosis more than 50% and 75%, the areas under the ROC curve were 0.898 and 0.866, respectively. The cutoff value, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 1030 mm3, 87%, 88%, 89%, 86% and 87% for stenosis more than 50% and 1030 mm3, 87%, 80%, 79%, 88% and 84% for stenosis more than 75%, respectively. CONCLUSION: Abdominal aortic calcification detected on CT may be a useful predictor of atherosclerotic stenotic disease of lower extremity arteries.
Angiography ; Arteries ; Constriction, Pathologic ; Humans ; Lower Extremity ; Mass Screening* ; Peripheral Vascular Diseases* ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

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