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Effect of Angulation between Aorta and Renal Artery on Signal Void of Proximal Renal Artery on MR Angiography:Phantom Study.

Byoung Wook CHOI ; Myung Joon KIM ; Eun Kee JEONG ; Seong Joon HONG ; Hae Young KONG ; Sam Hyeon LEE

Journal of the Korean Radiological Society.1999;40(2):317-324. doi:10.3348/jkrs.1999.40.2.317

PURPOSE: To determine the effect of anglulation between aorta the and renal artery on signal loss in theproximal renal artery, as seen on magnetic resonance angiography by phantom study using a pulsatile flow model. MATERIALS AND METHODS: Three phantoms of aorta and renal artery with angulation of 90 degree, 60 degree, and 30 degree wereobtained. Pulsatile recirculating flow (44%W/W glycerin, 60bpm) was used for MR angiography. First, axial 3D-TOFimages were obtained and reconstructed. MIP images were analyzed for the presence, area, and location of signalloss. 2D-PC images were obtained perpendicularly to the renal artery at a distance of 0, 4, 8 and 12mm from theostium. To calculate mean signal intensity of the renal artery, a ROI was drawn on 2D-PC images. To correlatesignal loss in 3D-TOF images with signal decrease in 2D-PC, we analyzed changes in signal intensity during onepulse cycle according to change of angulation and distance from the ostium of the renal artery by the calculatedvalues of relative signal decrease and ratio of signal decrease. RESULTS: A signal loss was observed up to 4mmfrom the ostium of the renal artery only in the case of the 90 degree phantom. Because the signal intensity measured inthe 2D-PC image of the 90 degree phantom was higher than that of the 60 degree phantom the signal loss observed in the3D-TOF images of the 90 degree phantom could not be explained by the magnitude of measured signal intensity alone.Relative signal decrease only at a distance of 0 and 4mm in the 90 degree phantom was evenly increased through a pulsecycle and the ratio of signal decrease at the same location was more than 50%. In contrast to the results of the90 degree phantom, those of 60 degree and 30 degree showed decreased of signal intensity mainly during the diastolic phase.CONCLUSION: Signal loss should become apparent at a certain angle between 60 degree and 90 degree. Decreased signalintensity causing signal loss in 3D-TOF was maintained throughout the systolic and diastolic phase of a pulsatilecycle and correlated with the ratio of signal decrease.
Angiography ; Aorta* ; Glycerol ; Magnetic Resonance Angiography ; Pulsatile Flow ; Renal Artery*

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Power Doppler Ultrasound Findings of Renal Infarct after Experimental Renal Artery Occlusion: Comparison withSpiral CT.

Seung Eun JUNG ; Kyung Sub SHINN ; Hak Hee KIM ; Seok Hwan MUN ; Young Joon LEE ; Bae Young LEE ; Byung Gil CHOI ; Jae Mun LEE ; Hee Jeong LEE

Journal of the Korean Radiological Society.1999;40(2):307-315. doi:10.3348/jkrs.1999.40.2.307

PURPOSE: To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction inrabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CTscanning. MATERIALS AND METHODS: In 28 rabbits weighing 2.5-4kg, the segmental renal artery was occluded throughthe left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography andspiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of thesegmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, wasevaluated by two radiologists. RESULTS: In all cases, as seen on power Doppler ultrasonography, infaretedareas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. Thelocation of the lesion closely corresponded to the location seen during CT scanning. After renal arterialocclusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% ofrabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Dopplerultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterialocclusion. CONCLUSION: Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congestedcapsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition,as seen on power Doppler ultrasonography.
Animals ; Arteries ; Diagnosis ; Estrogens, Conjugated (USP) ; Infarction ; Kidney ; Perfusion ; Rabbits ; Renal Artery* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography* ; Ultrasonography, Doppler

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Aneurysmal Malformation of the Extrahepatic Portal Vein: A Case Report.

Jeong Min LEE ; Sung Soo KANG ; Hyeun Young HAN ; Chong Soo KIM

Journal of the Korean Radiological Society.1999;40(2):303-306. doi:10.3348/jkrs.1999.40.2.303

Aneurysmal malformation of the portal vein is a rare entity. To our knowledge, only scattered reports ofportal vein aneurysms appear in the literature in English, and there is no previously published report in Korean.We describe a case exhibiting aneurysmal malformation of the extrahepatic portal vein at the hepatic hilum; thefindings demonstrated by ultrasound, CT and angiography are discussed, a review of previously described cases isincluded.
Aneurysm* ; Angiography ; Portal Vein* ; Ultrasonography ; Veins

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Primary Sclerosing Cholangitis in Patients with Ulcerative Colitis: Two Case Reports.

Se Hwan KWON ; Dong Ho LEE ; Dong Sik CHOI ; Young Tae KO

Journal of the Korean Radiological Society.1999;40(2):299-302. doi:10.3348/jkrs.1999.40.2.299

Primary sclerosing cholangitis, a chronic cholestatic liver disease, is uncommon and is characterized byinflammation and fibrosis of the bile ducts. It frequently occurs in association with ulcerative colitis. Wedescribe two cases of primary sclerosing cholangitis in patients with ulcerative colitis.
Bile Ducts ; Cholangitis ; Cholangitis, Sclerosing* ; Colitis, Ulcerative* ; Fibrosis ; Humans ; Liver Diseases ; Ulcer*

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Enhancement Pattern of Small Hepatic Hemangioma: Findings on Multiphase Spiral CT and Dynamic MRI.

Byung In CHOI ; Seung Koo LEE ; Myeong Jin KIM ; Jae Joon CHUNG ; Hyung Sik YOO ; Jong Tae LEE

Journal of the Korean Radiological Society.1999;40(2):293-297. doi:10.3348/jkrs.1999.40.2.293

PURPOSE: To compare the enhancement characteristics of small hemangiomas seen on multiphase spiral CT anddynamic MR imaging MATERIALS AND METHODS: Thirteen patients with 20 hepatic hemangiomas less than 25mm indiameter underwent both multiphase spiral CT and dynamic MR imaging. All lesions were assigned to one of threeclassified into 3 categories according to the enhancement pattern seen on multiphase spiral CT : typical delayedpooling, atypical early enhancement, or continuous low attenuation. The enhancement patterns seen on spiral CT andon dynamic MRI were correlated. RESULTS: On CT scans, ten lesions (50%) showed delayed pooling. Six(30%) showedearly arterial enhancement and four(20%) showed continuous low attenuation. On delayed-phase MRI, all lesionsshowed delayed high signal intensity compared to adjacent liver parenchyma. Four of six lesions with earlyenhancement on CT showed peripheral globular enhancement on early arterial-phase MRI. CONCLUSION: On multiphasespiral CT scans, small hemangiomas can show variable atypical enhancement features. In this situation,contrast-enhanced dynamic MRI is helpful for the diagnosis of hemangiomas.
Diagnosis ; Hemangioma* ; Humans ; Liver ; Magnetic Resonance Imaging* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

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Ultrasonography and CT Findings of Abdominal Wall Endometrioma.

Sang Ho KIM ; Hee Gon KIM ; Wei Chian LIU ; Kyo Nam KIM ; Sook Wook KANG ; Soo Ah KIM ; Keun EUR ; Seung Yeun BAEK ; Hee Jin KIM ; Jae Joon CHUNG ; Yoo Mi KANG

Journal of the Korean Radiological Society.1999;40(2):289-292. doi:10.3348/jkrs.1999.40.2.289

PURPOSE: To evaluate the US and CT findings of abdominal wall endometrioma. MATERIALS AND METHODS: We respectively reviewed nine patients with abdominal wall masses diagnosed as endometrioma during a recent three-year period. Both US and CT scans were performed in six cases, only ultrasound in one, and only CT scans in two. The location, size, shape, margin, internal echo or density, enhancement patterns, and relation to adjacent masses, as seen on US and CT images, were reviewed. RESULTS: All patients had a previous history of deliveries by caesarian section. All masses were 2-4.5cm in size ; five were located in subcutaneous layers and four in musclel ayers. In all cases, sonographic findings were low echoic masses with irregular margins(7/7). Internal echotextures were inhomogeneous in five cases and homogeneous in two. On CT, masses in subcutaneous layers(5/8)showed spiculated margins and linear enhancement of the rectus muscle fascia. In cases of lesion located in muscle(3/8), slight thickening of the rectus muscle was visible on precontrast CT scans, but on postcontrast CT scans, well-defined enhancing masses, separate from the rectus muscle were seen. CONCLUSION: When patients with a previous history of caesarian section present palpable abdominal wall masses, with cyclic pain, sonographic findings of a low echoic mass separated from the internal organs, and CT findings of a strongly enhanced mass are useful for the diagnosis of endometrioma.
Abdominal Wall* ; Diagnosis ; Endometriosis* ; Fascia ; Female ; Humans ; Tomography, X-Ray Computed ; Ultrasonography*

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Wall Thickening of The Gastric Antrum: Is It a Pseudolesion or a Tumor?.

Soon Gu CHO ; Won Hong KIM ; Kyung Hee LEE ; Mi Young KIM ; Heon HAN ; Chul Soo OK ; Chang Hae SUH

Journal of the Korean Radiological Society.1999;40(2):281-287. doi:10.3348/jkrs.1999.40.2.281

PURPOSE: To demonstrate the two-phase spiral CT features of pseudo-wall thickening and tumor in the gastricantrum, and to evaluate the possibility of differential diagnosis by analyzing two-phase spiral CT scans. MATERIALS AND METHODS: We retrospectively reviewed 120 cases in which two-phase spiral CT scans showed focal wallthickening in the prepyloric antrum of the stomach. Our series included 60 cases of gastric cancer (includingseven of early gastric cancer) and 60 cases of normal prepyloric antrum. All patients underwent two-phase spiralCT and upper gastrointestinal series (n=83) and/or gastric endoscopy (n=80). All cancer cases were confirmed bybiopsy (n=60). We evaluated the differential points between gastric cancer and pseudo-wall thickening of thegastric antrum. RESULTS: The mean thickness of the antral wall was 19.0mm in the cancer group and 12.5mm in thenormal group. Thirty-one cases (51.7%) in the cancer group and 51 (85.0%) in the normal group showed concentricwall thickening, while in each group, the remainder showed eccentric wall thickening. The common enhancementpatterns of thickened wall in the cancer group were 1) a thick enhanced mucosal layer during the arterial phase,with diffusely enhanced whole wall thickness during the venous phase (n=21); 2) a thick enhanced mucosal layerduring the arterial phase, with thicker and more intense enhancement of the same area during the venous phase(n=18). In the normal group, the common enhancement pattern was a thin enhanced mucosal layer during both thearterial and venous phase (n=34). In the cancer group, the common associated findings were regionallymphadenopathy (n=43) and food remnants in the stomach (n=15), and in the normal group, intraluminal normalmucosal folds in the thickened segment (n=50). The findings of food remnants despite overnight fasting andintraluminal normal folds occurred only in the cancer and normal group, respectively. CONCLUSION: Pseudo-wallthickening frequently showed thin enhancement of the mucosal layer on both the arterial and venous phases oftwo-phase spiral CT scan; a tumor frequently showed a thick enhanced mucosal layer during the arterial phase, withdiffusely enhanced whole-wall thickness during the venous phase or a thick enhanced mucosal layer during thearterial phase, with thicker and more intense enhancement of the same area during the venous phase. The finding ofthin and homogeneously enhanced intraluminal normal mucosal folds in the thickened segment strongly suggested thatthe lesion was a pseudo-lesion.
Diagnosis, Differential ; Endoscopy ; Fasting ; Humans ; Pyloric Antrum* ; Retrospective Studies ; Stomach ; Stomach Neoplasms ; Tomography, Spiral Computed

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Diagnosis of Acute Appendicitis in the Community Hospital: Validity and Usefulness of Sonography.

Jeong Min LEE ; Mi Suk LEE ; Hyeun Young HAN ; Young Gun YOON ; Seong Hee YM

Journal of the Korean Radiological Society.1999;40(2):275-280. doi:10.3348/jkrs.1999.40.2.275

PURPOSE: To compare the accuracy of initial clinical diagnosis with that of ultrasonography(US) in diagnosingappendicitis and to determine its effect on the care of patients in a community hospital. MATERIALS AND METHODS: One hundred and fifty patients with suspected appendicitis were prospectively examined with US. Prior to this,they had been divided into three groups on the basis of clinical judgement regarding diagnosis and their treatmentplan: Group I : high suspicion (probability > 75%) - urgent surgery indicated ; Group II : equivocal (probability25 - 75%) - in hospital for observation, Group III : very unlikely (probability < 25%)- discharge without furthertesting. In order to determine the validity of these groupings, we calculated the sensitivity, specificity, andaccuracy of sonographic examination, and the likelihood ratios of initial clinical diagnosis. RESULTS: USrevealed a sensitivity of 92%, specificity of 90%, positive predictive value of 95%, negative predictive value of85% and overall accuracy of 91%. The initial clinical impression showed a sensitivity of 70%, specificity of 82%,positive predictive value of 89%, negative predictive value of 58%, and overall accuracy of 74%. Among 79 patientsin the high clinical risk category (Group I), the sensitivity, specificity and accuracy of US were 96%, 89%, and95%, respectively. Among 71 patients in the low- and intermediate- clinical categories (Groups II and III), thesensitivity, specificity, and accuracy of US were 83%, 90%, and 87%. The likelihood ratios were 3.9 in Group I,0.52 in Group II, and 0.15 in Group III. In 32 of 150 patients (21%), the findings of US led to changes in theproposed management plan. CONCLUSION: The overall accuracy of US in the diagnosis of appendicitis wasstatistically superior to that of the clinician's initial impression (p<0.05). In addition, US played an importantrole in making decisions regarding the treatment plan.
Appendicitis* ; Diagnosis* ; Hospitals, Community* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography

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Pulmonary Vasculitis: Imaging Features.

Joon Beom SEO ; Jung Gi IM ; Jin Wook CHUNG ; Jae Woo SONG ; Jin Mo GOO ; Jae Hyung PARK ; Kyung Mo YEON

Journal of the Korean Radiological Society.1999;40(2):263-273. doi:10.3348/jkrs.1999.40.2.263

Vasculitis is defined as an inflammatory process involving blood vessels, and can lead to destruction of thevascular wall and ischemic damage to the organs supplied by these vessels. The lung is commonly affected. A numberof attempts have been made to classify and organize pulmonary vasculitis, but because the clinical manifestationsand pathologic features of the condition overlap considerably, these afforts have failed to achieve a consensus.We classified pulmonary vasculitis as belonging to either the angitiis-granulomatosis group, the diffuse pulmonaryhemorrhage with capillaritis group, or 'other'. Characteristic radiographic and CT findings of the different typesof pulmonary vasculitis are illustrated, with a brief discussion of the respective disease entities.
Blood Vessels ; Lung ; Pulmonary Artery ; Vasculitis*

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CT Findings of Pulmonary Edema: Comparison of Various Causes.

Hyae Young KIM ; Jung Gi IM ; Jin Mo GOO ; Jae Kyo LEE ; Jae Woo SONG

Journal of the Korean Radiological Society.1999;40(2):257-262. doi:10.3348/jkrs.1999.40.2.257

PURPOSE: To assess the CT findings of pulmonary edema and to compare them, according to the cause. MATERIALS AND METHODS: CT findings (thin section, 20 ; thick section, 16) of pulmonary edema in 36 patients [cardiacdisease (group I, n=20), renal disease (group II, n=13), ARDS (group III, n=3)] were analyzed and compared. Therewere 21 men and 15 women ranging in age from 27 to 77 years. Distribution (even, central, or peripheral) andpatterns of pulmonary edema were compared between the three groups. RESULTS: The distribution of edema, appearingas consolidation or ground-glass opacity, was even in 75% (n=15) of group I, even in 46% (n=6) and central in 38%(n=5) of group II, and peripherally predominant in 100% (n=3) of group III. Interlobular septal thickening wasseen in 80% (n=16), 69% (n=9), and 0% of group I, II and III, respectively. Centrilobular ground-glass opacity wasnoted in six patients. CONCLUSION: In spite of various findings and considerable overlapping of the findings ofpulmonary edema, the distribution and pattern of edema differed according to the cause, and this can be helpfulfor differential diagnosis.
Diagnosis, Differential ; Edema ; Female ; Humans ; Male ; Pulmonary Edema*

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