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Apocrine Carcinoma of the Breast: A Case Report.

Do Youn KIM ; Seok Seon KANG ; Hwa Young KIM ; Eun Kyung JI ; Tae Hee KWON ; Hai Lin PARK ; Jeong Yun SHIM

Journal of the Korean Radiological Society.2007;57(2):203-206. doi:10.3348/jkrs.2007.57.2.203

Apocrine carcinoma is a rare breast cancer and its frequency is about 0.4% of all breast cancers. Little is known about its clinical behavior and prognosis. To our knowledge, few studies have reported the radiologic appearances of apocrine carcinoma in the breast and there has been no such report from Korea. We describe the sonographic findings of a case of apocrine carcinoma in the breast. The sonographic findings are microlobulated heterogeneous hypoechoic lesion that has a central markedly hypoechoic portion and a peripheral mixture of iso and hypoechgenecity.
Apocrine Glands ; Breast Neoplasms ; Breast* ; Korea ; Prognosis ; Ultrasonography

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Dynamic MRI for Breast Cancer: Correlation with the Prognostic factors and the Time-Signal Intensity Curve.

Do Youn KIM ; Hye Young CHOI ; Guen Young LEE

Journal of the Korean Radiological Society.2007;57(2):197-202. doi:10.3348/jkrs.2007.57.2.197

PURPOSE: We wanted to evaluate the relation of the kinetic MRI features of dynamic contrast-enhanced MRI with the histopathological prognostic factors of breast cancer. MATERIALS AND METHODS: Fifty-four lesions of breast cancer patients were evaluated with using a 1.5 T MR scanner. The dynamic studies were performed in the axial plane with using T1 High Resolution Isotropic Volume Examination (THRIVE) so we obtained the time signal intensity curves. By considering the early peak signal intensity, the maximal signal intensity, the pre-enhanced signal intensity and the last signal intensity, we calculated the absolute value, percentage, slope of enhancement and the washout. The time of the early peak signal intensity and the time of the maximal signal intensity were obtained. We classified the early and delayed enhancement patterns. The kinetic MR features were correlated with the histopathological findings (the histologic and nuclear grades, estrogen receptor, progesteron receptor, Ki-67, p53 and c-erb B2). RESULTS: The early peak signal intensity slope was significantly correlated with the histologic grade (I versus II, III), and the Ki-67 (p=0.045, p=0.009). Ki-67 was also significantly correlated with the time of the peak signal intensity and the time of the maximal signal intensity (p=0.009, p=0.045). CONCLUSION: Some of the parameters of the time-signal intensity curve of dynamic MRI were associated with the prognostic factors, so these MRI signs may be useful to noninvasively identify prognostic factors in the future.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Magnetic Resonance Imaging* ; Prognosis

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The Diagnostic Accuracy of Multidetector Row CT for Evaluating the Axillary Lymph Nodes in Patients with Breast Cancer.

Doo Kyung KANG ; Jun Man KIM ; Hyunee YIM

Journal of the Korean Radiological Society.2007;57(2):187-196. doi:10.3348/jkrs.2007.57.2.187

PURPOSE: We investigated the CT (computed tomography) findings of metastatic lymph nodes (LNs), and we analyzed the diagnostic performance of multidetector row CT (MDCT) for detecting axillary LN metastases in patients with breast cancer. MATERIALS AND METHODS: We investigated 59 patients who preoperatively underwent chest MDCT, and they underwent sentinel LN biopsy or whole axillary LN dissection. We analyzed the morphologic features, the degree of enhancement and the delayed enhancement pattern. We classified the patients into the non-metastatic LN group and the metastatic LN group, and we calculated the diagnostic performance of MDCT for detecting metastatic LNs. RESULTS: When both the morphologic and quantitative criteria were consistent, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 58.1%, 100%, 100% and 68.3%, respectively, and MDCT accurately detected metastatic LNs in 2 patients that were false negative on sentinel LN biopsy. When the morphologic and quantitative criteria were consistent, the sensitivity, specificity, PPV and NPV were 87.1%, 53.6%, 67.5% and 78.9%, respectively. However, MDCT could not detect metastatic LNs, including two micrometastases (a total of 8 micrometastases) that were in each of four patients. CONCLUSION: MDCT can be used to perform the morphology and quantitative analysis of axillary LNs, and this modality has excellent specificity and a PPV for detecting metastatic LNs when the both of the diagnostic criteria are consistent.
Axilla ; Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Nodes* ; Lymphatic System ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Sensitivity and Specificity ; Thorax ; Tomography, X-Ray Computed

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Intracortical Bone Metastasis Mimicking Intracortical Osteoid Osteoma: A Case Report.

Yu ri SHIN ; Jee Young KIM

Journal of the Korean Radiological Society.2007;57(2):181-185. doi:10.3348/jkrs.2007.57.2.181

Cortical metastasis usually occurs in the diaphysis of the long bones with the appearance of a cookie-bite pattern; this is associated with cortical destruction extending into the soft tissue as well as into the medullary cavity, or there can be a periosteal reaction. We report here on a 66-year-old woman who was diagnosed with intracortical metastasis in the proximal metaphysis of the right femur as an initial metastatic focus from primary lung cancer. CT detected an intracortical osteolytic lesion without cortical destruction or thickening. The MR images showed extensive peritumoral edema in the surrounding soft tissue and adjacent bone marrow edema, and this all mimicked osteoid osteoma.
Aged ; Bone Marrow ; Diaphyses ; Edema ; Female ; Femur ; Humans ; Lung Neoplasms ; Neoplasm Metastasis* ; Osteoma, Osteoid*

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Herniation of a Lipomatous Tumor in the Extremity: A Report of 3 Cases.

Jee Young KIM

Journal of the Korean Radiological Society.2007;57(2):175-179. doi:10.3348/jkrs.2007.57.2.175

Lipomas can occur in any soft tissue, including that found in bone. Although it is known that most lipomas are restricted to the involved compartment, we found some lipomas that herniated across the compartment barrier. Here, we report 3 cases of a herniated soft tissue lipomatous tumor. Radiological findings of the herniated lipomas indicated the presence of a waist portion, and the associated findings were related to a focal ischemic change.
Extremities* ; Hernia ; Lipoma

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The Role of an Axial MR Scan on the Diagnosis of a Meniscal Tear of the Knee Joint.

Suk Keu YEOM ; Baek Hyun KIM ; Suk Joo HONG ; Hae Young SEOL

Journal of the Korean Radiological Society.2007;57(2):167-174. doi:10.3348/jkrs.2007.57.2.167

PURPOSE: To evaluate the role of standard axial MR images for the diagnosis of meniscal tears of the knee. MATERIALS AND METHODS: Forty-five patients with a prior MRI examination that underwent arthroscopic surgery of the knee due to clinical impression of a meniscal tear were included in the study group. The sequence for meniscal evaluation was an axial fat-saturated proton density-weighted image with a 4 mm slice thickness. Axial MR images were independently reviewed by two radiologists and were compared with findings of arthroscopy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the axial MR scan for the diagnosis of the meniscal tear were calculated. RESULTS: A total 90 menisci of 45 patients were evaluated in the axial MR scans. Forty-two patients had meniscal tears, and two of the patients had tears in both menisci; thus, a total of44 meniscal tears were found by arthroscopy. For meniscal tears, the sensitivity of the axial plane was 76.2%, the specificity was 89.1% and the accuracy was 81.1%. False negative meniscal tears were seen in 12 cases and false positive meniscal tears were seen in 5 cases on the axial MR images. CONCLUSION: In standard knee MRI examinations, axial images may be valuable for the detection and localization of meniscal tears.
Arthroscopy ; Diagnosis* ; Humans ; Knee Injuries ; Knee Joint* ; Knee* ; Magnetic Resonance Imaging ; Medial Collateral Ligament, Knee ; Menisci, Tibial ; Protons ; Sensitivity and Specificity

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Usefulness of a Pharmacokinetic Model Based on Dynamic Contrast-enhanced MRI for the Detection and Localization of Prostate Cancer.

Ae Kyung JEONG ; Jeong Kon KIM ; Kyoung Sik CHO

Journal of the Korean Radiological Society.2007;57(2):159-165. doi:10.3348/jkrs.2007.57.2.159

PURPOSE: To investigate the usefulness of a pharmacokinetic model based on dynamic contrast-enhanced (DCE) MR imaging for the detection and localization of prostate cancer. MATERIALS AND METHODS: Forty-four patients that had undergone radical prostatectomy for prostate cancer and dynamic contrast enhanced (DCE) MR imaging (slice thickness, 4 mm; time resolution of each set, 5 seconds), were enrolled in the study. From the pharmacokinetic model, the time of arrival, and the parameters Ah, Kep, and Kel were extracted and were compared for cancerous tissue and non-cancerous tissue in the central gland and peripheral zone. The diagnostic performance of each parameter for differentiating cancerous tissue from non-cancerous tissue was evaluated using receiver-operating-characteristics analysis. RESULTS: The Kep and Kel values were significantly greater in cancerous tissue (0.13 sec(-1) +/- 0.14 and 1.59 x 10(-3) sec(-1) +/- 1.35 x 10(-3)) than in non-cancerous tissue from the central gland (0.03 sec(-1) +/- 0.02 and 0.26 x 10(-3) sec(-1) +/- 1.24 x 10(-3)) and peripheral zone (0.04 sec(-1) +/- 0.07 and 0.58 x 10(-3) sec(-1) +/- 1.98 x10(-3)) (p < 0.05). The area under the ROC curve for differentiating cancerous from non-cancerous tissue was 0.850 (95% CI, 0.778-0.876) for Kep and 0.814 (95% CI, 0.737-0.876) for Kel. CONCLUSION: Kep and Kel are useful perfusion parameters for the differentiation of prostate cancerous tissue from non-cancerous tissue.
Humans ; Magnetic Resonance Imaging* ; Neoplasm Staging ; Perfusion ; Pharmacokinetics ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; ROC Curve

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Duodenal Duplication Cyst that Manifested as Duodeno-jejunal Intussusception in an Adult: A Case Report.

Hee Jin KWON

Journal of the Korean Radiological Society.2007;57(2):155-158. doi:10.3348/jkrs.2007.57.2.155

Duodenal duplication cyst account for 4% or 5% of all gastrointestinal duplications. Duodenal duplication acting as a lead point for an intussusception is an extremely rare event as it is largely a fixed retroperitoneal structure. We report here on the radiologic findings of a case of duodenal duplication cyst that manifested as duodeno-jejunal intussusception in an adult.
Adult* ; Humans ; Intussusception*

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Intestinal Arteriovenous Malformation Involving the Descending Colon: A Case Report.

Eun Jin LEE ; Young Chan PARK ; Young Hwan LEE ; Kyung Jae JUNG ; Ho Kyun KIM

Journal of the Korean Radiological Society.2007;57(2):151-154. doi:10.3348/jkrs.2007.57.2.151

Arteriovenous malformations (AVMs) comprising a feeding artery, nidus, and draining vein rarely develop in the gastrointestinal tract. Although almost all AVMs are asymptomatic, they cause massive painless rectal bleeding and subsequent chronic anemia. The definitive diagnosis of AVM is achieved by selective mesenteric angiography, and surgical resection is the treatment of choice. We detected an intestinal AVM involving the descending colon in a patient with severe hematochezia. The diagnosis was made by CT angiography performed using a 64-channel MDCT and the obtained 3D reconstruction images. The AVM showed an extensive vascular network on CT images, and it was treated by surgical resection. Here, we report this case of an intestinal AVM along with its imaging findings.
Anemia ; Angiography ; Arteries ; Arteriovenous Malformations* ; Colon, Descending* ; Diagnosis ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Veins

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Methods of Counting Ribs on Chest CT: The Modified Sternomanubrial Approach.

Kyung Sik YI ; Sung Jin KIM ; Min Hee JEON ; Seung Young LEE ; Il Hun BAE

Journal of the Korean Radiological Society.2007;57(2):145-150. doi:10.3348/jkrs.2007.57.2.145

PURPOSE: The purpose of this study was to evaluate the accuracy of each method of counting ribs on chest CT and to propose a new method: the anterior approach with using the sternocostal joints. MATERIALS AND METHODS: CT scans of 38 rib lesions of 27 patients were analyzed (fracture: 25, metastasis: 11, benign bone disease: 2). Each lesion was independently counted by three radiologists with using three different methods for counting ribs: the sternoclavicular approach, the xiphisternal approach and the modified sternomanubrial approach. The rib lesions were divided into three parts for evaluation of each method according to the location of the lesion as follows: the upper part (between the first and fourth thoracic vertebra), the middle part (between the fifth and eighth) and the lower part (between the ninth and twelfth). RESULTS: The most accurate method was a modified sternomanubrial approach (99.1%). The accuracies of a xiphisternal approach and a sternoclavicular approach were 95.6% and 88.6%, respectively. A modified sternomanubrial approach showed the highest accuracies in all three parts (100%, 100% and 97.9%, respectively). CONCLUSION: We propose a new method for counting ribs, the modified sternomanubrial approach, which was more accurate than the known methods in any parts of the bony thorax, and it may be an easier and quicker method than the others in clinical practice.
Bone Diseases ; Humans ; Neoplasm Metastasis ; Ribs* ; Sternocostal Joints ; Thorax* ; Tomography, X-Ray Computed*

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