Korean Journal of Radiology.2017;18(6):1012-1013. doi:10.3348/kjr.2017.18.6.1012
Korean Journal of Radiology
2000 to Present ISSN: 1229-6929
Sort by
DISPLAY OPTIONS
Format:
Per page:
Korean Journal of Radiology.2017;18(6):1005-1011. doi:10.3348/kjr.2017.18.6.1005
OBJECTIVE: To assess the current practice patterns of radiologists who perform transthoracic needle biopsy (TNB). MATERIALS AND METHODS: An email survey of 71 questions on TNB was sent to 240 members of the Korean Society of Thoracic Radiology. The answers to multiple-choice questions (n = 56) were analyzed. RESULTS: Of 60 respondents, 45% had 10 or more years of experience in chest radiology, and 70% had 5 or more years of experience in TNB. For the question on the most frequently used diagnostic method for lesions with high probability of being resectable-stage lung cancer, 70% of respondents answered that TNB is initially used, with or without bronchoscopy. In patients at high-risk of TNB-related complications, the proportion of the respondents who consistently declined TNB was only 5%. The number of rebiopsies was said to be increased; molecular analysis for an established target therapy (43.6%) and clinical trial of a new drug (28.2%) were the two most common reasons for it. The most popular needle type was the coaxial cutting needle (55%), and the popular guiding modality was conventional computed tomography (CT) (56.7%). In addition, 15% of respondents have encountered air embolism. CONCLUSION: Despite high variation in how TNB is being performed in Korea, some patterns were noted. It is common for patients with resectable-stage lung cancer to undergo TNB prior to surgery. Rebiopsy is now more common than before, with personalized medicine as the most important reason for it. The most popular type of needle is the coaxial system; the most popular modality for guidance is still CT.
Biopsy, Needle* ; Bronchoscopy ; Electronic Mail ; Embolism, Air ; Humans ; Korea ; Lung Neoplasms ; Methods ; Needles* ; Precision Medicine ; Surveys and Questionnaires ; Thorax
Biopsy, Needle* ; Bronchoscopy ; Electronic Mail ; Embolism, Air ; Humans ; Korea ; Lung Neoplasms ; Methods ; Needles* ; Precision Medicine ; Surveys and Questionnaires ; Thorax
Signs in Neuroradiology: A Pictorial Review.
Korean Journal of Radiology.2017;18(6):992-1004. doi:10.3348/kjr.2017.18.6.992
One of the major problems radiologists face in everyday practice is to decide the correct diagnosis, or at least narrow down the list of possibilities. In this context, indicative evidences (signs) are useful to recognize pathologies, and also to narrow the list of differential diagnoses. Despite classically being described for a single disease, or a closely related family of disorders, most indications are not restricted exclusively to their traditional definition. Therefore, using signs for prognosis requires knowledge of the mechanism of their appearance, and which pathologies they are observed in. In this study, we demonstrate some of the more common and useful neuroradiologic signs with relevant images, and discuss their use in differential diagnosis.
Brain ; Diagnosis ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Pathology ; Prognosis ; Ultrasonography
Brain ; Diagnosis ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Pathology ; Prognosis ; Ultrasonography
Korean Journal of Radiology.2017;18(6):983-991. doi:10.3348/kjr.2017.18.6.983
OBJECTIVE: To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. MATERIALS AND METHODS: Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. RESULTS: Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). CONCLUSION: Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease.
Alzheimer Disease* ; Biomarkers ; Brain ; Cerebrum ; Humans ; Magnetic Resonance Imaging ; Neuroimaging* ; Parietal Lobe ; Retrospective Studies ; Support Vector Machine ; Temporal Lobe
Alzheimer Disease* ; Biomarkers ; Brain ; Cerebrum ; Humans ; Magnetic Resonance Imaging ; Neuroimaging* ; Parietal Lobe ; Retrospective Studies ; Support Vector Machine ; Temporal Lobe
Korean Journal of Radiology.2017;18(6):973-982. doi:10.3348/kjr.2017.18.6.973
OBJECTIVE: To compare the contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR), the CE T1-weighted (CE-T1W) sequence with fat suppression (FS) and magnetization transfer (MT) for early detection and characterization of infectious meningitis. MATERIALS AND METHODS: Fifty patients and 10 control subjects were evaluated with the CE-FLAIR and the CE-T1W sequences with FS and MT. Qualitative assessment was done by two observers for presence and grading of abnormal leptomeningeal enhancement. Quantitative assessment included computation of net meningeal enhancement, using single pixel signal intensity software. A newly devised FLAIR based scoring system, based on certain imaging features including ventricular dilatation, ependymal enhancement, infarcts and subdural effusions was used to indicate the etiology. Data were analysed using the Student's t test, Cohen's Kappa coefficient, Pearson's correlation coefficient, the intraclass correlation coefficient, one way analysis of variance, and Fisher's exact test with Bonferroni correction as the post hoc test. RESULTS: The CE-FLAIR sequence demonstrated a better sensitivity (100%), diagnostic accuracy (95%), and a stronger correlation with the cerebrospinal fluid, total leukocyte count (r = 0.75), protein (r = 0.77), adenosine deaminase (r = 0.81) and blood glucose (r = -0.6) values compared to the CE-T1W sequences. Qualitative grades and quantitative meningeal enhancement on the CE-FLAIR sequence were also significantly greater than those on the other sequences. The FLAIR based scoring system yielded a diagnostic accuracy of 91.6% and a sensitivity of 96%. A strong inverse Pearson's correlation (r = -0.95) was found between the assigned score and patient's Glasgow Coma Scale at the time of admission. CONCLUSION: The CE-FLAIR sequence is better suited for evaluating infectious meningitis and could be included as a part of the routine MR imaging protocol.
Adenosine Deaminase ; Blood Glucose ; Cerebrospinal Fluid ; Dilatation ; Glasgow Coma Scale ; Humans ; Leukocyte Count ; Magnetic Resonance Imaging ; Meningitis*
Adenosine Deaminase ; Blood Glucose ; Cerebrospinal Fluid ; Dilatation ; Glasgow Coma Scale ; Humans ; Leukocyte Count ; Magnetic Resonance Imaging ; Meningitis*
Korean Journal of Radiology.2017;18(6):964-972. doi:10.3348/kjr.2017.18.6.964
OBJECTIVE: To evaluate the utility of high-resolution vessel wall imaging (HR-VWI) of middle cerebral artery (MCA), and to compare HR-VWI findings between striatocapsular infarction (SC-I) and lenticulostriate infarction (LS-I). MATERIALS AND METHODS: This retrospective study was approved by the Institutional Review Board, and informed consent was waived. From July 2009 to February 2012, 145 consecutive patients with deep subcortical infarctions (SC-I, n = 81; LS-I, n = 64) who underwent HR-VWI were included in this study. The degree of MCA stenosis and the characteristics of MCA plaque (presence, eccentricity, location, extent, T2-high signal intensity [T2-HSI], and plaque enhancement) were analyzed, and compared between SC-I and LS-I, using Fisher's exact test. RESULTS: Stenosis was more severe in SC-I than in LS-I (p = 0.040). MCA plaque was more frequent in SC-I than in LS-I (p = 0.028), having larger plaque extent (p = 0.001), more T2-HSI (p = 0.001), and more plaque enhancement (p = 0.002). The eccentricity and location of the plaque showed no significant difference between the two groups. CONCLUSION: Both SC-I and LS-I have similar HR-VWI findings of the MCA plaque, but SC-I had more frequent, larger plaques with greater T2-HSI and enhancement. This suggests that HR-VWI may have a promising role in assisting the differentiation of underlying pathophysiological mechanism between SC-I and LS-I.
Cerebral Infarction* ; Constriction, Pathologic ; Ethics Committees, Research ; Humans ; Infarction ; Informed Consent ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Retrospective Studies ; Stroke
Cerebral Infarction* ; Constriction, Pathologic ; Ethics Committees, Research ; Humans ; Infarction ; Informed Consent ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Retrospective Studies ; Stroke
Korean Journal of Radiology.2017;18(6):957-963. doi:10.3348/kjr.2017.18.6.957
OBJECTIVE: Lister's tubercle is used as a standard anatomical landmark in hand surgery and arthroscopy procedures. In this study, we aimed to evaluate and propose a classification for anatomical variants of Lister's tubercle. MATERIALS AND METHODS: Between September 2011 and July 2014, 360 MRI examinations for wrists performed using 1.5T scanners in a single institution were retrospectively evaluated. The prevalence of anatomical variants of Lister's tubercle based on the heights and morphology of its radial and ulnar peaks was assessed. These were classified into three distinct types: radial peak larger than ulnar peak (Type 1), similar radial and ulnar peaks (Type 2) and ulnar peak larger than radial peak (Type 3). Each type was further divided into 2 subtypes (A and B) based on the morphology of the peaks. RESULTS: The proportions of Type 1, Type 2, and Type 3 variants in the study population were 69.2, 21.4, and 9.5%, respectively. For the subtypes, the Type 1A variant was the most common (41.4%) and conformed to the classical appearance of Lister's tubercle; whereas, Type 3A and 3B variants were rare configurations (6.4% and 3.1%, respectively) wherein the extensor pollicis longus tendon coursed along the radial aspect of Lister's tubercle. CONCLUSION: Anatomical variations of Lister's tubercle have potential clinical implications for certain pathological conditions and pre-procedural planning. The proposed classification system facilitates a better understanding of these anatomical variations and easier identification of at-risk and rare variants.
Arthroscopy ; Classification* ; Hand ; Magnetic Resonance Imaging* ; Prevalence ; Retrospective Studies ; Tendons ; Wrist
Arthroscopy ; Classification* ; Hand ; Magnetic Resonance Imaging* ; Prevalence ; Retrospective Studies ; Tendons ; Wrist
Cancer of the Anal Canal: Diagnosis, Staging and Follow-Up with MRI.
Korean Journal of Radiology.2017;18(6):946-956. doi:10.3348/kjr.2017.18.6.946
Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performant evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.
Anal Canal* ; Anus Neoplasms ; Chemoradiotherapy ; Diagnosis* ; Follow-Up Studies* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Papillomaviridae ; Rare Diseases ; Recurrence ; Risk Factors
Anal Canal* ; Anus Neoplasms ; Chemoradiotherapy ; Diagnosis* ; Follow-Up Studies* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Papillomaviridae ; Rare Diseases ; Recurrence ; Risk Factors
Post-Ischemic Bowel Stricture: CT Features in Eight Cases.
Korean Journal of Radiology.2017;18(6):936-945. doi:10.3348/kjr.2017.18.6.936
OBJECTIVE: To investigate the characteristic radiologic features of post-ischemic stricture, which can then be implemented to differentiate that specific disease from other similar bowel diseases, with an emphasis on computed tomography (CT) features. MATERIALS AND METHODS: Eight patients with a diagnosis of ischemic bowel disease, who were also diagnosed with post-ischemic stricture on the basis of clinical or pathologic findings, were included. Detailed clinical data was collected from the available electronic medical records. Two radiologists retrospectively reviewed all CT images. Pathologic findings were also analyzed. RESULTS: The mean interval between the diagnosis of ischemic bowel disease and stricture formation was 57 days. The severity of ischemic bowel disease was variable. Most post-ischemic strictures developed in the ileum (n = 5), followed by the colon (n = 2) and then the jejunum (n = 1). All colonic strictures developed in the “watershed zone.” The pathologic features of post-ischemic stricture were deep ulceration, submucosal/subserosal fibrosis and chronic transmural inflammation. The mean length of the post-ischemic stricture was 7.4 cm. All patients in this study possessed one single stricture. On contrast-enhanced CT, most strictures possessed concentric wall thickening (87.5%), with moderate enhancement (87.5%), mucosal enhancement (50%), or higher enhancement in portal phase than arterial phase (66.7%). CONCLUSION: Post-ischemic strictures develop in the ileum, jejunum and colon after an interval of several weeks. In the colonic segment, strictures mainly occur in the “watershed zone.” Typical CT findings include a single area of concentric wall thickening of medium length (mean, 7.4 cm), with moderate and higher enhancement in portal phase and vasa recta prominence.
Colon ; Constriction, Pathologic* ; Diagnosis ; Electronic Health Records ; Fibrosis ; Humans ; Ileum ; Inflammation ; Jejunum ; Retrospective Studies ; Tomography, X-Ray Computed ; Ulcer
Colon ; Constriction, Pathologic* ; Diagnosis ; Electronic Health Records ; Fibrosis ; Humans ; Ileum ; Inflammation ; Jejunum ; Retrospective Studies ; Tomography, X-Ray Computed ; Ulcer
Korean Journal of Radiology.2017;18(6):926-935. doi:10.3348/kjr.2017.18.6.926
OBJECTIVE: To assess intra- and inter-observer reproducibility of a new point shear wave elastography technique (pSWE, S-Shearwave, Samsung Medison) and compare its accuracy in assessing liver stiffness (LS) with an established pSWE technique (Virtual Touch Quantification, VTQ). MATERIALS AND METHODS: Thirty-three patients were enrolled in this Institutional Review Board-approved prospective study. LS values were measured by VTQ on an Acuson S2000 system (Siemens Healthineer) and S-Shearwave on an RS-80A (Samsung Medison) in the same session, followed by two further S-Shearwave sessions for inter- and intra-observer variation at 8-hour intervals. The technical success rate (SR) and reliability of the measurements of both pSWE techniques were compared. The intra- and inter-observer reproducibility of S-Shearwave was determined by intraclass correlation coefficients (ICCs). LS values were measured by both methods of pSWE. The diagnostic performance in severe fibrosis (F ≥ 3) and cirrhosis (F = 4) was evaluated using the receiver operating characteristics curve analysis and the Obuchowski measure with the LS values of transient elastography as the referenced standard. RESULTS: The VTQ (100%, 33/33) and S-Shearwave (96.9%, 32/33) techniques did not display a significant difference in technical SR (p = 0.63) or reliability of LS measurements (96.9%, 32/33; 93.9%, 30/32, respectively, p = 0.61). The inter- and intra-observer agreement for LS measurements using the S-Shearwave technique was excellent (ICC = 0.98 and 0.99, respectively). The mean LS values of both pSWE techniques were not significantly different and exhibited a good correlation (r = 0.78). To detect F ≥ 3 and F = 4, VTQ and S-Shearwave showed comparable diagnostic accuracy as indicated by the following outcomes: areas under receiver operating characteristics curve (AUROC) = 0.87 (95% confidence intervals [CI] 0.70–0.96), 0.89 for VTQ (95% CI 0.74–0.97), respectively; and AUROC = 0.84 (95% CI 0.67–0.94), 0.94 (95% CI 0.80–0.99) for S-Shearwave (p > 0.48), respectively. The Obuchowski measures were similarly high for S-Shearwave and VTQ (0.94 vs. 0.95). CONCLUSION: S-Shearwave shows excellent inter- and intra-observer agreement and diagnostic effectiveness comparable to VTQ in detecting LS.
Elasticity Imaging Techniques ; Fibrosis ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Observer Variation ; Prospective Studies* ; ROC Curve
Elasticity Imaging Techniques ; Fibrosis ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Observer Variation ; Prospective Studies* ; ROC Curve
Country
Republic of Korea
Publisher
The Korean Society of Radiology
ElectronicLinks
http://www.kjronline.org/Editor-in-chief
Abbreviation
Korean J Radiol
Vernacular Journal Title
ISSN
1229-6929
EISSN
2005-8330
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
2000
Description
Powered by IMICAMS(
备案号: 11010502037788, 京ICP备10218182号-8)