1.Clinical and Imaging Features of a Focal Intrahepatic Biliary Stricture Visualized Only as Duct Dilatation
Byoung Je KIM ; Min Seong KIM ; Mi Jeong KIM ; Jae Hyuck YI ; Jin Hyuk PAEK ; Hye Won LEE ; Chan Hee PARK ; Gisu LEE ; Koo Jeong KANG
Journal of the Korean Society of Radiology 2024;85(6):1157-1168
Purpose:
We assessed the proportion of patients with a focal intrahepatic stricture (FIHS) that was a precursor lesion or malignancy and visualized only as a duct dilatation.
Materials and Methods:
This retrospective study assessed patients who underwent surgery or biopsy for an FIHS on CT or MRI between January 2010 and March 2022. The number and proportion of non-precursor benign lesions, precursors, and malignancies were calculated.Clinical variables and imaging features were compared between non-premalignant benign and premalignant/malignant FIHSs.
Results:
Twenty-eight patients with confirmed histopathological diagnoses were identified, including 15 men (54.0%) and 13 women (46.0%). The median age of all patients at the first imaging diagnosis was 65 ± 9.54 (range, 43–78) years. Of the 28 patients with FIHSs, 9 (32%) were diagnosed with cholangiocarcinoma and 7 (25%) were diagnosed with precursor lesions, which included six intraductal papillary neoplasms of the bile duct and one biliary intraepithelial neoplasm. Accordingly, 16 (57%) patients had malignant or precursor lesions, and 12 (43%) were diagnosed with non-precursor benign lesions. None of the clinical variables and imaging features used for analysis showed a statistically significant difference between the non-premalignant benign and premalignant/malignant FIHS groups (p > 0.05).
Conclusion
FIHSs visualized only as duct dilatation can harbor malignant or precursor lesions.
2.Unusual Imaging Findings of Epithelioid Hemangioma:Case Report of Single Intramedullary Sclerotic Bone Lesion
Yun Chul HWANG ; Tae Eun KIM ; Jae Hyuck YI
Journal of the Korean Society of Radiology 2024;85(5):986-991
Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH.
3.Clinical and Imaging Features of a Focal Intrahepatic Biliary Stricture Visualized Only as Duct Dilatation
Byoung Je KIM ; Min Seong KIM ; Mi Jeong KIM ; Jae Hyuck YI ; Jin Hyuk PAEK ; Hye Won LEE ; Chan Hee PARK ; Gisu LEE ; Koo Jeong KANG
Journal of the Korean Society of Radiology 2024;85(6):1157-1168
Purpose:
We assessed the proportion of patients with a focal intrahepatic stricture (FIHS) that was a precursor lesion or malignancy and visualized only as a duct dilatation.
Materials and Methods:
This retrospective study assessed patients who underwent surgery or biopsy for an FIHS on CT or MRI between January 2010 and March 2022. The number and proportion of non-precursor benign lesions, precursors, and malignancies were calculated.Clinical variables and imaging features were compared between non-premalignant benign and premalignant/malignant FIHSs.
Results:
Twenty-eight patients with confirmed histopathological diagnoses were identified, including 15 men (54.0%) and 13 women (46.0%). The median age of all patients at the first imaging diagnosis was 65 ± 9.54 (range, 43–78) years. Of the 28 patients with FIHSs, 9 (32%) were diagnosed with cholangiocarcinoma and 7 (25%) were diagnosed with precursor lesions, which included six intraductal papillary neoplasms of the bile duct and one biliary intraepithelial neoplasm. Accordingly, 16 (57%) patients had malignant or precursor lesions, and 12 (43%) were diagnosed with non-precursor benign lesions. None of the clinical variables and imaging features used for analysis showed a statistically significant difference between the non-premalignant benign and premalignant/malignant FIHS groups (p > 0.05).
Conclusion
FIHSs visualized only as duct dilatation can harbor malignant or precursor lesions.
4.Unusual Imaging Findings of Epithelioid Hemangioma:Case Report of Single Intramedullary Sclerotic Bone Lesion
Yun Chul HWANG ; Tae Eun KIM ; Jae Hyuck YI
Journal of the Korean Society of Radiology 2024;85(5):986-991
Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH.
5.Clinical and Imaging Features of a Focal Intrahepatic Biliary Stricture Visualized Only as Duct Dilatation
Byoung Je KIM ; Min Seong KIM ; Mi Jeong KIM ; Jae Hyuck YI ; Jin Hyuk PAEK ; Hye Won LEE ; Chan Hee PARK ; Gisu LEE ; Koo Jeong KANG
Journal of the Korean Society of Radiology 2024;85(6):1157-1168
Purpose:
We assessed the proportion of patients with a focal intrahepatic stricture (FIHS) that was a precursor lesion or malignancy and visualized only as a duct dilatation.
Materials and Methods:
This retrospective study assessed patients who underwent surgery or biopsy for an FIHS on CT or MRI between January 2010 and March 2022. The number and proportion of non-precursor benign lesions, precursors, and malignancies were calculated.Clinical variables and imaging features were compared between non-premalignant benign and premalignant/malignant FIHSs.
Results:
Twenty-eight patients with confirmed histopathological diagnoses were identified, including 15 men (54.0%) and 13 women (46.0%). The median age of all patients at the first imaging diagnosis was 65 ± 9.54 (range, 43–78) years. Of the 28 patients with FIHSs, 9 (32%) were diagnosed with cholangiocarcinoma and 7 (25%) were diagnosed with precursor lesions, which included six intraductal papillary neoplasms of the bile duct and one biliary intraepithelial neoplasm. Accordingly, 16 (57%) patients had malignant or precursor lesions, and 12 (43%) were diagnosed with non-precursor benign lesions. None of the clinical variables and imaging features used for analysis showed a statistically significant difference between the non-premalignant benign and premalignant/malignant FIHS groups (p > 0.05).
Conclusion
FIHSs visualized only as duct dilatation can harbor malignant or precursor lesions.
6.Unusual Imaging Findings of Epithelioid Hemangioma:Case Report of Single Intramedullary Sclerotic Bone Lesion
Yun Chul HWANG ; Tae Eun KIM ; Jae Hyuck YI
Journal of the Korean Society of Radiology 2024;85(5):986-991
Epithelioid hemangioma (EH) is an uncommon, benign vascular tumor of mesenchymal origin. It mainly presents as a tumor with a lytic appearance and septations. However, no case reports have documented the predominantly sclerotic appearance of EH. Here, we present the imaging findings, including X-ray, CT, MRI, and histopathological findings of a 24-year-old female with EH.
7.Validation and modification of HEART score components for patients with chest pain in the emergency department
Min Jae KIM ; Sang Ook HA ; Young Sun PARK ; Jeong Hyeon YI ; Won Seok YANG ; Jin Hyuck KIM
Clinical and Experimental Emergency Medicine 2021;8(4):279-288
Objective:
This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score.
Methods:
This study evaluated the HEART score components for patients with chest symptoms visiting the emergency department from November 19, 2018 to November 19, 2019. All components were evaluated using logistic regression analysis and the scores for HEART, mHEART, and Thrombolysis in Myocardial Infarction (TIMI) were determined using the receiver operating characteristics curve.
Results:
The patients were divided into a derivation (809 patients) and a validation group (298 patients). In multivariate analysis, age did not show statistical significance in the detection of MACE within 3 months and the mHEART score was calculated after omitting the age component. The areas under the receiver operating characteristics curves for HEART, mHEART and TIMI scores in the prediction of MACE within 3 months were 0.88, 0.91, and 0.83, respectively, in the derivation group; and 0.88, 0.91, and 0.81, respectively, in the validation group. When the cutoff value for each scoring system was determined for the maintenance of a negative predictive value for a MACE rate >99%, the mHEART score showed the highest sensitivity, specificity, positive predictive value, and negative predictive value (97.4%, 54.2%, 23.7%, and 99.3%, respectively).
Conclusion
Our study showed that the mHEART score better detects short-term MACE in high-risk patients and ensures the safe disposition of low-risk patients than the HEART and TIMI scores.
8.Comparative Analysis of Image Quality and Adverse Events between Iopamidol 250 and Ioversol 320 in Hepatic Angiography for Transcatheter Arterial Chemoembolization
Min Jae GU ; Jae Hyuck YI ; Young Hwan KIM ; Hee Jung LEE ; Ung Rae KANG ; Seung Woo JI
Journal of the Korean Radiological Society 2020;81(1):166-175
PURPOSE:
This study aimed to compare the image quality and adverse events between Iopamidol 250 and Ioversol 320 usage during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
MATERIALS AND METHODS:
Medical records and hepatic angiography from 113 patients who underwent TACE with Iopamidol 250 (44 patients) and Ioversol 320 (69 patients) were retrospectively reviewed. Vessel perception on hepatic angiography was graded into three categories by two radiologists for hepatic subsegmental arteries, the right gastroepiploic artery, right gastric artery, and pancreaticoduodenal artery. Imaging concordance was assessed by comparing the number of detected HCCs on hepatic angiography and CT. The adverse events before and after hepatic angiography were evaluated.
RESULTS:
The mean vessel perception scores were 2.92 and 2.94 for Iopamidol 250 and Ioversol 320, respectively. The imaging concordance was 31 (70.5%) and 46 (66.7%) patients for Iopamidol 250 and Ioversol 320, respectively. There were no statistical differences in vessel perception or imaging concordance (p > 0.05). One and six patients experienced nausea for Iopamidol 250 and Ioversol 320, respectively. There was no statistical difference in adverse events (p = 0.24).
CONCLUSION
Iopamidol 250 can be used in hepatic angiography for TACE without significant difference in image quality or occurrence of adverse events from Ioversol 320.
9.Clinically Occult Diffuse Large B-Cell Lymphoma of the Middle Turbinate Identified Using ¹â¸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Case Report
Dong Hyeon KIM ; Sang Kwon LEE ; Mi Jeong KIM ; Jae Hyuck YI ; Mi Sun CHOI
Journal of the Korean Radiological Society 2019;80(3):548-554
We report a case of clinically occult diffuse large B-cell lymphoma (DLBCL) of the middle turbinate (MT) identified by ¹â¸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹â¸F-FDG PET/CT) in a 71-year-old man along with imaging findings. DLBCL was presented with a hypermetabolic right MT [maximum standardized uptake values (SUV(max)) = 8.8 gm/dL] on ¹â¸F-FDG PET/CT, while rhinologic examination was normal. CT showed nothing but slightly more intense enhancement of the right MT compared with the opposite side. The disease progressed during next 7 months until follow-up CT demonstrated solidly enhancing mass occupying entire right nasal cavity which was intensely hypermetabolic (SUV(max) = 12.8 gm/dL). Surgical biopsy confirmed the diagnosis. Follow-up CT and 18F-FDG PET/CT performed after chemotherapy demonstrated complete resolution of DLBCL of the right nasal cavity including the right MT. This is thought to be the first case report in the literature concerning clinically occult DLBCL presenting as a hypermetabolic MT on ¹â¸F-FDG PET/CT.
10.Soft Tissue Metastasis in Patients with Primary Malignancies; Magnetic Resonance Imaging and Clinical Evaluations
So Min PARK ; In Sook LEE ; You Seon SONG ; Shin Young PARK ; Hoseok LEE ; Jae Hyuck YI ; Jong Woon SONG
Journal of the Korean Radiological Society 2018;78(5):321-329
PURPOSE:
The purpose of this study was to evaluate the clinical and magnetic resonance imaging (MRI) findings of soft tissue metastases distinct from benign soft tissue lesions.
MATERIALS AND METHODS:
We retrospectively analyzed the MRI findings of soft tissue lesions found incidentally in patients with primary carcinoma and those without primary carcinoma from 2002–2015. To evaluate the features of soft tissue metastases distinct from benign soft tissue lesions, patients with benign soft tissue lesions were randomly selected and statistically analyzed for the distinctive features of the two groups.
RESULTS:
A total of 47 patients (mean age 46.2 years) and 36 controls (mean age 46.2 years) were enrolled. Thirty six of the 47 patients were diagnosed with soft tissue metastasis, most commonly as the primary cancer (31%). The most common site of soft tissue metastasis was the lower extremities (36%) followed by the upper extremities (31%). Soft tissue metastasis was statistically significantly different from benign soft tissue lesions according to patient age, lesion size, margin, presence of degenerative changes in lesions, and presence of edema around the mass.
CONCLUSION
If the incident soft tissue lesion shows malignant features on MRI in patients with primary carcinoma or in patients over 40 years of age, the radiologist should consider the possibility of metastatic cancer.

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