Imaging of a Marjolin’s Ulcer: A Case Report

차장규,유재호,김희경,백상현,홍현숙,이혜경 대한영상의학회 2011 대한영상의학회지 Vol.64 No.6

A Marjolin’s ulcer refers to malignancies that developed in chronic venous ulcers, scars, or sinuses. We report three-dimensional computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT findings in a patient who developed skin cancer from a chronic leg ulcer. Although rare, on MR, a Marjolin’s ulcer should be considered when a well-enhanced soft-tissue mass with a broad based skin ulcer shows a mass effect and invasion of the adjacent bone. CT angiography and PET-CT complement MRI for evaluating the nature of Marjolin’s ulcers and may provide essential anatomical information, enabling the physician to design the optimal surgical approach or determining cancer staging. A Marjolin’s ulcer는 만성 정맥성 궤양, 흉터, 동(sinus)에서 발생한 악성 종양을 말한다. 저자들은 만성 하지 궤양에 발생한 피부암 환자의 3차원 CT, MR, PET-CT 소견을 보고한다. A Marjolin’s ulcer는 드물지만, 조영증강을 보이는 연부조직 종괴가 피부 궤양에 넓은 기저부를 형성하고 종괴 효과를 보이면서 궤양성 골종을 침범했을 경우 A Marjolin’s ulcer를 의심해야 한다. CT angiography와 PET-CT 영상을 통해서 A Marjolin’s ulcer의 특성을 평가하는데 MR영상을 보완할 수 있었고 필수적인 해부학적 정보를 제공 함으로써 효과적인 외과적 계획 수립과 종양의 병기 결정을 도움을 줄 수 있었다.

Practical Application of Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-Squares Estimation (IDEAL) Imaging in Minimizing Metallic Artifacts

차장규,홍현숙,박재성,백상현,이혜경 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.3

Iterative decomposition of water and fat with echo asymmetry and the least-squares estimation (IDEAL) is a recently developed method for robust separation of fat and water with very high signal-to-noise-ratio (SNR) efficiency. In contrast to conventional fat-saturation methods, IDEAL is insensitive to magnetic field (B0 and B1) inhomogeneity. The aim of this study was to illustrate the practical application of the IDEAL technique in reducing metallic artifacts in postoperative patients with metallic hardware. The IDEAL technique can help musculoskeletal radiologists make an accurate diagnosis particularly in musculoskeletal imaging by reducing metallic artifacts, enabling the use of contrast enhancement, improving SNR performance, and providing various modes of MR images with one scan parameter.

Comparison of MRI T2 Relaxation Changes of Knee Articular Cartilage before and after Running between Young and Old Amateur Athletes

차장규,이재철,김현주,한종규,이은혜,김용대,전찬홍 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.5

Objective: To compare changes in T2 relaxation on magnetic resonance (MR) images of knee articular cartilage in younger and older amateur athletes before and after running. Materials and Methods: By using a 3.0-T MR imager, quantitative T2 maps of weight-bearing femoral and tibial articular cartilages in 10 younger and 10 older amateur athletes were acquired before, immediately after, and 2 hours after 30 minutes of running. Changes in global cartilage T2 signals of the medial and lateral condyles of the femur and tibia and regional cartilage T2 signals in the medial condyles of femoral and tibia in response to exercise were compared between the two age groups. Results: Changes in global cartilage T2 values after running did not differ significantly between the age groups. In terms of the depth variation, relatively higher T2 values in the older group than in the younger group were observed mainly in the superficial layers of the femoral and tibial cartilage (p < 0.05). Conclusion: Age-related cartilage changes may occur mainly in the superficial layer of cartilage where collagen matrix degeneration is primarily initiated. However, no trend is observed regarding a global T2 changes between the younger and older age groups in response to exercise.

소용돌이 징후:난소 염전의 영상 소견

차장규 대한영상의학회 1997 대한영상의학회지 Vol.36 No.3

Vertebra Plana Caused by a Giant Cell Tumor: A Case Report and Literature Review

차장규,신원한,박관웅,김희경,박재성,이혜경 대한영상의학회 2010 대한영상의학회지 Vol.62 No.6

We report here on the case of a 19-year-old woman who presented with progressive weakness of the lower extremities. The radiographs and CT showed vertebra plana of the first thoracic vertebral body. The mass had low signal intensity on the T1-weighted MR image and intermediate signal intensity on the T2-weighted MR image, and this low signal intensity extended to the spinal canal. Histological examination revealed a giant cell tumor (GCT). MR imaging is the imaging modality of choice for helping to distinguish spinal GCT from other spinal tumors by defining the extent and characteristic signal intensity of the tumor.

Postmortem CT in major skeletal injury: The mechanism leading to death

차장규 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2

Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

차장규,김동훈,김대호,백상현,박재성,박성진,이혜경,홍현숙,최득린,양경무,정낙은,이봉우,서중석 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.4

Objective: We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Materials and Methods: Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Results: Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. Conclusion: A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations. Objective: We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Materials and Methods: Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Results: Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. Conclusion: A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations.

수근관 증후군에서 내시경 횡수근 인대 유리술 전 후 고해상 초음파 촬영술: 초음파 소견과 수술 결과의 비교 연구

차장규,임수빈,석현,이범하,진욱,최나미,이혜경 대한초음파의학회 2008 ULTRASONOGRAPHY Vol.27 No.1

목적 : 이 논문의 목적은 고해상도 초음파를 이용하여 내시경적 횡수근 인대 유리술 전과 시행후 의 환자의 정중신경의 형태학적 변화를 평가하고 초음파 소견과 수술 결과의 연관성을 알아보고자 함이다. 대상 및 방법 : 임상적, 전기생리학적 검사로 확인된 30명의 수근관 증후군 환자를 대상으로 수술 전과 수술 후에 7-15 Hz 탐촉자가 장착된 초음파 기기로 원위 요척골 부위, 근위 수근관과 원위 수근관등 3부위에 정중신경의 단면적, 팽윤비, 편평도를 측정하였다. 결과 : 원위 요척골에서 정중 신경의 면적은 수술 전 0.13 ± 0.03 cm2 에서 수술 후 0.11 ± 0.03cm2 로 감소하였고 근위 수근관 부위에서는 0.17 ± 0.07 cm2 에서 0.14 ± 0.05 cm2 로 각각 통계학적으로 의미 있게 감소하였다. 정중신경의 형태학적 변화와 증상 개선과는 연관관계가 없었다. 결론 : 본 연구에서는 고해상도의 초음파 영상을 이용하여 내시경 수근관 유리술을 받은 환자에서 원위 요척골 정중신경 및 근위 수근관 정중신경의 종창의 감소를 확인하였다. 수술 후의 정중 신경의 종창 감소와 환자의 증상 변화의 유의한 연관 관계는 없는 것으로 나타났다. 그렇지만 앞으로 더 많은 환자를 대상으로 장기간에 걸친 반복적 측정을 통해 정확한 상관 관 PURPOSE : The aim of this study is to evaluate morphological changes of the medial nerve in patients with carpal tunnel syndrome (CTS) before and after endoscopic release of the transverse carpal ligament, and to correlate the ultrasonography (US) findings with the use of high resolution US and the surgical outcome for the median nerve. MATERIALS and METHODS : Thirty patients with CTS confirmed by a clinical and electrophysiological study underwent high resolution US. The US instrumentation was equipped with a high frequency linear transducer to measure the cross sectional area, flattening ratio and swelling ratio of the medial nerve at the distal radioulnar joint,proximal and distal carpal tunnel before and three months after surgery. RESULTS : The cross sectional area (CSA) of the median nerve at the distal radioulnar level showed a decrease from 0.13 ± 0.03 cm2 before surgery to 0.11 ± 0.03 cm2 after surgery, and the CSA of the proximal carpal tunnel showed a decrease from 0.17 ± 0.07 cm2 to 0.14 ± 0.05 cm2; these differences were statistically significant. There was no statistically significant correlation between the morphological change and symptom improvement. CONCLUSION : This study confirmed a decreasing CSA of the medial nerve at the distal radioulnar and proximal carpal tunnel in a postoperative patient with CTS, as determined by the use of high resolution US. No association was found between a change in the CSA of the median nerve and symptom improvement. A further study based on multiple measurements of the median nerve with a longer period is necessary to establish the associa association between a change in the CSA of the median nerve and symptom improvement.

Chronic-Contained Rupture of an Isolated Internal Iliac Arterial Aneurysm: A Case Report

차장규,최나미,이범하,이종세,김대호,박성일 대한영상의학회 2008 대한영상의학회지 Vol.58 No.6

We describe here a 57-year-old woman with a chronic-contained rupture of an internal iliac arterial aneurysm, and this was eroding the sacral neural foramen. Although an isolated internal iliac arterial aneurysm is known to be rare, the ruptured internal iliac arterial aneurysm was diagnosed based on the characteristic radiolgic findings with performing color Doppler ultrasound, MRI and multi-slice computed tomography. The ruptured aneurysm was successfully treated by coil embolization. Color Doppler US, MRI and multi-slice CT are useful for evaluating a mass of a vascular origin that involves the neural foramen.

Generalized Lymphangiomatosis: A Case Report

차장규,박재성,백상현,김희경 대한자기공명의과학회 2009 Investigative Magnetic Resonance Imaging Vol.13 No.2

Generalized lymphangiomatosis is a rare congenital malformation of the lymphatics. CT and MR scan have been used to evaluate lymphangiomas, which appear as large multicystic fluid-filled masses. CT and MR Imaging findings are often helpful in distinguishing lymphangiomas from various vascular disorders. We report the findings of CT, MRI and bone scan in a patient with generalized cystic lymphangiomatosis. Whole body 3.0-T MR scan using STIR sequence with a larger FOV could detect the additional lesions that were not seen at other imaging modalities. We believe that whole body 3.0 T MR imaging is a good modality to evaluate the extent of the disease and following up the patients with the generalized cystic lymphangiomatosis.