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RISS 인기검색어
- 검색키워드
- 저자 : Hyun-JungJang (검색결과 3 건)
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Focal Hepatic Lesions: Evaluation with Contrast-Enhanced Gray-Scale Harmonic US
Hyun-JungJang,HyoK.Lim,WonJaeLee,SeongHyunKim,MinJuKim,DongilChoi,SoonJinLee,JaeHoonLim 대한영상의학회 2003 Korean Journal of Radiology Vol.4 No.2
Objective: To determine the findings of various focal hepatic lesions at contrast- enhanced gray-scale ultrasound (US) using a coded harmonic angio (CHA) technique and emphasizing lesion characterization. Materials and Methods: The study involved 95 patients with 105 focal hepatic lesions, namely 51 hepatocellular carcinomas (HCCs), 22 metastases, 22 hemangiomas, four cases of focal nodular hyperplasia (FNH), and six nontumorous nodules. After the injection of a microbubble contrast agent (SH U 508A), gray-scale harmonic US studies using a CHA technique were performed with a combination of continuous scanning to assess the intratumoral vasculature (vascular imaging) and interval-delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed. Results: At vascular imaging, 69% of HCCs (35/51) showed irregular branching vessels, while in 91% of metastases (20/22) a peripherally stippled pattern was observed. Intratumoral vessels were absent in 95% of hemangiomas (21/22) and all nontumorous lesions (6/6), while in 75% of FNHs (3/4) a spoke-wheel pattern was evident. At acoustic emission imaging, 71% of HCCs (36/51) showed heterogeneous enhancement and 86% (19/22) of metastases showed rim- or flame-like peripheral enhancement during the early phase, with washout occurring in all HCCs and metastases (100%, 73/73) during the late phase. In hemangiomas, enhancement was either peripheral and nodular (19/22, 86%) or persistent and homogeneous (3/22, 14%), and 75% of FNHs (3/4) became isoechoic during the late phase. Conclusion: At contrast-enhanced gray-scale US using a CHA technique, a period of continuous scanning depicted the intratumoral vasculature, and intervaldelay scanning demonstrated the sequential enhancement pattern. The characteristic findings of various focal hepatic lesions were thus determined.
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Hyun-JungJang,WonJaeLee,SoonJinLee,SeungHoonKim,HyoK.Lim,JaeHoonLim 대한영상의학회 2002 Korean Journal of Radiology Vol.3 No.4
Objective: To determine the helical CT findings which help differentiate between focal eosinophilic necrosis (FEN) of the liver and metastasis in patients with underlying gastric or colorectal cancer. Materials and Methods: In 21 patients with underlying gastric and colorectal cancer examined during a recent 18-month period, the presence of FEN (n=90) was proven at CT. The diagnosis was verified by biopsy in eight patients and by the transient nature of the findings related to peripheral eosinophilia (>10%) in the remainder. For comparison, 20 consecutive patients with pathologically proven hepatic metastasis from gastric or colorectal cancer (n=158) were selected. Single-phase helical CT images (7-mm collimation, pitch 1:1) were independently analyzed in a random order by two blinded readers. The parameters evaluated included the margin (depicted border, fuzzy), shape (spherical, non-spherical), attenuation (subtle hypoattenuation, hypoattenuation), and the presence or absence of rim enhancement. Results: FEN far more frequently showed a fuzzy margin (81%, 84%), subtle hypoattenuation (89%, 91%), and a non-spherical shape (84% for both readers) than metastasis, for which the respective findings were 6%, 22%; 20%, 39%; and 15%, 23%. Rim enhancement was seldom found in FEN (0%, 2%), but was recognized by both readers in 40% of metastases. For all parameters, the results were statistically significant (p < .01), and showed that both readers correctly differentiated FEN from metastasis in 78% of the patients (32/41). Interobserver agreement was, in addition, excellent (к= 0.66). Conclusion: When focal hepatic lesions with a fuzzy margin, non-spherical shape and subtle hypoattenuation without rim enhancement are found, the possibility of FEN should be considered even in patients with underlying gastrointestinal malignancy.
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SeungHoonKim,DongilChoi,JaeHoonLim,WonJaeLee,Hyun-JungJang,HyoKeunLim,SoonJinLee,JaeMinCho,SeungKwonKim,GabChulKim 대한영상의학회 2002 Korean Journal of Radiology Vol.3 No.2
Objective: To identify the optimal pulse sequence for ferumoxides-enhanced magnetic resonance (MR) imaging in the detection of hepatocelluar carcinomas (HCCs). Materials and Methods: Sixteen patients with 25 HCCs underwent MR imaging following intravenous infusion of ferumoxides. All MR studies were performed on a 1.5-T MR system, using a phased-array coil. Ferumoxides (Feridex IV) at a dose of 15 mol/Kg was slowly infused intravenously, and axial images of seven sequences were obtained 30 minutes after the end of infusion. The MR protocol included fast spin-echo (FSE) with two echo times (TR3333 8571/TE18 and 90-117), singleshot FSE (SSFSE) with two echo times (TR /TE39 and 98), T2*-weighted gradient-recalled acquisition in the steady state (GRASS) (TR216/TE20), T2*-weighted fast multiplanar GRASS (FMPGR) (TR130/TE8.4 9.5), and T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR) (TR130/TE8.4 9.5). Contrast-to-noise ratios (CNRs) of HCCs determined during the imaging sequences formed the basis of quantitative analysis, and images were qualitatively assessed in terms of lesion conspicuity and image artifacts. The diagnostic accuracy of all sequences was assessed using receiver operating characteristic (ROC) analysis. Results: Quantitative analysis revealed that the CNRs of T2*-weighted FMPGR and T2*-weighted FMPSPGR were significantly higher than those of the other sequences, while qualitative analysis showed that image artifacts were prominent at T2*-weighted GRASS imaging. Lesion conspicuity was statistically significantly less clear at SSFSE imaging. In term of lesion detection, T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE imaging were statistically superior to the others. Conclusion: T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE appear to be the optimal pulse sequences for ferumoxidesenhanced MR imaging in the detection of HCCs.
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