Hashimoto’s Encephalopathy with Unusual MRI Findings Mimicking Meningoencephalitis: A Case Report and Literature Review

서희붐,김현석,김학진 대한영상의학회 2020 대한영상의학회지 Vol.81 No.2

Hashimoto’s encephalopathy (HE) is a rare autoimmune disease characterized by a high serum concentration of antithyroid antibodies without evidence of cerebral disease. Magnetic resonance imaging (MRI) findings in HE patients are nonspecific, although diffuse or focal white matter changes have been reported in several cases. We present a rare case involving a 79-yearold woman with elevated antithyroid antibody levels and abnormal imaging findings similar to meningoencephalitis. Serial MRI initially showed multiple T2 hyperintense lesions with diffuse leptomeningeal enhancement that disappeared after steroid therapy.

충수돌기의 신경내분비종양과 동반된 점액성 종양: 증례 보고

서희붐,이남경,김석,박원영,김재훈 대한영상의학회 2014 대한영상의학회지 Vol.70 No.5

Primary neoplasm of the appendix is an uncommon pathology, representing 0.5--1% of all appendix specimens. Especially, simultaneous occurrence of two tumors of the appendix was rarely documented. We report a case of the concomitant neuroendocrine tumor and the mucinous neoplasm of the appendix on abdominal computed tomography, in a 62-year-old female who came for a check-up. 충수돌기에 발생하는 원발성 종양은 충수 표본의 약 0.5~1.0%에서 발견되는 드문 질환이다. 특히, 충수돌기에 두 가지의 종양이 동시에 발생하는 경우는 매우 드문 것으로 알려져 있다. 저자들은 62세 여성이 건강검진을 위해 촬영한 복부 전산화단층촬영에서 충수돌기에 신경내분비종양과 동반된 충수돌기 점액성 종양이 진단되었던 예를 보고하고자 한다.

이하선 병변에서 활경근 침윤의 빈도와 조건

서희붐,김학진 대한영상의학회 2021 대한영상의학회지 Vol.82 No.1

Purpose To evaluate the incidence and condition of platysma infiltration in benign tumors, malignant tumors, and inflammatory disease in the parotid gland using CT or MRI. Materials and Methods Patients with benign tumors (n = 314), malignant tumors (n = 52), and inflammatory disease (n = 22) in the parotid gland were included. The incidence of platysma infiltration and the relationship between platysma infiltration and the location, capsular involvement, and focality of the mass were retrospectively evaluated using CT or MRI. Results The incidence of platysma infiltration was 0% in benign tumors,19.2% in malignant tumors (10/52), and 50.0% in inflammation (11/22). Platysma infiltration was positive in 10 of 13 patients with inflammatory lesion with capsular involvement. Platysmal infiltrations in inflammatory lesion showed diffuse lesion in 10 patients and focal lesion in one patient. Malignant tumor with platysmal infiltration showed all capsular involvement, and diffuse lesion in seven and focal lesion in three. Conclusion Platysma infiltration was more common in patients with inflammatory disease than those with malignant tumors or benign tumors. In inflammatory disease, platysma infiltration was more common in patients with capsular involvement or diffuse lesion. 목적 CT나 MRI에서 이하선의 양성종양, 악성종양 및 염증 질환에서 나타나는 활경근 침윤의빈도와 어떤 상황에서 잘 일어나는지 그 조건을 알아보고자 하였다. 대상과 방법 이하선에서 발생한 양성종양 314명, 악성종양 52명 그리고 염증 22명을 대상으로하였다. CT나 MRI에서 활경근 침윤의 빈도 및 병변의 위치, 피막침범 유무, 국소성에 따른활경근 침윤 유무를 후향적으로 알아보았다. 결과 활경근 침윤의 빈도는 양성종양에서 0%, 악성종양에서 19.2% (10/52), 염증 환자에서50% (11/22)였다. 피막을 침범한 염증 환자 13명 중 10명에서 활경근 침윤을 보였다. 활경근침윤을 보인 염증 환자 11명 중 10명이 미만성을, 1명은 국소성을 보였다. 활경근 침윤을 보인 악성종양 총 10명 모두에서 피막을 침범하였으며, 그중 미만성 병변이 7명, 국소성이 3명이었다. 결론 이하선 질환에서 활경근 침윤은 악성종양보다 염증 질환에서 더 흔하게 일어났다. 염증질환에서의 활경근 침윤은 이하선 피막을 침범하거나 미만성 병변일 경우 더 잘 나타났다.

Magnetic Resonance Imaging Findings of Early Spondylodiscitis: Interpretive Challenges and Atypical Findings

염정아,이인숙,서희붐,송유선,송종운 대한영상의학회 2016 Korean Journal of Radiology Vol.17 No.5

MR findings of early infectious spondylodiscitis are non-specific and may be confused with those of other conditions. Therefore, it is important to recognize early MR signs of conditions, such as inappreciable cortical changes in endplates, confusing marrow signal intensities of vertebral bodies, and inflammatory changes in paraspinal soft tissues, and subligamentous and epidural spaces. In addition, appreciation of direct inoculation, such as in iatrogenic spondylodiscitis may be important, because the proportion of patients who have undergone recent spine surgery or a spinal procedure is increasing. In this review, the authors focus on the MR findings of early spondylodiscitis, atypical findings of iatrogenic infection, and the differentiation between spondylodiscitis and other disease entities mimicking infection.

Cystic Neck Mass in an Adult: Unusual Manifestation of a Mediastinal Mature Teratoma

이유진,정연주,서희붐,김학진,이병주,이호석,노지은,염정아 대한영상의학회 2018 대한영상의학회지 Vol.79 No.3

Anterior mediastinal teratomas are congenital tumors containing derivatives of all three germ layers. They usually grow slowly and are often detected incidentally by imaging studies. We describe the case of a 38-year-old man with an anterior mediastinal teratoma extending to the anterior neck, which resulted in a cystic neck mass.

Study of the Efficacy of PET/CT in Lung Aspiration Biopsy and Factors Associated with False-Negative Results

손일완,이지원,정연주,김아롱,서희붐,이지원 대한영상의학회 2018 대한영상의학회지 Vol.79 No.3

Purpose: We compared the outcomes of percutaneous transthoracic needle aspiration biopsy (PCNA) of lung masses in cases with and without prior positron emission tomography/ computed tomography (PET/CT) information, and investigated the factors associated with false-negative pathological results. Materials and Methods: From a total of 291 patients, 161 underwent PCNA without prior PET/CT imaging, while 130 underwent PET/CT before PCNA. Clinical characteristics, procedural variables, pathological results, and diagnostic success rates were compared between the 2 groups. Among patients with initial negative (non-specific benign) PCNA results, the radiological findings of these groups were compared to evaluate the predictors of false-negative lesions. Results: No significant difference was found in the clinical characteristics, procedural characteristics, and pathological results of the 2 groups, nor was the diagnostic rate significantly different between them (p = 0.818). Among patients with initial negative PCNA results, radiological characteristics were similar in both the groups. In multivariate analysis, the presence of necrosis (p = 0.005) and ground-glass opacity (GGO) (p = 0.011) were the significant characteristics that indicated an increased probability of initial false-negative results in PCNA. Conclusion: Routine PET/CT did not have any additional benefit in patients undergoing PCNA of lung masses. The presence of necrosis or GGO could indicate an increased probability of false-negative pathological results.

안장 위 수막종의 시신경 침범 환자에서 나타난자발적인 시력회복 1예

김동선(Dong Seon Kim),문상우(Sang Woo Moon),서희붐(Hie Bum Suh),전혜신(Hyeshin Jeon),최희영(Hee-Young Choi) 대한안과학회 2021 대한안과학회지 Vol.62 No.3

목적: 안장 위 수막종과 연관된 시력저하가 자연 호전된 증례를 보고하고자 한다. 증례요약: 55세 여자 환자가 1주일 전 시작된 시야장애를 주소로 내원하였다. 두통 및 안구통이 동반되어 있었다. 우안의 시력은 0.1로 감소되어 있었고, 이측 및 하측의 시야결손이 관찰되었다. 우안의 상대구심동공이상이 있었다. 안와 자기공명영상에서 우측 접형골융기 부위의 바닥면에 넓은 종괴가 발견되었으며 균일한 조영증강을 보였다. 수막종에 가장 합당한 소견으로 생각되어 신경외과로 의뢰하였다. 환자가 거부하여 수술은 시행하지 않았으며, 1개월 후 우안의 시력은 0.5로 호전되었으며, 6개월 이후까지 호전된 시력을 유지하였다. 결론: 수막종과 연관된 시력저하가 자발적으로 호전될 수 있으므로 진단 및 치료 결정에 이를 염두에 두어야 한다. Purpose: To report a case of spontaneously improved visual acuity in a patient with suprasellar meningioma. Case summary: A 55-year-old female presented with decreased visual acuity for 1 week. She had chronic headache and ocular pain. Her visual acuity of the right eye was 0.1 and temporal and inferior visual field defects were found. Relative afferent pupillary defect was observed in the right eye. On orbital magnetic resonance image, a homogenous enhancing mass with a broad dural base at the jugum sphenoidale was found. This was likely to represent a meningioma and was referred to neurosurgery. The patient refused the surgery and did not receive any treatment. After 1 month, the visual acuity of the right eye improved to 0.5. The improved vision remained until 6 months later. Conclusions: Visual loss associated with meningioma can spontaneously improve and this should be considered when making diagnostic and treatment decisions for meningioma.