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Hyun Cheol Kim

Publications and source records attributed to Hyun Cheol Kim.

9 recordsLinked to original sources
PubMed2006

Altered findings of hepatic arteriography after radiofrequency ablation of hepatocellular carcinoma: comparison of pre-ablation and post-ablation angiograms.

OBJECTIVE: To evaluate the altered findings of hepatic arteriography after radiofrequency (RF) ablation of hepatocellular carcinoma which can potentially influence subsequent transcatheter arterial chemoembolization. MATERIALS AND METHODS: Hepatic arteriograms of 26 index hepatocellular carcinomas in 24 patients treated only by RF ablation (M:F = 22:2, mean age 55 years), in which hepatic arteriography was performed before and after RF ablation, were retrospectively compared for the altered findings. RESULTS: The altered findings of hepatic arteriography after RF ablation of the hepatocellular carcinoma were arterio-portal shunt (n = 3), periablational enhancement (n = 5), varied caliber of the feeding artery to the index tumor (n = 12) among which eight decreased, and occlusion of an adjacent arterial branch (n = 8). Residual unablated or locally progressed tumor was not detected in post-RF ablation arteriography (n = 5) due to the arterio-portal shunt (n = 2) or the periablational enhancement (n = 3). The possibility of not detecting the residual unablated or locally progressed tumor was higher within 24 weeks after RF ablation (Mann-Whitney test, P = 0.041). CONCLUSION: The findings of hepatic arteriography are altered after RF ablation, and the altered findings may increase the difficulty in performing super-selective transcatheter arterial chemoembolization due to undetected tumor staining, decreased caliber, or occlusion of the feeding artery.

Adult↗
PubMed2006

Diagnostic values of sonography for assessment of sternal fractures compared with conventional radiography and bone scans.

OBJECTIVE: This study was prospectively undertaken to evaluate the diagnostic value of sonography for detection of sternal fractures. We compared sonographic, conventional radiographic, and bone scan examinations of sternal fractures. METHODS: Fifty consecutive patients (26 male and 24 female; mean age, 45.2 years) were evaluated. Conventional radiography and sonography were performed in all patients, and bone scans were performed in 39 patients. All patients had acute pain and tenderness in anterior midline chest areas. Sonography was performed by 2 musculoskeletal radiologists within 1 to 2 days after admission. Patients underwent conventional radiography at admission and bone scans within 4 to 7 days after admission. Two radiologists reviewed all imaging findings by means of consensus. In addition, sonography was performed in 20 asymptomatic patients in a normal control group. RESULTS: Conventional radiography depicted sternal fractures in 12 of 50 patients. Sternal fractures were detected in 31 of 50 patients on sonography. Fractures on sonography were located in the manubrium (8 cases), upper sternal body (11 cases), mid sternal body (5 cases), and lower sternal body (7 cases). Bone scans showed sternal hot uptakes (accumulations of the radionuclide used) in 18 of 39 patients. In the control group, there were no bony defects or abnormal contours. CONCLUSIONS: We could detect sternal fractures more effectively with sonography than with conventional radiography and bone scans. In addition, sternal fracture locations showed relatively even distributions, and focal fractures in the manubrium were not easily detected on bone scans.

Adolescent↗
PubMed2006

Assessment of the therapeutic response of hepatocellular carcinoma treated with transcatheter arterial chemoembolization: comparison of contrast-enhanced sonography and 3-phase computed tomography.

OBJECTIVE: The purpose of this study was to compare contrast-enhanced sonography with 3-phase computed tomography (CT) in assessing the therapeutic response of hepatocellular carcinomas (HCCs) treated with transcatheter arterial chemoembolization (TACE). METHODS: Twenty-nine nodular HCCs treated with TACE were examined with contrast-enhanced sonography, 3-phase helical CT, and conventional angiography. Contrast-enhanced sonographic and CT findings were interpreted separately and prospectively for the presence or absence of contrast enhancement in the treated HCCs. Conventional angiography served as the reference standard. RESULTS: Intratumoral enhancement was seen in 19 HCCs (61%) on contrast-enhanced sonography and 12 HCCs (39%) on CT. Enhancement patterns on sonography were blush in 8 (42%), branching in 2 (11%), nodular in 4 (21%), and stippled in 5 (26%). Of the 19 HCCs with intratumoral enhancement on contrast-enhanced sonography, 13 (68%) showed tumor staining on angiography. Of the 12 HCCs without intratumoral enhancement on sonography, 1 (8%) showed tumor staining on angiography. The sensitivity and specificity of contrast-enhanced sonography in depicting flow in HCCs treated with TACE were 93% and 65%, respectively. The sensitivity and specificity of 3-phase CT were 64% and 100%. CONCLUSIONS: Contrast-enhanced sonography is a more sensitive imaging method than 3-phase CT in depicting vascularity in HCCs treated with TACE.

Adult↗
PubMed2004

[A case of the ruptured splenic artery aneurysm treated with transcatheter embolization].

Splenic artery aneurysms are the most common visceral artery aneurysms, which are usually found incidentally. The most common complication of splenic artery aneurysms is spontaneous rupture into the peritoneal cavity, which leads to acute peritonitis and shock. Less commonly, it may rupture directly into the stomach, small bowel or pancreatic duct and may present with acute gastrointestinal hemorrhage. We report a rare case of the ruptured splenic artery aneurysm, presenting as acute massive hematochezia which was treated with transcatheter embolization.

Aneurysm, Ruptured↗
PubMed2003

Preoperative evaluation of hepatocellular carcinoma: combined use of CT with arterial portography and hepatic arteriography.

OBJECTIVE: This study was undertaken to determine the usefulness of combined CT during arterial portography and CT hepatic arteriography in the preoperative evaluation of patients with known or suspected hepatocellular carcinoma and to describe the findings on CT during arterial portography and CT hepatic arteriography by which hepatocellular carcinomas may be differentiated from pseudolesions. SUBJECTS AND METHODS: This study included 137 patients who underwent combined CT during arterial portography and CT hepatic arteriography for the preoperative evaluation of known or suspected hepatocellular carcinoma. The images were prospectively evaluated to identify focal hepatic lesions and their differential diagnoses (hepatocellular carcinoma versus pseudolesion). We assessed the diagnostic accuracy of our prospective interpretation by comparing the interpretations with the results of histopathology or follow-up imaging. We also retrospectively analyzed imaging features seen on CT during arterial portography and CT hepatic arteriography-the size, shape, and location of the lesion within the liver; attenuation of the lesion; and opacification of the peripheral portal vein branches on CT hepatic arteriography. RESULTS: One hundred and forty-nine hepatocellular carcinomas (75 lesions confirmed at histopathology and 74 lesions on follow-up imaging) were found in 120 patients, and 104 pseudolesions (15 lesions confirmed at histopathology and 89 lesions on follow-up imaging) were found in 91 patients. The sensitivity of our prospective interpretations was 98.7%, and the specificity of our prospective interpretations was 90.4%. Our positive and negative predictive values were 93.6% and 97.9%, respectively. We found that hepatocellular carcinomas were larger, more frequently nodular, and more likely to be located intraparenchymally than were the pseudolesions (p < 0.01). Opacification of the peripheral portal vein branches on CT hepatic arteriography was detected in 36 pseudolesions (34.6%) but in none of the hepatocellular carcinomas (p < 0.01). CONCLUSION: Combining CT during arterial portography and CT hepatic arteriography is useful for the preoperative evaluation of patients with known or suspected hepatocellular carcinoma. Familiarity with the imaging features of hepatocellular carcinomas and pseudolesions can help in the accurate differentiation of hepatocellular carcinomas from pseudolesions.

Adult↗
PubMedDate not supplied

Traumatic bowel perforation: analysis of CT findings according to the perforation site and the elapsed time since accident.

Abdominal CTs of 57 patients with bowel perforation after blunt abdominal trauma were retrospectively analyzed to determine: the diagnostic accuracy of the perforation site, and the differential findings according to the elapsed time from the trauma. Diagnostic accuracy of the perforation site was as follows: duodenum (100%), jejunum (81%), jejunoileal junction (100%), ileum (93%), and colon (20%). Extraluminal air was the only significant differential findings according to the elapsed time, and was seen more commonly on late stage of bowel perforation (P<.05).

Abdominal Injuries↗
PubMedDate not supplied

CT during hepatic arteriography and portography: an illustrative review.

The combination of computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) has been used for evaluation of hepatic neoplasms before partial hepatic resection. Focal hepatic lesions that can be demonstrated with CTAP and CTHA include regenerative nodules, dysplastic nodules, dysplastic nodules with malignant foci, hepatocellular carcinoma, cholangiocarcinoma, hemangioma, and metastases. CTAP is considered the most sensitive modality for detection of small hepatic lesions, particularly small hepatic tumors such as hepatocellular carcinoma and metastatic tumors. CTHA can demonstrate not only hypervascular tumors but also hypovascular tumors and can help differentiate malignant from benign lesions. However, various types of nontumorous hemodynamic changes are frequently encountered at CTAP or CTHA and appear as focal lesions that mimic true hepatic lesions. Such hemodynamic changes include several types of arterioportal shunts, liver cirrhosis, Budd-Chiari syndrome, inflammatory changes, pseudolesions due to an aberrant blood supply, and laminar flow in the portal vein. Familiarity with the CTAP and CTHA appearances of various hepatic lesions and nontumorous hemodynamic changes allows the radiologist to improve the diagnostic accuracy.

Angiography↗
PubMedDate not supplied

Multislice CT cholangiography using thin-slab minimum intensity projection and multiplanar reformation in the evaluation of patients with suspected biliary obstruction: preliminary experience.

Thirty-three patients with suspected biliary obstruction were prospectively evaluated with multislice CT cholangiography using thin-slab minimum intensity projection (MinIP) and multiplanar reformation (MPR) to determine its usefulness and to compare with the comparative studies of endoscopic retrograde cholangiography (ERC), magnetic resonance cholangiography (MRC), or percutaneous transhepatic cholangiography (PTC). CT cholangiography made correct diagnoses in all biliary obstructions except in two patients with common bile duct stones. The correspondence with the comparative study was 93.9%. Multislice CT cholangiography may be favorable in noninvasive evaluation of biliary obstructions.

Bile Duct Diseases↗