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Biomedical subjects

K M Yeon

Publications and source records attributed to K M Yeon.

At least 37 records · Page 2Linked to original sources

Craniofacial arteriovenous malformation: preoperative embolization with direct puncture and injection of n-butyl cyanoacrylate.

PURPOSE: To evaluate the use of n-butyl cyanoacrylate (NBCA) for preoperative embolization of craniofacial arteriovenous malformation. MATERIALS AND METHODS: Fourteen patients with craniofacial arteriovenous malformation (forehead [n = 9], deep facial [n = 3], occipital [n = 1], or lip [n = 1] lesion) were treated with injection of NBCA. Forehead lesions were supplied by ophthalmic (n = 6) and/or superficial temporal arteries (n = 7); and facial and scalp lesions, by bilateral internal maxillary (n = 4), facial (n = 2), and/or occipital arteries (n = 1). Lesions were percutaneously punctured with a 20-gauge needle in the area of arteriovenous connection. Direct angiography was performed before and after compression of venous drainage, and NBCA diluted 30%-50% with iodized oil was injected during venous compression. RESULTS: Postembolization arteriograms showed that six lesions were completely devascularized after single or multiple (one to nine) injections, and five were effectively devascularized (> or = 90%). Although three lesions were 60%-70% devascularized after injection, two of these were successfully extirpated with no notable blood loss. In nine patients, the ophthalmic arterial supply had disappeared after embolization. There were no procedure-related complications. CONCLUSION: Direct-puncture embolization with NBCA is an effective and safe technique for preoperative devascularization of craniofacial arteriovenous malformation. For safe and effective devascularization, compression of draining venous channels is thought to be important.

Adolescent↗

Ovarian teratomas appearing as solid masses on ultrasonography.

The purposes of this study were to evaluate the prevalence and imaging characteristics of ovarian teratomas that appear as solid masses on ultrasonography and to compare the ultrasonographic imaging features of the tumors with their pathologic findings. The ultrasonographic images of 202 ovarian teratomas were reviewed retrospectively. Solid-appearing masses were selected from among them and were evaluated in terms of internal echotexture, the presence or lack of peripheral hypoechogenicity, posterior sonic attenuation, and tumoral calcification. Seventy-six (37.6%) masses of 202 belonged to the atypical solid-appearing masses on ultrasonography. Of 76 masses, 57 (75.0%) had peripheral hypoechogenicity; 38 masses had well-defined thin hypoechoic rims, whereas 19 had poorly demarcated peripheral hypoechogenicity. Posterior sonic attenuation was evident in 18 (23.7%) masses. The presence of peripheral hypoechogenicity, which is suggestive of the fluid portion of the tumor, might be one of the characteristic findings of solid-appearing ovarian teratomas on ultrasonography.

Adolescent↗

Radiological features of focal nodular hyperplasia of the liver in children.

BACKGROUND: Focal nodular hyperplasia (FNH) is an unusual hepatic tumour in children and should be distinguished from other hepatic lesions. OBJECTIVE: To describe the imaging characteristics of FNH in children. MATERIALS AND METHODS: We examined five patients (three boys and two girls, mean age 9.4 years) with pathologically confirmed FNH. The diagnosis was obtained by tumour resection (n = 4) and percutaneous needle biopsy (n = 1). One patient with multiple FNHs showed recurrent lesions after tumour resection. All patients were studied with US (including colour and power Doppler US [n = 3]) and CT. Dynamic enhanced CT scans were available in three patients. MRI (n = 2) or coeliac angiography (n = 1) was performed in three patients. RESULTS: Seven of eight FNH lesions in five patients were demonstrated by imaging. The average size of the lesions was 6.5 cm. Six lesions detected on US showed variable echogenicity with a central hyperechoic scar (n = 2). On Doppler examination, central or peripheral hypervascular areas were seen (n = 3). Six lesions detected on contrast-enhanced CT showed high attenuation (n = 4) or iso-attenuation (n = 2). On early phase scans, all the lesions (n = 3) showed high attenuation. Irregular linear or ovoid central scars were detected in two patients on CT. MR demonstrated three lesions in two patients, one of which had not been detected by US or CT. A central low signal intensity scar (n = 1) was seen on T2-weighted MRI. Coeliac angiography performed in one patient showed a hypervascular mass with homogeneous staining. CONCLUSION: FNH in children shows a wide spectrum of imaging findings on various radiological examinations and the typical central scar was not always seen on imaging studies. Dynamic enhanced CT obtained in the early phase and colour Doppler studies may be helpful in the diagnosis of FNH by allowing characterisation of tumour vascularity. FNH should be included in the differential diagnosis of liver mass in children.

Adolescent↗

Experimentally induced pulmonary arterial occlusion with detachable balloon in pigs: thin-section CT findings.

RATIONALE AND OBJECTIVES: The authors evaluated changes of lung attenuation in pigs, with special attention to the mosaic pattern of low attenuation, at thin-section computed tomography (CT) after obstruction of the proximal pulmonary artery with a detachable balloon. MATERIALS AND METHODS: In seven pigs, nine sites of the descending pulmonary artery were obstructed with detachable balloons. This-section CT scans of the lungs were obtained immediately (n = 9) and at 1 week (n = 5), 2 weeks (n = 1), 3 weeks (n = 2), 4 weeks (n = 1), 6 weeks (n = 1), 8 weeks (n = 1), and 12 weeks (n = 1) after pulmonary artery obstruction. RESULTS: No statistically significant difference was found between the measured lung attenuation of the normal lung and that of the lung distal to the obstruction. Of the nine sites of pulmonary artery obstruction, five (56%) showed an irregular area of increased lung attenuation without lobular architecture. The diameter of the pulmonary artery after obstruction, compared with the diameter before obstruction, decreased by a range of 13%-57% (mean, 35%) and by 0-67% (mean, 44%) at levels 1 cm and 2 cm distal to the obstruction, respectively. CONCLUSION: This experimental study reveals that regional low-attenuation areas do not develop for up to 12 weeks after the obstruction of proximal pulmonary artery, despite a marked decrease in the diameter of the pulmonary artery distal to the obstruction.

Angiography↗

Intratumoral vascularity of experimentally induced VX2 carcinoma: comparison of color Doppler sonography, power Doppler sonography, and microangiography.

RATIONALE AND OBJECTIVES: Tumor vascularity is useful for characterizing tumors and determining tumor management. The recent development of power Doppler sonography has enhanced the sensitivity of color Doppler imaging in the detection of blood flow because of low power noise and less angle dependence. The purpose of this study was to compare the capability of color and power Doppler sonography with that of microangiography for showing tumor vascularity of VX2 carcinoma. METHODS: Color and power Doppler sonography was performed on VX2 carcinomas in the rabbit thighs, and their findings were correlated with those of microangiography. For qualitative analysis, tumor vascularity was categorized into four items including distribution of tumor vessels, crowdedness of vessels, small vessels, (> or = 0.1 mm), and micro-vessels (< 0.1 mm). Tumor blood flow signals of color Doppler sonography and power Doppler sonography were graded as 3, 2, 1, and 0 and were compared with tumor vascularity on microangiography. For quantitative analysis, percentages of tumor vascular area per tumor area on each study were compared. RESULTS: The mean scores of tumor vascularity on power Doppler sonography were 2.87, 2.73, 2.93, and 2.73 in tumor vascular distribution, crowdedness of vessels, small vessels, and micro-vessels, respectively. Those on color Doppler sonography were 2.4, 2.2, 2.8, and 1.67, respectively. Power Doppler sonography was statistically superior to color Doppler sonography in displaying tumor vascular distribution (P < 0.05) and micro-vessels (P < 0.01). The means and medians of percentages of tumor vascular area per tumor area were 22.7% and 23.5% on microangiography, 17.9% and 21.4% on color Doppler sonography, and 36.4% and 34.7 % on power Doppler sonography, respectively. Percentages of tumor vascular area per tumor area on both color Doppler sonography (r = 0.70) and power Doppler sonography (r = 0.84) were well correlated with those on microangiography. CONCLUSIONS: Power Doppler sonography can demonstrate the tumor vascularity on microangiography relatively well, however, it tends to overestimate the blood flow signals. Color Doppler sonography may have some limitations in imaging tumor vascular distribution and micro-vessels and tends to underestimate tumor vascularity, but can display the blood flow direction. Therefore, power Doppler and color Doppler sonography could complement each other in demonstrating the tumor vascularity.

Angiography↗

Hypertrophied bronchial artery at thin-section CT in patients with bronchiectasis: correlation with CT angiographic findings.

PURPOSE: To evaluate hypertrophied bronchial arteries on thin-section computed tomographic (CT) scans in patients with bronchiectasis by using CT angiographic correlation. MATERIALS AND METHODS: Spiral CT angiography was performed prospectively in 14 patients (eight men, six women; age range, 34-71 years) with bronchiectasis who were suspected of having bronchial arterial hypertrophy at thin-section CT (performed without contrast medium). The inclusion criteria were tubular (in six patients) or nodular (in 14 patients) areas of soft-tissue attenuation that had an appearance unlike that of lymph nodes at thin-section CT and that were within the mediastinum and around the central airway. These findings were subsequently correlated with the spiral CT angiographic findings. RESULTS: At comparative analysis of thin-section CT scans and CT angiograms, seven of the eight (88%) tubular lesions and 19 of the 36 (53%) nodular lesions in the mediastinal soft tissue were proved to be hypertrophied bronchial arteries. All of the six (100%) tubular and 19 of the 21 (90%) nodular lesions around the walls of the main (primary) and lobar bronchi were hypertrophied bronchial arteries. In eight (57%) patients, CT angiograms showed 11 intraluminal protrusions caused by hypertrophied bronchial arteries in the main bronchi, lobar bronchi, or both. CONCLUSION: Nodular and tubular structures in the mediastinum and around the central airway on thin-section CT scans in the patients with bronchiectasis are suggestive of hypertrophied bronchial arteries. Recognition of the hypertrophied bronchial artery can be critical for the bronchoscopist.

Adult↗

Thoracic actinomycosis: CT findings.

PURPOSE: To characterize computed tomographic (CT) findings of thoracic actinomycosis. MATERIALS AND METHODS: Chest CT scans and radiographs obtained in 22 patients with histopathologically proved thoracic actinomycosis were retrospectively reviewed. All patients were immunocompetent; they were aged 12-73 years (mean, 42.6 years; 14 male, eight female). CT findings were correlated with histopathologic findings in nine patients who underwent surgery (lobectomy [n = 8] or segmental resection [n = 1]). RESULTS: All of the lesions were unilateral, with an average diameter of 6.5 cm (range, 2-12 cm). Patchy air-space consolidation (n = 20) or a mass (n = 2) was seen on CT scans. Fifteen (75%) of the 20 patients with air-space consolidation had central areas of low attenuation (5-30 mm in diameter) within the consolidation. Thirteen of the 15 patients underwent contrast medium-enhanced CT. Ten (77%) of the 13 patients showed ring-like rim enhancement. Adjacent pleural thickening was seen in 16 patients (73%). At histopathologic examination, central low-attenuation areas at CT were seen as microabscesses with sulfur granules or a dilated bronchus that contained inflammatory cells and Actinomyces colonies. Peripheral enhancement of the low-attenuation areas was wall of the microabscess or surrounding parenchyma composed of granulation tissue rich in vascularity. CONCLUSION: Findings of chronic segmental air-space consolidation that contained low-attenuation areas with peripheral enhancement or adjacent pleural thickening at CT were suggestive of thoracic actinomycosis.

Actinomycosis↗

Choledochal cyst with or without biliary atresia in neonates and young infants: US differentiation.

PURPOSE: To differentiate at ultrasonography (US) between the choledochal cyst associated with biliary atresia (CCBA) and that in the absence of biliary atresia (CC) in neonates and young infants. MATERIALS AND METHODS: Preoperative US findings in 28 neonates and infants younger than 4 months in whom choledochal cyst was subsequently surgically confirmed were retrospectively analyzed. There was no statistically significant difference in age between the CCBA group (n = 19) and the CC group (n = 9). US findings in both groups were compared, with focus on the size of the cyst in the hepatic portal, dilatation of the intrahepatic bile ducts, and the size and morphology of the gallbladder. RESULTS: At US, the width and length of the cysts in the hepatic portal in the CC group were significantly larger than those in the CCBA group (P < .001). Dilatation of the intrahepatic bile ducts, seen in only one patient (5%) of the CCBA group, was observed in all patients (100%) of the CC group. The gallbladder was normal or distended in all patients of the CC group, while it was atretic or irregularly elongated in 17 patients (89%) of the CCBA group. CONCLUSION: US can be helpful in the preoperative differential diagnosis of choledochal cysts in neonates and infants. Cysts are larger, intrahepatic ducts are dilated, and gallbladders are not atretic in patients with CC as compared with those in patients with CCBA.

Bile Ducts, Intrahepatic↗

Ejaculatory duct obstruction: TRUS-guided opacification of seminal tracts.

OBJECTIVE: To assess the usefulness of TRUS-guided aspiration and opacification of seminal tracts in the evaluation and management of patients with ejaculatory duct obstruction (EDO). METHODS: In 21 men who had dilated seminal vesicles and/or midline cysts on TRUS, a mixture of contrast media and indigocarmine was injected and then pelvic radiographs were taken. RESULTS: The diagnoses based on the findings of TRUS-guided opacification were bilateral EDO in 9 patients, unilateral EDO in 1, and midline cyst with EDO in 11. Midline cysts had communication with seminal tracts in 7. Transurethral unroofing was performed in 12, in all of whom blue color of the injected indigocarmine facilitated the surgical procedure. CONCLUSION: TRUS-guided opacification of the seminal tracts with a mixture of contrast media and indigocarmine may be valuable in the evaluation and management of the patients with EDO.

Adult↗

Mediastinal tuberculous lymphadenitis: CT findings of active and inactive disease.

OBJECTIVE: The purpose of this study was to analyze CT findings of active and inactive disease in patients with mediastinal tuberculous lymphadenitis. MATERIALS AND METHODS: Using biopsy and culture results, we categorized 49 consecutive patients with mediastinal tuberculous lymphadenitis studied with CT scans as patients with active disease (n = 37) or patients with inactive disease (n = 12). Follow-up CT scans were obtained after antituberculous therapy in 25 patients with active disease and three patients with inactive disease. In 10 patients (seven with active disease and three with inactive disease), CT findings were analyzed and correlated with pathologic findings. RESULTS: In all 37 patients with active disease, the nodes (n = 151) varied in size (1.5-6.7 cm; mean, 2.8 +/- 1.0 cm) and had central low attenuation and peripheral rim enhancement. Calcifications within the nodes were seen in seven patients (19%). In the 12 patients with inactive disease, the nodes (n = 34) varied in size (1.0-4.7 cm; mean, 2.1 +/- 1.0 cm) but were usually smaller than nodes in patients with active disease. In the patients with inactive disease, the diseased nodes were homogeneous and without low-attenuation areas. Calcifications within the nodes were seen in 10 (83%) of the 12 patients with inactive disease. Low-attenuation areas within the nodes corresponded pathologically to areas of caseation necrosis in seven patients with active disease and in no patients with inactive disease. After treatment, enlarged mediastinal nodes in patients with active disease shrunk and low-attenuation areas within the nodes disappeared in all 25 patients. However, the findings of calcified nodes in the three patients with inactive disease did not change after 6 months of follow-up. CONCLUSION: In these 49 patients with mediastinal tuberculous lymphadenitis, CT findings of nodes with central low attenuation and peripheral rim enhancement suggested active disease, and findings of homogeneous and calcified nodes suggested inactive disease. Low-attenuation areas within the nodes had pathologic correspondence to areas of caseation necrosis and may be a reliable indicator for disease activity.

Adolescent↗

Three-tiered integration of PACS and HIS toward next generation total hospital information system.

The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

Hospital Information Systems↗

An experimental study of embolic effect according to infusion rate and concentration of suspension in transarterial particulate embolization.

RATIONALE AND OBJECTIVES: The authors evaluate the embolic effect according to infusion rate and concentration of particulate suspension, focusing on arterial occlusion level. METHODS: The renal arteries of 14 rabbits were embolized with 150 to 250 microns polyvinyl alcohol (PVA) particles, divided into four groups according to two different infusion rates (1 mg/second and 0.1 mg/second) and two different concentrations of suspension (10 mg/mL and 2.5 mg/mL). Arteriograms obtained immediately and a week after embolization were assessed for occlusion level. For the nephrograms obtained a week after embolization, the opacifying areas were graded from 0 to 4. Median coronal sections of each kidney specimen were investigated for the presence of peripheral infarct grossly and for the presence of PVA particles in the small artery microscopically. RESULTS: Arteriograms showed various occlusion levels. Using a 0 to 4 grading system, the opacifying area of the nephrogram obtained 1 week after embolization was noted to be smaller in the low infusion rate group (P < 0.05). In gross and microscopic pathologic examination, the number of cases with peripheral infarct or PVA particles in the small artery (< 300 microns) was greater in the group with the low infusion rate and low concentration (P < 0.05). CONCLUSIONS: In transarterial particulate embolization, slower infusion of more diluted suspension provides for a more distal arterial occlusion.

Animals↗

Pericaval fat collection that mimics thrombosis of the inferior vena cava: demonstration with use of multi-directional reformation CT.

PURPOSE: To evaluate the causes for localized fat collection that seemed to be within the subdiaphragmatic inferior vena cava (IVC) on axial computed tomographic (CT) scans. MATERIALS AND METHODS: Six consecutive patients with presumed intracaval fat collection at routine abdominal CT (n = 2) or thin-section CT of the lung (n = 4) were studied prospectively with helical CT. Three patients had chronic liver diseases. Multi-directional, two-dimensional, reformatted images were obtained from the helical CT data for identification of the relation between the IVC and fat collection. Six patients without intracaval fat collection were studied as control subjects. RESULTS: On axial CT scans, the fat collection had a round or oval shape (in four of six patients) and was located posteromedial to the IVC (in four of six patients). On coronal reformatted images, the fat collection was outside the IVC between the diaphragm and subdiaphragmatic IVC, which was contiguous to the fat around the subdiaphragmatic esophagus. In the fat collection group, the IVC angled toward the right and narrowed to half in diameter as it passed down to the diaphragm. In the control group, the IVC was straight, although the diameter decreased similarly. CONCLUSION: A localized fat collection adjacent to the subdiaphragmatic IVC that mimics intracaval fat on axial CT scans is due to acute angulation of the IVC, which is probably a result of anatomic variation, chronic liver disease, or both.

Adipose Tissue↗

Congenital cystic adenomatoid malformation of the lung: CT-pathologic correlation.

OBJECTIVE: The purpose of this study was to correlate CT findings of congenital cystic adenomatoid malformation (CCAM) of the lung with pathologic findings. MATERIALS AND METHODS: CT scans of CCAM from 21 consecutive patients were analyzed retrospectively by two chest radiologists who achieved consensus. Pathologic findings were assessed by an experienced pulmonary pathologist. Preoperative CT findings were correlated with pathologic findings. RESULTS: Areas with small cysts (< 2 cm in diameter) were seen on CT scans in 19 (90%) of 21 patients, whereas areas with a large cyst (> 2 cm in diameter) were observed in 18 patients (86%). Areas of consolidation (n = 9; 43%) with heterogeneous attenuation on enhanced scans and areas of low attenuation (lower than normal lung) around cystic lesions (n = 6; 29%) were also seen on CT scans. The diameter of the largest cyst seen on CT scans in each patient ranged from 1.0 to 8.0 cm (median, 4.5 cm). Cysts that CT showed to be filled with air, fluid, or both correlated completely with the pathologic findings. Areas of consolidation corresponded histologically to areas of glandular or bronchiolar structures with or without areas of endogenous lipoid or organizing pneumonia or mucus plugs. Areas of low attenuation corresponded to areas of microcysts blended with normal lung parenchyma. CONCLUSION: CT scans show the variable internal characteristics of CCAM and can suggest the underlying pathology of such lesions.

Adolescent↗

Pulmonary tuberculosis in children: evaluation with CT.

OBJECTIVE: The purpose of our study was to describe the CT findings of pulmonary tuberculosis in children and to define indications for the use of CT. MATERIALS AND METHODS: CT findings in 41 consecutive children with confirmed tuberculosis were retrospectively analyzed by two radiologists. Chest radiographs and medical records were also reviewed to determine whether additional information provided by CT scans had altered clinical management of the disease. RESULTS: Mediastinal and hilar lymphadenopathy was seen in 34 patients (83%). In 29 of these patients, enlarged nodes had low-attenuation centers and enhancing rims. In the five other patients, enlarged nodes had calcification. Segmental (n = 12) or lobar (n = 8) air space consolidation was seen in 20 patients (49%), nodules of bronchogenic spread were seen in 12 patients (29%), and miliary nodules were seen in seven patients (17%). Bronchial (n = 15), pleural (n = 7), pericardiac (n = 1), or chest wall (n = 1) complications of tuberculosis were seen in 22 patients (54%). In eight (20%) of 41 patients, a diagnosis of tuberculosis was suggested only on CT scans, which revealed low-attenuation nodes with rim enhancement, calcifications, and nodules of bronchogenic spread or miliary nodules. These findings were not seen on chest radiographs. In 15 patients (37%), CT scans provided information that altered clinical management. Also two of these patients underwent surgery because of pleural and chest wall complications that were seen only on CT scans. CONCLUSION: Mediastinal or hilar lymphadenopathy revealed as low-attenuation nodes with rim enhancement or calcification was the most characteristic CT finding of pulmonary tuberculosis in children. CT can be useful when tuberculosis or its complications are suspected in children and the radiographic findings are normal or inconclusive.

Adolescent↗

Tuberculosis of the central airways: CT findings of active and fibrotic disease.

OBJECTIVE: Management of patients with central airways tuberculosis differs according to the activity of the disease. The purpose of this study was to analyze CT findings of active and fibrotic disease in patients with central airways tuberculosis. MATERIALS AND METHODS: According to bronchoscopic findings and biopsy results, 41 patients with tuberculosis of the trachea and main bronchi were categorized as having active disease (n = 30) or fibrotic disease (n = 11). Follow-up CT scans were obtained after antituberculous therapy in 11 patients with active disease and two patients with fibrotic disease. All CT scans were retrospectively analyzed with particular attention to the locations of airway lesions, patterns of luminal narrowing, wall thickening of diseased airways, and presence of abnormal adjacent lymph nodes. RESULTS: Active disease in 30 patients involved the trachea (n = 20), the right main bronchus (n = 14), or the left main bronchus (n = 13). Seventeen patients had multiple lesions. On CT scans, these airways showed irregular (n = 24) or smooth (n = 4) narrowing in 28 patients: minimal (n = 5) or marked (n = 18) wall thickening with contrast enhancement in 23 patients: and obstruction with peribronchial cuffing in nine patients. Enlarged mediastinal lymph nodes were seen in 26 patients. Fibrotic disease in 11 patients involved the trachea (n = 6), the right main bronchus (n = 2), or the left main bronchus (n = 9). Six patients had multiple lesions. On CT scans, the airways showed smooth (n = 7) or irregular (n = 2) narrowing without (n = 5) or with minimal (n = 4) wall thickening in nine patients and obstruction without peribronchial cuffing in four patients. On follow-up CT scans, the findings for the airway lesions were almost normal in nine patients who had had initial active disease. However, the findings for airway narrowing did not change in two patients with fibrotic disease after 6 months of follow-up. CONCLUSION: Principal CT findings in our patients depended on disease stage. Central airways narrowing was seen in both active and fibrotic stages. However, in patients with active disease, CT scans showed irregular and thick-walled airways, a pattern that was reversible, whereas patients with fibrotic disease generally had smooth narrowing of airways and minimal wall thickening, a pattern that was not reversible during the follow-up period.

Adolescent↗

Standard bone-age of infants and children in Korea.

To evaluate the developmental status of children and adolescents, a bone-age chart based on the radiograph of hand and wrist has been used in many countries. Bone-age reflects not only the functional status of various hormones but also the influence of chronic disease and it has been used more widely than other indices such as the height-weight-age table. As a standard bone-age chart has not been established in Korea, a foreign bone-age chart has been used in clinics. To make a Korean standard bone-age chart, we took the radiographs of the left hand of about 5,400 children covering the whole country, and 3,407 radiographs of 1,830 boys and 1,577 girls ranging from two months to 16 years of age were selected and analyzed for bone maturity scores by the TW2-20 method. The range of ages were divided into 27 groups, and the radiographs of 50th percentile score were chosen as the standard bone-ages for the median age of each group. The youngest and oldest chronological age which had the same TW2-20 score of the standard bone-age were decided as the range of variation from the median age. We hope that a Korean standard bone-age chart can be used as the radiological index in the evaluation of the developmental status in Korean children and adolescents.

Adolescent↗

Idiopathic pulmonary fibrosis vs. pulmonary involvement of collagen vascular disease: HRCT findings.

The purpose of this study is to assess the differences of high-resolution CT (HRCT) findings in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease (CVD). We analyzed the HRCT findings of 33 patients with IPF and 23 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change, and pulmonary volume loss. The predominant HRCT pattern was honeycombing for IPF (58%), and ground-glass opacity for CVD (57%). Predominantly subpleural involvement was seen in 90% of IPF and 83% of CVD patients. Mediastinal lymph node enlargement was seen in 61% of the patients with IPF and 13% with CVD (p = 0.0004). Pleural thickening was seen in 97% of the patients with IPF and 35% with CVD and the severity of pleural thickening is statistically significant (p = 0.00001). Pleural effusion was seen in 6% of the patients with IPF and 26% with CVD (p = 0.0351). The hilar height ratio was more than 1.5 in 52% of the patients with IPF and 30% with CVD (p = 0.2620). Although HRCT findings of IPF and pulmonary involvement of CVD are similar and overlap considerably, but patients with IPF showed a tendency to more progressed fibrosis than patients with CVD.

Adult↗