ABSTRACT
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.
ABSTRACT
Background@#The presence of an acromial spur implies a rotator cuff disorder due to impingement between the acromial spur and the rotator cuff. The purpose of the study was to observe acromial spurs using ultrasonography and to compare measurements between plain radiographs and sonograms. @*Methods@#We retrospectively enrolled 51 consecutive patients with acromial spurs, which were interpreted on preoperative plain radiographs (supraspinatus outlet view and 30° caudal tilt) and preoperative sonograms. The ultrasonography transducer was held vertically and continuously moved laterally, which corresponded to the long axis of the long head of the biceps. The distance from the most distal margin of the original acromion to the most projected point of the acromial spur was measured. @*Results@#No significant difference was found between the plain radiograph and ultrasonography measurements (p=0.186). A moderate to strong correlation was detected between the ultrasonography and supraspinatus outlet-view measurements (r=0.776, p=0.000). @*Conclusions@#Anteriorly projected acromial spurs were well-visualized by ultrasonography. No discrepancy in acromial spur length was detected between the use of plain radiography (supraspinatus outlet view and 30° caudal-tilt view) and ultrasonography. The correlation coefficients between the plain radiography and ultrasonography measurements exceeded 0.7.
ABSTRACT
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.
ABSTRACT
Background@#The presence of an acromial spur implies a rotator cuff disorder due to impingement between the acromial spur and the rotator cuff. The purpose of the study was to observe acromial spurs using ultrasonography and to compare measurements between plain radiographs and sonograms. @*Methods@#We retrospectively enrolled 51 consecutive patients with acromial spurs, which were interpreted on preoperative plain radiographs (supraspinatus outlet view and 30° caudal tilt) and preoperative sonograms. The ultrasonography transducer was held vertically and continuously moved laterally, which corresponded to the long axis of the long head of the biceps. The distance from the most distal margin of the original acromion to the most projected point of the acromial spur was measured. @*Results@#No significant difference was found between the plain radiograph and ultrasonography measurements (p=0.186). A moderate to strong correlation was detected between the ultrasonography and supraspinatus outlet-view measurements (r=0.776, p=0.000). @*Conclusions@#Anteriorly projected acromial spurs were well-visualized by ultrasonography. No discrepancy in acromial spur length was detected between the use of plain radiography (supraspinatus outlet view and 30° caudal-tilt view) and ultrasonography. The correlation coefficients between the plain radiography and ultrasonography measurements exceeded 0.7.
ABSTRACT
Background@#The glenoid version of the shoulder joint correlates with the stability of the glenohumeral joint and the clinical results of total shoulder arthroplasty. We sought to analyze and compare the glenoid version measured by traditional axial two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) reconstructed images at different levels. @*Methods@#A total of 30 cases, including 15 male and 15 female patients, who underwent 3D shoulder CT imaging was randomly selected and matched by sex consecutively at one hospital. The angular difference between the scapular body axis and 2D CT slice axis was measured. The glenoid version was assessed at three levels (midpoint, upper one-third, and center of the lower circle of the glenoid) using Friedman’s method in the axial plane with 2D CT images and at the same level of three different transverse planes using a 3D reconstructed image. @*Results@#The mean difference between the scapular body axis on the 3D reconstructed image and the 2D CT slice axis was 38.4°. At the level of the midpoint of the glenoid, the measurements were 1.7° ± 4.9° on the 2D CT images and −1.8° ± 4.1° in the 3D reconstructed image. At the level of the center of the lower circle, the measurements were 2.7° ± 5.2° on the 2D CT images and −0.5° ± 4.8° in the 3D reconstructed image. A statistically significant difference was found between the 2D CT and 3D reconstructed images at all three levels. @*Conclusions@#The glenoid version is measured differently between axial 2D CT and 3D reconstructed images at three levels. Use of 3D reconstructed imaging can provide a more accurate glenoid version profile relative to 2D CT. The glenoid version is measured differently at different levels.
ABSTRACT
Purpose@#Single-photon emission computed tomography/computed tomography (SPECT/CT) is an advanced hybrid nuclear medicine technology that generates both functional and anatomical images in a single study. As utilization of SPECT/CT in Korea has been increasing, the purpose of this study was to survey its application of cardiac and skeletal SPECT/CT imaging for protocol optimization. @*Methods@#We surveyed CT protocols established for cardiac and skeletal SPECT/CT. We searched the guidelines for the CT protocols for SPECT/CT and reviewed the literature recently published. @*Results@#Among 36 hybrid SPECT scanners equipped with four or more multi-channel detector CTs (MDCTs), 18 scanners were used to perform cardiac studies at both very low current CT (30–80 mA; 11.1%) and ultra-low current CT (13–30 mA; 88.9%). Among the 33 canners, very low current (≤ 80 mA) CT or low current CT (80–130 mA) was used in 23.5%, and 41.8% for spine disorders, and in 36.4% or 30.3% for foot/ankle disorders, respectively. In the CT reconstructions, slice thickness of 5 mm for cardiac studies was most commonly used (94.4%); thinner slices (0.6–1.0 mm) for spine and foot/ankle studies were used in 24.2% and 45.5%, respectively. We also reviewed the international guidelines. @*Conclusions@#The results and current recommendations will be helpful for optimizing CT protocols for SPECT/CT. Optimization of SPECT/CT protocols will be required for generating the proper strategy for the specific lesions and clinical purpose.
ABSTRACT
The dramatic spread of Coronavirus Disease 2019 (COVID-19) has profound impacts on every continent and life. Due to humanto-human transmission of COVID-19, nuclear medicine staffs also cannot escape the risk of infection from workplaces. Everystaff in the nuclear medicine department must prepare for and respond to COVID-19 pandemic which tailored to the characteristicsof our profession. This article provided the guidance prepared by the Korean Society of Nuclear Medicine (KSNM) incooperation with the Korean Society of Infectious Disease (KSID) and Korean Society for Healthcare-Associated InfectionControl and Prevention (KOSHIC) in managing the COVID-19 pandemic for the nuclear medicine department.We hope that thisguidance will support every practice in nuclear medicine during this chaotic period.
ABSTRACT
We present images of an 83-year-old female with a history of osteoporosis and bilateral total knee replacement arthroplasty, referred for bone scintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT), owing to left knee pain. No trauma to, or intense exercise of, the kneewas reported. The bone scan and SPECT/CT revealed a focally increased Tc-99m methylene diphosphonate (MDP) uptake in the medial cortex of the left femoral diaphysis with matched linear radiolucency on CT images. This was misinterpreted as atypical femoral stress fracture; however, focal stress reaction injury to the nutrient foramen was confirmed on contrast-enhanced magnetic resonance imaging.
ABSTRACT
We present images of an 83-year-old female with a history of osteoporosis and bilateral total knee replacement arthroplasty, referred for bone scintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT), owing to left knee pain. No trauma to, or intense exercise of, the kneewas reported. The bone scan and SPECT/CT revealed a focally increased Tc-99m methylene diphosphonate (MDP) uptake in the medial cortex of the left femoral diaphysis with matched linear radiolucency on CT images. This was misinterpreted as atypical femoral stress fracture; however, focal stress reaction injury to the nutrient foramen was confirmed on contrast-enhanced magnetic resonance imaging.