Clinical Application of 3 Dimensional Reconstruction of CT from Fish Bone Foreign Body Model / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aimed to gather three-dimensional data to detect fish bones as an esophageal foreign body model and to assess the possibility that this method could be applied for cases of real fish bone foreign body (FBFB). MATERIALS AND METHOD: Fish bones from two species were collected and sizes were measured. Pork meat loaf was placed flat into a plastic box containing plaster cast and bones were laid over the meat layer. Another layer of meat was placed on the bones, then another layer of plaster cast, and the final layer of meat were placed. The meat-bone sandwich was regarded as a fish bone foreign body model of esophagus. The model was imaged using computed tomography (CT) scan and the CT data were reconstructed three-dimensionally making multi-planar reconstruction, maximal intensity projection, and volume rendering images. We tried to find tools to detect the shape and lying position of the FBFB model. The above tools were applied to 3 FBFB cases to verify effectiveness of the tools. RESULTS: Multi-planar reconstruction, maximal intensity projection, and volume rendering images were reconstructed easily. After single or more processing, all of the bones could be detected. The shape and lying positions could be detected using tools made from FBFB models. CONCLUSION: Reconstructed images of CT data readily enabled the detection of fish bone in the esophageal model and real cases.

Relationship of Shape of Macrocalcification and Thyroid Cancer: Correlation with US and Pathologic Findings

PURPOSE: The purpose of this study was to categorize macrocalcifications into several subtypes by the US findings and to determine which type of macrocalcification in a thyroid nodule is associated with thyroid malignancy. MATERIALS AND METHODS: We retrospectively analyzed the macrocalcification patterns of thyroid nodules in 396 patients that underwent ultrasonography (US)-guided thyroid FNA or surgery in our institution between August 2009 and August 2011. Two radiologists evaluated US findings and categorized macrocalcifications into 5 subtyes : (A) solitary macrocalcification no association with thyroid nodule; (B) nodular macrocalcification(s) within indeterminate thyroid nodule; (C) dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing; (D) irregular-shaped macrocalcification(s); (E) macrocalcification with other suspicious malignant US finding(s). A chi-squared test and a Fisher exact test were used for comparison of categoric variables. The diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) were obtained. RESULTS: Among total of 417 nodules, 114 (27.3%) were suspicious malignancy or malignancy on histopathological result. Macrocalcification with other malignant US feature had the highest incidence of malignancy (77.5%), followed by irregular-shaped macrocalcification(s) (43.9%), and dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing (38.5%), solitary macrocalcification no association with thyroid nodule (8.3%) respectively, and nodular macrocalcification(s) with indeterminate thyroid nodule had the lowest incidence (7.5%). A nodule with macrocalcification with other malignant US finding(s) has the highest odds ratio (42.52), followed by a nodule with irregular-shaped macrocalcification(s) (9.65) and dense macrocalcification (7.72). Leaving macrocalcification with compositive malignant findings aside, irregular-shaped macrocalcification is more likely to be associated with increased risk for malignancy compared with other patterns of macrocalcification. CONCLUSIONS: Irregular-shaped macrocalcification is a fine indicator for differentiation between benign and malignant thyroid nodules on ultrasonography.

The Ultrasonographic Findings of a Gallbladder Schwannoma: A Case Report

A schwannoma of the gallbladder is an extremely rare tumor. We report a case of a 45-year-old woman with a polypoid mass in her gallbladder. The mass was discovered incidentally as a heterogeneous enhancing mass in the infundibulum of the gallbladder on an abdominal CT scan performed during an evaluation of a reported nonspecific left lower abdominal pain. An ultrasonography revealed that the overlying mucosa of gallbladder was intact. Moreover, a laparoscopic cholecystectomy was performed and the mass was confirmed as a gallbladder schwannoma.