Journal of the Korean Society of Radiology最新文献

Hepatic steatosis is a key characteristic of metabolic dysfunction-associated steatotic liver disease and may progress to cirrhosis and end-stage liver disease through metabolic dysfunction-associated steatohepatitis in 10%-30% of patients. Consequently, early detection and accurate assessment are essential. Grayscale US has traditionally been used for evaluating hepatic steatosis; however, its limitations include reduced sensitivity for mild cases and subjective interpretation. In addition to controlled attenuation parameter, two-dimensional attenuation-based techniques have been recently introduced to quantify US beam attenuation for assessing hepatic steatosis, demonstrating high diagnostic accuracy and reproducibility while addressing some of the limitations of grayscale US. To enhance diagnostic precision and reduce measurement variability, the standardization of examination protocols, including measurement processes, is necessary. Additionally, further research is needed to explore the role of a multiparametric approach combining attenuation-based techniques with elastography in predicting disease progression. This review examines the principles, recent research findings, and future perspectives on attenuation-based quantitative evaluation of hepatic steatosis using US.

Right upper lobe resection is a common surgical procedure in patients diagnosed with lung cancer. However, in certain cases, there may be an anatomical variation in which the fissure between the right middle and right lower lobes is more prominently developed than usual. This atypical development can create a predisposition to torsion of the right middle lobe, a complication that may occur during or shortly after the surgical procedure, especially if pneumopexy or surgical fixation of the lung is not performed. Torsion is a rare but serious complication that can lead to significant postoperative morbidity if not promptly recognized and treated. In this case report, we provide a detailed illustration of the radiologic findings associated with right middle lobe torsion that manifested following right upper lobectomy to excise a hamartoma located in the proximal bronchus of the right upper lobe.

Immunoglobulin G4-related disease (IgG4-RD) is a fibro-inflammatory disorder characterized by tumefactive lesions containing IgG4-positive plasma cells. It affects diverse organs in the head and neck, but mainly the lacrimal glands, orbital tissues, thyroid glands, pituitary glands, and meninges. The involvement of the pituitary glands and meninges is uncommon; therefore, it may be misdiagnosed as infectious or malignant. IgG4-related hypophysitis (IgG4-RH) causes hypopituitarism, headache, and visual disturbances. IgG4-related hypertrophic pachymeningitis (IgG4-RHP) causes visual or hearing impairment, motor or sensory alterations, headaches, and seizures. Biopsy is the most definitive diagnostic method; however, it can be invasive and unnecessary in certain cases. IgG4-RH shows an enhanced sellar mass/thickened pituitary stalk, whereas IgG4-RHP shows linear dural thickening or a bulging mass. Currently, long-term steroid therapy is the first-line of treatment. Here, we report a case of intracranial IgG4-RD diagnosed as IgG4-RH and IgG4-RHP based on serological examination, imaging findings, and response to steroid treatment.

The liver imaging reporting and data system (LI-RADS) CT/MRI treatment response assessment (TRA) provides a standardized framework for evaluating treatment response following loco-regional therapy for hepatocellular carcinoma (HCC). Initially introduced in 2017, it was revised in 2024 to reflect advances in research. The updated LI-RADS CT/MRI TRA v2024 presents a bifurcated algorithm based on the mechanisms underlying loco-regional therapy and introduces distinct assessment criteria with which to evaluate treatment response after radiation therapy. Furthermore, ancillary imaging features, including diffusion restriction and mild-to-moderate T2 hyperintensity, have been incorporated as optional adjuncts to refine the assessment of viable tumors. The effective implementation of the LI-RADS CT/MRI TRA v2024 is anticipated to enhance treatment response assessment following loco-regional therapy for HCC. Further research is encouraged in order to ensure the continuous refinement and optimization of the assessment criteria.

Although US has been widely used for hepatocellular carcinoma (HCC) surveillance, it exhibits limited sensitivity for detecting early-stage HCC. Abbreviated MRI (AMRI) has attracted attention as a superior alternative, offering higher sensitivity for early-stage HCC detection than US and reduced imaging time and cost compared to comprehensive contrast-enhanced MRI. AMRI focuses on essential sequences tailored for HCC detection, with three main strategies: gadoxetate disodium-enhanced hepatobiliary phase AMRI, dynamic contrast-enhanced AMRI, and non-contrast AMRI. In this review, we aim to highlight the technical considerations, performance, and strengths and limitations of each AMRI strategy as well as reporting strategies and recall practices. In addition, to maximize HCC surveillance efficacy using AMRI, a risk-adapted strategy tailored to different patient groups would be necessary, which we will also explore in this review.

Purpose: This study aimed to evaluate the adequate adenosine administration time for stress T1 mapping in patients with hypertrophic cardiomyopathy (HCM).

Materials and methods: Ten patients with HCM underwent cardiac MRI, including rest and adenosine stress T1 mapping, as well as late gadolinium enhancement. Myocardial T1 values for stress T1 reactivity (ΔT1) were evaluated. Stress T1 values measured at 1, 3, and 5 minutes after adenosine administration were compared with the native T1 value using a paired t-test.

Results: The stress T1 value at 5 minutes was the highest, followed by 3 minutes, 1 minute, and the native T1 value (1389 ± 16 vs. 1372 ± 19, 1354 ± 23, 1325 ± 23; all p < 0.001). The relationship between ΔT1 in each stress T1 map at 1, 3, and 5 minutes showed that ΔT1 at 3 and 5 minutes was significantly higher in all segments compared to that at 1 minute (4.83% ± 3.63%, 6.09% ± 3.97% vs. 2.96% ± 3.61%; p = 0.01, p = 0.006). However, ΔT1 at 5 minutes did not significantly differ from that at 3 minutes (4.83% ± 3.63%, 6.09% ± 3.97%; p = 0.237).

Conclusion: Adenosine administration for 3 minutes is adequate for stress T1 mapping in patients with hypertrophic cardiomyopathy.

Abdominal compartment syndrome (ACS) is a life-threatening condition that rarely occurs in patients with severe abdominal trauma. Increased intra-abdominal pressure, often owing to hemoperitoneum, can reduce the mesenteric blood flow, making it challenging to evaluate the bleeding focus in multi-detector CT. Herein, we report a case of severe ACS after abdominal trauma. The initial CT scan showed hemoperitoneum but the source of active bleeding could not be identified. Percutaneous catheter drainage (PCD) was promptly performed to reduce the intra-abdominal pressure. Additional CT scans confirmed the bleeding source to be the superior mesenteric vein. The patient presented CT findings of primary ACS, and we evaluated the pre- and post-ACS imaging changes after PCD on abdominal CT. Accurate and timely recognition of the characteristic CT signs of ACS and shock bowel as well as precise interventional treatment are important skills for radiologists, particularly in cases of severe trauma and hypovolemia.

Penile emergencies are uncommon and can be categorized as having infectious, vascular, traumatic, or multifactorial etiologies. To facilitate early diagnosis and treatment during emergency, US and color Doppler imaging are imperative. US depicts hypoechoic collections regardless of the presence of air foci in infections like abscess and Fournier's gangrene. Color Doppler imaging is conducted to evaluate vascular conditions such as penile Mondor disease (PMD) and priapism. PMD is indicated by the absence of color flow and non-compressibility of dorsal penile vein. Priapism can be categorized based on cavernosal artery flow: high flow and low flow. In traumatic injuries like penile fracture, US reveals breach in tunica albuginea with hematoma. Peyronie's disease can be multifactorial in origin and the imaging is commonly visualized as thickening of the tunica albuginea and echogenic calcified plaques. Urethral injuries are urethral discontinuity with adjacent collection. Urethral calculus is visualized as echogenic focus with posterior acoustic shadowing. Therefore, effective collaboration between radiologists and urologists is required for appropriate initial diagnosis and prompt treatment.

Splenic duplication, also known as polysplenia syndrome, is a condition occasionally observed in which the spleen is divided into segments of similar size. However, gastric fundic varices arising from a duplicated spleen are exceedingly rare, and this medical anomaly has been infrequently reported in the literature. This case report presents a 40-year-old male with a rare instance of gastric fundic varices secondary to splenic duplication. Comprehensive imaging studies, including endoscopy, CT, Doppler US, and radioisotope splenic scans, were performed to confirm the diagnosis. This case contributes to valuable information in the medical literature, shedding light on a seldom-discussed condition.