The torsion of the uterus is a rare gynecological emergency. It occurs mainly in the gravid uterus and extremely rarely in the non-gravid uterus. In this article, we report a case of a torsion of non-gravid uterus accompanied by a huge intramural leiomyoma with focus on CT and MR imaging findings.
{"title":"[Torsion of a Myomatous Uterus in a Non-Gravid Female: A Case Report].","authors":"Yuri Kim, Young Mi Ku, Yoo Dong Won","doi":"10.3348/jksr.2022.0072","DOIUrl":"https://doi.org/10.3348/jksr.2022.0072","url":null,"abstract":"<p><p>The torsion of the uterus is a rare gynecological emergency. It occurs mainly in the gravid uterus and extremely rarely in the non-gravid uterus. In this article, we report a case of a torsion of non-gravid uterus accompanied by a huge intramural leiomyoma with focus on CT and MR imaging findings.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/e5/jksr-84-467.PMC10083626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dong Hyun Kim, Ung Rae Kang, Young Hwan Kim, Jung Guen Cha
Purpose: Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization.
Materials and methods: First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery.
Results: Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding.
Conclusion: The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.
{"title":"Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular Embolization.","authors":"Dong Hyun Kim, Ung Rae Kang, Young Hwan Kim, Jung Guen Cha","doi":"10.3348/jksr.2022.0068","DOIUrl":"https://doi.org/10.3348/jksr.2022.0068","url":null,"abstract":"<p><strong>Purpose: </strong>Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization.</p><p><strong>Materials and methods: </strong>First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery.</p><p><strong>Results: </strong>Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding.</p><p><strong>Conclusion: </strong>The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/85/jksr-84-418.PMC10083636.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung A Kim, Ji-Young Kim, Myeong Ja Jeong, Soung Hee Kim, Soo Hyun Kim, Mi-Jin Kang, Ji Hae Lee
In general, neuroendocrine cancer develops in the digestive or respiratory tract, and when it is found in other organs, it is often due to metastasis. Primary neuroendocrine carcinoma of the breast occurs very rarely, and the exact clinical picture, radiological findings, treatment and prognosis are not well known. Furthermore, only a small number of literature reports have been published. Here, we report the imaging findings of primary neuroendocrine carcinoma in the breast of a 51-year-old female, along with a literature review.
{"title":"[Primary Neuroendocrine Carcinoma of the Breast: A Case Report and Literature Review].","authors":"Jung A Kim, Ji-Young Kim, Myeong Ja Jeong, Soung Hee Kim, Soo Hyun Kim, Mi-Jin Kang, Ji Hae Lee","doi":"10.3348/jksr.2022.0063","DOIUrl":"https://doi.org/10.3348/jksr.2022.0063","url":null,"abstract":"<p><p>In general, neuroendocrine cancer develops in the digestive or respiratory tract, and when it is found in other organs, it is often due to metastasis. Primary neuroendocrine carcinoma of the breast occurs very rarely, and the exact clinical picture, radiological findings, treatment and prognosis are not well known. Furthermore, only a small number of literature reports have been published. Here, we report the imaging findings of primary neuroendocrine carcinoma in the breast of a 51-year-old female, along with a literature review.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/47/jksr-84-460.PMC10083638.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Preface for Special Issue on Breast Image-Guided Interventional Procedure: Tips & Tricks].","authors":"Hak Hee Kim","doi":"10.3348/jksr.2023.0028","DOIUrl":"https://doi.org/10.3348/jksr.2023.0028","url":null,"abstract":"","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/fb/jksr-84-319.PMC10083641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung A Kim, Mi-Jin Kang, Jung Yeon Kim, Ji-Young Kim, Soung Hee Kim, Myeong Ja Jeong, Ji Hae Lee
Nuclear portein in testis (NUT) midline carcinoma is a very rare and low-differentiating malignant epithelial tumor that differentiates very aggressively and has poor prognosis. NUT midline carcinoma occurring in the lungs in particular can be confused with other cancers because few cases have been reported in Korea to date and can show various histological forms. Reports of radiology findings are very rare worldwide. Here we report the imaging findings of pulmonary NUT midline carcinoma in a 25-year-old female along with pathological findings.
{"title":"[Radiologic Manifestations of Pulmonary Nuclear Protein in Testis Midline Carcinoma: A Case Report].","authors":"Jung A Kim, Mi-Jin Kang, Jung Yeon Kim, Ji-Young Kim, Soung Hee Kim, Myeong Ja Jeong, Ji Hae Lee","doi":"10.3348/jksr.2022.0055","DOIUrl":"https://doi.org/10.3348/jksr.2022.0055","url":null,"abstract":"<p><p>Nuclear portein in testis (NUT) midline carcinoma is a very rare and low-differentiating malignant epithelial tumor that differentiates very aggressively and has poor prognosis. NUT midline carcinoma occurring in the lungs in particular can be confused with other cancers because few cases have been reported in Korea to date and can show various histological forms. Reports of radiology findings are very rare worldwide. Here we report the imaging findings of pulmonary NUT midline carcinoma in a 25-year-old female along with pathological findings.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/39/jksr-84-498.PMC10083623.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
So Ra Shin, Eun Young Ko, Boo-Kyung Han, Eun Sook Ko, Ji Soo Choi, Haejung Kim
Purpose: This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast.
Materials and methods: Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision.
Results: All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy.
Conclusion: Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.
{"title":"Benign Adenomyoepithelioma of the Breast: Imaging Characteristics.","authors":"So Ra Shin, Eun Young Ko, Boo-Kyung Han, Eun Sook Ko, Ji Soo Choi, Haejung Kim","doi":"10.3348/jksr.2022.0021","DOIUrl":"https://doi.org/10.3348/jksr.2022.0021","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast.</p><p><strong>Materials and methods: </strong>Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision.</p><p><strong>Results: </strong>All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy.</p><p><strong>Conclusion: </strong>Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/97/jksr-84-398.PMC10083621.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ga Eun Park, Jeongmin Lee, Bong Joo Kang, Sung Hun Kim
In Korea, the number of institutions providing breast MRI, as well as the number of breast MRIs, has recently increased. However, MRI-guided procedures, including biopsy and needle localization, are rarely performed compared to ultrasound-guided or stereotactic biopsy. As breast MRI has high sensitivity but limited specificity, lesions detected only on MRI require pathologic confirmation through MRI-guided biopsy or surgical excision with MRI-guided needle localization. Thus, we aimed to review MRI-guided procedures, including their indications, techniques, procedural considerations, and limitations.
{"title":"[MRI-Guided Breast Intervention: Biopsy and Needle Localization].","authors":"Ga Eun Park, Jeongmin Lee, Bong Joo Kang, Sung Hun Kim","doi":"10.3348/jksr.2022.0162","DOIUrl":"https://doi.org/10.3348/jksr.2022.0162","url":null,"abstract":"<p><p>In Korea, the number of institutions providing breast MRI, as well as the number of breast MRIs, has recently increased. However, MRI-guided procedures, including biopsy and needle localization, are rarely performed compared to ultrasound-guided or stereotactic biopsy. As breast MRI has high sensitivity but limited specificity, lesions detected only on MRI require pathologic confirmation through MRI-guided biopsy or surgical excision with MRI-guided needle localization. Thus, we aimed to review MRI-guided procedures, including their indications, techniques, procedural considerations, and limitations.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/7f/jksr-84-345.PMC10083625.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyun-Jae Lim, Kyung-Sook Shin, Jeong-Eun Lee, Sun-Kyoung You, Kyung-Hee Kim
Hemolymphangioma or hemangiolymphangioma is a rare venolymphatic vascular malformation composed of proliferations or networks of vascular spaces including the lymphatics, capillaries, veins, or arteries. The small bowel is a rare location for hemolymphangioma, and the small bowel mesentery is an even rarer site. Herein, we report a surgically confirmed large complex hemolymphangioma in the small bowel mesentery in a 55-year-old male.
{"title":"Rare Case of Large Hemolymphangioma in the Small Bowel Mesentery: A Case Report.","authors":"Hyun-Jae Lim, Kyung-Sook Shin, Jeong-Eun Lee, Sun-Kyoung You, Kyung-Hee Kim","doi":"10.3348/jksr.2022.0043","DOIUrl":"https://doi.org/10.3348/jksr.2022.0043","url":null,"abstract":"<p><p>Hemolymphangioma or hemangiolymphangioma is a rare venolymphatic vascular malformation composed of proliferations or networks of vascular spaces including the lymphatics, capillaries, veins, or arteries. The small bowel is a rare location for hemolymphangioma, and the small bowel mesentery is an even rarer site. Herein, we report a surgically confirmed large complex hemolymphangioma in the small bowel mesentery in a 55-year-old male.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/b6/jksr-84-504.PMC10083628.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breast cancer is one of the most common cancers and causes several complications in females. Currently, MRI is a necessary method for preoperative studies in patients with breast cancer. A high frequency of breast MRI can lead to an increase in the number of incidental extramammary findings. Moreover, it can provide accurate preoperative workup; therefore, the prognosis of patients can be improved. Herein, we provide several extramammary findings, including the mediastinum, lung, upper abdomen, bone, and soft tissue, correlating with US, chest CT, liver MRI, PET-CT, and bone scan.
{"title":"Incidental Extramammary Findings on Preoperative Breast MRI in Breast Cancer Patients: A Pictorial Essay.","authors":"Jin-A Ryoo, Shin Young Kim","doi":"10.3348/jksr.2022.0076","DOIUrl":"https://doi.org/10.3348/jksr.2022.0076","url":null,"abstract":"<p><p>Breast cancer is one of the most common cancers and causes several complications in females. Currently, MRI is a necessary method for preoperative studies in patients with breast cancer. A high frequency of breast MRI can lead to an increase in the number of incidental extramammary findings. Moreover, it can provide accurate preoperative workup; therefore, the prognosis of patients can be improved. Herein, we provide several extramammary findings, including the mediastinum, lung, upper abdomen, bone, and soft tissue, correlating with US, chest CT, liver MRI, PET-CT, and bone scan.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/09/jksr-84-372.PMC10083632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed.
{"title":"Endovascular Management of Iatrogenic Vertebral Artery Pseudoaneurysm: A Case Report.","authors":"Jae Yang Park, Sanghyeon Kim, Myongjin Kang","doi":"10.3348/jksr.2022.0107","DOIUrl":"https://doi.org/10.3348/jksr.2022.0107","url":null,"abstract":"<p><p>Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed.</p>","PeriodicalId":17455,"journal":{"name":"Journal of the Korean Society of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/cb/jksr-84-483.PMC10083639.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}