Young Kwon Cho

Superficial venous aneurysm: reports of 3 cases and literature review.

Objective. The purpose of this series is to describe the ultrasonographic and computed tomographic (CT) findings of superficial venous aneurysms sometimes misdiagnosed as subcutaneous soft tissue tumors. Methods. Two of the patients had an asymptomatic subcutaneous mass that gradually increased in size; the third patient had a superficial mass in the right antecubital fossa associated with pain and occasional edema. All of the patients were examined with ultrasonography, and 2 had CT scans. Results. In all cases, ultrasound examinations showed a well‐defined heterogeneous echoic lesion that was contiguous with the adjacent superficial vein and easily compressed by the probe, whereas a Doppler study indicated a venous spectral wave without pulsation. Dynamic enhanced CT showed homogeneous enhancement in the late phase, with contiguity with the adjacent vein. Only the third patient had an internal, floating, heterogeneous, echoic mass‐like lesion, suggesting a chronic thrombus in the lesion on ultrasonography. This patient underwent aneurysmectomy with end‐to‐end anastomosis. Conclusions. Venous aneurysm should be included in the differential diagnosis of a subcutaneous mass, and an accurate understanding of the differences between superficial and deep venous aneurysms may help in diagnosis and treatment.

Fluoroscopically Guided Balloon Dilation of Anastomotic Strictures After Total Gastrectomy: Long-Term Results

OBJECTIVE The purpose of this study was to evaluate the radiologic and clinical effectiveness and long-term results of fluoroscopically guided balloon dilation of anastomotic strictures after total gastrectomy. CONCLUSION Fluoroscopically guided balloon dilation is effective and safe and has encouraging long-term results in the management of benign anastomotic strictures after total gastrectomy.

Rupture of a pseudoaneurysm as a rare cause of severe postpartum hemorrhage: analysis of 11 cases and a review of the literature

OBJECTIVE To clarify the clinical features of severe postpartum hemorrhage (PPH) resulting from a ruptured pseudoaneurysm and to determine the efficacy of selective arterial embolization as a method of management. STUDY DESIGN Eleven women who underwent selective arterial embolization for treatment of severe hemorrhage due to a ruptured pseudoaneurysm were identified from 2 hospitals within the past 5 years. A retrospective analysis was performed to identify the clinical characteristics of the hemorrhage and to evaluate the efficacy of arterial embolization. RESULTS Nine women delivered by cesarean delivery. Eight of the 11 women had late PPH with onset of bleeding occurring 6-100 days (median, 11.5) after delivery. The average volume of transfusion was 3196 ml of packed red blood cells (range, 1600-8980 ml). Uterine atony occurred in only one patient and was accompanied by an intrauterine abscess. Administration of uterotonic agents did not diminish the bleeding. Only one patient out of 11 underwent re-embolization. CONCLUSION If late PPH without uterine infection or retained placenta occurs after cesarean delivery, one should suspect the possibility of a ruptured pseudoaneurysm. Selective arterial embolization may be considered as a primary means of treatment.

Cardiovascular Behcet disease: the variable findings of rare complications with CT angiography and conventional angiography and its interventional management.

Abstract Unusual radiological manifestations of rare complications of cardiovascular Behcet disease (BD) are the following: (a) aneurysm and (b) occlusion in the aorta and its major branches, (c) pseudoaneurysms on the aortic root and coronary artery, and recurrent valvular dehiscence in the heart, (d) venous thrombosis in the deep and superficial venous system and vena cava. The initial exact diagnosis of cardiovascular BD has been extremely difficult for these rare complicated findings, especially in the absence of the florid clinical manifestations of BD. Radiologist should be aware of possibility of cardiovascular BD via familiarity with its rare imaging features, including computed tomographic angiography (and its 3-dimensional reconstructed images), conventional angiography, and with the clinical characteristics of BD because of high mortality of cardiovascular BD.

Rapidly aggravated dissecting flap by angiography during percutaneous stent placement for acute isolated superior mesenteric artery dissection.

Acutely aggravated dissecting flap and consequent occlusion of the superior mesenteric artery (SMA) by simple contrast passage during initial angiography for percutaneous stent placement is a uncommon event, which usually is not reported. After analysis of many factors that underlie development of such complications, we present herein one case of successful treatment of isolated SMA dissection and its complications with favorable outcomes during 25 months follow-up after percutaneous stent placement.

Trend Toward an Increase in Authorship for Leading Radiology Journals

OBJECTIVE The purpose of this study was to determine authorship trends in two leading radiology journals over the past 2 decades. MATERIALS AND METHODS All original articles (n = 5195) published in AJR and Radiology for the periods 1991-1993, 2001-2003, and 2011-2013 were reviewed. The following variables were extrapolated from each article: number of authors, radiologic subspecialty, and country of origin. The number of authors listed per article was correlated with the publication period, journal, radiologic subspecialty, and country of origin. RESULTS The mean number of authors per article increased from 5.1 in 1991-1993 to 6.2 in 2001-2003 and to 7.1 in 2011-2013 across both journals (p < 0.0001). Both AJR and Radiology had statistically significant increases in the number of authors per article over time, but the number of authors per article in Radiology was significantly higher than that in AJR (p < 0.0001 for all study periods). The number of authors per article significantly increased for all radiologic subspecialties. The mean numbers of authors per article by country of origin are as follows: Italy, 8.3; Japan, 7.6; France, 7.5; Germany, 7.4; China, 7.3; Austria, 7.2; and South Korea, 6.8. These were significantly higher than the mean number of authors from Switzerland, which was 6.3. CONCLUSION The number of authors significantly and consistently increased in two leading radiology journals over the past 2 decades.

Treatment of an Acute Mycotic Aneurysm of the Common Carotid Artery with a Covered Stent-Graft

We report herein a case successful endovascular treatment with a stent-graft of a rare case of rapidly growing mycotic aneurysm of the left common carotid artery due to acute bacterial endocarditis after eradication of the infection. Infected mycotic aneurysms of the peripheral vasculature have been considered as a contraindication for stent-graft implantation because of the possibility of microorganism spreading to the stent-graft; however, if there is evidence of complete eradication of microorganism and surgery is not an option, stent-graft implantation can be an effective and safe treatment modality for exclusion of the mycotic aneurysm.

Characteristics and Quality of Radiologic Randomized Controlled Trials: A Bibliometric Analysis Between 1995 and 2014

OBJECTIVE The aim of this bibliometric study was to assess the characteristics and quality of radiologic randomized controlled trials (RCTs) over the past 20 years. MATERIALS AND METHODS A PubMed search was conducted to identify radiologic RCTs (defined as RCTs in which the first author or corresponding author is affiliated with a radiology department) published between 1995 and 2014. The following information was extracted from each article: journal, radiologic subspecialty, imaging technique, number of subjects, study result, funding, number of authors, number of institutions, country of origin, and methodologic quality (assessed using the Jadad scale). RESULTS A total of 358 radiologic RCTs were published between 1995 and 2014. Dramatic increases in the numbers of radiologic RCTs were found, from 43 conducted in 1995-1999 to 172 conducted in 2010-2014. One-hundred seventeen (32.7%) RCTs were concerned with the field of vascular and interventional radiology; 78 (21.8%) evaluated more than one imaging technique; 164 (45.8%) had a sample size of 50-150 subjects; 246 (68.7%) showed positive study results; 185 (51.7%) were not funded; 179 (50.0%) had four to seven authors; 263 (73.5%) were single-center trials; 88 (24.6%) had a first author or corresponding author located in the United States; and 187 (52.2%) were of low quality. In the time trend analysis, the following variables showed a significantly positive trend: abdominal imaging subspecialty, CT as the imaging technique, more than 150 subjects, more than seven authors, and high methodologic quality. CONCLUSION The quantity and quality of radiologic RCTs have significantly increased over the past 2 decades; however, the methodologic quality remains suboptimal.

Angiographic analysis of the lateral intercostal artery perforator of the posterior intercostal artery: anatomic variation and clinical significance

PURPOSE Knowledge of the anatomic variations of the posterior intercostal artery (PICA) and its major branches is important during transthoracic procedures and surgery. We aimed to identify the anatomic features and variations of the lateral intercostal artery perforator (LICAP) of the PICA with selective PICA arteriography. METHODS We retrospectively evaluated 353 PICAs in 75 patients with selective PICA arteriography for the following characteristics: incidence, length (as number of traversed intercostal spaces), distribution at the hemithorax (medial half vs. lateral half), and size as compared to the collateral intercostal artery of the PICA. RESULTS The incidence of LICAPs was 35.9% (127/353). LICAPs were most commonly observed in the right 8th-11th intercostal spaces (33%, 42/127) and in the medial half of the hemithorax (85%, 108/127). Most LICAPs were as long as two (35.4%, 45/127) or three intercostal spaces (60.6%, 77/127). Compared to the collateral intercostal artery, 42.5% of LICAPs were larger (54/127), with most of these observed in the right 4th-7th intercostal spaces (48.8%, 22/54). CONCLUSION We propose the clinical significance of the LICAP as a potential risk factor for iatrogenic injury during posterior transthoracic intervention and thoracic surgery. For example, skin incisions must be as superficial as possible and directed vertically at the right 4th-7th intercostal spaces and the medial half of the thorax. Awareness of the anatomical variations of the LICAPs of the PICA will allow surgeons and interventional radiologists to avoid iatrogenic arterial injuries during posterior transthoracic procedures and surgery.

Korean Guidelines for Interventional Recanalization of Lower Extremity Arteries

Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care.