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Chondrolipomas, which are lipomas with chondroid metaplasia, are rare benign soft tissue tumors with no relevant epidemiological reports or radiological information. A limited number of lipomas with osteo/chondroid differentiation have been reported in the literature between 1960 and 2008. Moreover, only few studies have described the radiologic findings of chondrolipomas. Herein, we present a case of chrondrolipoma arising from the left supraclavicular region in a 77-year-old female.

Chlorfenapyr is widely used as an insecticide, despite it being fatal to humans. However, chlorfenapyr- induced central nervous system toxicity has rarely been reported. We report the magnetic resonance imaging (MRI) findings in a rare case of chlorfenapyr-induced toxic leukoencephalopathy. A 71-year-old man who had ingested chlorfenapyr approximately two weeks prior visited our hospital and presented with bilateral lower motor weakness and voiding dysfunction that had developed two days before admission. Brain MRI revealed extensive bilateral white matter abnormalities involving the corpus callosum, internal capsule, brain stem, and bilateral middle cerebellar peduncle. Furthermore, spine MRI revealed diffuse swelling and hyperintensity on the T2-weighted images.

Coronary artery aneurysm is a rare disease. It occurs in the epicardial space, mostly along the course of major coronary arteries. Here, we report a case of a giant incidental aneurysm embedded in the basal posterior wall of the left ventricle. A 43-year-old woman was referred to our institution for the evaluation of cardiac palpitations that had been present from the previous 2 months. She reported no medical history (such as Kawasaki’s disease or hypertension) or previous operative history. Echocardiogram and subsequent cardiac CT revealed a giant aneurysm in the left ventricle, with a direct fistulous connection to a dilated and tortuous left circumflex artery, which showed direct communication with the straight right coronary artery.

Purpose The purpose of this study was to investigate the relationship between abdominal fat as assessed by abdominal fat CT and metabolic syndrome (MS), especially in asymptomatic Korean individuals. Materials and Methods Retrospectively, a medical record analysis was performed in a total of 111 patients with screening abdominal fat CT. The data such as visceral fat (VF), subcutaneous fat (SF) and VF/SF were elicited by abdominal fat CT, and we analyzed the relationship of VF, SF, and VF/SF with MS and cardiovascular risk factors. Results In males, VF and SF had a positive correlation with many cardiovascular risk factors and MS, but VF was superior to SF. In females, VF, but not SF, had a positive correlation with some cardiovascular risk factors and MS. The cut-off values of VF and SF to predict MS, which were calculated by drawing receiver operating characteristic curves, were as follows: the cut-off value of VF in men: 136.50 cm2, the cut-off value of SF in men: 159.50 cm2, and the cut-off value of VF in women: 134.50 cm2. Conclusion In conclusion, VF accumulation was the best predictor of MS and it had a positive correlation with cardiovascular risk factors in both sexes. SF also had a significant association with MS, especially in men, although it was not superior to VF.

Purpose The aim of the study was to evaluate the correlation between decreased echogenicity of thyroid and thyroid hormones or autoantibodies. Materials and Methods From January 2009 to December 2011, 543 patients with decreased parenchymal echogenicity [M:F = 133:410, median age: 42 years (range: 9–82 years)], who did not have solid nodule, symptom or medication related to thyroid and underwent thyroid function test were retrospectively reviewed. Images were classified based on the degree of hypoechogenicity, heterogenicity or thyroid size. 1) Group A: mild decreased echogenicity, group B: marked decreased echogenicity, 2) group Ho: homogeneous echogenicity, group He: heterogeneous echogenicity, 3) group 1: decreased size, group 2: normal size, group 3: increased size. Differences in triiodiothyronyne (T3), free-thyroxine (fT4), thyrotropin (TSH), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and anti-TSH receptor antibody (TSH-rAb) were evaluated among groups. Results T3, fT4, and TSH levels differed between groups A and B (p < 0.001, p = 0.001, p < 0.001). TgAb and TPOAb of group B were higher than group A (p = 0.006, p < 0.001). TPOAb of group He was higher than group Ho (p < 0.001). TSH-rAb and TPOAb of group 3 were higher than group 2 (p = 0.017, p < 0.001). Conclusion The patients with findings of markedly decreased, heterogeneous echogenicity or thyroid enlargement may have abnormal thyroid function and autoantibodies. These may facilitate the physicians' decision to order tests for thyroid function and autoimmune activity.

Charcoal is used for localization of a non-palpable breast mass. Although charcoal is known to be safe when injected subcutaneously for preoperative localization, it can cause a foreign body reaction (1). Several cases of post-charcoal-marking granuloma of the breast have been reported, but the imaging modalities employed were limited to mammography or ultrasonography (2, 3) and other imaging findings have not yet been reported. Herein, we report multimodal imaging [i.e., ultrasound (US), computed tomography (CT), 18F-fluorodeoxyglucose (FDG)positron emission tomography/CT (PET/CT), and breast-specific gamma imaging (BSGI)] findings of a recurrence-mimicking charcoal granuloma in a breast cancer patient.

Purpose We explored the association between Framingham risk score (FRS) and coronary artery calcium score (CACS) in asymptomatic Korean individuals. Materials and Methods We retrospectively analyzed 2216 participants who underwent routine health screening and CACS using the 64-slice multidetector computed tomography between January 2010 and June 2014. Relationship between CACS and FRS, and factors associated with discrepancy between CACS and FRS were analyzed. Results CACS and FRS were positively correlated (p < 0.0001). However, in 3.7% of participants with low coronary event risk and high CACS, age, male gender, smoker, hypertension, total cholesterol, diabetes mellitus, and body mass index (BMI; ≥ 35) were associated with the discrepancy. In the diagnostic prediction model for discrepancy, the receiver operating characteristic curve including factors associated with FRS, diastolic blood pressure (≥ 75 mm Hg), diabetes mellitus, and BMI (≥ 35) showed that the area under the curve was 0.854 (95% confidence interval, 0.819–0.890), indicating good sensitivity. Conclusion Diabetes mellitus or obesity (BMI ≥ 35) compensate for the weakness of FRS and may be potential indicators for application of CACS in asymptomatic Koreans with low coronary event risk.

Sparganosis is a rare parasitic infection caused by the plerocercoid of the cestode Spirometra mansoni. The definitive hosts are dogs and cats, and humans are typically infected as aberrant hosts. The clinical manifestations are diverse and the most common symptom presents as movable or fixed subcutaneous nodules. Differentiation of sparganosis from a soft tissue tumor and subcutaneous or skin metastasis in a patient with cancer is difficult; and imaging finding of sparganosis in lymphoma patient has rarely been reported (1, 2). We reported multimodal image findings including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and follow-up imagings on multifocal sparganosis, mimicking lymphoma involvement in a patient with lymphoma. This case was approved by the Institutional Review Board and informed consent was waived.

Tubulinopathy commonly refers to complex congenital and non-progressive brain malformations caused by mutations in the tubulin genes. Among tubulin-encoding genes, TUBB3 has rarely been reported as a cause of complex cortical malformations. Herein, we report a case of tubulinopathy in a 21-month-old boy who presented with delayed development. He could not walk on his own and was not able to speak more than five words. Physical examination revealed right esotropia and hypotonia of the lower extremities. MRI showed dysmorphic brainstem and dysmorphic and hypertrophic basal ganglia. The right thalamus was relatively smaller than the left one. The cerebellum showed disorganization of the cerebellar folia. DNA sequencing revealed a missense mutation of the TUBB3 gene.

We report a rare case of hyperglycemia-related osmotic demyelination syndrome (ODS) with focus on the imaging findings. A 61-year-old man with diabetes was admitted for general weakness and severe thirst. A few days later, he complained of dysarthria, dysphasia, and dysmetria. Laboratory examinations showed significant hyperglycemia, but normal electrolyte levels. Brain MRI revealed T2-signal abnormalities that were symmetrical, non-space occupying, and located in the central pons with a peripheral sparing pattern, which were suggestive of ODS. In addition, subsequent MRI revealed progression of signal hyperintensity; however, the patient’s symptoms improved.

Although the thyroid gland is one of the most vascular organs of the body, metastatic disease in the thyroid is encountered infrequently. However, at autopsy, the incidence rate of thyroid metastasis ranges from 1.25% to 24%. The primary sites are the kidney, lung, breast, and gastrointestinal tract. We report a rare case of a hepatocellular carcinoma metastatic to the thyroid gland. The patient had multiple palpable masses in the anterior and left lateral neck along the internal jugular chain on physical examination 9 months after the initial diagnosis of liver tumor. These masses were confirmed as metastasis from hepatocellular carcinoma by ultrasonography-guided 16-G core needle biopsy. We discuss the sonographic findings of thyroid metastasis and their use as an additional aid for differentiating between unknown primary tumor and thyroid metastasis.

Cerebral air embolism is a rare, potentially catastrophic iatrogenic complication of central venous catheter removal. Cerebral air embolism can lead to serious neurological sequelae, resulting from cerebral infarction. Early radiological diagnosis of cerebral air embolism is critical for emergent hyperbaric oxygen treatment. In this study, we report the case of a 68-year-old man who developed cerebral air embolism after the removal of a central venous catheter that was immediately diagnosed using brain CT and brain diffusion-weighted imaging.

Primary sarcomas of the great vessels are extremely uncommon tumors, with aortic sarcoma being the rarest type. They tend to occur in the thoracic aorta, followed by the abdominal aorta and the thoracoabdominal aorta. They have a propensity for metastases and they cause acute arterial embolism (1). Undifferentiated pleomorphic sarcoma, also called malignant fibrous histiocytoma, has been defined as a group of pleomorphic, high-grade sarcomas that fail to show any line of differentiation using currently available ancillary techniques (2). To the best of our knowledge, no fewer than 24 cases of undifferentiated pleomorphic sarcoma originating from the aorta have been reported in the worldwide literature, but imaging findings have been rarely reported (3-7). Herein, we describe the case of a 67-year-old male who had a primary undifferentiated pleomorphic sarcoma of the descending thoracic aorta with an emphasis on computed tomography (CT) and magnetic resonance imaging (MRI) findings. CASE REPORT

췌장성 지방층염은 1883년 Chiari (1)에 의해 처음 기술되었 으며 췌장질환과 동반되어 원발 부위와 떨어진 부위의 피하지 방에 괴사와 염증을 일으키는 질환으로, 임상적으로 크기가 작 은 동통을 동반한 홍반성 판(erythematous plaque)이나 결절이 주로 하지나 둔부, 몸통 등의 원위부에 발생하고 심한 경우 전 신적으로 발생하기도 한다. 급성 또는 만성췌장염이나 췌장가 성낭종, 췌장종양과 같은 다양한 췌장질환과 연관되어 발생하 며, 40% 정도는 췌장질환에 선행하여 나타난다(2). 췌장성 지방층염은 췌장질환의 약 2~3%에서 볼 수 있는 드 문 질환으로(2) 저자들은 췌장의 출혈성 가성낭종을 동반한 급성췌장염에 병발되어 복벽에 다발성 피하결절을 보이는 지방 층염을 진단하여 문헌고찰과 함께 보고하고자 한다.

Osteoblastoma-like osteosarcoma is a rare, low-grade variant of osteosarcoma that may resemble osteoblastoma clinically, radiographically and histologically. We report a case of osteoblastoma-like osteosarcoma in the right proximal tibia in a 17-year-old woman. Plain radiography revealed an irregular osteolytic lesion in the metaepiphysis of the right proximal tibia and transverse fracture line of the metaphysic through an osteolytic lesion. MRI showed well-defined mass confined to the medullary space with cortical disruption and pathologic fracture. The MR signals were low on T1-weighted image and intermediate on T2-weighted image.

Copyrights © 2011 The Korean Society of Radiology Purpose: To assess the satisfaction, attitude, dissatisfaction and general opinion of radiologic reports on the plain radiography, except for chest plain radiographies. Materials and Methods: A questionnaire was distributed to the 63 physicians of our hospital. The questionnaire aimed to investigate physician’s general attitude, dissatisfaction and opinions. The responses elicited, as well as discrepancies among residents, staff, medical clinicians and surgical clinicians were assessed. Chi-square and t-tests were used to determine the value of the data. Results: The mean rate of satisfaction for the reading report by medical clinicians (64%) was higher than surgical clinicians (25%) (p < 0.001). The mean satisfaction score was 3.1 (2.8-3.61). The main cause for dissatisfaction was the absence of reports when they were needed, especially for residents. Conclusion: The medical clinician’s dependence on radiologic reports was higher than that of the surgical clinicians. The satisfaction score was in the middle range and the main cause of dissatisfaction was absence of the reports when they were needed. Index terms Radiology Reporting System Radiography Consumer Satisfaction Survey of the Satisfaction and Dissatisfaction of Referring Physicians Concerning the Radiologic Report of Plain Radiography Except for Chest Plain Radiography 흉부단순촬영을 제외한 단순촬영판독에 대한 만족도와 불만족에 대한 조사

Lipoma arborescens is a rare intra-articular lesion consisting of villous lipomatous proliferation of the synovium that tends to occur in the knee joint, especially in the suprapatellar pouch. The lesion has been observed in other locations, including the glenohumeral joint, subdeltoid bursa, hip, and elbow. We report a case of a lipoma arborescens of a unilateral hip joint in a 34-year-old man. MRI and a whole body bone scan were performed. In addition, a surgical synovectomy was performed and microscopic examination of the tumor revealed multiple variable-sized villous masses composed of mature fat tissue and lined by synovial cells which confirmed the diagnosis of lipoma arborescens.

Herlyn-Werner-Wunderlich syndrome is a rare Mullerian ductal anomaly that is characterized by the presence of a hemivaginal septum, a didelphic uterus and ipsilateral renal agenesis. It is generally difficult to diagnose the uterine malformation before menarche owing to its small size. Therefore, a follow-up study is very important for confirming the uterine malformation in girls with renal agenesis. We report a patient with renal agenesis and microscopic hematuria, who showed symptoms before menarche. A follow-up study eventually revealed uterine didelphys with a hemivaginal obstruction. A biopsy proved that the microscopic hematuria was caused by thin glomerular basement membrane disease of the contralateral kidney.

Purpose: With the advent of MSCT, the detection rate of small pulmonary nodules is markedly greater. However, there is no definite diagnostic clue to differentiate between malignant and benign nodules, except for the interval growth in small nodule less than 1 cm in diameter. We evaluated the accuracy of computeraided volumetry (CAV) and compared it with 4 radiologists' measurement. Materials and Methods: Fifteen artificial nodules that were embedded in the ex vivo porcine lung were scanned by MSCT. The diameters and volumes of nodules were independently measured three times, at 5-day intervals, and by four radiologists as well as by CAV. We evaluated the accuracy of the measurements on the basis of the true diameter and volume of the nodules. Using a paired t-test and a Bland-Altman plot, we evaluated whether there was a statistically significant difference between the radiologists' measurements and the CAV. Results: The accuracy of the manual measurements by radiologists revealed a statistically significant difference from the true diameter and volume of the artificial nodules (p0.01) Conclusion: The results of this study suggest that CAV is an accurate and useful tool to evaluate the volume of pulmonary nodules and can eventually be used to differentiate malignant and benign nodules as well as evaluate the therapeutic response of lung cancer.

Objective To demonstrate a variety of MR imaging findings of orbital inflammatory pseudotumors with extraorbital extension. Materials and methods We retrospectively reviewed the MR features of five patients, who were diagnosed clinically and radiologically as having an orbital inflammatory pseudotumor with extraorbital extension. Results The types of orbital pseudotumors were a mass in the orbital apex (n = 3), diffuse form (n = 2), and myositis (n = 1). The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. The orbital lesions extended into the following areas: the cavernous sinus (n = 4), the middle cranial fossa (n = 4), Meckel's cave (n = 2), the petrous apex (n = 2), the clivus (n = 2), the pterygopalatine fossa and infratemporal fossa (n = 2), the foramen rotundum (n = 1), the paranasal sinus (n = 1), and the infraorbital foramen (n = 1). On MR imaging, the lesions appeared as an isosignal intensity with gray matter on the T1-weighted images, as a low signal intensity on the T2-weighted images and showed a marked enhancement on the post-gadoliniumdiethylene triamine pentaacetic acid (post-Gd-DTPA) T1-sequences. The symptoms of all of the patients improved when they were given high doses of steroids. Three of the five patients experienced a recurrence. Conclusion MR imaging is useful for demonstrating the presence of a variety of extraorbital extensions of orbital inflammatory pseudotumors.

Granular cell tumor is an uncommon benign tumor derived from Schwann cells. The most common location is the tongue, followed by striated muscle bundles at other sites, and the skin. About 6-8% of granular cell tumors occur in the breast. We report the sonographic findings of a case of graunlar cell tumor occurring at that site.

Orthostatic proteinuria has been recognized as a benign condition with a good prognosis and has not been associated with any underlying glomerular disease. The pathogenesis of orthostatic proteinuria is unclear. Recently, a few foreign reports suggested that the nutcracker phenomenon, which is known as a cause of asymptomatic hematuria, may also be a major cause of orthostatic proteinuria. We report a case of a 12-yearold female patient presenting only with orthostatic proteinuria, who was diagnosed as having nutcracker phenomenon by Doppler study and venography.

Purpose: To identify the characteristic ultrasonographic findings of the normal appendix in children in order to detect it more easily and so to exclude acute appendicitis from a diagnosis with more confidence. Materials and Methods: Among 64 patients presenting with right lower quadrant pain, 44 patients, excluding 15 patients diagnosed as acute appendicitis and 5 patients with non-visualization of the appendix due to severe ileus and obesity, were evaluated for the point of incidence, the thickness and the presence of folding of the inner hypoechoic band of the normal appendix. The age of the patients ranged from 3 to 15 years with a mean age of 6.5 years. Two patients were operated on and we correlated the preoperative ultrasonographic findings with the histologic findings. Results: In all the cases of the 44 patients with normal appendix, the inner hypoechoic band was discovered, which was seen as a linear structure without folding along the whole length of appendix. This measured as 0.75 mm (0.3-1.5 mm) for the mean thickness. The inner hypoechoic band corresponded to the mucosal layer that had abundant lymphoid tissue on the histologic examination. Conclusion: For the pediatric normal appendix, the inner hypoechoic band without folding is present, and this corresponds to the mucosal layer with abundant lymphoid tissue.

Intracranial lipoma usually occurs at or near the midline, predominantly in the callosal cistern and very rarely in the sylvian fissure. We report a case of lipoma of the sylvian fissure without association with other congenital anomaly or vascular abnormality.