392 results on '"Hsu, Hsian-He"'
Search Results
102. Using Multidetector-Row CT for the Diagnosis of Afferent Loop Syndrome Following Gastroenterostomy Reconstruction
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Juan, Yu-Hsiu, primary, Yu, Chih-Yung, additional, Hsu, Hsian-He, additional, Huang, Guo-Shu, additional, Chan, De-Chuan, additional, Liu, Chang-Hsien, additional, Tung, Ho-Jui, additional, and Chang, Wei-Chou, additional
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- 2011
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103. Incidentally Detected Enhancing Breast Lesions on Chest Computed Tomography
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Lin, Wen-Chiung, primary, Hsu, Hsian-He, additional, Li, Chao-Shiang, additional, Yu, Jyh-Cherng, additional, Hsu, Giu-Cheng, additional, Yu, Cheng-Ping, additional, Chang, Tsun-Hou, additional, and Huang, Guo-Shu, additional
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- 2011
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104. Concurrent Measurement of Isokinetic Muscle Strength of the Trunk, Knees, and Ankles in Patients With Lumbar Disc Herniation With Sciatica
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Chen, Liang-Cheng, primary, Kuo, Chu-Wen, additional, Hsu, Hsian-He, additional, Chang, Shin-Tsu, additional, Ni, Shou-Min, additional, and Ho, Cheng-Wen, additional
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- 2010
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105. Regional Perfusion And Aeration Distribution In Acute Lung Injury Characterized By Fluorescent Microsphere And Computed Tomography Imaging
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Chang, Hung, primary, Peng, Chung Kan, additional, Hsu, Hsian-He, additional, and Lee, Shih-Chun, additional
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- 2010
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106. Ultrasonographic alterations associated with the dilatation of mammary ducts: feature analysis and BI-RADS assessment
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Hsu, Hsian-He, primary, Yu, Jyh-Cherng, additional, Hsu, Giu-Cheng, additional, Chang, Wei-Chou, additional, Yu, Cheng-Ping, additional, Tung, Ho-Jui, additional, Tzao, Ching, additional, and Huang, Guo-Shu, additional
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- 2009
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107. Value of sonographically guided needle sampling of cystic versus solid components in the diagnosis of complex cystic breast masses
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Lin, Wen-Chiung, primary, Hsu, Giu-Cheng, additional, Yu, Cheng-Ping, additional, Yu, Jyh-Cherng, additional, Lee, Hsiu-Nan, additional, Hsu, Hsian-He, additional, Chang, Tsun-Hou, additional, Chen, Tom, additional, Li, Chao-Shiang, additional, and Huang, Guo-Shu, additional
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- 2009
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108. Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula
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Wang, Chih-Wei, primary, Juan, Chun-Jung, additional, Liu, Yi-Jui, additional, Hsu, Hsian-He, additional, Liu, Hua-Shan, additional, Chen, Cheng-Yu, additional, Hsueh, Chun-Jen, additional, Lo, Chung-Ping, additional, Kao, Hung-Wen, additional, and Huang, Guo-Shu, additional
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- 2009
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109. Atypical Pulmonary Metastases from a True Malignant Mixed Tumor of the Parotid Gland
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Lin, Wen-Chiung, primary, Li, Chao-Shiang, additional, Lin, Chih-Kung, additional, Hsu, Hsian-He, additional, Chang, Tsun-Hou, additional, Chen, Tom, Yun-Cheng, additional, and Huang, Guo-Shu, additional
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- 2009
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110. An Unusual Radiologic Pattern of Cryptogenic Organizing Pneumonia: Diffuse Pulmonary Nodules in a Leukemia Patient
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Ko, Kai-Hsiung, primary, Hsu, Hsian-He, additional, Kao, Woei-Yau, additional, Chang, Ching-Feng, additional, Cheng, Ming-Fang, additional, and Huang, Guo-Shu, additional
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- 2009
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111. Simultaneous bilateral primary spontaneous pneumothorax
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LEE, Shih-Chun, primary, CHENG, Yeung-Leung, additional, HUANG, Chi-Wang, additional, TZAO, Ching, additional, HSU, Hsian-He, additional, and CHANG, Huang, additional
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- 2007
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112. High Agatston Calcium Score of Intracranial Carotid Artery: A Significant Risk Factor for Cognitive Impairment.
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Hung-Wen Kao, Liou, Michelle, Hsiao-Wen Chung, Hua-Shan Liu, Ping-Huei Tsai, Shih-Wei Chiang, Ming-Chung Chou, Giia-Sheun Peng, Guo-Shu Huang, Hsian-He Hsu, Cheng-Yu Chen, Kao, Hung-Wen, Chung, Hsiao-Wen, Liu, Hua-Shan, Tsai, Ping-Huei, Chiang, Shih-Wei, Chou, Ming-Chung, Peng, Giia-Sheun, Huang, Guo-Shu, and Hsu, Hsian-He
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- 2015
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113. Value of F-FDG uptake on PET/CT and CEA level to predict epidermal growth factor receptor mutations in pulmonary adenocarcinoma.
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Ko, Kai-Hsiung, Hsu, Hsian-He, Huang, Tsai-Wang, Gao, Hong-Wei, Shen, Daniel, Chang, Wei-Chou, Hsu, Yi-Chih, Chang, Tsun-Hou, Chu, Chi-Ming, Ho, Ching-Liang, and Chang, Hung
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EPIDERMAL growth factor receptors ,PULMONARY artery ,ADENOCARCINOMA ,POSITRON emission tomography ,COMPUTED tomography ,PATIENTS ,TUMORS - Abstract
Purpose: The identification of the mutation status of the epidermal growth factor receptor ( EGFR) is important for the optimization of treatment in patients with pulmonary adenocarcinoma. The acquisition of adequate tissues for EGFR mutational analysis is sometimes not feasible, especially in advanced-stage patients. The aim of this study was to predict EGFR mutation status in patients with pulmonary adenocarcinoma based on F-fluorodeoxyglucose (FDG) uptake and imaging features in positron emission tomography/computed tomography (PET/CT), as well as on the serum carcinoembryonic antigen (CEA) level. Methods: We retrospectively reviewed 132 pulmonary adenocarcinoma patients who underwent EGFR mutation testing, pretreatment FDG PET/CT and serum CEA analysis. The associations between EGFR mutations and patient characteristics, maximal standard uptake value (SUVmax) of primary tumors, serum CEA level and CT imaging features were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors. Results: EGFR mutations were identified in 69 patients (52.2 %). Patients with SUVmax ≥6 ( p = 0.002) and CEA level ≥5 ( p = 0.013) were more likely to have EGFR mutations. The CT characteristics of larger tumors (≥3 cm) ( p = 0.023) and tumors with a nonspiculated margin ( p = 0.026) were also associated with EGFR mutations. Multivariate analysis showed that higher SUVmax and CEA level, never smoking and a nonspiculated tumor margin were the most significant predictors of EGFR mutation. The combined use of these four criteria yielded a higher area under the ROC curve (0.82), suggesting a good discrimination. Conclusion: The combined evaluation of FDG uptake, CEA level, smoking status and tumor margins may be helpful in predicting EGFR mutation status in patients with pulmonary adenocarcinoma, especially when the tumor sample is inadequate for genetic analysis or genetic testing is not available. Further large-scale prospective studies are needed to validate these results. [ABSTRACT FROM AUTHOR]
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- 2014
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114. Tissues Classification for Breast MRI Contrast Enhancement Using Spectral Signature Detection Approach
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Chung, Pau-Choo, primary, Wang, Chuin-Mu, additional, Yang, Sheng-Chih, additional, and Hsu, Hsian-He, additional
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- 2006
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115. Acute concomitant pulmonary artery and aortic dissection with rupture
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Hsu, Hsian-He, primary, Tzao, Ching, additional, Tsai, Chien-Sung, additional, Sun, Guang-Huang, additional, and Chen, Cheng-Yu, additional
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- 2006
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116. An Unusual Case of Thymic Carcinoma With Endobronchial Metastases Manifesting as Centrilobular Opacities
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Kao, Hung-Wen, primary, Yu, Cheng-Ping, additional, Tzao, Ching, additional, Lin, Wen-Chiung, additional, Hsu, Hsian-He, additional, and Chen, Cheng-Yu, additional
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- 2006
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117. Pulmonary Cryptococcosis
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Chang, Wei-Chou, primary, Tzao, Ching, additional, Hsu, Hsian-He, additional, Lee, Shih-Chun, additional, Huang, Kun-Lun, additional, Tung, Ho-Jui, additional, and Chen, Cheng-Yu, additional
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- 2006
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118. Isolated cryptococcal thoracic empyema with osteomyelitis of the rib in an immunocompetent host
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Chang, Wei-Chou, primary, Tzao, Ching, additional, Hsu, Hsian-He, additional, Chang, Hon, additional, Lo, Chung-Ping, additional, and Chen, Cheng-Yu, additional
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- 2005
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119. Isolated endobronchial metastasis of Wilms' tumor
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Lee, Tzu-Peng, primary, Tzao, Ching, additional, Liu, Jia-Hung, additional, Yu, Cheng-Ping, additional, Hsu, Hsian-He, additional, and Chien, Hsing-Nan, additional
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- 2005
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120. Isokinetic Muscle Strength of the Trunk and Bilateral Knees in Young Subjects With Lumbar Disc Herniation
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Ho, Cheng-Wen, primary, Chen, Liang-Cheng, additional, Hsu, Hsian-He, additional, Chiang, Shang-Lin, additional, Li, Min-Hui, additional, Jiang, Shuu-Hai, additional, and Tsai, Kao-Chung, additional
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- 2005
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121. Pneumomediastinum following smoking crack cocaine
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Chang, Wei-Chou, primary, Hsu, Hsian-He, additional, Tzao, Ching, additional, and Chen, Cheng-Yu, additional
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- 2005
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122. Metastatic Pulmonary Calcification in Renal Failure Mimicking Pulmonary Embolism on Lung Scan
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Cherng, Shiou-Chi, primary, Cheng, Cheng-Yi, additional, Chen, Ching-Yuan, additional, Hsu, Hsian-He, additional, and Chu, Pauling, additional
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- 2005
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123. Fast fully automatic detection, classification and 3D reconstruction of pulmonary nodules in CT images by local image feature analysis.
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Kuo, Chung-Feng Jeffrey, Barman, Jagadish, Hsieh, Chia Wen, and Hsu, Hsian-He
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COMPUTED tomography ,PULMONARY nodules ,IMAGE analysis ,IMAGE reconstruction algorithms ,COMPUTER-aided diagnosis ,RIEMANN integral - Abstract
• Fast fully automatic lung nodule detection system for ground-glass opacity, part-solid and solid nodules in CT. • The process includes image preprocessing, pulmonary lobe block extraction, nodule feature selection, ANN and 3D reconstruction. • The method is stable, reliable, automatic, and fast for lung nodule segmentation. • The medical indispensability of easy-access efficient methods justifies the approach. • The detection and classification results enhanced the clinical detection of missing nodules. This study develops a computer-aided diagnosis (CAD) system for automatic detection and classification of pulmonary nodules in lung computed tomography (CT) images, which can simultaneously detect and classify ground-glass opacity (GGO), part-solid, and solid nodules. From the morphological feature and local image features of pulmonary nodules, a total of ten features were selected for artificial neural network (ANN) training and testing, to ensure the system can detect and classify pulmonary nodules. Then, the cross-sectional area of each slice of pulmonary nodule was extracted. The response evaluation criteria in solid tumor (RECIST) value was obtained using the Euclidean distance formula, and the number of pixels of the maximum cross-sectional area was counted for area computation. The nodule volume and 3D reconstruction was obtained using the marching cube algorithm and Riemann integral formula. The sensitivity of system detection and classification were 93.13% and 92.70%, respectively. The proposed system can detect GGO, part-solid, and solid nodules, and takes only 0.1 s to process a single image. This study used the clay model imitating pulmonary nodule morphology as physical samples. Each physical sample underwent three CT. The average difference between the physical volume and the volume derived from this study was 0.37%. The detection and classification results of the system enhanced the clinical detection of missing nodules. 3D reconstruction and volume information of the nodules can give their volume doubling time and growth rate when the patient undergoes CT for the second time, thus enhancing the effect of diagnosis and treatment. [ABSTRACT FROM AUTHOR]
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- 2021
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124. Detection of left ventricular systolic dysfunction using an artificial intelligence–enabled chest X-ray
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Hsiang, Chih-Weim, Lin, Chin, Liu, Wen-Cheng, Lin, Chin-Sheng, Chang, Wei-Chou, Hsu, Hsian-He, Huang, Guo-Shu, Lou, Yu-Sheng, Lee, Chia-Cheng, Wang, Chih-Hung, and Fang, Wen-Hui
- Abstract
Assessment of left ventricular systolic dysfunction provides essential information related to the prognosis and management of cardiovascular diseases. The aim of this study is to develop a deep-learning model (DLM) to identify LVEF≤35% via chest X-ray (CXR-EF≤35%) features and investigate the performance and clinical implications.
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- 2022
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125. Automatic lung nodule detection system using image processing techniques in computed tomography.
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Kuo, Chung-Feng Jeffrey, Huang, Chang-Chiun, Siao, Jing-Jhong, Hsieh, Chia-Wen, Huy, Vu Quang, Ko, Kai-Hsiung, and Hsu, Hsian-He
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PULMONARY nodules ,IMAGE processing ,COMPUTED tomography ,EDGE detection (Image processing) ,SUPPORT vector machines ,TUMOR classification - Abstract
• Automatic lung nodule detection system for ground glass opacity, part solid and solid nodules in CT. • The process comprises image preprocessing, lung segmentation, nodule enhancement, candidate detection and reducing false positives. • A new three-dimensional feature was proposed for lung nodule detection. • This detection system has high sensitivity and low false positives. Diagnosing and treating lung cancer at an early stage can improve the survival rate of patients. This study attempted to develop a computer-aided detection (CAD) system. In order to include all nodule types in the detection, this study proposes an image processing method for detecting ground glass opacity (GGO), part solid, and solid nodules in chest computed tomography. The process comprises image preprocessing, lung segmentation, nodule enhancement, candidate detection, and reduction of false positives. For lung segmentation, the edge searching method replaces the computing-intensive iterative hole-filling method. In order to extract nodules with extensively distributed gray levels, image accumulation is used in the nodule enhancement to rapidly enhance the gray level of individual nodules. In order to reduce false positives, the support vector machine (SVM) is applied twice. On the first run, the candidate nodules are obtained by using 4 two-dimensional features, and the classification result is obtained by using 11 three-dimensional features on the second run. This study used 667 lung nodules for experiment and evaluation. The proposed system can detect GGO, part solid, and solid nodules and takes only 0.1 s to process a single image. The total sensitivity of the system is more than 92.05%. The system excels at detecting small nodules in the range of 5 mm–9 mm with a sensitivity of 93.73% and GGO with a sensitivity of 93.02%. The results showed that the proposed rapid detection system has high sensitivity and low false positives, contributing to helping the clinicians' diagnosis. [ABSTRACT FROM AUTHOR]
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- 2020
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126. Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula.
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Wang, Chih-Wei, Juan, Chun-Jung, Liu, Yi-Jui, Hsu, Hsian-He, Liu, Hua-Shan, Chen, Cheng-Yu, Hsueh, Chun-Jen, Lo, Chung-Ping, Kao, Hung-Wen, and Huang, Guo-Shu
- Abstract
Although the ABC/2 formula has been widely used to estimate the volume of intracerebral hematoma (ICH), the formula tends to overestimate hematoma volume. The volume-related imprecision of the ABC/2 formula has not been documented quantitatively.
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- 1958
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127. Complete fully automatic segmentation and 3-dimensional measurement of mediastinal lymph nodes for a new response evaluationcriteria for solid tumors
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Jeffrey Kuo, Chung-Feng, Hsun Lin, Kuan, Weng, Wei-Han, Barman, Jagadish, Huang, Chun-Chia, Chiu, Chih-Wei, Lee, Ji-Lun, and Hsu, Hsian-He
- Abstract
We aimed to automatically detect and segment mediastinal lymph nodes, and to establish an objective method and reliable new response evaluation criteria to monitor the effectiveness of cancer treatment. The image processing techniques were applied and developed 3D measurement of the mediastinal lymph nodes based on automatic settings when segmenting the lymph node image. A repeatable and consistent lymph node evaluation system was created based on such features as the position of occurrence, grayness, and number of serial sections of lymph nodes. A total of 200 lymph node samples from Tri-Service General Hospital, Taiwan, were examined for statistical analysis. The proposed approach used weighted k-nearest neighbors for classification, achieving superior results with an accuracy and specificity of 97.5% and 99.4%, respectively. The volume of the lymph nodes was used as the reference index for tumor invasiveness evaluation. The error in the lymph node volume was 1.71% according to the verification results. Receiver operating characteristic (ROC) curves for each analysis were constructed and the area under the curve (AUC) was calculated with histopathology diagnosis as outcome for determining the optimal volume threshold of benign and malignant lymph nodes. It was observed that the lymph node volume was highly correlated with tumor invasion (p-value was less than 0.05). The experiment showed that the volume for the area under the ROC curve was 0.90 of tumor invasion evaluation. The lymph node volume was most effective in predicting tumor invasiveness, with the value 798.53 mm3used as the standard for judging benignity and malignancy.
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- 2021
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128. Performance measures of 8,169,869 examinations in the National Breast Cancer Screening Program in Taiwan, 2004–2020.
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Yao, Melissa Min-Szu, Vy, Vu Pham Thao, Chen, Tony Hsiu-Hsi, Hsu, Hsian-He, Hsu, Giu-Cheng, Lee, Cindy S., Lin, Li-Ju, Chia, Shu-Li, Wu, Chao-Chun, Chan, Wing P., and Yen, Amy Ming-Fang
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EARLY detection of cancer , *NATIONAL competency-based educational tests , *BREAST cancer , *BREAST exams , *SURVIVAL rate , *MEDICAL screening - Abstract
Background: The benefits of mammographic screening have been shown to include a decrease in mortality due to breast cancer. Taiwan's Breast Cancer Screening Program is a national screening program that has offered biennial mammographic breast cancer screening for women aged 50–69 years since 2004 and for those aged 45–69 years since 2009, with the implementation of mobile units in 2010. The purpose of this study was to compare the performance results of the program with changes in the previous (2004–2009) and latter (2010–2020) periods. Methods: A cohort of 3,665,078 women who underwent biennial breast cancer mammography screenings from 2004 to 2020 was conducted, and data were obtained from the Health Promotion Administration, Ministry of Health and Welfare of Taiwan. We compared the participation of screened women and survival rates from breast cancer in the earlier and latter periods across national breast cancer screening programs. Results: Among 3,665,078 women who underwent 8,169,869 examinations in the study population, the screened population increased from 3.9% in 2004 to 40% in 2019. The mean cancer detection rate was 4.76 and 4.08 cancers per 1000 screening mammograms in the earlier (2004–2009) and latter (2010–2020) periods, respectively. The 10-year survival rate increased from 89.68% in the early period to 97.33% in the latter period. The mean recall rate was 9.90% (95% CI: 9.83–9.97%) in the early period and decreased to 8.15% (95%CI, 8.13–8.17%) in the latter period. Conclusions: The evolution of breast cancer screening in Taiwan has yielded favorable outcomes by increasing the screening population, increasing the 10-year survival rate, and reducing the recall rate through the participation of young women, the implementation of a mobile unit service and quality assurance program, thereby providing historical evidence to policy makers to plan future needs. [ABSTRACT FROM AUTHOR]
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- 2023
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129. Docetaxel (Taxotere®)-induced cavitary change of pulmonary metastatic lesions complicated by bilateral spontaneous pneumothoraces in a patient with primary adenocarcinoma of the lung.
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Kao, H L, Lin, W C, Hsu, H H, Huang, G S, Kao, Hao-Lun, Lin, Wen-Chiung, Hsu, Hsian-He, and Huang, Guo-Shu
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Pneumothorax is a complication that rarely occurs after chemotherapy for lung cancer. We report the chest computed tomography findings of a case of spontaneous pneumothorax complicating docetaxel (Taxotere®) treatment for pulmonary metastasis in a 70-year-old woman with pulmonary adenocarcinoma. The patient developed bilateral pneumothoraces, which was induced by changes in the cavitary pulmonary metastatic lesions, after systemic chemotherapy with docetaxel. The chest computed tomography findings and possible mechanisms of this unusual complication are discussed in this report. [ABSTRACT FROM AUTHOR]
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- 2013
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130. Complete, Fully Automatic Detection and Classification of Benign and Malignant Breast Tumors Based on CT Images Using Artificial Intelligent and Image Processing.
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Kuo, Chung-Feng Jeffrey, Chen, Hsuan-Yu, Barman, Jagadish, Ko, Kai-Hsiung, and Hsu, Hsian-He
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BREAST tumors , *IMAGE processing , *COMPUTED tomography , *AUTOMATIC classification , *THREE-dimensional imaging , *PHYLLODES tumors - Abstract
Breast cancer is the most common type of cancer in women, and early detection is important to significantly reduce its mortality rate. This study introduces a detection and diagnosis system that automatically detects and classifies breast tumors in CT scan images. First, the contours of the chest wall are extracted from computed chest tomography images, and two-dimensional image characteristics and three-dimensional image features, together with the application of active contours without edge and geodesic active contours methods, are used to detect, locate, and circle the tumor. Then, the computer-assisted diagnostic system extracts features, quantifying and classifying benign and malignant breast tumors using a greedy algorithm and a support vector machine. The study used 174 breast tumors for experiment and training and performed cross-validation 10 times (k-fold cross-validation) to evaluate performance of the system. The accuracy, sensitivity, specificity, and positive and negative predictive values of the system were 99.43%, 98.82%, 100%, 100%, and 98.89% respectively. This system supports the rapid extraction and classification of breast tumors as either benign or malignant, helping physicians to improve clinical diagnosis. [ABSTRACT FROM AUTHOR]
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- 2023
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131. Differentiating focal interstitial fibrosis from adenocarcinoma in persistent pulmonary subsolid nodules (> 5 mm and < 20 mm): the role of coronal thin-section CT images.
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Ko, Kai-Hsiung, Huang, Tsai-Wang, Chang, Wei-Chou, Huang, Hsu-Kai, Tsai, Wen-Chiuan, and Hsu, Hsian-He
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COMPUTED tomography , *PULMONARY nodules , *ADENOCARCINOMA , *RECEIVER operating characteristic curves , *FIBROSIS - Abstract
Objectives: To investigate thin-section computed tomography (CT) features of pulmonary subsolid nodules (SSNs) with sizes between 5 and 20 mm to determine predictive factors for differentiating focal interstitial fibrosis (FIF) from adenocarcinoma. Methods: From January 2017 to December 2018, 169 patients who had persistent SSNs 5–20 mm in size and underwent preoperative nodule localization were enrolled. Patient characteristics and thin-section CT features of the SSNs were reviewed and compared between the FIF and adenocarcinoma groups. Univariable and multivariable analyses were used to identify predictive factors of malignancy. Receiver operating characteristic (ROC) curve analysis was used to quantify the performance of these factors. Results: Among the 169 enrolled SSNs, 103 nodules (60.9%) presented as pure ground-glass opacities (GGOs), and 40 (23.7%) were FIFs. Between the FIF and adenocarcinoma groups, there were significant differences (p< 0.05) in nodule border, shape, thickness, and coronal/axial (C/A) ratio. Multivariable analysis demonstrated that a well-defined border, a nodule thickness >4.2, and a C/A ratio >0.62 were significant independent predictors of malignancy. The performance of a model that incorporated these three predictors in discriminating FIF from adenocarcinoma achieved a high area under the ROC curve (AUC, 0.979) and specificity (97.5%). Conclusions: For evaluating persistent SSNs 5–20 mm in size, the combination of a well-defined border, a nodule thickness > 4.2, and a C/A ratio > 0.62 is strongly correlated with malignancy. High accuracy and specificity can be achieved by using this predictive model. Key Points: • Thin-section coronal images play an important role in differentiating FIF from adenocarcinoma. • The combination of a well-defined border, nodule thickness>4.2 mm, and C/A ratio >0.62 is associated with malignancy. • This predictive model may be helpful for managing persistent SSNs between 5 and 20 mm in size. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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132. Demands for medical imaging and workforce Size: A nationwide population-based Study, 2000–2020.
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Ko, Chih-Hsiang, Chien, Li-Nien, Chiu, Yu-Ting, Hsu, Hsian-He, Wong, Ho-Fai, and Chan, Wing P.
- Abstract
• Radiologist workload in Taiwan was greater than that in western countries. • Workload growth was confounded by ageing population and ever-changing imaging technologies. • Increasing radiologist recruitment activities is needed. The aim of this study was to investigate associations between workforce and workload among radiologists in Taiwan. Data for the period 2000–2020 describing the demand for imaging services and radiologists have been obtained from databases and statistical reports of the Ministry of Health and Welfare. The future demand for radiologists was based on Taiwanese people aged 40 and over. The workforce of Taiwan's radiologists has increased by 6 % annually over the past 20 years (from 450 to 993), performing 2125, 3202 and 3620 monthly examinations (mainly conventional radiography and CT) in medical centers, regional hospitals and district hospitals. Between 2000 and 2020, the use of CT and MRI increased by more than 3.5 times. Demand for interventional radiology also increased by 1.77 times, 2.25 times, and 5 times, respectively. To maintain this volume of services in 2040, at least 1168 radiologists are needed, about 1.18 times more in 2020. Taiwan has 2.4 to 2.9 times fewer radiologists than the United States and 3 times fewer than Europe, while the annual workload is approximately 2 to 3.4 times greater than that of the United States and 1.4 to 2.5 times greater than that of the United Kingdom. This report may serve as a reference for policy makers who address the challenges of the growing workload among radiologists in countries of similar situations. [ABSTRACT FROM AUTHOR]
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- 2024
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133. Post-operative assessment in patients after liver transplantation: imaging parameters associated with 1-year graft failure.
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Chang, Wei-Chou, M. Yeh, Benjamin, Chu, Lisa, Kim, So Yeon, Wen, Kwun Wah, Chiu, Sung-Hua, Ding, Chien-Kuang Cornelia, Wu, En-Haw, Roberts, John P., Huang, Guo-Shu, and Hsu, Hsian-He
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LIVER transplantation , *PORTAL vein , *PORTAL vein surgery , *GRAFT rejection - Abstract
Purpose: To identify post-liver transplant CT findings which predict graft failure within 1 year. Materials and methods: We evaluated the CT scans of 202 adult liver transplants performed in our institution who underwent CT within 3 months after transplantation. We recorded CT findings of liver perfusion defect (LPD), parenchymal homogeneity, and the diameters and attenuations of the hepatic vessels. Findings were correlated to 1-year graft failure, and interobserver variability was assessed. Results: Forty-one (20.3%) of the 202 liver grafts failed within 1 year. Graft failure was highly associated with LPD (n = 18/25, or 67%, versus 15/98, or 15%, p < 0.001), parenchymal hypoattenuation (n = 20/41, or 48.8% versus 17/161, or 10.6%, p < 0.001), and smaller diameter of portal veins (right portal vein [RPV], 10.7 ± 2.7 mm versus 14.7 ± 2.2 mm, and left portal vein [LPV], 9.8 ± 3.0 mm versus 12.4 ± 2.2 mm, p < 0.001, respectively). Of these findings, LPD (hazard ratio [HR], 5.43, p < 0.001) and small portal vein diameters (HR, RPV, 3.33, p < 0.001, and LPV, 3.13, p < 0.05) independently predicted graft failure. All the measurements showed fair to moderate interobserver agreement (0.233~0.597). Conclusion: For patients who have CT scan within the first 3 months of liver transplantation, findings of LPD and small portal vein diameters predict 1-year graft failure. Key Points: •Failed grafts are highly associated with liver perfusion defect, hypoattenuation, and small portal vein. •Right portal vein < 11.5 mm and left portal vein < 10.0 mm were associated with poor graft outcome. •Liver perfusion defect and small portal vein diameter independently predicted graft failure. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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134. A simple and efficient method to perform preoperative pulmonary nodule localization: CT-guided patent blue dye injection.
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Ko, Kai-Hsiung, Huang, Tsai-Wang, Lee, Shih-Chun, Chang, Wei-Chou, Gao, Hong-Wei, and Hsu, Hsian-He
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PULMONARY nodules , *CHEST tubes , *CHEST endoscopic surgery , *GEOMETRIC tomography , *INJECTIONS , *COMPUTED tomography , *LUNG cancer - Abstract
To assess the efficacy of computed tomography (CT)-guided localization with the injection of a low dose of patent blue dye (PBD) for the thoracoscopic resection of pulmonary nodules. Overall, 125 consecutive patients underwent CT-guided localization with injection of a lower dose of PBD between June 2015 and June 2016. The total injection dose relative to the distance between nodules and the visceral pleura was recorded. The clinical and radiological characteristics, technical details, pathological results and procedure-related complications were reviewed. A total of 137 indeterminate pulmonary nodules were identified. The mean nodule size was 9.5 (3.0–22.0) mm. The mean injection dose of PBD relative to the distance between nodules and the visceral pleura was classified as follows: 0.07 ml: <1 cm, 0.1 ml: 1–2 cm and 0.18 ml: >2 cm. The mean time of CT-guided localization was 16.5 (10–50) min. The mean time interval from localization to surgery was 188 (24–1440) min. Pneumothorax developed in 50 patients (40%), and focal parenchymal hemorrhage occurred in 16 patients (12.8%) after localization. No patient required chest tube placement or emergent resuscitation. The success rate of dye marking was 98.5% (135/137). Malignancies, including 82 lung cancers, were diagnosed in 97 nodules (70.8%). The injection of a lower dose PBD based on the distance to the visceral pleura can be successful with nodular localization and may facilitate thoracoscopic surgery, even in cases with a long interval from localization to surgery. • The injection of a lower dose PBD according to different nodular depths achieves a high success rate of nodular localization. • This setting may lead to less diffusion effect and avoid overresection of normal lung parenchyma. • It is a simple and efficient technique facilitating thoracoscopic surgery for impalpable nodules. • This procedure may allow for more flexibility in the surgical schedule because of the longer staining effect. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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135. Prognostic value of tumor volume for patients with advanced lung cancer treated with chemotherapy.
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Kuo, Chung-Feng Jeffrey, Ke, Bo-Han, Wu, Nain-Ying, Kuo, Joseph, and Hsu, Hsian-He
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LUNG cancer treatment , *CANCER chemotherapy , *LUNG radiography , *IMAGE reconstruction , *HEALTH outcome assessment - Abstract
Background and objective We aim to develop a reference system utilizing computed tomography to calculate changes in tumor volume of lung cancer patients after chemotherapy to assist physicians in clinical treatment and evaluation. Methods Image processing techniques were used to analyze the computed tomography of lung cancer, locate the tumor, and calculate the tumor volume. The medical indicator was then evaluated and analyzed. We examined the correlation between reduced tumor volume and survival duration of 88 patients after chemotherapy at Tri-Service General Hospital, Taiwan. The innovative survival prediction index was obtained by four statistical methods: receiver operating characteristic curve, Youden index, Kaplan-Meier method, and log rank test. Results From the image processing techniques, tumor volume from each patient were obtained within an average of 7.25 seconds. The proposed method was shown to achieve rapid positioning of lung tumors and volume reconstruction with an estimation error of 1.92% when calibrated with an irregularly shaped stone. In medical indicator evaluation and analysis, the area below the receiver operating characteristic curve is greater than 0.8, indicating good predictability of the medical index used herein. The Youden index spotted the best cut-off point of volume, and the correlation between the volume's cut-off point and survival time was confirmed again by Kaplan-Meier and log rank test. The p-values were all less than 0.05, presenting a high degree of correlation between the two, indicating that this medical indicator is highly reliable. Conclusions The proposed techniques can automatically find the location of tumors in the lung, reconstruct the volume, and calculate changes in volume before and after treatment, thus obtaining an innovative survival prediction index. This will help facilitate early and accurate predictions of disease outcomes during the course of therapy, and categorize patient stratification into risk groups for more efficient therapies. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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136. Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study.
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Chang GC, Chiu CH, Yu CJ, Chang YC, Chang YH, Hsu KH, Wu YC, Chen CY, Hsu HH, Wu MT, Yang CT, Chong IW, Lin YC, Hsia TC, Lin MC, Su WC, Lin CB, Lee KY, Wei YF, Lan GY, Chan WP, Wang KL, Wu MH, Tsai HH, Chian CF, Lai RS, Shih JY, Wang CL, Hsu JS, Chen KC, Chen CK, Hsia JY, Peng CK, Tang EK, Hsu CL, Chou TY, Shen WC, Tsai YH, Tsai CM, Chen YM, Lee YC, Chen HY, Yu SL, Chen CJ, Wan YL, Hsiung CA, and Yang PC
- Subjects
- Humans, Female, Smokers, Prospective Studies, Early Detection of Cancer methods, Taiwan epidemiology, Tomography, X-Ray Computed methods, Mass Screening, Lung Neoplasms diagnostic imaging, Lung Neoplasms epidemiology, Adenocarcinoma in Situ, Adenocarcinoma
- Abstract
Background: In Taiwan, lung cancers occur predominantly in never-smokers, of whom nearly 60% have stage IV disease at diagnosis. We aimed to assess the efficacy of low-dose CT (LDCT) screening among never-smokers, who had other risk factors for lung cancer., Methods: The Taiwan Lung Cancer Screening in Never-Smoker Trial (TALENT) was a nationwide, multicentre, prospective cohort study done at 17 tertiary medical centres in Taiwan. Eligible individuals had negative chest radiography, were aged 55-75 years, had never smoked or had smoked fewer than 10 pack-years and stopped smoking for more than 15 years (self-report), and had one of the following risk factors: a family history of lung cancer; passive smoke exposure; a history of pulmonary tuberculosis or chronic obstructive pulmonary disorders; a cooking index of 110 or higher; or cooking without using ventilation. Eligible participants underwent LDCT at baseline, then annually for 2 years, and then every 2 years up to 6 years thereafter, with follow-up assessments at each LDCT scan (ie, total follow-up of 8 years). A positive scan was defined as a solid or part-solid nodule larger than 6 mm in mean diameter or a pure ground-glass nodule larger than 5 mm in mean diameter. Lung cancer was diagnosed through invasive procedures, such as image-guided aspiration or biopsy or surgery. Here, we report the results of 1-year follow-up after LDCT screening at baseline. The primary outcome was lung cancer detection rate. The p value for detection rates was estimated by the χ
2 test. Univariate and multivariable logistic regression analyses were used to assess the association between lung cancer incidence and each risk factor. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of LDCT screening were also assessed. This study is registered with ClinicalTrials.gov, NCT02611570, and is ongoing., Findings: Between Dec 1, 2015, and July 31, 2019, 12 011 participants (8868 females) were enrolled, of whom 6009 had a family history of lung cancer. Among 12 011 LDCT scans done at baseline, 2094 (17·4%) were positive. Lung cancer was diagnosed in 318 (2·6%) of 12 011 participants (257 [2·1%] participants had invasive lung cancer and 61 [0·5%] had adenocarcinomas in situ). 317 of 318 participants had adenocarcinoma and 246 (77·4%) of 318 had stage I disease. The prevalence of invasive lung cancer was higher among participants with a family history of lung cancer (161 [2·7%] of 6009 participants) than in those without (96 [1·6%] of 6002 participants). In participants with a family history of lung cancer, the detection rate of invasive lung cancer increased significantly with age, whereas the detection rate of adenocarcinoma in situ remained stable. In multivariable analysis, female sex, a family history of lung cancer, and age older than 60 years were associated with an increased risk of lung cancer and invasive lung cancer; passive smoke exposure, cumulative exposure to cooking, cooking without ventilation, and a previous history of chronic lung diseases were not associated with lung cancer, even after stratification by family history of lung cancer. In participants with a family history of lung cancer, the higher the number of first-degree relatives affected, the higher the risk of lung cancer; participants whose mother or sibling had lung cancer were also at an increased risk. A positive LDCT scan had 92·1% sensitivity, 84·6% specificity, a PPV of 14·0%, and a NPV of 99·7% for lung cancer diagnosis., Interpretation: TALENT had a high invasive lung cancer detection rate at 1 year after baseline LDCT scan. Overdiagnosis could have occurred, especially in participants diagnosed with adenocarcinoma in situ. In individuals who do not smoke, our findings suggest that a family history of lung cancer among first-degree relatives significantly increases the risk of lung cancer as well as the rate of invasive lung cancer with increasing age. Further research on risk factors for lung cancer in this population is needed, particularly for those without a family history of lung cancer., Funding: Ministry of Health and Welfare of Taiwan., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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137. Schädigung des N. medianus bei ultraschallgesteuerter Hydrodissektion und Kortikosteroid-Injektionen bei Karpaltunnelsyndrom.
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Hsu YC, Yang FC, Hsu HH, and Huang GS
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
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- 2022
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138. Median Nerve Injury in Ultrasound-Guided Hydrodissection and Corticosteroid Injections for Carpal Tunnel Syndrome.
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Hsu YC, Yang FC, Hsu HH, and Huang GS
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- Adrenal Cortex Hormones adverse effects, Humans, Ultrasonography, Ultrasonography, Interventional, Carpal Tunnel Syndrome diagnostic imaging, Carpal Tunnel Syndrome drug therapy, Carpal Tunnel Syndrome surgery, Median Nerve diagnostic imaging, Median Nerve surgery
- Abstract
Purpose: Permanent nerve damage after corticosteroid injection has been suggested when symptoms of median nerve injury (MNI) are irreversible. We assess the outcomes of MNI and their association with ultrasonography (US)-guided hydrodissection and the following corticosteroid injection for symptomatic carpal tunnel syndrome (CTS)., Methods: US-guided hydrodissection and the following corticosteroid injections were administered to 126 CTS patients. Occurrence of MNI, clinical data, and post-hydrodissection findings were evaluated. Post-hydrodissection findings included vascular injury during hydrodissection, altered echogenicity, reduced flattening ratio, and increased cross-sectional area of the MN at the inlet of the carpal tunnel (MN-CSA-Inlet) on ultrasonography after hydrodissection. The relevance of MNI with respect to these clinical data and findings was determined. The outcome was rated using Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores., Results: Nine patients suffered MNI (incidence, 7.1 %) but improved significantly at follow-up. Clinical data and vascular injury during hydrodissection, altered echogenicity, and reduced flattening ratio after hydrodissection were unrelated to prolonged transient MNI (p > 0.05). MNI was significantly associated with increased CSA (p = 0.005). A CSA increase > 2 mm
2 after hydrodissection yielded the greatest performance (0.979) for MNI in the receiver operating characteristic analysis. Decreases in BCTQ scores after injection did not differ significantly between groups with and without MNI (p > 0.05)., Conclusion: MNI during hydrodissection may be reversible. MNI is indicated by an increase in MN-CSA-inlet immediately after hydrodissection., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)- Published
- 2022
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139. Consensus survey on pre-procedural safety practices in radiological examinations: a multicenter study in seven Asian regions.
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Lee YH, Quek ST, Khong PL, Lee CS, Wu JS, Zhang L, Ng KH, Yang SO, Kudo K, Do KH, Kim SH, Chen DC, Cheng A, Leung JH, Chang YC, Hsu HH, and Chan WP
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- Asia, China, Humans, Internship and Residency, Japan, Magnetic Resonance Imaging standards, Malaysia, Positron-Emission Tomography, Radiology education, Republic of Korea, Safety Management standards, Singapore, Taiwan, Tomography, X-Ray Computed standards, Consensus, Health Care Surveys statistics & numerical data, Patient Safety standards, Quality of Health Care standards, Radiography standards
- Abstract
Objective: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions., Methods: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice., Results: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic., Conclusion: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care., Advances in Knowledge: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.
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- 2020
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140. Preparedness and Best Practice in Radiology Department for COVID-19 and Other Future Pandemics of Severe Acute Respiratory Infection.
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Wan YL, Schoepf UJ, Wu CC, Giovagnoli DP, Wu MT, Hsu HH, Chang YC, Yang CT, and Cherng WJ
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- COVID-19, Humans, Lung diagnostic imaging, SARS-CoV-2, Betacoronavirus, Coronavirus Infections diagnostic imaging, Coronavirus Infections prevention & control, Pandemics prevention & control, Personal Protective Equipment, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral prevention & control, Practice Guidelines as Topic, Tomography, X-Ray Computed methods
- Abstract
The COVID-19 global pandemic has emerged as an unprecedented health care crisis. To reduce risks of severe acute respiratory syndrome coronavirus 2 transmission in the Radiology Department, this article describes measures to increase the preparedness of Radiology Department, such as careful screening of staff and patients, thorough disinfection of equipments and rooms, appropriate use of personal protection equipment, and early isolation of patients with incidentally detected computed tomography findings suspicious for COVID-19. The familiarity of radiologists with clinical and imaging manifestations of COVID-19 pneumonia and their prognostic implications is essential to provide optimal care to patients.
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- 2020
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141. Ultrasound-Guided Corticosteroid Injection in Patients with Carpal Tunnel Syndrome: Efficacy of Intra-Epineurial Injection.
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Hsu YC, Yang FC, Hsu HH, and Huang GS
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- Humans, Injections, Median Nerve, Adrenal Cortex Hormones administration & dosage, Carpal Tunnel Syndrome diagnostic imaging, Carpal Tunnel Syndrome drug therapy, Ultrasonography, Interventional
- Abstract
Purpose: To identify the ultrasound (US) findings of intra-epineurial corticosteroid injection during US-guided hydrodissection in patients with carpal tunnel syndrome (CTS), and to determine their clinical relevance in relation to treatment outcomes., Materials and Methods: We performed 101 US-guided hydrodissections and corticosteroid injections in 101 patients with CTS, and evaluated their pre- and post-injection US findings. We categorized these injections into two groups based on the occurrence of intra-epineurial injection. We also recorded clinical data including sex, age, side of injection, BMI, and the duration of pre-injection CTS-related discomfort. The outcomes were measured using the Likert satisfaction scale and Boston Carpal Tunnel Questionnaire (BCTQ) scores. The clinical data, cross-sectional area of the median nerve (CSA-MN) at the inlet of the carpal tunnel measured on US images, and the symptom relief for the patients receiving intra-epineurial and extra-epineurial injection were compared., Results: The intra-epineurial injection rate was 38.6 % in the 101 US-guided injections. The clinical data, pre-injection CSA-MN at the inlet of the carpal tunnel, and pre-injection BCTQ scores showed no significant intergroup differences (p > 0.05). The group with intra-epineurial injections had significantly decreased CSA-MN (difference in means, 2.5 mm
2 ; p < 0.0001), greater patient satisfaction (p = 0.002), and lower BCTQ scores (p < 0.05) than the group with extra-epineurial injections., Conclusion: We characterized the US findings of intra-epineurial corticosteroid injection during US-guided hydrodissection. Intra-epineurial injection provided a more meaningfully reduction in edema of the MN, greater patient satisfaction, and greater symptom relief than extra-epineurial injection., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)- Published
- 2018
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142. JOURNAL CLUB: The Warthin Tumor Score: A Simple and Reliable Method to Distinguish Warthin Tumors From Pleomorphic Adenomas and Carcinomas.
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Wang CW, Chu YH, Chiu DY, Shin N, Hsu HH, Lee JC, and Juan CJ
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- Adenolymphoma pathology, Adenoma, Pleomorphic pathology, Adenoma, Pleomorphic surgery, Biopsy, Large-Core Needle, Carcinoma pathology, Carcinoma surgery, Female, Humans, Male, Middle Aged, Parotid Neoplasms pathology, Parotid Neoplasms surgery, Predictive Value of Tests, Retrospective Studies, Sensitivity and Specificity, Adenolymphoma diagnostic imaging, Adenoma, Pleomorphic diagnostic imaging, Carcinoma diagnostic imaging, Diffusion Magnetic Resonance Imaging methods, Echo-Planar Imaging, Parotid Neoplasms diagnostic imaging
- Abstract
Objective: The objective of this article is to propose a Warthin tumor (WT) score to distinguish WTs from other parotid tumors., Materials and Methods: The study included 78 patients with 92 histologically proven parotid tumors, including 42 WTs, 30 pleomorphic adenomas (PMAs), and 20 carcinomas. Echo-planar DW images were acquired. The WT score, which comprised the mean apparent diffusion coefficient (ADC
M ) and the SD of the ADC (ADCSD ) of tumors, patient age, and patient sex, was used to predict WTs. The diagnostic performance of the WT score was evaluated using ROC analyses. Statistical significance was denoted by p < 0.05., Results: With the use of optimized criteria, including an ADCM less than or equal to 1.016 × 10-3 mm2 /s (WT score, 1), an ADCSD less than or equal to 0.1171 × 10-3 mm2 /s (WT score, 1), patient age older than 49 years (WT score, 1), and male sex (WT score, 1), a WT score greater than 2 had a sensitivity, specificity, positive negative value, negative predictive value, and accuracy of 85.7%, 100.0%, 100.0%, 89.3%, and 93.4%, respectively., Conclusion: The WT score allows parotid WTs to be distinguished from PMAs and carcinomas with high accuracy.- Published
- 2018
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143. Assessment of factors that could affect the success of US-guided contrast injection for hip MR arthrography.
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Hsu YC, Wu YC, Ko KH, Hsu HH, and Huang GS
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- Adult, Female, Humans, Injections, Male, Retrospective Studies, Arthrography methods, Contrast Media administration & dosage, Magnetic Resonance Imaging methods, Ultrasonography, Interventional
- Abstract
Background: To retrospectively evaluate the association between possible influencing factors and failed first attempts to inject a contrast agent intra-articularly under ultrasound (US)-guidance for direct magnetic resonance (MR) arthrography of the hip joint., Methods: Ninety consecutive patients (38 women and 52 men; mean age, 42 years) undergoing US-guided hip MR arthrography (3 bilaterally) were retrospectively included in this study. The potential influencing factors were sex, age, body mass index (BMI), side of injection, target site, trajectory of the needle, additional use of needle tip rotation, failed first-attempt, and capsule elongation at the site of needle insertion., Results: First-attempt failure was significantly associated with reduced capsule elongation at the target site and no additional use of needle tip rotation (OR 10.708; 95% CI 1.847-62.059; OR 3.518; 95% CI 1.120-11.047). Capsule elongation (sufficient for needle bevel insertion) was significantly larger at the femoral head-neck junction (5.2 ± 1.5 mm) than at the femoral head (2.9 ± 1.3 mm) (p < 0.001)., Conclusion: Less capsular elongation of the femoral head and no additional use of needle tip rotation to reduce the difficulty in contrast material delivery can increase the first-attempt failure rate in patients undergoing US-guided hip arthrography., (Copyright © 2017. Published by Elsevier Taiwan LLC.)
- Published
- 2017
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144. Cookie bite cortical osteolytic lesions: a hint of skeletal metastasis from bronchogenic carcinoma.
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Ho HH, Hsu YC, Hsu HH, and Huang GS
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- Adenocarcinoma complications, Adenocarcinoma diagnostic imaging, Adult, Bone Neoplasms complications, Bone Neoplasms diagnostic imaging, Female, Humans, Lung Neoplasms diagnostic imaging, Osteolysis diagnostic imaging, Radiography, Adenocarcinoma secondary, Bone Neoplasms secondary, Osteolysis etiology, Tibia diagnostic imaging
- Published
- 2015
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145. Contrast Pooling and Layering in a Patient with Left Main Coronary Artery Occlusion and Cardiogenic Shock.
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Lin TC, Lin CS, Hsu HH, and Liou JT
- Abstract
Unlabelled: A 57-year-old male with type 2 diabetes mellitus presented to the emergency department with sudden onset of chest pain. Shock status and considerably low right arm blood pressure were detected. The patient underwent contrast-enhanced computed tomography (CT) which revealed dependent contrast pooling and layering of contrast material within the inferior vena cava. Post-processing CT angiography depicted total occlusion of the left main coronary artery. Sudden cardiac arrest developed after CT examination, and following emergency coronary angiography we confirmed the diagnosis of left main coronary artery occlusion and cardiogenic shock. Clinical physicians should recognize these CT findings of imminent cardiovascular decompensation and provide prompt medical management to prevent further patient deterioration., Key Words: Cardiogenic shock; Dependent pooling; Layering; Left main coronary artery disease.
- Published
- 2015
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146. Prognostic potential of initial CT changes for progression-free survival in gefitinib-treated patients with advanced adenocarcinoma of the lung: a preliminary analysis.
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Wu YC, Hsu HH, Chang WC, Tung HJ, Ko KH, Hsu YC, Huang TW, Ho CL, and Chang H
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- Adenocarcinoma diagnostic imaging, Adenocarcinoma mortality, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Carcinoma, Non-Small-Cell Lung mortality, Disease-Free Survival, Epidemiologic Methods, Female, Gefitinib, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms mortality, Male, Middle Aged, Molecular Targeted Therapy methods, Tomography, X-Ray Computed, Treatment Outcome, Adenocarcinoma drug therapy, Antineoplastic Agents therapeutic use, Carcinoma, Non-Small-Cell Lung drug therapy, Lung Neoplasms drug therapy, Quinazolines therapeutic use
- Abstract
Objectives: We aimed to determine whether initial tumour responses measured during short-term follow-up computed tomography (CT) examinations after baseline examinations would correlate with clinical outcomes in patients with non-small cell lung cancer (NSCLC) who received epidermal growth factor receptor (EGFR)-targeted therapy., Methods: A total of 86 gefitinib-treated patients with advanced adenocarcinoma of the lung were retrospectively reviewed. All patients underwent baseline and short-term follow-up CT examinations. The new response criteria (NRC) by Lee et al. were used for the response evaluations. A Cox proportional hazards multiple regression model and Kaplan-Meier survival analyses were used to evaluate correlations between the initial tumour changes and progression-free and overall survival (PFS, OS)., Results: Better separation and smaller p values were observed for both PFS and OS when good and poor disease responses (as defined by NRC) were compared after excluding tumours with characteristic morphologies. Early tumour changes correlated with PFS in a size-dependent manner. Moreover, a stronger association was observed between size changes and PFS when characteristic morphology was also considered., Conclusions: Initial changes in tumour size during short-term post-treatment CT examinations could act as a potential prognostic imaging surrogate for PFS in gefitinib-treated patients with advanced adenocarcinoma of the lung., Key Points: • Initial responses to gefitinib on computed tomography significantly correlate with clinical outcomes. • Regardless of morphology, size decrease greater than 30 % predicts prolonged progression-free and overall survival. • Combination of size and morphological changes yields prognostic independence regarding progression-free survival.
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- 2015
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147. Clinical features and computed tomography characteristics of non-Klebsiella pneumoniae liver abscesses in elderly (>65 years) and nonelderly patients.
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Hsiang CW, Liu CH, Fan HL, Ko KH, Yu CY, Wang HH, Liao WI, Hsu HH, and Chang WC
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- Adult, Aged, Aged, 80 and over, Female, Humans, Klebsiella Infections microbiology, Klebsiella pneumoniae, Length of Stay, Liver Abscess complications, Liver Abscess microbiology, Logistic Models, Male, Microscopy, Middle Aged, Multivariate Analysis, ROC Curve, Retrospective Studies, Bacterial Infections complications, Bacterial Infections diagnostic imaging, Liver Abscess diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Purpose: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients., Materials and Methods: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age ≥65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA., Results: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA., Conclusion: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
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- 2015
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148. Non-mass-like breast lesions at ultrasonography: feature analysis and BI-RADS assessment.
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Ko KH, Hsu HH, Yu JC, Peng YJ, Tung HJ, Chu CM, Chang TH, Chang WC, Wu YC, Lin YP, and Hsu GC
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- Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Young Adult, Breast Neoplasms diagnostic imaging, Radiology Information Systems statistics & numerical data, Ultrasonography, Mammary methods
- Abstract
Objective: To analyze the features of non-mass-like (NML) breast lesions on ultrasound (US) and determine their corresponding malignancy rate and to stratify these lesion patterns according to US BI-RADS categories., Materials and Methods: One hundred sixty-four consecutive lesions were retrospectively classified into four types according to the US features, the corresponding positive predictive values (PPVs) were obtained. Clinical, imaging, and histopathological findings were reviewed., Results: Among the 164 lesions, 39 (24%) were classified as type Ia, 14 (8%) as type Ib, 39 (24%) as type IIa, 19 (12%) as type IIb, 19 (12%) as type III, and 34 (21%) as type IV. The PPVs for malignancy were 21% for type Ia, 79% for type Ib, 10% for type IIa, 58% for type IIb, 16% for type III, and 21% for type IV. All NML lesions were classified as BI-RADS category 4a (type IIa), 4b (type Ia, III and IV) and 4c (type Ib and IIb) according to their PPVs. There was a significantly higher frequency of malignancy among lesions of type Ib and type IIb compared with the other types (P<0.01 for each). Lesions with associated calcifications, presence of abnormal axillary nodes, or a mammographic finding of suspected malignancy had a higher probability of malignancy (P<0.05 for each)., Conclusion: US is useful in clarifying the indication for biopsy of NML lesions. The types of US classifications used in our study establish reliable references for the NML patterns when stratified according to the BI-RADS categories., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
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149. Underestimation of invasive lesions in patients with ductal carcinoma in situ of the breast diagnosed by ultrasound-guided biopsy: a comparison between patients with and without HER2/neu overexpression.
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Chang WC, Hsu HH, Yu JC, Ko KH, Peng YJ, Tung HJ, Chang TH, and Hsu GC
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- Adult, Aged, Aged, 80 and over, False Negative Reactions, Female, Humans, Middle Aged, Neoplasm Invasiveness, Observer Variation, Reproducibility of Results, Sensitivity and Specificity, Ultrasonography, Mammary methods, Up-Regulation, Biomarkers, Tumor metabolism, Breast Neoplasms metabolism, Breast Neoplasms pathology, Carcinoma, Intraductal, Noninfiltrating metabolism, Carcinoma, Intraductal, Noninfiltrating pathology, Endoscopic Ultrasound-Guided Fine Needle Aspiration methods, Receptor, ErbB-2 metabolism
- Abstract
Purpose: To determine the rate of underestimation of ductal carcinoma in situ (DCIS) diagnosed at imaging-guided biopsy and to analyze its association with HER2/neu oncogene, an important biomarker in assessing the tumour aggressiveness and guiding hormone therapy for breast cancer., Methods: We retrospectively reviewed 162 patients with DCIS diagnosed by imaging-guided core needle biopsy between January 2008 and March 2013. All of these patients received surgical excision, and in 25, the diagnosis was upgraded to invasive breast cancer. In this study, we examined the ultrasound, mammographic features and histopathological results for each patient, and compared these parameters between those with and without HER2/neu overexpression., Results: Of the 162 DCIS lesions, 110 (67.9%) overexpressed HER2/neu. Nineteen patients with HER2/neu overexpressing DCIS (n=19/110, 17.3%) were upgraded after surgery to a diagnosis of invasive breast cancer. In this group, the upgrade rate was highest in patients with a dilated mammary duct pattern (42.1%, n=8/19, p=0.02) and the presence of abnormal axillary nodes (40.0%, n=12/30, p<0.01) at ultrasound and was significantly associated with comedo tumour type on pathology., Conclusions: Biopsy may underestimate the invasive component in DCIS patients. Sonographic findings of dilated mammary ducts and presence of abnormal axillary lymph nodes may help predicting the invasive components and possibly driving more targeted biopsy procedures., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2014
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150. Intrathoracic caudate lobe of the liver: a case report and literature review.
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Chen YY, Huang TW, Chang H, Hsu HH, and Lee SC
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- Bronchopulmonary Sequestration diagnosis, Bronchopulmonary Sequestration surgery, Choristoma diagnosis, Choristoma surgery, Female, Humans, Incidental Findings, Middle Aged, Pneumonectomy, Predictive Value of Tests, Thoracic Diseases surgery, Thoracic Surgery, Video-Assisted, Thoracotomy, Tomography, X-Ray Computed, Treatment Outcome, Bronchopulmonary Sequestration complications, Choristoma complications, Liver, Thoracic Diseases diagnosis
- Abstract
Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.
- Published
- 2014
- Full Text
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