• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.241-250
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• 2001

Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

• The Monthly Diabetes
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• s.210
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• pp.14-16
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• 2007

65세 김모씨는 가족들과 외출을 하려다가 갑자기 발음이 어눌해 지면서 우측에 힘이 빠지기 시작하였다. 가족들은 일단 김씨를 다시 집안으로 데리고 들어와 팔 다리를 주므르고 바늘로 손을 따 보았지만 상태는 점점 악화되어 전혀 말도 못하고 일어설 수 도 없었으며 정신도 흐려지는 등 급속히 악화되었다. 김씨의 아들은 뇌졸중이 아닌가 하는 생각이 들었고 최근에 언론매체를 통해 혈관이 막히는 뇌졸중의 경우에 빨리 병원에 가면 막힌 혈관을 다시 뚫어주는 치료가 가능하다는 이야기를 들은 기억을 떠올렸다. 김씨의 아들은 119에 연락해 아버님을 응급실로 모시고 왔다. 김씨가 병원에 도착한 시간은 증상이 발생한 후 약 1시간 만이였다. 뇌촬영을 비롯한 피검사 등이 시행되었고 의료진은 김씨가 혈관이 막힌 뇌졸중, 즉 뇌경색이라고 하였고, 현재 발병한 지 채 2시간이 지나지 않았으므로 혈관을 뚫어주는 혈전용해술을 시행하겠다고 했다. 혈관이 막힌 원인은 오랫동안 가지고 있던 당뇨, 고혈압, 고지혈증 등이 복합적으로 작용하여 혈관에 동맥경화를 유발하고 있다가 혈전이 생기면서 혈관이 막힌 것이라고 하였다. 그리고 혈관을 막고 있는 혈전을 녹이기 위해 혈전용해술을 시행하는 것이라고 하였다. 뇌출혈등의 부작용이 일부에서 동반될 수 있지만 지금 상태에서 가장 최선의 치료는 혈전용해술이라 것이 의료진의 설명이었다. 다음날 김씨는 완벽하지는 않았지만 말하는 기능과 우측 팔다리 마비가 상당히 호전되었다. 1주일 후 김씨의 상태는 더욱 호전 되었고 열심히 재활치료를 받고 있었다. 김씨와 가족들은 의료진으로부터 꾸준히 재활치료를 하면서 3개월 후 정도면 이전과 거의 비슷한 상태로 회복될 수 있을 것이라는 희망적인 이야기를 들을 수 있었다.

• 건강소식
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• v.26 no.11 s.288
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• pp.6-13
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• 2002

지난 30여년 동안 급속한 경제 성장과 생활 양식의 변화는 우리 사회에 많은 변화를 초래하였고 한국인의 질병 양상에도 많은 영향을 주었다. 동물성 식품과 지방질 섭취의 증가, 신체활동 감소,노령인구 증가, 생활양식의 서구화 및 도시화 등은 한국인에서 만성질환의 발생과 이환을 증가시키고 있다. 통계청의 2001년 사망원인통계를 보면 1위가 암, 2위가 뇌혈관 질환, 3위가 심장질환, 4위가 당뇨병, 5위가 간질환으로 모두 잘못된 생활습관으로 인한 만성질환이다. 이중에서도 당뇨병은 지난 1991년 이후 암 다음으로 많이 증가한 질병으로 인구 10만명 당 23.8명이 당뇨병으로 사망했으며 하루 평균 당뇨병으로 31명이 사망한다. 2002년 4월, 대한당뇨병학회의 "한국인의 당뇨병 발생 현황 보고"에 따르면 우리나라 성인의 당뇨병 유병률은 10%선으로 최소 3백만명에서 최대 5백만명 정도가 당뇨병을 앓고있다. 우리나라는 식생활의 서구화, 고령화 등으로 당뇨병 환자가 급증하고 있어 생활 양식의 개선이 이루어지지 않을 경우 앞으로 10년 안에 전체 국민의 1/4정도인 1천2백만명 가량이 당뇨병으로 고통을 받게 될 것이라 한다. 당뇨병은 당뇨뿐만 아니라 그에 따른 만성 합병증이 매우 무서운 병으로 일단 발병하면 적극적인 치료에도 불구하고 정상으로 회복되기 어렵다. 따라서 합병증의 효과적인 예방을 위해서는 특별한 임상 증상이 없더라도 당뇨병을 처음 진단 받은 날부터 주기적인 검진을 통하여 조기에 발견해 낼수 있도록 노력하여야 한다. 이와 더불어 주기적인 혈액 검사와 주치의 면담을 통하여 정상 혈당을 유지할 수 있는 혈당 조절 방법과 함께 만성 합병증을 예방할 수 있는 생활 습관 개선(금연, 금주,표준체중 유지,규칙적 운동,정상 혈압 유지,정상 혈중 지질 유지등)을 반드시 실천하여야 한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5345-5349
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• 2012

Recently obesity from the child until being early in the adult, there is to an increase tendency. The obesity influences to various metabolicdisease and there is a possibility of an effect in relationship disease of the heart, brain vascular system etc. This research analyzed the interrelation -ship of apolipoprotein AI consistency and body mass index. It used spss 19.0 with t-test and a regression analysis. Analytical result the interrelationship of apolipoprotein AI and body mass index was -0.484 (p=0.01). The high density cholesterol was 0.89 (p=0.01). The trigriceride was -0.88 (p=0.01). Free fatty acid were not interrelationship. Conclusively, interrelationship of apolipoprotein AI and body mass index was not high. Encourage to examine trigriceride or cholesterol and prevent Arteriosclerosis.

• Journal of radiological science and technology
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• v.41 no.2
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• pp.123-128
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• 2018

Recently, the use of contrast agents has been increasing as a broader range of tests and dynamic tests have become common due to the development of equipment and imaging techniques such as Multi-Detector CT. However, the side effects of using contrast agents have been reduced by the development of non-ionic contrast agents, but they are still occurring often. The purpose of this study was to propose a method to minimize the side effect of contrast agent by using the amount of contrast agent injected to the brain angiography test to suppress excessive use of contrast agent and analyze the amount of contrast agent. Patients who were prescribed Brain Angiography due to cerebrovascular disease, According to the results of the comparison of the results obtained by dividing into 4 groups of 10ml each according to the amount of contrast medium injected with contrast agent according to the BMI of the patient, BA and SNR were not different between groups, and even if the amount of contrast injection was reduced, there was no problem in the evaluation of CT angiography through 3D reconstruction. This result shows that even if the contrast medium is injected into the blood vessels of the patient first and then the contrast medium is used as the physiological saline solution, the contrast medium is reduced by 40% it can be expected to minimize.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.43-48
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• 2004

Cerebral vasoreactivity is an index of autoregulation of cerebral perfusion, and can be measured using functional images such as Xe CT, SPECT and PET in reponse to hypercapneic stimulus. In order to measure cerebral $CO_2$ vasoreactivity in routine TCD study conveniently and reliably, we devised a method of rebreathing into closed volume of reservoir bag as a hypercapneic stimulus, and applied it to 44 healthy volunteers. As a hypercapneic stimulus, we applied fitting mask connected with closed reservoir bag for about 90 seconds, and mean blood flow velocity(MBFV) and pulsatility index(PI) were evaluated at proximal middle cerebral arteries(MCA) of 50-55 mm depth, before and after the hypercapneic stimulus. Age affected the MFV and PI value showed significant and the MFV was 56.45(SD=9.75)cm/sec, while PI was 0.406(SD=0.089). As age increases the flow velocity decreased significantly whereas PI value increased(P<0.05). The vasoreactvity significantly decreased with age(P<0.05). The decrease of cerebral blood flow quantity and cerebral blood flow velocity is not only because of increase of diameter of cerebrovascular resulting from aging, but the resistance increase of small blood vessel resulting from the increase of PI & RI value is regarded. We suppose that the rebreathing method is a reliable and convenient technique as a hypercapneic stimulus in determining cerebral $CO_2$ vasoreactivity. The rebreathing method could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied to the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.339-348
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• 2019

The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.81-88
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• 2016

The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.187-193
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• 2016

In this study, we performed the carotid artery ultrasound targeting 140 subjects who have conducted to evaluate the changes in intima-media thickness(IMT) and plaque correlated with the presence or absence of a hematological test of the carotid artery. Considering that the IMT thickness more than 1mm is abnormal based on the carotid artery ultrasound to assess the presence or absence of plaque, and examined the correlation by classifying the blood lipid value and the fasting blood glucose level through the serum test. Consequently, the fasting blood glucose level is being analyzed as independent predictors of causing dental plaque(p=0.033), cut off value was determined as 126 mg/dL(sensitivity 56.25%, specificity 68.38%) in ROC curve analysis. Furthermore, the odds ratio appeared 1.01 times the value in the Logistic regression. Therefore, it seemed that the necessity to prospective studies in a number of subjects are considered, and also taking into account a number of blood test values along with the sonography of the carotid artery as a valuable part for effective primary prevention and follow-up observation of the cardiac and brain vascular disease is highly recommended.

• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.999-1005
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• 2021

The object of this research is CS, which increases resolution while shortening inspection time, is applied to MRA to compare the quality of images for SENSE and CS techniques and to evaluate SNR and CNR to find out the optimal techniques and to provide them as clinical basic data based on this information. Data were analyzed on 32 patients who performed TOF MRA tests at a university hospital in Chung cheong-do (15 males, 17 females), ICA stenosis:10, M1 Aneurysm:10, and average age 53 ± 4.15). In the inspection, the inspection equipment was Ingenia CX 3.0T, Archieva 3.0T, and 32 channel head coil and 3D gradient echo as a method for equipment data. SNR and CNR of each image were measured by quantitative analysis, and the quality of the image was evaluated by dividing the observer's observation into 5 grades for qualitative evaluation. Imaging evaluation is described as being significant when the p-value is 0.05 or less when the paired T-test and Wilcoxon test are performed. Quantitative analysis of SNR and CNR in TOF MRA images Compared to the SENSE method, the CS method is a method measurement method (p <0.05). As an observer's evaluation, the sharpness of blood vessels: CS (4.45 ± 0.41), overall image quality: CS (4.77 ± 0.18), background suppression of images: CS (4.57 ± 0.18) all resulted in high CS technique (p = 0.000). In conclusion, the Compressed SENSE TOF MRA technique shows superior results when comparing and evaluating the SENSE and Compressed SENSE techniques in increased flow rate magnetic resonance angiography. The results are thought to be the clinical basis material in the 3D TOF MRA examination for brain disease.