• 한국HCI학회:학술대회논문집
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• 2006.02a
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• pp.541-546
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• 2006

3차원 관상동맥을 분석하기 위해서는 혈관의 분기점, 극단점, 혈관의 계층적 구조 관계를 함축적으로 표현하는 것이 매우 중요하다. 본 논문에서는3차원 CT 혈관 조영 영상으로부터 관상동맥의 3차원 골격을 자동으로 추출하는 방법을 개발하였다. 먼저, CT혈관 조영술에 의해 획득된 슬라이스 이미지로부터 3차원 조작 및 수술 시뮬레이션 등을 위하여 혈관의 3차원 표면에 대한 메쉬 모델을 생성한다. 생성된 메쉬 모델이 임의로 변형된 후에도 자동으로 골격을 쉽게 추출할 수 있도록 메쉬 모델을 복셀화하는 단계를 거친다. 이렇게 얻어진 복셀 모델로부터 표면복셀을 결정하고 표면 복셀로부터 객체 복셀까지의 유클리드 거리값를 계산하여 유클리드 거리맵(EDM)을 계산한다. 계산된 EDM 으로부터 객체 복셀이 가지게 되는 최대 내접 구를 계산하여 Discrete Medial Surface을 생성하게 되는데 이것은 골격의 후보가 된다. 골격의 후보집합 복셀에 대하여 Dijkstra 최단 경로 결정 알고리즘을 적용하여 골격을 자동으로 추출하게 된다. 이렇게 추출된 3차원 골격은 관상동맥 수술 시뮬레이션 등의 다양한 형상 분석에 유용하게 사용될 수 있다.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.142-149
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• 2003

To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.

• Journal of the Korean Society of Radiology
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• v.17 no.4
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• pp.589-595
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• 2023

If complete coronary artery occlusion occurs due to severer coronary spasm, malignant arrhythmias can lead to death. Therefore, early screening for coronary artery spasm angina is essential. Among the test methods, the drug injection test through coronary angiography is generally performed. Therefore, the purpose of this study was to evaluate the advantages of ergonovine drug test for vasospasitc angina examination during coronary angiography, such as the relationship between the procedure time, contrast medium usage, and radiation exposure effects of coronary angiography. Follow-up data of 142 patients who underwent coronary angiography and variant angina examination from september 2021 to february 2023 were used. As a result of analyzing contrast usage dose and dose area product and air kerma dose and number of imaging series and procedure time, variant angina examination was statistically significantly higher than coronary angiography. (p<0.001) In conclusion, variant angina examination other than coronary artery angiography are radiologically negative. Therefore, we think it is better to avoid excessive inspection. Nevertheless, in the case of the provocation test, the longer the examination time, the higher the fluoroscopy time and the amount of contrast medium used, so it is better to conduct the test as quickly as possible or shorten it.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.113-120
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• 2018

Angiography and CT angiography are used widely for the examination of vascular diseases, but the diagnosis of such diseases is made mostly by the subjective judgment of the inspector. This paper proposes a method for detecting the suspicious regions of stenosis and aneurysm in the inner surfaces of 3D blood vessel models reconstructed from medical images. Initially, the 3D curve-skeletons of the blood vessel models and the contours at the nodes of the curve-skeletons were generated. Next, the 3D curve-skeletons were divided into a set of branches and the areas of normal contours of nodes located in each branch were calculated. The nodes whose contours contain suspicious regions were detected by taking into account the average area, maximum and minimum areas, and the area difference between the adjacent normal contours. The diagnosis of stenosis and aneurysm can be supported by properly visualizing the suspicious regions detected. The suspicious regions of the disease were identified by implementing and testing it using several data sets of human blood vessels, highlighting the usefulness of the proposed method.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2011.10a
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• pp.554-556
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• 2011

The occurrence of various vascular diseases due to the need for accurate and rapid diagnosis was emphasized. Several limitations to the presence of pulmonary vascular angiography for chest CT imaging was aware of the need for diversity in medical image processing with Insight Toolkit(ITK) suggested pulmonary vascular division. In this paper, by contrast, based on the value of a two-step partitioning of the lungs and blood vessels to perform the process of splitting. Lung area segmentation of each stage image enhancement, threshold value, resulting in areas of interest cut image acquisition and acquired pulmonary vascular division in lung area obtained by applying the fill area. Partitioned on the basis of pulmonary vascular imaging to obtain three-dimensional visualization image of the pulmonary vascular analysis and diagnosis of a variety of perspectives are considered possible.

• The Journal of the Korea Contents Association
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• v.7 no.4
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• pp.184-191
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• 2007

Our objective was to develop and evaluate a non-invasive device for rigid immobilization and surface disease non-contact of the table in the lower extremity during CT angiography. The immobilization device consists of two components. The patient's lower limb device stabilizing elements made of polyethylene resin soft materials, and pelvis parts foam pad is used for non-contact surface. In a Prospective study the lower extremity device was used in patients who underwent a CT angiography of the lower limb. Immobilization with our device was well tolerated by all patients. The quality of the resulting images in the popliteal and infrapopliteal region was rated by five-point scale. The rigid immobilization resulted in a complete absence of motion artifacts. The new device is an effective, well tolerated and easily used immobilization that is suitable of use in 3D lower extremity CT angiography.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.143-148
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• 2013

Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous disorder, which can affect different organs or systems of the body, including the cardiovascular system. One of the more serious aspects of the disease relates to arterial involvement. In particular, renal artery stenosis is one of the most common vascular abnormalities in patients with NF-1, and the manifestations vary, ranging from no symptoms to end-stage renal failure. Treatment usually consists of antihypertensive drugs, percutaneous transluminal angioplasty, or surgery. Other causes of hypertension should be ruled out and the patient followed up for close monitoring and proper management. We report a case of bilateral renal artery stenosis and hypertension in a patient with moyamoya disease associated with neurofibromatosis type 1. This report discusses the literature available on the current subject, its clinical features, diagnosis, and treatment.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.152-158
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• 2012

Purpose : To compare the arterial and venous detection sites of triggering methods in contrast-enhanced-MR-venography (CE-MRV) for the evaluation of intracranial venous system. Materials and Methods: 41 healthy patients underwent CE-MRV with autotriggering at either the cavernous segment of internal carotid artery with an inserted time-delay of 6 seconds (n = 20) or the superior sagittal sinus without any timedelay (n = 21). 0.1 mmol/kg gadolinium-based contrast material ($Magnevist^{(R)}$, Schering, Germany) was intravenously injected by hand injection. A sagittal fast-spoiled-gradient-echo-sequence ranging from one ear to the other was performed (TR/TE5.2/1.5, Matrix $310{\times}310$, 124 sections in the 15-cm-thick volume). 17 predefined venous structures were evaluated on all venograms by two neuroradiologists and defined as completely visible, partially visible, or none visible. Results: The rate of completely visible structures were 272 out of 323 (84%) in the arterial triggering CE-MRV and 310 out of 340 (91%) in the venous triggering CE-MRV. The venous triggering CE-MRV demonstrated an overall superior visualization of the cerebral veins than the arterial triggering CE-MRV (Fisher exact test, p < 0.006). Conclusion: CE-MRV using venous autotriggering method provides higher-quality images of the intracranial venous structures compared to that of arterial.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.702-706
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• 2004

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.152-160
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• 2009

Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: $0.66{\times}0.66{\times}1.1$ or $1.2\;mm^3$), and CTA on 64-slice CT scanners (voxel dimension: $0.42{\times}0.42{\times}0.63\;mm^3$). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n= 19) and intracranial (n = 15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity; specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1 % on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.