• Journal of Trauma and Injury
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• 제27권4호
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• pp.145-150
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• 2014

Purpose: To assess the accuracy and role of single-contrast computed tomography (CT) in the management of anterior abdominal stab wound (AASW). Methods: During 8-years period, single-contrast CT was performed in 21 hemodynamically stable AASW patients (age range, 22-64 years; median age, 45 years), including 19 men and 2 women. CT scans were evaluated by one trauma surgeon and one senior resident to determine the depth of injury(peritoneal violation or not), and abnormal findings of intraperitoneal cavity associated with stab injury. We retrospectively reviewed medical records regarding operative findings. Results: Nine patients underwent abdominal surgery and 12 patients nonoperative management. In the abdominal surgery group, abnormal CT findings included peritoneal violation in 14 patients and abnormal intraperitoneal cavity findings in 5 patients. There was no statistical significant difference regarding abnormal CT findings between abdominal surgery group and nonoperative management group. Among the nine abdominal surgery patients, therapeutic laparotomy was performed on 4 patients. The positive predictive value (PPV) and negative predictive value (NPV) of peritoneal violation to predictive therapeutic laparotomy were 28.6% and 100%, respectively. In addition, the PPV and NPV of abnormal intraperitoneal cavity CT findings to predict therapeutic laparotomy were 40.0% and 87.5%, respectively. There was no statistical significant difference regarding the abnormal CT findings between therapeutic laparotomy group and non therapeutic laparotomy group. Conclusion: CT is a good adjunctive method to evaluate hemodynamicaly stable AASW patients. If peritoneal violation is not seen on CT scan, conservative treatment on local wound may be safely performed without additional abdominal surgery. However, further study is warranted to evaluate the exact role of CT in the diagnostic workup of AASW patients.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.391-395
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• 2018

We report a case of a patient with locally advanced prostate cancer who had only lymph node involvement without bone metastasis on F-18 FDG PET/CT. A 62-year-old Korean male was admitted to our hospital due to dysuria. His PSA level on admission was 79.35 ng/mL. A transrectal ultrasound-guided prostate biopsy confirmed prostate cancer and his Gleason score was 10 (5+5). F-18 FDG PET/CT demonstrated a hypermetabolic mass lesion with SUVmax 7.0 in the prostate and hypermetabolism with SUVmax 4.7 of the abdominal and pelvic lymph nodes. Tc-99m HDP bone scan showed no significant bone metastasis. The patient underwent hormonal therapy for 9 months. Follow-up F-18 FDG PET/CT showed significantly reduced size and FDG uptake in the prostate and abdominal and pelvic lymph nodes. In this case, treatment monitoring with F-18 FDG PET/CT showed decreased mass size and FDG uptake in the prostate and abdominal and pelvic lymph nodes.

• 대한응급의학회지
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• 제26권1호
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• pp.29-37
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• 2015

Purpose: Stool exams are a useful tool for the early presumptive diagnosis of infectious bacterial diarrhea in the Emergency Department (ED). CT scans are often used to increase the physician's level of certainty and to facilitate patient triage by identifying the source of pain in most patients with an acute abdomen in the ED. This study was designed to investigate the correlation between stool exams and abdominal CT in patients with acute diarrhea visiting the ED. Methods: We conducted a retrospective study in the emergency department of a national university hospital from January 1, 2012 to June 30, 2013. The subjects consisted of 156 patients with acute diarrhea and abdominal pain who had stool exam results and abdominal CT findings. We divided the patients into three groups according to the stool exam results. Simultaneously, we evaluated their CT findings of the bowel and adjacent structures. Results: A total of 156 patients were enrolled. Frequency of abnormal CT findings showed statistically significant correlation with stool exams (p-value <0.001). Abnormal CT findings increased as WBCs and RBCs in stool increased (p-value <0.001). Conclusion: The stool exam was a statistically significant predictive variable in indirectly determining the severity of acute diarrhea and it showed correlation with the frequency of abnormal CT findings. It is suggested that stool exams can be used as a susceptible marker for predicting the probability of severe infectious colitis, and for making an early decision regarding close medical attention.

• Journal of Magnetics
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• 제21권4호
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• pp.603-615
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• 2016

In this study, in order to determine the validity and accuracy of MR imaging of 3D gradient dual echo 2-point DIXON technique for measuring abdominal adipose tissue volume and distribution, the measurements obtained by CT were set as a reference for comparison and their correlations were evaluated. CT and MRI scans were performed on each subject (17 healthy male volunteers who were fully informed about this study) to measure abdominal adipose tissue volume. Two skilled investigators individually observed the images acquired by CT and MRI in an independent environment, and directly separated the total volume using region-based thresholding segmentation method, and based on this, the total adipose tissue volume, subcutaneous adipose tissue volume and visceral adipose tissue volume were respectively measured. The correlation of the adipose tissue volume measurements with respect to the observer was examined using the Spearman test and the inter-observer agreement was evaluated using the intra-class correlation test. The correlation of the adipose tissue volume measurements by CT and MRI imaging methods was examined by simple regression analysis. In addition, using the Bland-Altman plot, the degree of agreement between the two imaging methods was evaluated. All of the statistical analysis results showed highly statistically significant correlation (p<0.05) respectively from the results of each adipose tissue volume measurements. In conclusion, MR abdominal adipose volumetry using the technique of 3D gradient dual echo 2-point DIXON showed a very high level of concordance even when compared with the adipose tissue measuring method using CT as reference.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.151-156
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• 2010

Purpose: The liver is the second most common organ injured by blunt abdominal trauma. The purpose of this study was to determine the utility of liver transaminase in screening blunt abdominal trauma patients for traumatic liver injury. Methods: We retrospectively reviewed the medical records of 231 patients who sustained blunt trauma and were at risk for traumatic liver injury between June 2009 and August 2010. All of them underwent a focused assessment with sonography for trauma (FAST) and abdominal computed tomography (CT). Based on the diagnosis of abdominal CT, patients were divided into two groups: group I with liver injury and group II without liver injury. We compared the two groups and calculated the sensitivity, the specificity and the predictive values of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: Of 231 patients with no abdominal free fluid in the FAST, 33 had traumatic liver injury on abdominal CT. The mean AST and ALT levels in group I (311.6 IU/L and 228.1 IU/L, respectively) were significantly higher than the values in group II (48.4 IU/L and 35.6 IU/L, respectively). The cutoff to distinguish liver injury is 60 IU/L for AST and 58 IU/L for ALT, with 93.8% sensitivity and 79.8% specificity for AST, and 90.6% sensitivity and 87.4% specificity for ALT. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though no abdominal free fluid is shown on the FAST. If AST > 60 IU/L and/or ALT > 58 IU/L, abdominal CT was useful to confirm liver injury in this study.

• 한국방사선학회논문지
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• 제9권1호
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• pp.9-16
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• 2015

이중에너지 기법을 이용한 복부 CT 검사에서 적정한 조영제 양에 대하여 알아보고자 하였다. 일반적인 단일에너지 복부 CT 검사를 시행했던 환자들 중 이중에너지 기법을 이용하여 추적검사를 시행한 30명을 대상으로 하였다. 단일에너지 복부 검사에서 사용했던 조영제 양 대비 30%, 40%, 50%, 60%, 70%로 각각 설정하여 영상을 획득한 후 대동맥, 하대정맥, 간문맥, 간실질에 관심영역을 설정하여 조영증강정도(hounsfield unit; HU)를 구하여 단일에너지에서 측정된 부위와의 값을 비교 분석하였다. 그 결과 기존대비 60%로 조영제를 설정한 군에서는 대동맥 HU : $210.80{\pm}13.609$, 하대정맥 HU : $190.40{\pm}25.215$, 간문맥 $198.40{\pm}21.232$, 간실질 HU : $119.20{\pm}7.98$로 각각 측정되었으며. 단일에너지 복부 CT 검사는 대동맥 HU : $205.40{\pm}16.426$, 하대정맥 HU : $188.20{\pm}21.476$, 간문맥 HU : $195.40{\pm}22.744$, 간실질 HU : $121.00{\pm}6.595$ 이었다. 따라서 이중에너지를 이용하여 복부 조영 CT검사를 시행할 때 조영제의 양을 60%로 설정한 후 검사하는 것이 각 장기에서의 단일에너지 조영검사시와 비슷한 조영증강정도를 획득할 수 있어 기존 조영제 양의 감소와 동시에 조영제를 낮은 속도로 주입할 수 있어 신장기능 저하환자, 정맥혈관이 약한 환자, 과거 조영제 부작용이 있었던 환자에게 유용한 검사라 사료된다.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1082-1089
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• 2005

목 적 : 복부 비만은 고혈압, 인슐린 저항, 고인슐린혈증, 당뇨, 고지혈증과 같은 많은 심혈관계 질환의 위험 요인으로 제시되고 있다. 복부 비만을 측정하는 지표로 허리/둔부 비와 허리둘레가 사용되고 있으나, 관상동맥 질환의 예측인자로 복부 비만의 측정학적 cut-off 수치가 소아에서는 아직 제시되지 못하고 있다. 복부 전산화 단층촬영과 초음파를 이용하여 복부 지방을 측정하고, 여러 비만 지표들과의 상관관계를 연구함으로써 복부 비만의 합병증으로 초래되는 심혈관계 질환의 위험인자 평가 방법을 알아 보고자 본 연구를 실시하였다. 방 법 : 비만한 청소년 27명과 나이와 성별이 대등한 정상 체중을 가진 청소년 22명을 대상으로 하여 체질량 지수와 비만 지수, 상완둘레 및 삼각근에서 피부 두께를 비교하였다. 또한, 12시간 공복 상태에서 혈중 지질 및 혈당, 인슐린, 4가지 사이토카인을 측정하고, 인슐린 저항 지수를 구하였으며, 생체 전기저항법을 이용하여 체지방량, 체지방률, 복부지방률을 측정하여 비교하였다. 비만군에서는 복부 초음파로 배꼽부위 피하지방 두께와 복강 내 지방 두께를 측정하고, 복부 전산화 단층 촬영으로 얻은 횡단면 스캔에서 전체 지방 면적을 구하였고, 이 중 피하지방의 면적을 감산하여 복강 내 지방 면적을 구하였다. 결 과 : 소아에서 복부 CT로 측정한 총 지방 면적과 생체 전기 저항법으로 측정한 총지방량과 상관성이 매우 높았다(r=0.954, P<0.05). 복부 CT에서 측정한 복강 내 지방 면적은 상완둘레, 복부비만율, 초음파로 측정한 복부 내 지방 깊이 및 피하 지방량, 체질량 지수, 중성지방 등과 상관성이 높았다. 결 론 : 복부 CT는 복강 내 지방을 측정하는 가장 정확한 방법이지만 임상적으로 유용하지 못하므로, CT와 상관성이 높은 복부 초음파로 대치할 수 있다. 외래나 학교 신체검사에서 사용할 수 있는 선별 검사로는 생체 전기 저항법에 의한 체지방 측정, 상완 둘레, 체질량 지수, 허리/둔부 비 등이 있다. 소아 성인병의 심혈관 위험 예측 지표로는 공복시 leptin, 중성지방, 인슐린 농도 등을 사용할 수 있다.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.28-35
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• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• 한국방사선학회논문지
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• 제17권3호
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• pp.315-325
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• 2023

본 연구는 복부 비만도에 따라 콩팥 크기의 상관관계를 분석하여 3차원 전산화단층영상(3-Dimensional Computed Tomography, 3D CT)의 콩팥 크기 계측으로 복부 비만도를 예측하고자 하였다. 대상자는 전주 예수병원 건강의학센터에서 종합검진을 받은 자로 기저질환이 없는 건강한 성인 178명으로 하였다. 복부 비만도는 CT의 배꼽 주변의 횡단면에서 내장지방 면적, 피하지방 면적, 비만도로 구분하여 측정하였다. 복부 비만도 간에 따라 분류한 콩팥 크기의 평균 비교는 일원배치 분산분석(One-way analysis of variance, ANOVA) 및 Scheffe 사후 검정을 통해 시행하였다. 모든 계측 값의 상관관계는 Pearson 상관분석 하였다. 그 결과 복부 비만도에 따른 콩팥 크기 ANOVA 분석 결과는 다음과 같다. 내장 지방도 간에 따른 콩팥 계측치의 평균은 모든 콩팥 계측치에서 유의한 차이가 있었다(p<0.05). 피하 지방도 간에 따른 콩팥 계측치의 평균은 3D CT 우측 콩팥 너비 계측 시 중증 비만군에서 유의한 차이를 보였다(p<0.05). 비만도 간에 따른 콩팥 계측치의 평균은 3D CT 우측 콩팥 너비와 좌측 콩팥 너비 계측 시 중증 비만군에서 유의한 차이를 보였다(p<0.05). 콩팥 계측치와 CT 복부 비만도 간의 Pearson 상관분석 결과 내장지방 면적은 3D CT 좌측 콩팥 너비와 상대적으로 높은 양의 상관관계(r=0.467)를 보였으며 피하지방 면적은 3D CT 우측 콩팥 너비와 양의 상관관계(r=0.249)를 보였다. 비만도에서는 3D CT 좌측 콩팥 너비와 양의 상관관계(r=0.291)를 보였다.

• 한방재활의학과학회지
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• 제20권2호
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• pp.129-143
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• 2010

Objectives : This study examined search on how the obesity indices, that are largely used in clinics such as waist circumference(WC), body mass index(BMI) and waist-hip ratio(WHR), are related to the visceral fat that was measured from abdominal computed tomography(CT) and the ratio of visceral fat/subcutaneous fat. Then, two groups ware compared in order to find out which characteristics of ordinary adults relationship with the abdominal obesity. Two groups are divided as follows; ones who are obese based on the measurement of WC and the others who are obese based on the level of BMI. Methods : A group of 63 test subjects that were gathered in the oriental medical hospital of Kyung-Won university is divided into two groups; ones (n=51, general obesity; group A) who have $BMI{\geq}25$ and $WC{\geq}85$, and the others (n=12, abdominal obesity; group B) who have BMI<25 and $WC{\geq}85$. Then, each group's obesity indices, abdominal CT, lipid level, glucose, adiponectin, leptin and C-reactive protein(CRP) are compared. In addition, subjects are again divided into two to examine the characteristics; ones (n=14, visceral obesity; group C) with visceral obesity based on the ratio between visceral fat and subcutaneous fat measured through abdominal CT, and the others (n=38, non-visceral obesity; group D) who are obese but not viscerally obese. Results & Conclusions : As a measurement that applies abdominal visceral fat and subcutaneous fat, BMI and WC can be considered as an appropriate obesity index while WHR cannot appropriately apply the abdominal fat amount. Moreover, the study indicates that abdominal obesity group based on the ratio of visceral fat/subcutaneous fat has more significant difference than the abdominal obesity group based on the WC in case of blood lipid index.