• Tuberculosis and Respiratory Diseases
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• 제67권4호
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• pp.318-324
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• 2009

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

• 대한핵의학회지
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• 제22권2호
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• pp.209-213
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• 1988

To Appreciate the value of bone scintigraphy in determination of the bony infection, we performed three phase bone scintigraphy in 34 cases of osteomyelitis of extremities prospectively. They were clinically inactive in 11 and active in 23 cases. We confirmed the active osteomyelitis by operation or aspiration within one week after scintigraphy. Perfusion, blood pool and delayed images were analyzed respectively and compared with the plain roentgenograms. All 23 active lesions showed diffusely increased perfusion in affected limbs. The areas of the increased activities on blood pool images were larger than or similar to those on delayed images in 17 cases (73.9%) with active osteomyelitis and smaller in 6 cases (26.1%). 5 of the latter 6 cases showed definite soft tissue activities on blood pool images. In inactive cases bone scintigrams were completely normal in 4 cases. Two of those were normal on plain films and remaining two showed mild focal bony sclerosis. Among 7 inactive lesions, perfusion was normal in 2 cases, diffusely increased in 4 cases and diffusely decreased in 1 case. 6 of these 7 cases showed increased activities both on blood pool and delayed images and the areas of increased activities on blood pool images didn't exceed those on delayed images. Bony sclerosis was noted on plain films in those 7 inactive lesions and the extent of the sclerosis correlated well to delayed images. Large blood pool activity was characteristics of active osteomyelitis. Normal three phase bone scintigram may indicate the time to terminate the treatment, but increased activity on perfusion and blood pool scans is not absolute indication of active lesion if the extent of the lesion on the blood pool image is smaller than that on delayed image and if no difinite soft tissue activity is noted on perfusion and blood pool images in clinically inactive patient.

• 핵의학기술
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• 제14권1호
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• pp.147-148
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• 2010

Introduction: A metastatic calcification is known for taking in bone scintigram medicine at metastatic calcification lesion due to abnormal distribution of the calcium and phosphorus. The one paper reports that a metastatic calcification occurs mainly at lung, stomach, kidney and myocardium. Index: The patient is seventy four years old man who is afflicted with clonic kidney disease, hypercalcemia, hypertension. Because of an ability of the multiple myeloma, we take a bone scan after intravenous injection $^{99m}Tc$-DPD 25 mCi in three hours. We found out homogeneous $^{99m}Tc$-DPD uptake at both lung and myocardium. Conclusions: Nothing unusual was found in other bone scan. We obtains a purity beyond 95 percent at $^{99m}Tc$-DPD vial. In spite of no evidence about a myocardial infarction, the patient has a $^{99m}Tc$-DPD uptake at both lung and myocardium.

• 대한핵의학회지
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• 제19권1호
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• pp.73-75
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• 1985

Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.

• 대한핵의학회지
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• 제33권4호
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• pp.405-412
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• 1999

목적: 대퇴골두의 무혈관성괴사에서 치료 후 치유되는 과정의 평가는 매우 중요하다. 그러나 무혈관성괴사의 치료에 대한 병리학적 변화를 단순방사선 촬영만으로 평가하기에는 어려움이 있다. 이에 저자들은 무혈관성괴사에서 바늘구멍 골신티그라피 소견과 병변의 치유과정과의 관계에 대해 비교 분석하였다. 대상 및 방법: 조직학적으로 대퇴골두 무혈관성 괴사로 진단된 환자 16명의 21예의 대퇴골두 병소(남자: 11명 14예, 여자. 5명 7예, 평균나이: 39.4 세)를 대상으로 하였다. 다발성 천공술은 14예, 혈관부착 골이식술은 7예에서 시행하였다. 바늘구멍 골신티그라피를 얻었고, 골신티그라피는 치료 전 1-3개월 사이에, 수술 후 첫 번째 검사는 $1{\sim}3$개월 사이에, 그 이후 추적검사는 $1{\sim}4$회(평균 2.7)로 $2{\sim}4$년간에 걸쳐 시행하였고, 이 소견을 환자의 임상경과와 비교 분석하였다. 결과 추적 검사상 보이는 소견을 괴사부위의 냉소와 그 주위의 방사능집적의 유형에 따라 분류하였는데, 이들 소견은 서로 혼재되어 있는 경우가 많아 주된 소견을 중심으로 3가지유형으로 나누었다 첫 번째 유형은 냉소주위에 곡선모양의 방사능집적이 있는 유형으로 11예였고, 이후의 추적검사상 10예는 열소는 넓어지며 냉소는 줄어들었다. 1예는 소견의 변화가 없었으며 인공치환술을 시행하였다. 두 번째 유형은 냉소주위로 산재된 모양의 방사능집적이 보이는 유형으로 6예였고, 이후의 추적검사상 열소와 냉소의 변화가 거의 없었으며 경과가 좋지 않아서 모두 인공치환술이 시행되었다. 나머지 4예는 위의 두 가지 유형으로 분류할 수 없었던 경우로 2예는 경과가 좋았고 다른 2예는 경과가 좋지 않아 인공치환술이 시행되었다 골신티그라피 소견에 따라서 인공치환술을 요하는 환자의 예후는 유의한 차이가 있었다(p<0.05). 결론: 대퇴골두 무혈관성 괴사 환자에서 치료 후 $1{\sim}3$개월 사이에 시행한 바늘구멍 골신티그라피에서 보인 소견이 치료 후 병변의 치유과정을 예측하는 데 유용한 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제53권1호
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• pp.46-51
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• 2002

Numb chin 증후군은 악성질환의 진행과 재발의 소견인 경우 외에도 암의 최초 증상으로 발현하기도 하며, 진단 후 대개 나쁜 경과와 예후를 보이는 것으로 알려져 있다. 저자들은 numb chin 증후군으로 발현한 비소세포폐암 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 치과방사선
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• 제19권1호
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• pp.55-64
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• 1989

The purpose of this study was to clarify that scintigram was a more effective method than radiogram in the early detection of periapical lesion. Periapical lesions were produced artificially by the opening of the pulp chambers of the lower right 3rd and 4th premolars in 6 dogs. The serial bone scintigrams using 99m-Tc-MDP and periapical radiograms were taken weekly. The uptake counts of the 99-Tc-MDP in the experimental side were compared with those in the control side. The periapical radiograms were interpreted with the joint evaluation by three dental radiologists. The following results were obtained; 1. The radioactivity in the experimental side was increased at the Ist week except one animal in which the radioactivity was increased at the 2nd week. 2. It was observed that increasing amount of radioactivity per week was prominent from the 1st day of experiment to the Ist week, and the 3rd week to the 4th week. 3. The radiographic evidence of the periapical lesions was observed at the 3rd week and became more apparent at the 4th week. 4. Histologically, proliferation of blood vessels and infiltration of chronic inflammatory cells were observed at the 1st week and osteoblasts were found after the 3rd week.

• 치과방사선
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• 제27권2호
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• pp.135-144
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• 1997

The primary intra-osseous carcinoma (PIOC) is a very rare lesion. PIOC is an odontogenic carcinoma defined as a squamous cell carcinoma arisinig within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. The authors diagnosed a 51-year-old female as primary intra-osseous carcinoma after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of gingival bleeding on the premolar area in the left maxilla 2. The conventional radiograms showed a relatively well-defined unilocular radiolucent lesion from the mesial aspect of the upper left canine to the mesial aspect of the upper left 1st molar. The 2nd premolar was separated from the 1st molar and the floor of the maxillary sinus was elevated by the lesion. There was a external root resorption of the upper left canine, the 1st premolar, and the 2nd premolar. 3. On the computed tomograms, the osteolytic bony lesion expanded the cortical plate of the left maxilla and displaced the margin of the left maxillary sinus upwards. But the bony lesion was separated from the maxillary sinus by a bony septum. 4. Bone scintigram with /sup 99m/Tc demonstrated the increased uptake in the left maxilla. Sonograms in the neck area and chest P-A radiogram didn't show any abnormalities. 5. Histologically, the tumor islands infiltrating into the surrounding bone increased in alveolar pattern, composed of the malignant cells, and there was a necrosis in the center of the tumor islands.

• 대한핵의학회지
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• 제14권2호
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• pp.19-27
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• 1980

Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

• 대한핵의학회지
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• 제31권4호
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• pp.452-458
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• 1997

저자들은 섬유성 이형성증으로 진단받은 14명 환자의 16병변에서 단순 X-선사진의 소견에 따른 부위별 방사능 집적 정도를 알아보고 그 의의를 평가하기 위해 바늘구멍 골스캔과 단순 X-선사진 소견을 후향적으로 분석하여 비교하여 보았다. 10병변은 수술하여 조직학적으로 확진되었고, 6병변은 방사선학적으로 진단 받았다. 평균연령은 41.1세이며, 두 검사간의 간격은 평균 1.1일이었다. 병소의 위치는 늑골 7예, 골반골 4예, 쇄골 1예, 대퇴골 2예, 장골 1예, 상완골 1예였다. 바늘구멍골스캔 소견상 중심부에서 1+로 정상 방사능 집적을 보인예는 6예(방사선투과성 병변 5예, 간유리모양 병변 1예)이고, 2+로 중등도로 증가된 방사능 집적을 보인 경우는 7예(방사선투과성 병변 4예, 간유리모양 병변 3예)이며 3+로 현저히 증가된 경우는 3예(간유리모양 병변 1예, 경화성 병변 2예)가 있었다. 16예 중 15예에서 주변부 병소에 한 군데 이상의 증가된 방사능 집적이 불규칙한 환상이나 결절모양으로 나타났는데, 2+의 중등도 방사능 집적이 경화성테두리 5예와 비가시성 피질 1예에서, 그리고 3+의 현저한 방사능 집적증가는 격막과 피질천공을 보인 모든 예(7예, 8예)에서, 그리고 비가시성 피질 9예 중 8예에서 나타났다. 16예 중 1예는 중심부와 주변부 병소가 균일한 2+의 집적증가를 보였다. 바늘구멍 골스캔상 섬유성 이형성증의 방사선투과성병변은 이제까지 보고된 것과는 다르게 많은 예에서 인접 정상골과 비슷한 집적을 보였다. 또한, 격막, 피질골절 또는 비가시성 피질 등의 소견을 보이는 부분에 방사능 집적이 현저히 증가되어 주변부의 불규칙한 환상 또는 결절모양의 방사능 집적형태를 보였으며, 이들 병소는 골대사가 활발한 부위로 생각된다. 이와 같은 골의 섬유성 이형성증의 바늘구멍 골스캔 소견을 분석함으로써 부위별 활성도를 평가하여 진단, 예후 추정 및 치료방침을 결정하는데 유용하리라 사료된다.