• 대한방사선기술학회지:방사선기술과학
• /
• 제14권1호
• /
• pp.29-44
• /
• 1991

A Study on the distribution and types of the total 40 CT units, as of 1st October 1990, in Pusan area(29 for whole body CT units, 11 for brain CT units) were carried out during the period from January 1989 to December 1989 to find out the status of operation and utilization of whole body CT units. The results were as following ; 1. As of 1st October 1990 in Pusan area, a total of 40 CT units(29 for whole body CT units, 11 for brain CT units) were set up and operated. The number of cases of CT examination performed per day per unit were appeared to be less than 5 cases among 59.5% of CT units, and 2.7% of the total units has peformed more than 16 examinations. 2. The CT units under operation occupied 93.5% of the total and 2.6% of the total units was not properly been operated due to mechanical breakdown. This results is appeared to be better than other reports. 3. The average number of scanning per week for each CT were 35 cases and the average days under operation of the unit per week were 6.7 days. Consequently, the average days under operation of units was higher than that of the other reports, but the average number of scanning was lower. 4. The cases referred from other institutes to hospitals were 6.4% of total cases. 5. As a site of scanning, the brain appeared most frequently with 71.2% of the total cases and followed by spine 12.4%, abdomen 8.5%, and thorax 3.6%, respectively. 6. Positive rate by scanning was 70.8% of total cases, and it was 98.9% with thorax, abdomen 96.3%, spine 93.1%, and brain 38.4%, respectively. According to the results of this study, it is highly recommended that the regulations and the guidelines for setting-up of such high cost medical equipments as CT units be provided in order to ensure the cost-effectiveness of the system.

• Journal of Korean Neurosurgical Society
• /
• 제60권1호
• /
• pp.118-124
• /
• 2017

Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source.

• 한국방사선학회논문지
• /
• 제15권2호
• /
• pp.101-108
• /
• 2021

CT는 인체 내 장기의 해부학적 구조를 정확하게 나타낼 수 있으며, 영상의 분해능이 우수하다. Brain CT 검사 시 수정체의 방사선 감수성이 높아서 피폭의 영향을 많이 받는다. 본 연구는 수정체에 피폭선량을 감소하기 위해 비스무스와 텅스텐 필라멘트 차폐물질을 사용하여 Non-shield와 Shield에 대한 피폭선량의 변화와 차폐율을 비교 하고자 한다. 본 연구에서는 3D printing으로 제작한 비스무스, 텅스텐 필라멘트 차폐물질을 사용하여, 차폐물질 두께와 slice에 따라 피폭되는 선량을 측정하였다. 헤드팬텀을 고정시켜 안구에 Magicmax universal 선량계를 위치시켜 차폐 물질을 놓지 않았을 경우와 그 위에 차폐 물질을 놓았을 때 차폐율을 각각 비교하기 위해 두 물질을 1mm ~ 5mm 두께로 각각 측정하였다. 1 mm 두께의 필라멘트에서 비스무스 필라멘트는 26.8 %, 텅스텐 필라멘트는 43.1 % 차폐율이 나타났다. 따라서 비스무스 필라멘트보다 텅스텐 필라멘트에서 더 큰 차폐효과가 나타났다. 차폐체의 종류, 두께, 슬라이스 간격에 따라 선량을 측정한 결과, 비스무스 필라멘트 보다 텅스텐 필라멘트가 더 큰 차폐효과가 나타났다.

• Journal of Trauma and Injury
• /
• 제27권3호
• /
• pp.63-70
• /
• 2014

Purpose: In children, mild traumatic brain injuries (TBI) account for 70~90% of head injuries. Without guidelines, many of these children may be exposed to excess radiation due to unnecessary imaging. The purpose of this study was to evaluate the impact of a mild TBI guideline in imaging of pediatric patients. Methods: The medical records of all children who had head computed tomography and were admitted to our hospital with a TBI with Pediatric Glasgow Coma Scale and Glasgow Coma Scale of 14 to 15 were retrospectively reviewed and compared with PECARN Rule. Results: A total of 1260 children were included and all children checked with head computed tomography. 61 pediatrics had CT positive and presented skull fracture 40, hemorrhage 8, hemorrhagic contusion 7, and diffuse axonal injury 1. Also, 4 patients diagnosed both skull fracture and brain haemorrhage and 1 patient diagnosed both haemorrhage and haemorrhagic contusion. Conclusion: There are many pediatric traumatic patients who exposed to radiation due to CT. But, the most of results were negative. So, consider to follow the CT guideline for children and many do not require brain CT.

• 한국응급구조학회지
• /
• 제24권2호
• /
• pp.99-109
• /
• 2020

Purpose: Alcohol intoxication is frequently observed in patients with brain hemorrhage. The purpose of this study was to determine whether intoxication affects the Korean Triage and Acuity Stage (KTAS) level and the emergency medical process in emergency departments. Methods: This study was a retrospective observational study enrolled 253 brain hemorrhage patients (47 of those intoxicated) who visited the emergency medical center on public EMS ambulance from January. 1, 2017 to April, 30, 2019. Data were collected through the electronic medical record (EMR). KTAS level and time to computerized tomography (CT) were compared to evaluate whether inebriation affects care and examination processes. All data were analyzed using SPSS program. Results: Of the 47 patients intoxicated patients, 85.1% were male, and 74.5% accompanied by trauma. Initial KTAS level showed significant differences (77.2%; p=.000) when the level 3,4 was not drunk. The average time taken from triage to CT scans showed a significant difference of 24.81±23.72 (min) when the drunken state was not 58.38±56.54 (min)(p=.000). Conclusion: In patients with brain hemorrhage admitted to ED from public EMS, undertriage and delay after initial assessment were detected in inebriated patients. Careful initial evaluation and prompt medical response should be considered for patients transported by EMS.

• 대한방사선기술학회지:방사선기술과학
• /
• 제46권2호
• /
• pp.99-106
• /
• 2023

The height of the table should be considered important during computed tomography (CT) examination, but according to previous studies, not all radiology technologists set the table at the patient's center at the examination, which affects the exposure dose and image quality received by the patient. Therefore, this study intends to study the image quality exposure dose according to the height of the table to realize the optimal image quality and dose during the brain CT scan. The head phantom images were acquired using Philips Brilliance iCT 256. When the image was acquired, the table height was adjusted to 815, 865, 915, 965, 1015, and 1030 mm, respectively, and each scan was performed 3 times for each height. For the exposure dose measurement, optically stimulated luminescence dosimeter (OSLD) was attached to the front, side, eye, and thyroid gland of the head phantom. In the signal to noise ratio (SNR) measurement result, The SNR values for each table height were all lower than 915 mm. As a result of exposure dose, the exposure dose on each area increased as the table height decreased. The height of the table has a close relationship with the patient's radiation exposure dose in the CT scan.

• 한국콘텐츠학회논문지
• /
• 제14권1호
• /
• pp.356-363
• /
• 2014

소아 CT 촬영시 피폭선량을 저감시킬 수 있는 조건을 찾기 위하여 pediatric phantom을 이용하여 소아 방사선량을 비교 분석하였다. 관전류변동제어(tube current modulation:TCM) 방식과 low dose CT protocol(LDCTP)에 따라 소아 검사를 시행하였으며, 검사는 brain, chest, abdomen-pelvis 부위를 전산화 단층촬영 장치를 이용한 3개의 검사 프로토콜을 사용하였다. 거의 모든 MDCT 장치는 volume CT dose index(CTDIvol), dose length product(DLP)와 유효선량 평가 결과를 기록, 보관하고 있으며, 이러한 정보들은 환자들의 방사선 노출 및 위험도를 평가하는 데 필수적이다. 방사선 노출 위험도를 감소시키기 위해서 적정화 및 정당화 원칙을 반드시 준수해야 한다. 관전압(kV)에 따른 TCM 방식을 사용하였을 경우 kV가 낮아질수록 유효선량이 낮아지는 경향을 나타내었으며, low dose CT protocol을 사용한 경우가 유효선량이 상대적으로 더 적은 것을 알 수 있었다. 또한 평균 유효선량은 brain, chest, abdomen-pelvis CT의 결과가 독일의 reference dose 보다 각각 47%, 13.8%, 25.7%로 더 낮게 나타났고. 영국의 reference dose와 비교해도 55.7%, 10.2%, 43.6%에 불과했다. 결론적으로 선량 감소를 위해 주의할 것은 body-weight based tube current adaption을 포함한 TCM, 그리고 LDCTP 등 모든 선량 감소 방안을 이용하여야 한다.

• 핵의학기술
• /
• 제23권1호
• /
• pp.69-74
• /
• 2019

$^{18}F$-FDOPA는 뇌 종양의 아미노산 대사를 추적하는 방사성 의약품이다. 본 연구의 목적은 뇌 종양의 아미노산 대사를 영상화 하여 악성 종양을 진단하는 $^{18}F$-FDOPA와 포도당 대사를 통한 $^{18}F$-FDG의 Brain PET/CT 검사 영상의 대조도 분석을 통해 병변의 검출 능력을 비교하고, $^{18}F$-FDOPA Brain PET/CT 검사에서 섭취 시간에 따른 SUV의 변화를 분석하여 최적의 영상 획득 시간을 알아보기 위함이다. $^{18}F$-FDOPA 와 $^{18}F$-FDG 두 영상에서 종양(Tumor)과 소뇌(Cerebellum)의 중심에 각각 약 $350mm^2$의 관심 영역을 설정하여 $SUV_{max}$를 측정하였고, 종양과 소뇌의 $SUV_{max}$ 비율(T/C ratio)을 산출하였고, $^{18}F$-FDOPA 투여 직후 30분 동안 획득한 리스트 수집 방식 데이터(List mode data)를 활용해 2분씩 15프레임으로 나눈 뒤 각 프레임 별로 종양과 소뇌 중심에 $SUV_{max}$를 측정하여 위와 동일한 방법으로 T/C ratio를 산출하여 분석하였다. 종양의 평균 $SUV_{max}$를 비교해 본 결과, $^{18}F$-FDOPA Brain PET/CT 검사에서 $4.2{\pm}0.8$, $^{18}F$-FDG Brain PET/CT 검사에서는 $5.6{\pm}0.7$ 이었다. 또한, T/C ratio는 $^{18}F$-FDOPA 검사에서 $2.1{\pm}0.7$, $^{18}F$-FDG 검사에서는 $1.1{\pm}0.4$ 이었으며, $^{18}F$-FDOPA의 $SUV_{max}$는 $^{18}F$-FDG보다 낮지만 T/C ratio는 높게 나타나 종양 구별 능력이 더욱 뛰어난 것을 알 수 있었다(t=-5.214, p=0.000). $^{18}F$-FDOPA의 섭취 시간에 따른 $SUV_{max}$와 T/C ratio를 분석한 결과, $SUV_{max}$와 T/C ratio의 Peak는 모두 6~8분에서 나타났다. 이를 토대로 본원에서 $^{18}F$-FDOPA Brain PET/CT 검사에서 활용하는 10~30분의 영상과 Peak가 나타나기 시작한 6~26분의 영상을 비교한 결과 SUV와 T/C ratio가 각각 0.2, 0.1 증가하였다. 추후 지속적인 연구를 통해 검사 소요시간의 단축 가능성과 추가적인 스캔 정보 활용을 통한 정확한 진단에도 도움이 될 것으로 사료된다.

• Journal of Trauma and Injury
• /
• 제33권4호
• /
• pp.207-218
• /
• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

• 대한방사선기술학회지:방사선기술과학
• /
• 제42권2호
• /
• pp.105-111
• /
• 2019

A medical personnel could be placed beside a patient together in CT room to do Ambu-bag for a seriously ill patients or emergency patient. At this time, the medical personnel can be exposed indirect radiation unnecessarily. In this case, it is necessary to recognize indirect radiation dose levels and methods to reduce them using actual clinical CT protocols such as Chest, Abdomen, and Brain CT. We researched surface radiation dose with or without radiation protectors such as apron and goggles according to different distances far from gantry using two different CT scanners (Fixed MDCT and mobile CT). As a result, for Chest, Abdomen, and Brain CT with Fixed MDCT, indirect radiation dose on thorax portion were 0.047, 0.089, 0.034 mSv without apron. Also, those with apron were 0.007, 0.012, 0.006 mSv. In case of mobile CT, it was 0.014 mSv without apron and 0.005 mSv with apron. By using protectors and increasing the distance, we could reduce it to 97%. Systematic management is necessary based on the measured data in order to minimize radiation damage due to indirect exposure dose.