• Journal of radiological science and technology
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• v.35 no.1
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• pp.45-50
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• 2012

Nowadays, most of the hospital serves "one stop service" for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the wating time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.

• Journal of radiological science and technology
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• v.37 no.4
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• pp.307-313
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• 2014

The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about $4.8{\pm}0.3bpm$ (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

• Korean Journal of Radiology
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• v.20 no.4
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• pp.621-630
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• 2019

Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBF_ratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBF_ratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

• Korean Journal of Radiology
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• v.21 no.11
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• pp.1230-1238
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• 2020

Objective: We aimed to assess the effects of remote ischemic pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy (CIN) after an intravenous (IV) or intra-arterial injection of contrast medium (CM) in patient and control groups. Materials and Methods: This prospective, randomized, single-blinded, controlled trial included 26 patients who were hospitalized for the evaluation of the feasibility of transcatheter aortic valve implantation and underwent investigations including contrast-enhanced computed tomography (CT), with Mehran risk scores greater than or equal to six. All the patients underwent four cycles of five minute-blood pressure cuff inflation followed by five minutes of total deflation. In the RIPC group (n = 13), the cuff was inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in the control group (n = 13), it was inflated to 10 mm Hg below the patient's SBP. The primary endpoint was the occurrence of CIN. Additionally, variation in the serum levels of cystatin C was assessed. Results: One case of CIN was observed in the control group, whereas no cases were detected in the RIPC group (p = 0.48, analysis of 25 patients). Mean creatinine values at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 88 ± 32 μmol/L, 91 ± 28 μmol/L and 82 ± 29 μmol/L, respectively (p = 0.73) in the RIPC group, whereas in the control group, they were 100 ± 36 μmol/L, 110 ± 36 μmol/L, and 105 ± 34 μmol/L, respectively (p = 0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18] mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p = 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13 [1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in the control group. Conclusion: The risk of CIN after an IV injection of CM is very low in patients with Mehran risk score greater than or equal to six and even in the patients who are unable to receive preventive hyperhydration. Hence, the Mehran risk score may not be an appropriate method for the estimation of the risk of CIN after IV CM injection.

• Journal of radiological science and technology
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• v.28 no.4
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• pp.279-286
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• 2005

Purpose : There are two modalities, those are small bowel series(SBS) and abdominal pelvic computed tomography(CT), for diagnosis of small bowel disease. The aim of this study is to lend radiological technologists who are doing the two modalities assistance in the understanding characteristic of disease by comparing the two results. Meterials and method : 284 patients were examined the two SBS and abdominal pelvic CT together from 1999 to 2003. 250 ml $BaSO_4$ suspension 40 w/v% and 600ml carboxy methyl cellulose 0.5 w/v% were used for SBS. Abdominal Pelvic CT was examined in one hour before taking 450 ml $BaSO_4$ suspension 1.5 w/v%. The CT scan was done in 72 sec after 150 ml contrast media injection. the used protocol was helical mode 5:5 mm pitch 1.375:1, speed 27.50, exposure 120 kv, 240 mA, tube rotation time 0.5 sec. the statistic analysis was conducted with statistical program SPSS 10 version with frequency and crossing analysis. P-value less than 0.05 were considered significant. Results : In the results of SBS, normal findings were 131 patients(46.1%), inflammatory bowel disease(IBD) 64(22.9%), ischemia+ileocolitis+vasculitis 22(7.7%), Obstruction+stricture 21(7.7%) and Others 45(15.9%). In the results of abdominal pelvic CT, normal findings were 103 patients(36.3%), inflammatory bowel disease 65(22.9%), wall thickening+lymphadenopathy 42(14.8%), Fluid collection 17(6%), and Others 57case(20%). The same results of the two were 130patients(45.8%). 30patients(10.6%) of normal finding in SBS were diagnosed as wall thickening+lymphadenopathy and IBD in CT, and 15patients(5.3%) of normal finding in CT were diagnosed as ischemia+ileocolitis+vasculitis, mass and IBD in SBS(p<0.05). Transit time delay was diagnosed in 10patients(3.5%) on only SBS, wall thickening+lymphadenopathy was diagnosed in 20patients(7%) in only CT(p<0.05). Conclusion : We think that proper examination method will be selected in the small bowel disease, if we understand the characteristics of the disease and method.

• Progress in Medical Physics
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• v.17 no.3
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• pp.167-172
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• 2006

Catheter fragment and embolism are both potentially serious complications associated with the use of an intravenous (IV) catheter for contrast media bolus injection, and may be followed by serious or lethal sequelae. Though catheter fragment is a rare complication of IV catheter insertion, especially in peripheral veins, CT can be used to detect residual fragment. This study demonstrates the utility of MDCT to localize a small, subtle peripheral venous catheter, which can be easily reformatted of MDCT reformations. Various 3D techniques such as MPR and MIP, volume rendering, and shaded-surface displays are currently available for reconstructing MDCT data. Advances in MDCT technology contribute substantially to the detection and accurate localization of smaller IV catheter fragment.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.263-267
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• 1999

We have observed retroperitoneal hematoma after trigger point injections of quadratus lumborum in a patient with chronic low back pain. Severe flank pain and dyspnea was observed three hours after injection of local anesthetic and steroid to the trigger point of quadratus lumborum muscle. There was fuge hematoma in abdominal CT image around the right kidney, which displaced and compressed the kidney anteriorly. Following infusion of contrast media, extravasation through renal vein and IVC was notified. Patient had a past history of having been treated with platelet aggregation inhibitor and lower dose aspirin treatment after cerebral ischemia for a year, but coagulative function was within normal range. Patient was admitted 12 days for bed rest, pain control and transfusion. We need to take greater care with a frequent aspiration and exact direction of needle, during trigger point injection of quadratus lumborum, particu right side, to avoid vascular injury.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.184-192
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• 2009

Purpose: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. Methods: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. Results: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was $84.53{\pm}66.92$ minutes, and the CTA-to-embolization time was $147.65{\pm}99.97$ minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. Conclusion: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.1-15
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• 1987

Magnetic Resonance (M.R.) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. M.R.I. is conceptually quite different from currently used imaging methods. The complex nature of M.R.I. allows a great deal of flexibility in image product ion and available information, and key points are as follows. 1. M.R.I. offers a non-invasive technique with which to gene rate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of M.R.I. is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of M.R.I. 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fasternning scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen e. Further development of contrast media f. M.R. in vivo spectroscopy g. Real time M.R. imaging.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.49-66
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• 2014

Traditionally, cervical interventions have been performed under fluoroscopy. But radiation exposure is the major concern when obtaining fluoroscopic images and even under real-time fluoroscopy with contrast media or CT guidance, some cases of serious spinal cord injuries, cerebellar and brain stem infarction have been reported by unintentional intra-arterial injections especially during the transforaminal root blocks. Recently, the use of ultrasound-guided cervical interventions have increased. Ultrasound offers visualization of soft tissues including major neurovascular structures and also allows to observe the spread of injectant materials around the target structure. Ultrasound is radiation free, easy to use and the image can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound allows visualization of major nerves and vessels and thus leads to improve safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore reviewed to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.