• 한국의학물리학회지:의학물리
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• 제24권1호
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• pp.68-75
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• 2013

본 연구의 목적은 26명의 건강한 검진자들을 대상으로 PET/CT와 PET/MRI의 전신 영상에서 조기 정밀/ 진단 수준을 향상하고자 관심부피를 이용하여 정상부위의 $SUV_{LBM}$-최대치를 이용하여 PET/CT와 PET/MRI를 조영제 사용 유무와 관계없이 동시 평가할 수 있는 데이터를 구축하고자 하였다. 전신 F-18 FDG PET/CT와 전신 F-18 FDG PET/MRI의 정상부위의 VOI를 이용한 $SUV_{LBM}$-최대치평가는 PET/CT를 기준으로 PET/MRI의 영상은 매우 유의한 차이를 보였다(p<0.0001). 그러나 통계학적으로 높은 상관관계를 가진다(R>0.8). PET/MRI의 $SUV_{LBM}$ 평가 시 26.3% 감소하여 판단할 것과 조영제를 사용할 경우는 29.3% 감소하여 판단할 것으로 생각한다. PET/CT와 PET/MRI의 모든 영상의 판독에서는 $SUV_{LBM}$-최대치를 사용하는 것이 편리성과 효율성을 고려하여 임상의나 연구자들에게 많은 도움이 되리라 판단된다.

• 사상체질의학회지
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• 제26권2호
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• pp.205-212
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• 2014

Objectives Adverse reactions can becaused by contrast media used in computed tomography. The aim of this study was to report the improvement of allergic response caused by contrast media after treatment with Modified Hyeongbangpaedok-san, histamine antagonists and steroids. Methods We retrospectively reviewed the medical records. The patient's subjective symptoms such as rash and pruritus were evaluated by the range of rash and numeric rating scale(NPS). Results All symptoms showed nearly complete remission with continued Korean traditional medical treatment. Conclusions A female patient had been injected with contrast media for Computed tomography(CT) evaluation of lung cancer. Rash and pruritus appeared 1 day after injection. We prescribed Modified Hyeongbangpaedok-san. Patients were treated with both Korean medicine and Western medicine. Consequently, the symtoms were improved significantly after combination treatment of Korean medicine and Western medicine.

• 핵의학기술
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• 제12권1호
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• pp.27-32
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• 2008

Purpose: The evaluation of SUV (Standardized Uptake Values) for quantitative analysis in PET exam is the most significant. In PET exam, we make attenuation correction images by using $^{68}Ge$, $^{137}Cs$ or CT data. At this time, a distorted attenuation map affects quantitative analysis. After the exam using barium-sulfate and high density of barium contrast make attenuation map distorted. And then it brings bed influences on SUV. The aim of this study is to verify the relationship between high density barium-sulfate and SUV in PET exam. Materials and Methods By using $^{18}F$-FDG, we made barium-sulfate powder, density of 0, 1.5, 3, 5, 10 and 15% respectively and acquired PET and PET/CT images per each density. And we examined SUV variations from PET and PET/CT images according to differences of barium's density. Moreover, we finally calculated SUV causing variations in HU (Hounsfield Units) values to justify whether the differences of barium density bring any changes in PET/CT exam. Results: From PET images acquired from transmission scan with $^{68}Ge$, we got SUV figures from 6.46 to 6.8 in barium density between 0 to 15 percent. On the other hand, In PET images acquired from Tx scan that using CT, SUV was 6.77 to 23.73, derived from the same barium density. And CT HU values range from 29 to 2004. Conclusion: PET images from Tx data using $^{68}Ge$ weren't affected by barium density and had no differences in SUV. But in the PET/CT images using CT Tx data, there's considerable variations in HU and SUV values according to a difference of barium density in HU values. To perform a precise examination, barium sulfate should be removed from a human body before performing a PET exam.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.77-80
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• 2022

Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

• 대한방사선치료학회지
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• 제26권2호
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• pp.183-189
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• 2014

목 적 : 조영제는 CT모의치료시 정상조직과 악성종양을 구분하는데 뛰어난 대조도를 제공하기 때문에 CT모의치료에 널리 사용하고 있다. 하지만 조영제는 치료계획 CT에서 일시적으로 존재하기 때문에, 치료계획과 실제 치료 사이에는 Hounsfield Unit(HU)의 차이가 발생하게 된다. 이에 본 연구에서는 조영제 사용으로 인한 HU의 변화가 양성자 치료계획에 미치는 영향을 확인 하고자한다. 대상 및 방법 : 20명의 간암 환자에게서 Phase에 따른 HU값의 변화를 측정하였다, 그리고 5명의 양성자치료계획에서 HU변화에 따른 Range와 Spread-Out Bragg peak(SOBP)의 변화를 살펴보았다. Hand made water phantom을 이용하여 깊이와 HU의 변화에 따른 Range와 SOBP의 변화를 확인하였다. 결 과 : 20명 간암 환자의 HU 변화(Pre contrast, Arterial phase, Porta phase)는 간 조직에서 ($58{\pm}5.7$, $75{\pm}9.5$, $117{\pm}14.6$)이었으며 대동맥에서($40{\pm}6.1$, $279{\pm}49.0$, $154{\pm}22.8$)이었다. 5명의 간암 양성자치료계획에서 HU 변화에 따른 Range 변화는 평균 2.5 mm, SOBP 변화는 평균 1.4 mm 이었다. Hand made water phantom study에서는 HU가 증가함에 따라 Range는 감소되었고 SOBP는 줄어들었다. 결 론 : 양성자 치료계획에서 HU값의 변화는 양성자 Range와 SOBP를 변화시켰다. 실제 양성자 빔에서 HU 변화에 따른 Range와 SOBP의 변화에 대한 추가적인 연구가 필요할 것으로 사료 된다.

• Korean Journal of Radiology
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• 제21권10호
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• pp.1178-1186
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• 2020

Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT). Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses. Results: Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications. Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.345-352
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• 1993

The role of magnetic resonance(MR) imaging in the evaluation of thoracic disease has been limited Nontheless, MR has inherent properties of better contrast resolution than CT allowing tissue-specific diagnosis. MR has capability of direct imaging in sagittal, coronal, and oblique planes which provide better anatomic information than axial images of CT such as lesions in the pulmonary apex, aorticopulmonary window, peridiaphragmatic region, and subcarinal region. MR is sensitive to blood flow making it an ideal imaging modality for the evaluation of cardiovascular system of the thorax without the need for intravenous contrast media. Technical developments and better control of motion artifacts have resulted in improved image quality, and clinical applications of MR imaging in thoracic diseases have been expanded. Although MR imaging is considered as a problem-solving tool in patients with equivocal CT findings, MR should be used as the primary imaging modality in the following situations: 1) Evaluation of the cardiovascular abnormalities of the thorax 2) Evaluation of the superior sulcus tumors 3) Evaluation of the chest wall invasion or mediastinal invasion by tumor 4) Evaluation of the posterior mediastinal mass, especially neurogenic tumor 5) Differentiation of fibrosis and residual or recurrent tumor, especially in lymphoma 6) Evaluation of brachial plexopathy With technical developments and fast scan capabilities, clinical indications for MR imaging in thorax will increase in the area of pulmonary parenchymal and pulmonary vascular imaging.

• 핵의학기술
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• 제18권1호
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• pp.19-25
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• 2014

PET/MRI에서는 MRI의 진단적 가치를 높이기 위해 T1 조영제를 사용하고 있다. PET의 감쇠 보정을 위해 T1 시컨스 계열인 VIBE DIXON은 조영제에 직접적으로 영향을 미치지만, 실제 ${\mu}-map$과 감쇠 보정된 PET 영상에는 큰 변화가 없었다. 그러므로 PET/MRI 검사시 조영제 사용은 PET 데이터 얻기 전 후 언제든 사용할 수 있을 것이다.

• 대한방사선치료학회지
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• 제18권2호
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• pp.89-96
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• 2006

목 적: 방사선치료를 목적으로 촬영된 CT영상을 이용하여 조직내 불균질 물질 및 체위고정 기구에 대한 보정이 선량계산 결과에 미치는 영향을 알아보고자 한다. 대상 빛 방법: 체내불균질 물질의 다양한 사례를 알아보기 위하여 본원에서 제작한 물팬텀($250{\times}250{\times}250mm^3$) 내부에 (1) 뼈 (2) 금속 (3) 조영제 (4) 고정기구(Head holder/Vac-lok) 등 CT Number를 변화시킬 수 있는 물질을 삽입하여 CT촬영을 시행 하였다. 각기 다른 형태의 불균질 CT영상을 전산화치료계획장치(RTP)에 입력하여 동일한 조건(SAD=100 cm 조사야=$10{\times}10cm^2$, 깊이=10cm, 1문조사)으로 에너지별(4, 6, 10 MV X-선) 처방선량 100 cGy를 얻기 위한 선량계산(MU)을 시행하여 비교, 분석하였다. 결 과: 물로만 구성된 팬텀을 기준값으로, 불균질 보정계수 차이는 뼈조직 상태인 경우는 $2.7{\sim}5.3%$, 금속물질인 경우 $2.7{\sim}3.8%$, 조영제인 경우 $0.9{\sim}2.3%$, Head holder $0.9{\sim}2.3%$, Head holder와 Pillow인 경우 $3.5{\sim}6.9%$, 그리고 Vac-lok인 경우 $0.9{\sim}1.5%$의 차이로 나타났다. 결 론: 체내의 불균질 보정계수 차이는 임상적으로 그 적용 형태가 다양하고, 일관성을 보이지 않으며, 조사문수가 증가함에 따라 그 차이가 1%미만으로 허용 가능할 것이나, 고정 기구등에 의한 불균질 보정은 충분히 고려하여 선량계산의 부정확도를 최소화 시켜야 할 것으로 사료된다.

• 대한암한의학회지
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• 제12권1호
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• pp.75-82
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• 2007

Drug eruption is a cutaneous reaction caused by various drugs. It is a very common drug induced adverse reaction. Contrast media induced drug eruption is rare. But approximately 10% of people injected with contrast media experience adverse reaction, and drug eruption accounts for more than 40% of all adverse reactions. We report a case of mild drug eruption and its treatment process based on korean traditional medicine. The patient is a 50 years old female diagnosed with functional dyspepsia. The patient had gastric discomfort and alternation between diarrhea and constipation. All symptoms showed nearly complete remission with continued korean traditional medical treatment. The patient had been injected with contrast media for Computed tomography(CT) evaluation of her breast cancer history. Rashes appeared on back and abdomen, and urticaria and pruritus appeared on the patient's finger 1 day after injection. We prescribed Goreisan(TSUMURA CO &, TJ-17) and acupuncture on Quchi(LI11), Zusanli(ST36), Yangxi(LI5), Yanggu(SI5). Consequently, the drug eruption showed remarkable improvement. So the author reports korean traditional medicine is effective complementary treatment for drug eruption.