• Title/Summary/Keyword: CT contrast media

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Treatment Strategy of Transcatheter Arterial Embolization after Pelvic CT Angiography in Traumatic Pelvic Hemorrhage : A Single Regional Emergency Center's Experience (외상성 골반 출혈환자에서 CT 혈관조영술 후 동맥 색전술을 시행하는 치료방침의 유용성: 단일 권역응급센터의 경험)

  • Lee, Yu Jin;Jae, Hwan Jun;Cha, Won Chul;Seo, Jun Seok;Kim, Hyo Cheol;Shin, Cheong-Il;Shin, Sang Do
    • 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.

Characteristics of Magnetic Resonance(M.R.) and Comprehension of its Imaging Mechanism (자기공명(M.R.)진단법의 특징 및 그 영상기전의 이해)

  • Chang, Jae-Chun;Hwang, Mi-Soo;Kim, Sun-Yong
    • 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.

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Ultrasound-guided Intervention in Cervical Spine (경추부 초음파 유도하 중재술)

  • Moon, Sang Ho
    • 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.

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THE DIAGNOSIS OF IMPACTED MAXILLARY MESIODENS USING 3-DIMENSIONAL COMPUTED TOMOGRAPHY : A CASE REPORT (3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단)

  • Hong, Young-Woo;Kim, Seong-Oh;Sohn, Hyung-Kyu;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.549-554
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    • 1998
  • The prevalence of the supernumerary tooth is $1{\sim}4%$. It usually occurs in the permanent dentition. It frequently occurs in the maxillary mid palatal area. The presence of the supernumerary tooth causes the following problems ; (1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be removed as soon as possible. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography equipped with dental softwares can show the position of the impacted supernumerally tooth in 3-dimentional position. It has an advantage to eliminate the subjective opinion of the operator. With a fast computer this techenique is done in a relatively short period of time. The rationale of this methods is relatively simple. After tacking X-ray and reconstructing the data 3-dimentionally, sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2, the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

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Current Status of MRI Distribution, Prevailing Charges and Analysis of Its Performance (MRI 분포와 관행수가 현황 및 촬영실적 분석)

  • 문옥륜;장원기;이상이;김철웅;최경혜
    • Health Policy and Management
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    • v.8 no.1
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    • pp.155-182
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    • 1998
  • There exists a remarkable differences in use of MRI scanning among income classes. The poor can hardly utilize it. This is because, among high cost technnologies, MRI is the only equipment not covered under health insurance benefits in Korea. This study was designed 1) to reveal the status of nation-wide MRI installation, customary charges and per unit annual scanning performance, and 2) to analyse factors influencing the above variables. The data for this study came from "MRI Prevalence Survey" conducted by the National Federation of Medcial Insurance(NFMI) in 1997, and were analyzed through SAS packages for T-test, analysis of variance and stepwise multiple regression. Data were collected from 188 hospitals equipped with MRI scanners. Major findings are summarized as follows : The number of MRI scanners has increased from 69 in 994 to 158 in 1996(2.3 times) while per unit annual scanning performance has risen by 11.2% from 2,173 cases in 1994 to 2,417 cases in 1996. Such a rapid increase was made possible mainly due to the inclusion of CT scanning under the health insurance benefit package. The customary charges for MRI scanning with or without contrast media, on average, amounted to 484,000 Won and 402,000 Won, respectively, with the percentile increase of 17.8% and 8.1% each during the same time. Korea ranks the third worldwidely in terms of number of MRI installations, 4.8 scanners per one million persons, only next to Japan and United States. Geographical variation of MRI, however, was rather high, 7.91 unit, in Cheju area compared to 1.82 in Kyongnam area. Variations of customary charges of MRI scanning can be explained as much as by 44.8% by both the total amount of claims to NFMI and geographical variable. The charges were more likely to be higher in metropolitan areas like Seoul and in hospitals with a bigger amount of claims. While those of per unit annual scanning performance can be explained as much as by 30.7% by both MRI installation cost and level of MRI-installed organizations. Per capital scannig performance was higher in tertiary hospitals and hospitals equipped with more expensive scanners than hospitals with less expensive scanners. Two measures are called for the remedying the existing excessive abundance in MRI units in korea : One is to set a ceiling of MRI units in an area like a province or a metropolitan district. The other is to establish a committee on introduction of high cost technologies for reviewing its effective use.ctive use.

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Ultrasmall Polyethyleneimine-Gold Nanoparticles with High Stability (높은 안정성을 갖는 초미립 폴리에틸렌이민-금 나노입자)

  • Kim, Eun-Jung;Yeum, Jeong-Hyun;Ghim, Han-Do;Lee, Se-Guen;Lee, Ga-Hyun;Lee, Hyun-Ju;Han, Sang-Ik;Choi, Jin-Hyun
    • Polymer(Korea)
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    • v.35 no.2
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    • pp.161-165
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    • 2011
  • This study is related to the preparation of biocompatible gold nanoparticles (AuNPs) which are stable in aqueous solutions for a long time. Ultrasmall polyethyleneimine (PEI)-capped AuNPs (PEI-AuNPs) with limited agglomeration were prepared in aqueous solutions at room temperature, which were based on the roles of PEI as a reductant and a stabilizer. PEI-AuNPs with an average size of 8~12 nm formed highly stable nanocolloids with an average hydrodynamic cluster size of around 50 nm in aqueous media. At a low concentration of metal precursor hydrogen tetrachloroaurate (III), the particle size was reduced noticeably. The typical peaks of gold were observed in the X-ray diffraction pattern of AuNPs. The cell viability of 98% was obtained in the case of PEI-AuNPs, while PEI was cytotoxic. The PEI-AuNP is considered to be a potential candidate as a contrast agent for computed tomography.