• 한국임상수의학회지
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• 제41권3호
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• pp.178-182
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• 2024

A 10-year-old spayed female Poodle was referred for blindness. On ophthalmic examination, loss of bilateral ocular pupil light reflex, visual loss, and right retinal detachment were confirmed at a local hospital. Magnetic resonance imaging (MRI) of the brain was performed to identify the optic nerve, optic chiasm, and brain disease. A sessile mass centered on the region of the optic chiasm was identified. The mass had iso- to hypointense on fluid-attenuated inversion recovery and T2-weighted images and mildly hypointense on T1-weighted images compared to the gray matter, with strong contrast enhancement. Peripheral edema was also identified. Computed tomography (CT) brain perfusion was performed to obtain additional hemodynamic information about the patient using a multislice CT. CT perfusion showed that the cerebral blood volume in the left temporal lobe region (13.4 ± 1.6 mL/100 g) was decreased relative to the contralateral region (19.9 ± 0.3 mL/100 g). The patient showed decreased appetite and consciousness one week after the CT scan with clinical symptoms worsened. The patient had seizure, tetraparesis, and loss of consciousness. It was euthanized one month later at the request of the owner. This report suggests that CT brain perfusion can provide additional hemodynamic information such as insufficient brain perfusion in sellar region tumor which can help assess potential complications and prognosis and plan treatment.

• 대한방사선기술학회지:방사선기술과학
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• 제26권3호
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• pp.25-31
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• 2003

급성 허혈성 뇌경색 환자에서 Deconvolution 관류 전산화 단층촬영(computed tomography, CT)의 뇌혈류용적(cerebral blood volume, CBV), 뇌혈류(cerebral blood flow, CBF) 그리고 평균 조영제 통과 시간(mean transit time, MTT) 지도를 확산 강조(Diffusion weighted) MRI과 비교하여 그 유용성을 알아보고자 하였다. 뇌관류 CT와 확산강조 자기공명영상(diffusion weighted MR imaging, DWMRI)을 시행한 급성뇌경색 환자를 대상으로 Deconvolution 기법으로 획득한 CBV, CBF, MTT 지도에서 병변의 면적과 DWMRI의 병변의 면적을 비교 측정하여 일치도를 알아보았다. 또한, 병변 부위와 정상측 대칭부위의 MTT시간을 측정하여 차이를 알아보았다. 본 연구의 모든 예에서 CBV, CBF, 그리고 MTT 세 지도 모두 관류 결손을 인지할 수 있었고, 관류 결손이 인지되는 부위에서 MTT 시간의 현저한 지연이 있었다. 뿐만 아니라, MTT 지도의 결손부위 면적은 DWMRI 보다 크게 나타나 허혈성 패넘브라를 추측할 수 있었다. 결론적으로 Deconvolution 관류 CT의 지도를 이용하면 뇌경색의 조기진단뿐만 아니라 허혈 중심부, 그리고 허혈성 페넘브라를 예측할 수 있어 DWMRI에 비해 관류결손 부위의 혈류 역학적 상태의 평가나 효과적인 치료계획을 세우는데 보다 유용할 것으로 생각된다.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1749-1763
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• 2021

Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

• 한국의학물리학회지:의학물리
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• 제18권3호
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• pp.149-160
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• 2007

초급성 허혈성 뇌졸중 환자를 대상으로 관류 전산화단층촬영(CT)의 임상적 적용을 평가하였다. 뇌졸중 증상 발현 62명의 환자를 대상으로 하였고, 관류 CT는 소뇌 기저부위에서 8 cm 상방으로 스캔하여 후처리 과정을 거쳐 뇌혈용적(cerebral blood volume, CBV), 뇌혈류량(cerebral blood flow, CBF), 평균 조영제 통과시간(mean transit time, MTT) 및 조영제 최고 도달시간(time to peak, TTP) 등의 네 가지 지도의 영상을 얻었다. 관류 CT의 CBV, CBF, MTT, TTP 지도에서 병변을 평가하였으며, 병변 부위와 정상측 대칭부위에서 MTT와 TTP를 측정하여 차이를 비교하였다. 관류 CT의 네 가지 지도 모두에서 관류결손을 인지할 수 있었고, 관류 결손이 인지되는 부위에서 MTT와 TTP의 현저한 지연이 있었다. 관류 CT의 MTT와 TTP영상이 초급성 허혈성 경계부위의 페넘브라를 반영하였다. 관류 CT의 네 가지 지도를 이용하면 뇌졸중의 조기 진단, 허혈 중심부, 허혈 페넘브라를 알 수 있게 되어 관류결손 부위의 혈류역동학적 평가가 가능함으로써, 허혈성 뇌졸중 환자의 진단 및 효과적인 치료를 위해 관류 CT가 유용하여 임상적 적용이 가능하다.

• 한국방사선학회논문지
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• 제6권1호
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• pp.19-26
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• 2012

급성 뇌졸중의 경우 빠른 시간 내의 진단과 치료가 예후에 큰 영향을 미친다. 본 연구에서는 초급성기 뇌경색 환자에서 관류CT와 확산강조MRI의 영상을 비교하여 허혈 부위와 경색부위에 나타나는 차이점을 알아보고자 하였다. 뇌관류 CT와 확산강조 자기공명영상(diffusion weighted MR imaging, DW-MRI)을 시행한 12명의 급성뇌경색 환자를 대상으로 병변부위와 정상부위에서 각각의 CBF, CBV, MTT, TTP지도와 DW-MRI의 신호강도 값을 비교하고, 관류CT와 DW-MRI에서 병변의 크기 비교를 해보았다. CBF, CBV, MTT, TTP는 모두 관류결손을 보였고, 관류 결손이 인지되는 부위에서 MTT와 TTP시간의 현저한 지연이 있었다. 뿐만 아니라, MTT와 TTP 지도의 결손부위 면적은 DW-MRI 보다 크게 나타나 허혈성 반음영을 추측할 수 있었고, 일부 DW-MRI에서 경색부위를 나타내지 못하는 경우도 있었다. 결론적으로 관류 CT의 지도를 이용하면 뇌경색의 조기 진단뿐만 아니라 허혈 중심부, 그리고 허혈성 반음영을 예측하여 관류결손 부위의 혈류 역학적 상태를 평가 할 수 있어 보다 효과적인 치료계획을 세울 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6765-6768
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• 2015

Aims: To study the effectiveness of human recombinant endostatin injection (Endostar(R)) combined with cisplatin doublets in treating advanced non-small cell lung cancer (NSCLC), and to evaluate outcome by CT perfusion imaging. Methods: From April 2011 to September 2014, 76 patients with advanced NSCLC who were treated with platinum-based doublets were divided into group A (36 patients) and group B (40 patients). Endostar(R) 15mg/day was administered 4 days before chemotherapy and combined with chemotherapy from day 5 in group A, and combined with chemotherapy from the first day in Group B. Endostar(R) in the two groups was injected intravenously for 14 days. Results: Treatment effectiveness in the two groups differed with statistical significance (p<0.05). Effectiveness evaluated by CT perfusion imaging, BF, BV, MTT and PS also demonstrated significant differences (all p<0.05). Adverse reactions in the two groups did not significantly vary (p> 0.05). Conclusions: The response rate with Endostar(R) administered 4 days before chemotherapy and combined with chemotherapy from day 5 in group A was better than Endostar(R) combined with chemotherapy from the first day, and CT perfusion imaging could be a reasonable method for evaluation of patient outcomes.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1575-1578
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• 2012

Objectives: To obtain permeability surface (PS) values using multi-slice helical CT perfusion imaging and to evaluate the spatial distribution correlation between PS values and vascular endothelial growth factor (VEGF) expression in solitary brain metastases. Methods: Imaging was performed on 21 patients, PS values being calculated from the central, border and peripheral parts of tumours. VEGF expression was determined by immunohistochemical staining. Results: Rim enhancement was found in 16 cases, the border of the tumour featuring PS elevation with high VEGF expression in 13 cases. In the 5 cases with nodular enhancement, the border and the central part had high permeability and VEGF expression was high in all cases, the correlation being significant (P<0.01). Conclusion: VEGF expression in brain metastases positively correlates with PS values from CT perfusion imaging, so that the latter can be used in the surveillance of angiogenic activity in brain metastases.

• 한국임상수의학회지
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• 제40권5호
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• pp.375-381
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• 2023

A large abdominal mass was incidentally found in a 13-year-old mixed-breed dog and was confirmed to be a cecal gastrointestinal stromal tumor (GIST). Contrast-enhanced ultrasound and post-contrast computed tomography (CT) showed mild contrast enhancement of the mass, indicating low blood flow. The tumor origin was determined to be the cecum by identifying the vessels supplying the mass on post-contrast CT. The exophytic growth of the tumor left the cecal lumen intact without obstruction. This report described the CEUS and CT perfusion of the cecal GIST and perfusion evaluation can help diagnose and characterize GISTs in dogs.

• Nuclear Medicine and Molecular Imaging
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• 제42권1호
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• pp.77-78
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• 2008

A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of $^{99m}Tc$-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

• Korean Journal of Radiology
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• 제22권1호
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• pp.97-105
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• 2021

Objective: The present study aimed to investigate the association between myocardial blood flow (MBF) quantified by dynamic CT myocardial perfusion imaging (CT-MPI) and the increments in heart rate (HR) after stress in patients without obstructive coronary artery disease. Materials and Methods: We retrospectively included 204 subjects who underwent both dynamic CT-MPI and coronary CT angiography (CCTA). Patients with more than minimal coronary stenosis (diameter ≥ 25%), history of myocardial infarction/revascularization, cardiomyopathy, and microvascular dysfunction were excluded. Global MBF at stress was measured using hybrid deconvolution and maximum slope model. Furthermore, the HR increments after stress were recorded. Results: The median radiation dose of dynamic CT-MPI plus CCTA was 5.5 (4.5-6.8) mSv. The median global MBF of all subjects was 156.4 (139.8-180.4) mL/100 mL/min. In subjects with HR increment between 10 to 19 beats per minute (bpm), the global MBF was significantly lower than that of subjects with increment between 20 to 29 bpm (153.3 mL/100 mL/min vs. 171.3 mL/100 mL/min, p = 0.027). This difference became insignificant when the HR increment further increased to ≥ 30 bpm. Conclusion: The global MBF value was associated with the extent of increase in HR after stress. Significantly higher global MBF was seen in subjects with HR increment of ≥ 20 bpm.