• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.100-106
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• 2013

Objective : To investigate the cases of intracranial abnormal brain MRI findings even in the negative brain CT scan after mild head injury. Methods : During a 2-year period (January 2009-December 2010), we prospectively evaluated both brain CT and brain MRI of 180 patients with mild head injury. Patients were classified into two groups according to presence or absence of abnormal brain MRI finding even in the negative brain CT scan after mild head injury. Two neurosurgeons and one neuroradiologist validated the images from both brain CT scan and brain MRI double blindly. Results : Intracranial injury with negative brain CT scan after mild head injury occurred in 18 patients (10.0%). Headache (51.7%) without neurologic signs was the most common symptom. Locations of intracranial lesions showing abnormal brain MRI were as follows; temporal base (n=8), frontal pole (n=5), falx cerebri (n=2), basal ganglia (n=1), tentorium (n=1), and sylvian fissure (n=1). Intracranial injury was common in patients with a loss of consciousness, symptom duration >2 weeks, or in cases of patients with linear skull fracture (p=0.00013), and also more frequent in multiple associated injury than simple one (35.7%>8.6%) (p=0.105). Conclusion : Our investigation showed that patients with mild head injury even in the negative brain CT scan had a few cases of intracranial injury. These findings indicate that even though the brain CT does not show abnormal findings, they should be thoroughly watched in further study including brain MRI in cases of multiple injuries and when their complaints are sustained.

• 대한방사선기술학회지:방사선기술과학
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• 제45권3호
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• pp.213-223
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• 2022

Although the number of computed tomography(CT) is increasing every year, it is insufficient to establish appropriate workload calculation standards of radiologic technologist to provide optimal medical services to patients, such as patient safety management and infection management. The purpose of this study is to present guidelines for calculating the appropriate workload of radiologic technologist by analyzing the work flow of CT procedures and the time required for CT examination in major hospitals. As for the study subjects and methods, the appropriate process for each step of CT examination was investigated to systematically present the process and time required for the actual examination, and the CT procedure time of 104,105 adult patients and 465 pediatric patients under the age of 6 were analyzed. For the time required, data according to the use of contrast medium, procedure type, and adult/child were collected and compared. The test time of CT examination using contrast medium took about 13 minutes when one radiologic technologist worked and about 9 minutes when two radiologic technologists worked. The time required for the procedures were statistically significant depending on the presence or absence of contrast medium, multi-phase procedure, and patient age (considering pediatric patients). As a result, in order to thoroughly perform patient safety and infection management, the appropriate workload increased by about 40% when there were two radiologic technologists. The limit workload was an average of 32 people per day with one radiologic technologist per 15 minutes, and 48 people per day with two radiologic technologist per 10 minutes. This is a marginal workload, and in the case of procedures that require more time to acquire radiographic images, the interval between reservations should be widened.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.105-112
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• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.209-214
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• 2018

The results of CBCT was obtained using image guided radiation therapy for radiation therapy in 5 prostate cancer patients. Using these results, we compared and evaluated the dose changes according to the treatment plan depending on the volume and position of bladder, rectum, and prostate. The 28 images of CBCT were acquired using On-Board Imaging device before radiotherapy. After the outline of bladder, rectum, and PTV, pCT images and CBCT images for radiotherapy were treated respectively. The volume of the bladder was increased by 105.6% and decreased by 45.2%. The volume of the rectum was increased by 30.5% and decreased by 20.3%. Prostate volume was increased by 6.3% and decreased by 12.3%. The mean dose of the rectum was higher in the CBCT than in the pCT, and V40 (equivalent to 40 Gy) of the bladder showed a reduction in all treatment regimens in the CBCT than in the pCT. Conformity treatment and homogeneity index of PTV showed better results in all treatment regimens using pCT than CBCT. It was found that the dose distribution of the pelvic internal organs varied greatly according to the patient 's condition and pretreatment.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1031-1041
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• 2018

Objective: To compare image quality and radiation dose of high-pitch dual-source spiral cardiothoracic computed tomography (CT) between non-electrocardiography (ECG)-synchronized and prospectively ECG-triggered data acquisitions in young children with congenital heart disease. Materials and Methods: Eighty-six children (${\leq}3$ years) with congenital heart disease who underwent high-pitch dual-source spiral cardiothoracic CT were included in this retrospective study. They were divided into two groups (n = 43 for each; group 1 with non-ECG-synchronization and group 2 with prospective ECG triggering). Patient-related parameters, radiation dose, and image quality were compared between the two groups. Results: There were no significant differences in patient-related parameters including age, cross-sectional area, body density, and water-equivalent area between the two groups (p > 0.05). Regarding radiation dose parameters, only volume CT dose index values were significantly different between group 1 ($1.13{\pm}0.09mGy$) and group 2 ($1.07{\pm}0.12mGy$, p < 0.02). Among image quality parameters, significantly higher image noise ($3.8{\pm}0.7$ Hounsfield units [HU] vs. $3.3{\pm}0.6HU$, p < 0.001), significantly lower signal-to-noise ratio ($105.0{\pm}28.9$ vs. $134.1{\pm}44.4$, p = 0.001) and contrast-to-noise ratio ($84.5{\pm}27.2$ vs. $110.1{\pm}43.2$, p = 0.002), and significantly less diaphragm motion artifacts ($3.8{\pm}0.5$ vs. $3.7{\pm}0.4$, p < 0.04) were found in group 1 compared with group 2. Image quality grades of cardiac structures, coronary arteries, ascending aorta, pulmonary trunk, lung markings, and chest wall showed no significant difference between groups (p > 0.05). Conclusion: In high-pitch dual-source spiral pediatric cardiothoracic CT, additional ECG triggering does not substantially reduce motion artifacts in young children with congenital heart disease.

• 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.

• Korean Journal of Radiology
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• 제23권7호
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• pp.742-751
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• 2022

Objective: To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. Materials and Methods: This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GP_QSM) and CT (GP_CT) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GP_QSM and GP_CT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results: GP_CT and GP_QSM were significantly associated (p < 0.001) but were not identical. Higher GP_CT and GP_QSM grades showed smaller gray matter (p = 0.030 and p = 0.025, respectively) and white matter (p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes (p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GP_CT (p = 0.006) and brain atrophy was significantly associated with GP_QSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GP_CT (p < 0.001) and GP_QSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GP_CT (p = 0.040) and GP_QSM (p = 0.035). Conclusion: Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.

• 대한핵의학회지
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• 제34권4호
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• pp.353-359
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• 2000

목적: 최근 국내에서 방사면역측정법용 ${\alpha}$-FP 검사시약(Riakey AFP IRMA $CT^R$, Sin-Jin Medics, Seoul, Korea)이 개발되어 그 성능을 평가해 보고자 본 연구를 시행하였다. 대상 및 방법: 검사방법은 시약 내 설명서의 권고사항을 준수하여 실시하였으며, 정밀도, 회수율, 평행성, 민감도에 대한 검사를 시행하였고, 다른 상업용 방사면역측정법용 a-FP 검사시약에 의한 측정값과의 상관관계를 조사하였다. 결과: 측정 내 정밀도는 세 준위의 혈청을 각각 10개의 튜브에 분주한 후 한 배치에서 검사하였는데, 평균 18.9 ng/ml에서 변이계수 5.3%, 평균 133 ng/ml에서 3.4%, 평균 332 ng/ml에서 변이계수 1.6%였다. 측정간 정밀도는 세 준위의 혈청을 하루 간격으로 5회 측정하여, 평균 20.9 ng/ml에서 변이계수 9.7%, 평균 137 ng/ml에서 3.2%, 평균 330 ng/ml에서 변이계수 4.1%였다. 회수율은 저, 중, 고 세 가지 농도의 혈청에 각각 시약 내 표준용액 10, 70, 250 ng/ml을 1:1로 섞은 후 검사하여, 17.6 ng/ml에서 각각 102%, 105%, 101%, 105 ng/ml에서 각각 103%, 95%, 105%였고, 245 ng/ml에서 각각 97.3%, 92.1%, 98.6%이었다. 평행성 검사는 세 개의 고농도 검체를 각각 2, 4, 8, 10, 20, 100 배 희석하여 한번에 검사하였으며, 평행성 검사에서 계산한 수식은 각각 y=0.98x-10.3, y=0.99x-8.32, y=0.98x-11.3이었다. 민감도는 측정가능한 최소농도가 0.63 ng/ml이었다. 175명의 환자검체의 측정결과를 다른 시약들로 측정한 것과 비교하였을 때 강한 상관관계를 보였다(r=0.98). 결론: 이상의 결과로 ${\alpha}$-FP 검사시약인 Riakey AFP IRMA $CT^R$은 임상에 적용할 수 있는 유용한 시약으로 판단된다.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.380-384
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• 2010

Purpose: Distinguishing different types of implants and assessing the position and size of implants by radiologic exam after orbital wall reconstruction is important in determining the surgery outcome and forecasting prognosis. We observed time-dependent density changes in three types of implants (porous polyethylene, resorbing plate and titanium mesh plate) by performing facial bone CT after orbital wall reconstructions. Methods: A total of 32 patients, who had underwent orbital wall fracture surgery from October 2006 to March 2009 and received facial bone CT as outpatients at 1 postoperative year were included in the study. Follow-up facial bone CT was performed on the patients pre- operatively, 1 month post-operatively, and 1 year post-operatively to observe the status of the orbital implants. Medpor $^{(R)}$ (Porex Surgical, Inc., Newnan, Ga.) was used as porous polyethylene and followed-up in 14 cases; for resorbing plate, Synthes mesh plate (Synthes, Oberdorf, Switzerland) was used in the reconstruction, and followed-up in 11 cases; and titanium mesh plate usage was followed-up in 7 cases. Computed tomographic scan (CT) and water's view were done for radiography, and hounsfield unit (HU) was used to compare density of those facial bone CT. Wilcoxon signed rank test was applied to statistically verify measurement difference in each group of hounsfield units. Results: Facial bone CT examination performed in 1 month post-operative showed that the density of porous polyethylene, resorbing plate and titanium mesh plate were -42.07, 105.67 and 539.48 on average, respectively. Among the three types of implants, titanium mesh plate showed the highest density due to its radiopaque feature. Following up the density of three types of implants in CT during 1 year after the orbital wall fracture surgery, the density of porous polyethylene increased in 10.52 House Field Units and the resorbing plate was decreased in 26.87 HouseField Units. There were no significant differences between densities in 1 month post-operatively and 1 year post-operatively in each group ($p{\geq}0.05$). Conclusion: We performed facial bone CT on patients with orbital fractures during follow-up period, distinguishing the types of implants by the different concentration of implant density, and the densities showed little change even at 1 year post-operative. To observe how implant densities change in facial bone CT, further studies with longer follow-up periods should be carried out.

• 보험의학회지
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• 제31권1호
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• pp.34-36
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• 2012

Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.