• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.179-186
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• 2017

본 연구는 디지털 흉부 방사선 영상에서 한국인 성인 남성을 대상으로 자세(흉부 후-전과 전-후 촬영)와 연령에 따른 심장 크기 및 심흉비의 정상범위와 자세 및 연령 변화에 따른 상호 호환할 수 있는 변환율을 제시하고자 한다. 2014년 1월부터 12월까지 건강검진센터에서 같은 날에 흉부 후-전 촬영(chest PA)과 흉부 저선량 전산화단층촬영을 실시한 수진자 중 정상으로 판독된 1,300명에서 연구 목적에 적합한 남성 1,024명을 대상으로 하였다. 심장 크기(CS)와 심흉비(CTR) 측정은 Danzer의 방법을 이용하였다. 본 연구 결과, 한국 남성의 Chest PA 및 AP영상에서 CS와 CTR의 정상범위는 Chest PA의 경우 CS 135.48 mm, CTR 43.99％이었으며, Chest AP 영상에서 CS는 155.96 mm, CTR은 51.75％로 나타났다. CS와 CTR의 평균값 차이는 통계적으로 유의하였다(p<0.01). Chest PA와 AP영상에서 심장 좌 우측은 통계적으로 유의한 차이가 없었다(p>0.05). CS의 경우는 Chest PA(p>0.05)와 Chest AP(p<0.05)에서 통계적 유의성의 차이를 보였다. 흉곽크기와 CTR은 Chest PA와 AP 모두에서 연령변화에 따른 통계적으로 유의한 평균값의 차이를 보였다(p<0.01). 본 연구 결과 Chest PA보다 Chest AP영상에서 CS는 약 15%, CTR은 17% 확대되었고, 모든 연령에서 자세변화에 따른 CS와 CTR은 약 10%의 차이를 보였다.

• Journal of Chest Surgery
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• 제19권1호
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• pp.43-49
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• 1986

At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.

• Clinical and Experimental Pediatrics
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• 제61권11호
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• pp.362-365
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• 2018

Purpose: This study aimed to analyze changes in QRS duration and cardiothoracic ratio (CTR) following pulmonary valve replacement (PVR) in patients with tetralogy of Fallot (TOF). Methods: Children and adolescents who had previously undergone total repair for TOF (n=67; median age, 16 years) who required elective PVR for pulmonary regurgitation and/or right ventricular out tract obstruction were included in this study. The QRS duration and CTR were measured pre- and postoperatively and postoperative changes were evaluated. Results: Following PVR, the CTR significantly decreased (pre-PVR $57.2%{\pm}6.2%$, post-PVR $53.8%{\pm}5.5%$, P=0.002). The postoperative QRS duration showed a tendency to decrease (pre-PVR $162.7{\pm}26.4$ msec, post-PVR $156.4{\pm}24.4$ msec, P=0.124). QRS duration was greater than 180 msec in 6 patients prior to PVR. Of these, 5 patients showed a decrease in QRS duration following PVR; QRS duration was less than 180 msec in 2 patients, and QRS duration remained greater than 180 msec in 3 patients, including 2 patients with diffuse postoperative right ventricular outflow tract hypokinesis. Six patients had coexisting arrhythmias before PVR; 2 patients, atrial tachycardia; 3 patients, premature ventricular contraction; and 1 patient, premature atrial contraction. None of the patients presented with arrhythmia following PVR. Conclusion: The CTR and QRS duration reduced following PVR. However, QRS duration may not decrease below 180 msec after PVR, particularly in patients with right ventricular outflow tract hypokinesis. The CTR and ECG may provide additional clinical information on changes in right ventricular volume and/or pressure in these patients.

• 대한디지털의료영상학회논문지
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• 제12권2호
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• pp.119-125
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• 2010

In order to demonstrate the value of long-distance radiography, we have studied how distance affects images in chest frontal radiography and compared short-distance and long-distance images in chest lateral radiography. Cardiothoracic ratio(CTR %) of 50 patients with no disease in the chest(10 each at the age of 20~60) were evaluated in Supine AP(100 cm), Sitting AP(100 cm), Sitting AP(180 cm), and Erect PA(180 cm). In lateral radiography, we evaluated and compared left lateral radiography(100 cm and 180 cm) of the patients based on the horizontal maximum of the heart. The average value of CTR(%) were 0.48 in Erect PA(180 cm), 0.52 in Supine AP(100 cm), 0.50 in Sitting AP(100 cm), 0.49 in Sitting AP(180 cm), which were Supine AP(100 cm) > Sitting AP(100 cm) > Sitting AP(180 cm) > Erect PA(180 cm). The average value of Maximum transverse diameter of left of the cardiac(MLD), which showed how much axis of spine was slanted to the left, was 90.67 mm in Erect PA(180 cm), 103.92 mm in Supine AP(100 cm), 93.54 mm in Sitting(100 cm), 89.84 mm in Sitting AP(180 cm), 58.11 mm in the minimum value and 118.79 mm in the maximum value. The average value of Maximum transverse diameter of right side of the cardiac(MRD), which suggested how much axis of spine was slanted to the right, was 47.18 mm in Erect PA(180 cm), 48.12 mm in Supine AP(100 cm), 44.98 mm in Sitting AP(180 cm), and the minimum value 26.84 mm and the maximum value 65.30 mm. There was no standard method to calculate; therefore, the horizontal maximum of the heart was used for lateral radiography. The average value was 121.07 mm in 100 cm and 109.76 mm in 180 cm. Sitting AP(180 cm) among the types was closest to C-PA(180 cm). As a result, during C-AP radiography, long-distance radiography lessened shadow of the heart more than that of short distance, Sitting position more than Supine position.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.223-229
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• 2018

The purpose of this study is to present the reference values for cardiac size and cardiothoracic ratio change, normal range and diagnosis of cardiovascular disease in pregnancy and non pregnancy of normal Korean women using chest X-ray. The subjects of this study were 58 women, who were read as normal by chest radiologist, had chest radiography taken on both last month of pregnancy, pre-pregnancy and within 2 years following delivery. In this study, we defined the last month of pregnancy as pregnancy and before or post pregnancy as non-pregnancy. CS and CTR were measured by two radiological technologist who had clinical experience more ten years with Danzer's method. Statistical methods were paired t-test and one-way ANOVA. Significance level ${\alpha}$ was 0.05 and p-value 0.05 or less was statistically significant. For pregnancy, the mean of left and right cardiac size was $40.11{\pm}8.73mm$ and $89.51{\pm}11.9mm$, CS was $128.60{\pm}13.15mm$, CTR was $44.51{\pm}4.21%$. In non pregnancy, $36.50{\pm}8.18mm$ and $77.68{\pm}13.1mm$. CS and CTR were $114.18{\pm}14.28mm$ and $42.03{\pm}4.04%$. Both pregnancy and non pregnancy, the difference of the mean value in left and right cardiac size, CS and CTR were statistically significant (p<0.01). but comparing mean on age, height and weight, the difference of the mean value between groups was not (p>0.05). In the result of this study, the mean size of CS increased by 12.6% in pregnancy($128.60{\pm}13.15mm$) compared to the non pregnancy($114.18{\pm}14.28mm$), and increased by 9.8% in the right side of the heart and 15.2% in the left side. The mean size of CTR increased about 5.9% in pregnancy ($44.5{\pm}4.21%$) compared to non pregnancy($42.03{\pm}4.04%$).

• Journal of Chest Surgery
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• 제29권9호
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• pp.951-958
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• 1996

경북대학교병원 흉부외과에서 1991년 11월부터 1993년 12월 사이에 원발성 폐질환이 없이 승모판질환으로 승모판치환술을 받은 남자 2례, 여자 10례의 환자에서 술전 및 술후 평균 9개월에 폐기능검사를 실시하였다. 승모판질환의 종류는 승모판협착이 9례, 승모판폐쇄부전이 3례였다. 술전 환자들의 NYHA 기능등급은 3등급이 11례, 4등급이 1례였는데, 술후 평균 9개월이 경과한 시점에서는 10례(83%)에서 1등급으로 호전되어 있었다. 단순흉부 X·선상의 심흉비는 술전의 평균 60.2%에서 술후에는 평균 56.3%로 유의하게 감소되었다. 전체 환자에서의 폐기능검사성적은, 술전 검사에서는 폐활량과 노력성 호기중 간유량이 경도의 감소소견을 보였고, 술후 검사에서는 노력성 호기중간유량과 최대자발성 호흡량이 경도의 감소소견을 보였다. 그러나 술전후의 폐기능검사성적을 비교하였을 때에는 어느 검사항목도 유의한 차이를 보이지 않았다. 한편 술후의 NYHA 기능등급에 의해 환자들을 두 군으로 구분하였을 때, 2등 급군에서는 술후에 유의하게 변화된 폐기능검사항목이 하나도 없었는 반면에, 1등급군에서는 6가지 검사항목에서 유의한 변화가 있었다.