• 한국방사선학회논문지
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• 제11권6호
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• pp.493-500
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• 2017

본 데이터 분석은 INFINITT 프로그램을 사용하여 유속증강 자기공명 혈관 조영술(FRE-MRA)과 전산화단층 촬영 혈관 조영술(CTA)에서 신호대 잡음비(SNR)와 대조도대 잡음비(CNR) 분석에 따른 뇌혈관 질환에 대한 정량적 평가를 하고자 하였다. 2017년 1월~4월까지 C대학병원에서 뇌혈관영상검사를 시행한 63명의 환자 중 FRE-MRA와 CTA를 동시에 시행한 19명의 뇌혈관 질환 환자영상 중 움직임으로 인한 인공물로 분석이 어려운 2명의 영상을 제외한 17명의 영상을 분석하였다. 분석 방법으로 FRE-MRA와 CTA에 대하여 각각 5 부위(앞대뇌동맥, 좌 우 중간대뇌동맥, 좌 우 뒤대뇌동맥)에 관심영역을 설정하고 SNR과 CNR를 평가하였고, 분석결과에 대한 유의성 평가는 독립 t 검정을 통하여 유의성을 확인하였다. 본 연구에 대한 결과로서 각각의 SNR과 CNR을 평균하였을 때 FRE-MRA는 앞대뇌동맥($1500.73{\pm}12.23/970.43{\pm}14.55$), 좌중간대뇌동맥($1470.16{\pm}11.46/919.44{\pm}13.29$), 우중간대뇌동맥($1457.48{\pm}17.11/903.96{\pm}14.53$), 좌뒤대뇌동맥($1385.83{\pm}16.52/852.11{\pm}14.58$), 우뒤대뇌동맥($1318.52{\pm}13.49/756.21{\pm}10.88$)의 값이 측정되었고, CTA는 각각 앞대뇌동맥($159.95{\pm}12.23/123.36{\pm}11.78$), 좌중간대뇌동맥($236.66{\pm}17.52/202.37{\pm}15.20$), 우중간대뇌동맥($224.85{\pm}13.45/193.14{\pm}11.88$), 좌뒤대뇌동맥($183.65{\pm}13.47/151.44{\pm}11.48$), 우뒤대뇌동맥($177.7{\pm}16.72/144.71{\pm}11.43$)의 값이 측정되었다(p<0.05). 결론적으로 5부위의 뇌혈관 질환 영상을 분석한 결과 뇌경색이나 뇌출혈과는 관계없이 MRA가 SNR과 CNR값이 높은 것으로 나타났다. 따라서 환자협조가 가능하여 검사시간이 길다는 단점만 극복할 수 있으면 CTA에 비해 조영제의 부작용으로부터 자유로운 FRE-MRA가 유용하였다.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.175-182
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• 2019

Objective : Aberrant right subclavian artery (ARSA) is a rare anatomical variant of the origin of the right subclavian artery. ARSA is defined as the right subclavian artery originating as the final branch of the aortic arch. The purpose of this study is to determine the prevalence and the anatomy of ARSA evaluated with computed tomography (CT) angiography. Methods : CT angiography was performed in 3460 patients between March 1, 2014 and November 30, 2015 and the results were analyzed. The origin of the ARSA, course of the vessel, possible inadvertent ARSA puncture site during subclavian vein catheterization, Kommerell diverticula, and associated vascular anomalies were evaluated. We used the literature to review the clinical importance of ARSA. Results : Seventeen in 3460 patients had ARSA. All ARSAs in 17 patients originated from the posterior aspect of the aortic arch and traveled along a retroesophageal course to the right thoracic outlet. All 17 ARSAs were located in the anterior portion from first to fourth thoracic vertebral bodies and were located near the right subclavian vein at the medial third of the clavicle. Only one of 17 patients presented with dysphagia. Conclusion : It is important to be aware ARSA before surgical approaches to upper thoracic vertebrae in order to avoid complications and effect proper treatment. In patients with a known ARSA, a right transradial approach for aortography or cerebral angiography should be changed to a left radial artery or transfemoral approach.

• 동의생리병리학회지
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• 제30권1호
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• pp.73-79
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• 2016

It was aimed to report a case of both anterior cerebral artery territory infarction patient improved by korean medical treatment. The patient was diagnosed by brain magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA). The symptoms were quadriplegia, urinary frequency, urinary incontinence and abulia. I applied herbal medicine, acupuncture, moxibustion, pharmacopuncture, cupping and physical exercise therapy. As a result of them, the symptoms of the patient were improved considerably. Status of the patient was evaluated by manaul muscle test(MMT), modified barthel index(MBI) and functional independence measure(FIM) and medical interview. MBI score was changed from 35 to 95 and FIM score was changed from 66 to 115. Therefore this report suggests that korean medical treatment could be effective to the anterior cerebral artery territory infarction.

• Journal of Chest Surgery
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• 제53권1호
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• pp.34-37
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• 2020

Cerebral air embolism combined with cardiomyopathy secondary to pulmonary barotrauma is rare. Here, we report an unusual case of cerebral air embolism combined with transient cardiomyopathy secondary to large bulla rupture during a pulmonary function test after lung cancer surgery. The patient experienced loss of consciousness. Computed tomography and magnetic resonance imaging suggested a cerebral air embolism. Electrocardiography showed ST-segment elevation and abnormally high plasma levels of cardiac enzymes. Echocardiography and coronary angiography suggested cardiomyopathy. The patient was discharged with no sequelae.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.236-238
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• 2013

Rapidly developed de novo aneurysm is very rare. We present a rapidly developed and ruptured de novo anterior communicating aneurysm 8 days after the rupture of another aneurysm. This de novo aneurysm was not apparent in the initial 3-dimensional computed tomography and digital subtraction angiography. We reviewed the literature and discussed possible mechanisms for the development of this de novo aneurysm.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.312-315
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• 2005

The persistent hypoglossal artery[PHA] is a rare anomaly that belongs to the group of embryonic carotid-basilar artery anastomoses that may occur in adults. The most commonly reported type of such an anastomosis is the primitive trigeminal artery, followed by the PHA. We report a 35-year old man, hospitalized because of an intraventricular hemorrhage, who was found to have a right persistent PHA. Three-dimensional computed tomography[CT] angiography provided excellent anatomical topology of the anomaly. To our knowledge, this patient is the first case of a PHA identified by this means in Korea.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.125-128
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• 2007

The incidence of spontaneous recanalization after traumatic internal carotid artery occlusion is very rare. We have experienced a case of spontaneous recanalization after a traumatic internal carotid artery occlusion. A 5-year-old boy developed contra-lateral hemiparesis and dysphasia after a blunt injury on the head and neck. He had a complete left internal carotid artery occlusion which was diagnosed through angiography. We treated the patient with an anti platelet agent and rehabilitation. Six months later, he regained motor power of right extremities, language ability, and revisualization of internal carotid artery on the follow-up magnetic angiography. We confirmed a recanalization of injured internal carotid artery on the conventional cerebral angiography which was performed one year later. We suggest conservative treatment with serial angiographic studies as a possible option of traumatic internal carotid artery occlusion even though there is hemodynamic instability.

• 동의생리병리학회지
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• 제21권2호
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• pp.578-581
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• 2007

Moyamoya disease is characterized by the angiographic findings of bilateral occlusion of the distal portion of the internal carotid arteries with a vascular network at the base of the brain. The typical findings on conventional angiography and magnetic resonance imaging usually confirm the correct diagnosis of moyamoya disease. We experienced a 11-year-old girl with moyamoya disease showing repeated transient ischemic attacks and we report on this case with a review of the literature.

• 한국방사선학회논문지
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• 제13권3호
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• pp.399-406
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• 2019

본 연구의 목적은 디지털 혈관 조영 촬영장치를 이용한 검사 시 X선관, 환자 테이블, 검출기 또는 환자 등의 기하학적 특성에 따라 실무자가 수시로 변화시켜 적용할 수 있는 매개변수에 대해 알아보고 이에 따른 환자 및 의료진의 방사선 피폭선량을 감소시키는 방안에 대해 알아보고자 하였다. 기하학적 특성들에 따라 각각 fluoroscopy mode와 Digital subtraction angiography로 촬영하고 유효 선량으로 환산한 값을 비교하였다. 연구결과 FPS mode에 따른 선량은 FPS mode를 낮게 설정할수록 선량이 30-40%까지 감소하였다. X선관 각도에 따른 선량은 AP View에서 가장 높게 측정되었고 머리 방향으로 각도가 들어갈수록 선량이 낮게 측정되었다. FOV가 확대될수록 선량이 1.2-1.6배 증가하였고 X선관과 테이블의 거리가 가까워질수록 약 10% 증가하였다. X선관과 평판형 검출기의 거리가 100 mm 멀어질수록 선량이 20-30% 증가하였다. 결론적으로 혈관 조영검사 시 다양한 기하학적 특성들은 실무자가 수시로 변화시켜 적용할 수 있는 매개변수이며 다양한 상황에서 적합한 기하학적 특성들을 고려하여 적용함으로써 적절한 선량 감소 효과를 기대할 수 있다.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.360-366
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• 2023

Increased tortuosity of vessel is associated with high incidence of plaque formation leading to atherosclerosis. Surgical procedures are done after analyzing morphology of middle cerebral artery (MCA). However, literature describing MCA morphology using computed tomography angiography (CTA) is limited, so this study was planned to determine its incidence in Indian population. Datasets of CTA from 289 patients (180 males and 109 females), average age: 49.29±16.16 years (range: 11 to 85 years), from a tertiary care hospital were systematically reviewed for morphology of MCA. Cases involving aneurysms and infarcts were excluded. Four shapes of MCA were recognized: straight, U, inverted U, and S-shaped. MCA was straight in 44% (254/578), U-shaped in 37% (215/578), S shaped in 15% (89/578) and inverted U-shaped in 3% (20/578) cases. In males, MCA was straight in 46% (166/360), U-shaped in 37% (134/360), S-shaped in 16% (58/360) and inverted U-shaped in 4% (14/360) cases. In females, MCA was straight in 42% cases (92/218), U-shaped in 37% (81/218), S-shaped in 17% (36/218) and inverted U-shaped in 4% (9/218). On comparing shape with various age groups using chi square test, U shaped (P≤0.001) and S-shaped (P=0.003) MCA were found to be statistically significant. The incidence of straight shape was higher in advanced age group (>60 years). Knowledge of MCA shape will be useful for clinicians and surgeons in successful endovascular recanalization. Also, this data would help surgeons during neurointerventional procedures.