• 한국콘텐츠학회논문지
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• 제10권3호
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• pp.215-221
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• 2010

Time Resolved Imaging of Contrast Kinetics 기법을 이용한 4차원 자기공명혈관조영술 (TRICKS-MRA)영상과 기존 TOF-MRA영상을 비교하여 임상적 유용성에 대해 알아보고자 하였다. 총17명 중 뇌혈관 질환이 의심되는 11명과 뇌종양을 의심하는 6명을 대상으로 TOF-MRA와 TRICKS-MRA을 시행한 후 17 대상자 중 11명에서 DSA를 추가적으로 시행하였다. TOF-MRA는 공간해상력보다 시간해상력이 부족하였고, TRICKS-MRA에서는 TOF-MRA보다 공간분해능은 부족한 점이 많지만 영상판독에 큰 영향은 없었고 모든 대상자에서 동맥과 정맥의 구별이 가능하여 시간분해능이 우수한 것을 나타났다. 또한 종양과 혈관과의 관계성 평가에서 TOF-MRA보다 좋은 것으로 나타났다. TRICKS-MRA방법은 시간대별로 동맥, 모세혈관, 정맥기를 신속하면서 쉽게 4차원적으로 영상화가 가능하여 앞으로 임상에서 이용도가 더욱 증가 할 것으로 사료된다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1995년도 춘계학술대회
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• pp.235-238
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• 1995

In this paper, we propose an effective coding method of the angiography by using the scalable structure in the frequency domain for MPACS(Medical Picture Archiving and Communication System). We employed the subband decomposition method and MPEG-2 system which is the international standard coding method of the general moving picture. After the subband decomposition is applied to split an input image into 4 bands in the spatial frequency domain, the motion compensated DPCM coding method of MPEG-2 is carried out for each subband. As a result, an easily controllable coding Structure is accomplished by composing the compound hit stream for each subband group. Follows are the simulation results of the proposed sheme for the angiography. A scalable structure which can be easily controlled for a loss of transmission or the band limit can be accomplisbed in the MPEG-2 stucture by the subband decomposition minimizing the side information. And by reducing the search area of the motion vector between -4 and 3, the processing speed of a codec is enhanced by more than two times without a loss of the picture quality compare with the conventional DCT coefficients decompositon method. And the processing speed is considerably improved in the case of the parallel construction of each subband in the hardware.

• Journal of Korean Neurosurgical Society
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• 제57권2호
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• pp.127-130
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• 2015

A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.222-226
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• 2012

The waffle-cone technique is a modified stent application technique, which involves protrusion of the distal portion of a stent into an aneurysm fundus to provide neck support for subsequent coiling. The authors report two cases of wide necked basilar bifurcation aneurysms, which were not amenable to stent assisted coiling, that were treated using the waffle-cone technique with a Solitaire AB stent. A 58-year-old woman presented with severe headache. Brain CT showed subarachnoid hemorrhage and angiography demonstrated a ruptured giant basilar bifurcation aneurysm with broad neck, which was treated with a Solitaire AB stent and coils using the waffle-cone technique. The second case involved an 81-year-old man, who presented with dizziness caused by brain stem infarction. Angiography also demonstrated a large basilar bifurcation unruptured aneurysm with broad neck. Solitaire AB stent deployment using the waffle-cone technique, followed by coiling resulted in near complete obliteration of aneurysm. The waffle-cone technique with a Solitaire AB stent can be a useful alternative to conventional stent application when it is difficult to catheterize bilateral posterior cerebral arteries in patients with a wide-necked basilar bifurcation aneurysm.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1989년도 춘계학술대회
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• pp.27-28
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• 1989

In conventional line scan angiography, flow signal has been enhanced by the time_of_flight effect while the signal from stationary tissues has been suppressed by the saturation rf pulse followed by spoiling gradients. Due to the inhomogeneous rf field and the tissue dependent T1 relaxation time, however, stationary tissues can not be suppressed completely or uniformly, and the remnant stationary signal deteriorates the resultant angiogram. Here, the complete cancellation of stationary tissues is made possible by the spectral analysis of a series of repetitive line images of the same slice. The Fourier transformation of a set of line images results in the spectrum images, where stationary tissues are collected into the dc component while arteries are included in harmonic components because of the variation of the flow velocity and the resultant flow signal in arteries according to the cardiac cycle. The summation of harmonic components excluding the dc component results in the angiogram of arteries with the complete cancellation of stationary tissues.

• 대한방사선기술학회지:방사선기술과학
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• 제17권2호
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• pp.13-20
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• 1994

The paper is on the record of radiography the patients with SIEMENS ANGIOSTAR/POLYTRON S PLUS angiosystem with DSA system in the Chonbuk National University Hospital from October 1993 to June 1994. The results are as follow : 1. Among the total No, 836 case of utilization, angiography are 316(37.8 %), interventional radiography are 256(34.2 %), and dacryocystography and sialography are 168(20/1 %). Therefore non-angiogrlphy procedure are incerasing. 2. The aomunt of contrast material used are half as much as conventional angiovascular system. 3. The amount of film consumed are $10{\sim}15%$ of that of conventional angio vascular system and reduction of procedure time are $40{\sim}50%$. 4. Admitting that dignostic utility is in the utilization by examination region, there should be technological study which deal with fine vessel and motion artifact problem.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.184-191
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• 2015

Objective : Anterior communicating artery (AcomA) aneurysms represent the most common intracranial aneurysms and challenging to treat due to complex vascularity. The purpose of this study was to report our experience of endovascular treatment of AcomA aneurysms. Methods : Between January 2003 and December 2013, we retrospectively reviewed the medical records of 134 AcomA aneurysm patients available more than 6 months conventional angiographic and clinical follow-up results. We focused on aneurismal or AcomA vascular characters, angiographic and clinical follow-up results, and retreatment. Results : The rate of ruptured cases was 75.4%, and the small (<10 mm) aneurysms were 96.3%. Based on the subtypes defined by dominance of A1, 79 patients (59%) had contralateral A1 hypoplasia or agenesis. The immediate post-procedural angiography confirmed complete occlusion in 75.4%, partial occlusion in 24.6%. Procedure related complications were observed in 25 (18.6%) patients. Most of the adverse events were asymptomatic. Follow-up conventional angiography at ${\geq}6$ months was performed in all patients (mean 16.3 months) and major recanalization was noted in 6.7% and regrowth in one case. The aneurysm size (p=0.016), and initial treatment results (p=0.00) were statistically significant risk factors related to aneurysm recurrence. An overall improvement in mRS was observed during the clinical follow-up period and no rebleeding episode occurred. Conclusion : This study demonstrated that endovascular treatment is an effective treatment modality for AcomA aneurysms with low morbidity. Patients should take long term clinical and angiographic follow-up in order to assess the recurrence and warrant retreatment, especially ruptured, large, and initially incomplete occluded aneurysms.

• 대한방사선기술학회지:방사선기술과학
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• 제32권1호
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• pp.61-67
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• 2009

연구목적 : poly-L-guluronic alginate(PGA) 겔이 혈관색전술에 적용가능한지 시뮬레이션을 통해 확인하고, PGA 겔이 혈관 내에서도 유용한지 혈관조영술을 통해 알아보고자 하였다. 연구방법 : 겔을 형성하는 PGA는 다시마에서 추출하여 생물학적 적합성 시험을 거쳤고, 단백질 불순물을 완전히 정제한 후 실험에 이용하였다. 유리 동맥류 모형을 이용하여 PGA가 겔을 형성하여 색전을 일으키는지 확인하였고, 가토의 신장 혈관에서도 PGA가 색전을 일으키는지 혈관조영술을 통해 확인하였다. 결 과 : 유리 동맥류 모형에서 PGA는 자동 주입기를 이용하여 카테타를 통해 주입한 후 염화칼슘($CaCl_2$)을 주입하니 유리 동맥류 모형 내에서 겔을 형성하며 색전을 일으켰다. 가토 실험에서는 우신 동맥과 대동맥을 결찰한 후 혈관조영술을 통해 좌신의 혈류를 확인하였다. 좌신동맥으로 PGA와 염화칼슘($CaCl_2$)을 동일한 카테터를 통해 순서대로 주입한 후 우신동맥과 대동맥의 결찰을 제거하였다. 혈관조영술을 다시 실시하여 좌신동맥의 혈류를 확인하니 좌신동맥이 보이지 않았다. 이는 좌신 혈관 내에세 PGA가 겔을 형성하여 혈류를 완전히 차단하였기 때문이었다. 결 론 : PGA는 혈관 내에서 혈관을 완전히 차단하고 색전을 일으킴을 확인하였다. 그러므로 PGA는 혈관 색전물질로 유용할 것이고, 혈관색전술과 조영술 적용에 상당히 효과적일 것이다.

• Journal of Trauma and Injury
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• 제22권2호
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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.