• Korean Journal of Radiology
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• 제24권6호
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• pp.482-497
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• 2023

Sonazoid, a second-generation ultrasound contrast agent, was introduced for the diagnosis of hepatic nodules. To clarify the issues with Sonazoid contrast-enhanced ultrasonography for the diagnosis of hepatocellular carcinoma (HCC), the Korean Society of Radiology and Korean Society of Abdominal Radiology collaborated on the guidelines. The guidelines are de novo, evidence-based, and selected using an electronic voting system for consensus. These include imaging protocols, diagnostic criteria for HCC, diagnostic value for lesions that are inconclusive on other imaging results, differentiation from non-HCC malignancies, surveillance of HCC, and treatment response after locoregional and systemic treatment for HCC.

• Clinics in Shoulder and Elbow
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• 제22권3호
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• pp.121-127
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• 2019

Background: Posterior decentering is not an uncommon finding on rotator cuff tear patients' shoulder magnetic resonance imaging. No previous study has reported on the relationship between posterior decentering and rotator cuff tear. Methods: We assessed patients' rotator cuff tear humeral head positions based on humeral-scapular alignment (HSA). Subjects were classified into centering and decentering groups based on a <2 mm or >2 mm HSA value, respectively. Differences in rotator cuff tear size, degree of tear, and fatty degeneration between the two groups were evaluated. Results: One hundred seventy-five patients (80 males, 95 females; mean age: $59.7{\pm}6.5$ years old) were selected as subjects (casecontrol study; level of evidence: 3). Tear size, degree of subscapularis tendon tear, and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis muscles were significantly different between the two groups (p<0.001, p<0.001, p<0.001). Conclusions: The occurrence of decentering was related to rotator cuff tear size, degree of subscapularis tendon tear, and fatty degeneration of the rotator cuff muscles.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1240-1252
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• 2021

Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

• Investigative Magnetic Resonance Imaging
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• 제3권1호
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• pp.47-52
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• 1999

목적 : 시각자극을 이용하여 대뇌 후두엽에서 BOLD(blood oxygen level dependent)효과에 의한 기능적 자기공명영상과 양성자 자기공명분광법을 이용한 대사물질영상( metabolic i image)을 얻어 그 결과를 평가하고자 하였다. 대상 및 방법 : 24세에서 30세 사이의 8명의 남자와 2명의 여자를 포함하는 10명의 정상 성인 남녀를 대상으로 1.5T MRI에서 시각 지극을 이용하여 echo planar imaging펠스시퀀스를 사용하여 BOLD효과에 의한 영상들을 대뇌 후두엽에서 얻었다. 시각자극은 8Hz의 red flicker를 이용한 광 자극을 주였다. MR에서 얻어진 영상들을 workstation으로 전송한 뒤 자체 개발한 분석프로그램을 사용하여 상관계수방법을 이용하여 기능적 영상을 구하였다. 그리고 얻어진 영상의 활성화 부위를 선정한 뒤 양성자 자기공명 분광법을 사용하여 시각 자극에 의한 뇌 활성화시 대사물질의 변화를 분석했다. 그 후 자가공명분광영상법(magnetic resonance spectro-scopic imaging)를 실행하여 젖산(lactate)의 대사물질 영상을 얻었다. 결과 : 시각 자극에 따른 BOLD효과에 의한 뚜렷한 활성화 부위가 후두염 대뇌피질에 나타났다. 또한 이들 활성화 부위에서 자기공명분광법을 시행한 결과 휴식상태와 시각자극상태에서 NAA(N-acetyle aspartate)/Cr(creatine)이 $1.79{\pm}0.28$에서 $1.88{\pm}O.20$으로 거의 변화가 없는 것에 반해 lactate는 자극 전후 $9.48{\pm}4.38$배로 증가하였으며 이를 바탕으로 lactate에 대한 대사물질영상을 얻을 수 있었다. 결론 : 시각자극에 의한 뇌 활성화시 BOLD효과를 이용한 자기공명영상볍으로 활성화 부위를 확인할 수 있었고, 같은 부위에서 자기공명분광법을 이용하여 lactate의 증가를 확인하였다. 또한 lactate의 증가를 대사물질영상으로 표현함으로써 두 결과에 대한 상관관계 및 뇌 기능적영상에 대한 신뢰성을 높일 수 있게 되었다.

• 대한인간공학회지
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• 제33권5호
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• pp.377-386
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• 2014

Objective: In this study, we used resting-state fMRI data to map differences in functional connectivity between a comprehensive set of 8 distinct cortical and subcortical brain regions in healthy controls and Internet addicts. We also investigated the relationship between resting state connectivity strength and the level of psychopathology (ex. score of internet addiction scale and score of Barratt impulsiveness scale). Background: There is a lot of evidence of relationship between Internet addiction and impaired inhibitory control. Clinical evidence suggests that Internet addicts have a high level of impulsivity as measured by behavioral task of response inhibition and a self report questionnaire. Method: 15 Internet addicts and 15 demographically similar non-addicts participated in the current resting-state fMRI experiment. For the connectivity analysis, regions of interests (ROIs) were defined based on the previous studies of addictions. Functional connectivity assessment for each subject was obtained by correlating time-series across the ROIs, resulting in $8{\times}8$ matrixs for each subject. Within-group, functional connectivity patterns were observed by entering the z maps of the ROIs of each subject into second-level one sample t test. Two sample t test was also performed to examine between group differences. Results: Between group, the analysis revealed that the connectivity in between the orbito frontal cortex and inferior parietal cortex, between orbito frontal cortex and putamen, between the orbito frontal cortex and anterior cingulate cortex, between the insula and anterior cingulate cortex, and between amydgala and insula was significantly stronger in control group than in the Internet addicts, while the connectivity in between the orbito frontal cortex and insula showed stronger negative correlation in the Internet addicts relative to control group (p < 0.001, uncorrected). No significant relationship between functional connectivity strength and current degree of Internet addiction and degree of impulsitivy was seen. Conclusion: This study found that Internet addicts had declined connectivity strength in the orbitofrontal cortex (OFC) and other regions (e.g., ACC, IPC, and insula) during resting-state. It may reflect deficits in the OFC function to process information from different area in the corticostriatal reward network. Application: The results might help to develop theoretical modeling of Internet addiction for Internet addiction discrimination.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.237-244
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• 2020

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Korean Journal of Radiology
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• 제20권4호
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• pp.609-620
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• 2019

Minimally invasive treatment of symptomatic thyroid nodules is now commonplace. Ethanol ablation (EA) of thyroid cystic nodules has been performed since the 1990s, but there is no global consensus or guideline. Although various limitations of EA have been described, recommendations for practical application are necessary. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology initiated the present consensus statement and here we provide recommendations for the role of EA in the management of symptomatic thyroid nodules. These recommendations are based on evidence to date from the literature and expert opinion.

• Imaging Science in Dentistry
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• 제30권1호
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• pp.80-86
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• 2000

A 37-year-old male with the complaint of intermittent gingival swelling and dull pain associated with the food impaction of the mandibular third molar area was referred to our department of Chonbuk National University Hospital. The dental history of the patient showed that he had extracted the maxillary left third molar without complications two years ago. Intraoral and panoramic radiographs showed diffuse increased radiopacity of the maxilla and mandible. The trabecular pattern was obliterated. Postero-anterior skull and lateral skull radiographs showed thickening of cortical bone and diffuse increased radiopacity of the skull. Additional radiographs showed similar changes in the lumbar spine, clavicles, iliac bone and femur. However, no evidence of osteomyelitis was observed clinically and radiographically. Laboratory findings showed normal values of serum calcium, phosphorus, and alkaline phosphatase. Based on the radiographic examinations and the laboratory findings, final diagnosis was made as a benign osteopetrosis.

• Clinical and Experimental Pediatrics
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• 제58권4호
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• pp.117-122
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• 2015

Global developmental delay (GDD) is a relatively common early-onset chronic neurological condition, which may have prenatal, perinatal, postnatal, or undetermined causes. Family history, physical and neurological examinations, and detailed history of environmental risk factors might suggest a specific disease. However, diagnostic laboratory tests, brain imaging, and other evidence-based evaluations are necessary in most cases to elucidate the causes. Diagnosis of GDD has recently improved because of remarkable advances in genetic technology, but this is an exhaustive and expensive evaluation that may not lead to therapeutic benefits in the majority of GDD patients. Inborn metabolic errors are one of the main targets for the treatment of GDD, although only a small proportion of GDD patients have this type of error. Nevertheless, diagnosis is often challenging because the phenotypes of many genetic or metabolic diseases often overlap, and their clinical spectra are much broader than currently known. Appropriate and cost-effective strategies including up-to-date information for the early identification of the "treatable" causes of GDD are needed for the development of well-timed therapeutic applications with the potential to improve neurodevelopmental outcomes.