• Korean Journal of Radiology
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• 제1권4호
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• pp.185-190
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• 2000

Objective: To document the imaging findings of hepatic cavernous hemangioma detected in cirrhotic liver. Materials and Methods: The imaging findings of 14 hepatic cavernous hemangiomas in ten patients with liver cirrhosis were retrospectively analyzed. A diagnosis of hepatic cavernous hemangioma was based on the findings of two or more of the following imaging studies: MR, including contrast-enhanced dynamic imaging (n = 10), dynamic CT (n = 4), hepatic arteriography (n = 9), and US (n = 10). Results: The mean size of the 14 hepatic hemangiomas was 0.9 (range, 0.5-1.5) cm in the longest dimension. In 11 of these (79%), contrast-enhanced dynamic CT and MR imaging showed rapid contrast enhancement of the entire lesion during the early phase, and hepatic arteriography revealed globular enhancement and rapid filling-in. On contrast-enhanced MR images, three lesions (21%) showed partial enhancement until the 5-min delayed phases. US indicated that while three slowly enhancing lesions were homogeneously hyperechoic, 9 (82%) of 11 showing rapid enhancement were not delineated. Conclusion: The majority of hepatic cavernous hemangiomas detected in cirrhotic liver are small in size, and in many, hepatic arteriography and/or contrast-enhanced dynamic CT and MR imaging demonstrates rapid enhancement. US, however, fails to distinguish a lesion of this kind from its cirrhotic background.

• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.342-348
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• 2011

생체 간이식 공여자를 대상으로 시행되는 간생검 조직소견의 지방변성 정도와 복부초음파검사 결과를 분석하여, 지방간 질환의 진단에 있어서 초음파검사의 타당성을 알아보고자 하였다. 총 지방 함유량 10% 기준으로 범주화 하여 10% 이하를 음성, 10% 이상을 양성으로 하였을 때 초음파검사의 민감도는 64.6%이었고, 특이도는 68% 이었으며, 양성 예측도와 음성 예측도는 각각 76.8%, 54% 이었다. 초음파검사 결과 정상과 경증을 음성으로, 중등도를 양성으로 조작하였을 때 초음파검사의 민감도는 26.8% 이었고, 특이도는 100% 이었으며, 양성 예측도와 음성 예측도는 각각 100%, 45.5% 이었다. 총 지방 함유량 10% 이상을 상태변수(State variable)로 ROC curve 분석을 시행 하였을 때. 간/신장 명도비의 곡선하면적(Area under curve, AUC)은 0.859로 지방간을 예측하는데 좋은 지표로 나타났으며, 95% 신뢰구간(CI: 0.795~0.922)이 통계적으로 유의한 값을 보였다(p<0.001). 지방간진단에 있어서 복부초음파검사는 간생검 병리학적 결과를 예측하는데 높은 타당도를 보였다.

• 대한영상의학회지
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• 제84권3호
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• pp.666-675
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• 2023

목적 지방간 환자에서 초음파 감쇠영상(attenuation imaging; 이하 ATI)의 감쇠계수(attenuation coefficient; 이하 AC)와 시각적 평가 사이의 상관관계 여부를 파악하고 혈액화학 및 CT 감쇠계수와 AC 사이의 상관관계 여부를 평가하고자 하였다. 대상과 방법 본 후향적 연구에서는 2018년 4월부터 12월까지 ATI를 포함한 간초음파를 시행 받은 환자들 중 만성 간질환 및 간경화증을 제외한 환자들을 대상으로 하였다. AC와 초음파 시각적 평가, 혈액화학, 간 감쇠 및 간 대 비장 비율(liver to spleen ratio; 이하 L/S ratio) 사이의 상관관계를 분석하였다. 분산 분석을 통해 초음파 시각적 등급에 따른 AC 값을 비교하였다. 결과 총 161명의 환자가 포함되었다. 초음파 시각적 평가와 AC 사이의 상관 계수는 0.814였다(p < 0.001). 정상, 경도, 중등도, 고도 지방간의 AC 평균값은 각각 0.56, 0.66, 0.74, 0.85였다(p < 0.001). 알라닌 아미노전이효소는 AC와 유의한 상관관계가 있었다(r = 0.317, p < 0.001). 간 감쇠계수 및 L/S ratio와 AC 사이의 상관계수는 각각 -0.702 와 -0.626이었다(p < 0.001). 결론 초음파 시각적 평가와 AC는 강한 양의 상관관계 및 등급들 사이의 구별되는 AC 값을 보였고, CT 감쇠계수와 AC는 강한 음의 상관관계를 보였다.

• 대한방사선협회지
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• 제27권2호
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• pp.148-156
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• 2001

Ⅰ. Purpose : To determine echo value and duration of contrast enhancement of liver mass on contrast-enhanced US with Levovist by quantitative analysis. Ⅱ. Materials and Methods : Twenty three patients with liver mass were prospectively evaluated with cont

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권2호
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• pp.108-114
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• 2015

Purpose: The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. Methods: One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. Results: Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured $2.9{\pm}0.8cm$ and $1.9{\pm}0.7cm$ in the normal group, $3.3{\pm}0.8cm$ and $2.0{\pm}0.7cm$ in grade I, $3.8{\pm}0.8cm$ and $2.3{\pm}0.8cm$ in grade II, and $4.1{\pm}0.8cm$ and $2.8{\pm}1.4cm$ in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). Conclusion: Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.

• Korean Journal of Radiology
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• 제23권1호
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• pp.52-59
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• 2022

Objective: To investigate whether the diagnostic performance of CT angiography (CTA) could be improved by modifying the conventional criterion (anastomosis site abnormality) to diagnose hepatic artery occlusion (HAO) after liver transplantation (LT) in suspected patients with Doppler ultrasound (US) abnormalities. Materials and Methods: One hundred thirty-four adult LT recipients (88 males and 46 females; mean age, 52.7 years) with suspected HAO on Doppler US (40 HAO and 94 non-HAO according to the reference standards) were included. We evaluated 1) abnormalities in the HA anastomosis, categorized as a cutoff, ≥ 50% stenosis at the anastomotic site, or diffuse stenosis at both graft and recipient sides around the anastomosis, and 2) abnormalities in the distal run-off, including invisibility or irregular, faint, and discontinuous enhancement. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the conventional (considering anastomosis site abnormalities alone) and modified CTA criteria (abnormalities in both the anastomosis site and distal run-off) for the diagnosis of HAO were calculated and compared using the McNemar test. Results: By using the conventional criterion to diagnose HAO, the sensitivity, specificity, PPV, NPV, and accuracy were 100% (40/40), 74.5% (70/94), 62.5% (40/64), 100% (70/70), and 82.1% (110/134), respectively. The modified criterion for diagnosing HAO showed significantly increased specificity (93.6%, 88/94) and accuracy (93.3%, 125/134) compared to that with the conventional criterion (p = 0.001 and 0.002, respectively), although the sensitivity (92.5%, 37/40) decreased slightly without statistical significance (p = 0.250). Conclusion: The modified criterion considering abnormalities in both the anastomosis site and distal run-off improved the diagnostic performance of CTA for HAO in suspected patients with Doppler US abnormalities, particularly by increasing the specificity.

• 한국방사선학회논문지
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• 제18권2호
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• pp.135-144
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• 2024

초음파 영상 검사는 지방간 정량화에 제한점을 가지고 있다. 이에 본 연구에서는 가상 지방간 팬텀을 통해 지방간 함량을 초음파 주행 과정에서의 신호 감쇠 변화가 정량화가 가능한지를 실험적으로 입증하고자 하고자 하였다. 또한 초음파 영상에서의 지방 함량과 신호 강도의 관계를 분석하여 초음파를 통한 지방간 진단에 대한 가능성을 평가하고자 하였다. 본 연구에서는 물과 기름을 균질하게 혼합하여 총 5개의 가상 지방간 팬텀을 개발했다. 자기공명영상과 초음파 영상을 사용하여 팬텀의 지방 함량을 확인하고 초음파 영상에서 거리에 따른 신호 강도를 측정하였다. 이후 지방 함량과 신호 강도 간의 상관관계를 분석과 평균비교를 수행하였다. 초음파 영상에서는 지방의 함량이 높아짐에 따라 초음파의 투과 강도가 감소하는 현상을 확인하였으며, 이를 통해 초음파를 사용하여 지방간의 함량을 정량화할 가능성을 확인하였다. 또한 자기공명영상으로 측정한 지방 함량과 초음파 영상에서 측정한 신호 강도 간 높은 상관관계를 보였다. 본 연구에서는 지방의 함량이 높아질수록 초음파 영상의 초음파 주행 과정에서 신호를 표현한 기울기(US-GRE)값이 점점 작아지는 것을 통계적으로 확인하였으며 US-GRE는 지방간 함량을 표현하는 생체 마커(biomarker)로서 역할을 할 수 있을 것으로 판단된다.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1077-1086
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• 2021

Objective: To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods: In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results: The participants were classified based on MRI-PDFF: < 5% (n = 38), 5-10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF (r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786-0.918) and 0.835 (95% CI: 0.757-0.897), and those of SC-TSI were 0.964 (95% CI: 0.913-0.989) and 0.935 (95% CI: 0.875-0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion: AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

• Korean Journal of Radiology
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• 제1권3호
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• pp.165-168
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• 2000

We present two cases of solitary necrotic nodules of the liver which on radiologic images mimicked hepatic metastasis. Solitary necrotic nodule of the liver is a rare but benign entity which histopathologically consists of an outer fibrotic capsule with inflammatory cells and a central core of amorphous necrotic material. The lesion was seen on contrast-enhanced CT as an ovoid-shaped hypoattenuating nodule; on CT during hepatic arteriography as enhancing nodule; on intraoperative US as a target-appearing hypoechoic nodule; on T2WI as a hyperintensity nodule, and on dynamic MR as a subtle peripheral enhancing nodule. Although the radiologic features are not specific, solitary necrotic nodule of the liver should be included in the differential diagnosis of hepatic metastasis.

• 대한방사선협회지
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• 제27권2호
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• pp.137-147
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• 2001

For the cancer of the liver, surgery has been the best treatment, while patients who have the cancer of the liver in its early stages or metastatic liver cancer hardly be healed by surgery tend to be treated with PEIT (Percutaneous Ethanol Injection Thera