• 한국융합학회논문지
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• 제8권5호
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• pp.79-85
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• 2017

본 연구는 만성 B형 바이러스성 감염 환자의 간 기능 혈액 검사 수치와 간 섬유화 스캔 검사(FibroScan(R))의 비교 분석을 통한 간 섬유화 스캔 검사의 임상적, 기기적 융합 유용성을 평가하고자 하였다. 2015년 7월 1일부터 2016년 2월 28일까지 대전시 B내과에 내원한 만성 B형 바이러스성 감염 환자 75명의 간 섬유화 스캔 검사 결과와 간 기능 혈액검사 수치를 분석 하고 ROC곡선을 작성하였다. 알라닌 아미노전이요소, 아스파르테이트 아미노전이요소 수치가 각각 0.572, 0.502로 섬유화 수치와 가장 높은 상관관계를 보였다(p<0.000). 감마지티피, 총 빌리루빈, 알칼리성 인산분해효소 수치도 비교적 유의한 상관관계를 보였으나 알파태아단백과 총 단백정량은 통계적으로 유의하지 않았다. 또한 알부민(-0.449)과 혈소판치(-0.373)도 섬유화 수치와 상관관계가 없었다(p<0.000). 간 섬유화 정도가 높은 등급일수록 ROC 곡선의 정확도가 증가하였으며 F4의 간 경변 단계에서 가장 큰 AUROC값을 나타냈다. 따라서 간 섬유화 스캔 검사는 만성 간질환 환자의 간 기능 수치인 알라닌 아미노전이요소, 아스파르테이트 아미노전이요소 수치와 유의한 상관관계를 보여 간의 염증 검사 및 만성 간질환 진단에 매우 유용한 것으로 판단된다.

• 대한핵의학회지
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• 제15권1호
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• pp.45-49
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• 1981

The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unsual collateral circulation. But there was no report of this hots pot on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using $^{99m}Tc-tin$ colloid, and demonstrated collateral circulations with RI venography using $^{99m}Tc-O_4$. The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hot spot on liver scan in SVC obstruction with review of some liter atures.

• 핵의학기술
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• 제20권2호
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• pp.46-48
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• 2016

Gastrointestinal cancer 환자의 약 20%가 진단 당시에 이미 간에 전이가 된 상태에서 발견된다. Gastrointestinal cancer 환자에서 PET/CT 검사 시 Liver 추가 촬영을 함으로써 영상의 질적 변화에 대한 유용성을 평가하고자 하였다. 검사대상은 2015년 9월부터 2016년 2월까지 본원에 내원하여 Gastrointestinal cancer 진단을 받은 152명을 대상으로 PET/CT 검사 후 Liver 부위를 추가를 촬영하였다. Standard 영상과 추가 영상에서 같은 Level의 관심영역을 설정하여 Signal to Noise Ratio(SNR), Standardized Uptake Value(SUV), Tumor/Normal(T/N) ratio의 변화를 통한 영상의 질적변화를 평균값을 산출하여 비교 평가한 결과 SNR은 standard $17.7{\pm}10.3$, 추가영상 $22.3{\pm}9.7$, $SUV_{max}$는 각각 $6.7{\pm}2.8$와 $7.6{\pm}3.2$, T/N ratio는 standard는 $2.1{\pm}0.6$, 추가촬영에서는 $2.5{\pm}0.8$로 분석되었다. 이는 통계적으로 유의한 차이가 있는 것으로 나타났다. SNR의 변화량이 가장 큰 것으로 나타났고 Liver 추가 촬영에 따른 SNR과 $SUV_{max}$, T/N ratio는 상대적으로 Standard 보다 높게 나왔고 Liver 추가 촬영을 통한 영상의 질적 향상은 간 전이가 있는 암 환자를 판독 하는데 있어서 유용한 검사 방법이라고 사료된다.

• 대한핵의학회지
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• 제14권2호
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• pp.19-27
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• 1980

Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

• 대한핵의학회지
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• 제27권2호
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• pp.309-314
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• 1993

저자등은 33세 남자 환자에서 검사실 소견과 복부 전산화 단층촬영, 간 신티그라피 및 골주사, 복부 초음파 및 수술소견을 통해 알콜성 및 C형 간염에 의한 간경화를 동반한 환자가 교통사고로 복부 외상에 의한 간하부열상을 받아 복강내출혈로 입원한 환자에서 일시적으로 골주사소견에서 비장에 섭취를 보이는 것이 복부 비장의 잠재적 외상으로 인한 것으로 사료되며, 비장 비대 외에는 특이소견이 보이지 않으며 기전이 명확하지 않은 골주사상 비장섭취를 보인 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한핵의학회지
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• 제18권1호
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• pp.33-37
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• 1984

The accuracy of liver scanning was evaluated in 124 cases with primary or metastatic liver tumors, including a few benign localized lesions and in 277 cases without such lesions. All findings were histologically verified by operation or autopsy. 1) Of the 124 cases with space occupying lesions(SOLs) in the liver, 92 cases were detected by liver scan(sensitivity 74.2%). And of the 277 cases without such lesions, 266 cases were evaluated as no SOLs(specificity 96.0%). The overall accuracy was 89.3%. 2) The authors evaluated the liver scan sensitivity in each of different diseases with SOLs. The sensitivity was 88.9% in primary liver carcinoma, 82.4% in primary liver carcinoma with cirrhosis, 88.7% in liver abscess, and 100% in hemangioma. The sensitivity was low in metastatic tumor(65.8%). 3) The sensitivity of the SOLs in the right lobe was 53.3% and left lobe 27.7%. In the interlobar area, detectability was 41.7%. 4) The authors compared the sensitivity of the liver scan with the size of the SOLs. The smaller the size of the SOLs, the lower the detectability. In the pachy lesions, the sensitivity was 46.6%.

• 대한핵의학회지
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• 제4권2호
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• pp.41-53
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• 1970

Although the radioisotope liver scan has primarily been of use in the detection of the intra-hepatic space occupying lesions, there has been an increasing awareness of its use in evaluation of liver function. In this study, the degree of hepatomegaly, changes in shape and mottling radiodensity on each lobe and splenic visualization in the liver scans done with colloidal radiogold were numerically expressed as scores under the arbitrary standard in 210 patients with liver cirrhosis. The clinical value of this scoring system was studied with special regards to the correlation between the radiogold hepatic uptake half time and conventional liver function tests. Following were the results; 1) The normal scan appeared in 6.7% of 210 patients with liver cirrhosis. 2) The colloidal radiogold hepatic uptake half time was abnormally and progressively prolonged in parallel to severity of hepatocellular dysfunction. The mean hepatic uptake half time in cirrhosis showing normal scan was $2.76{\pm}0.73$ minutes. 3) The scoring system was well correlated with the serum albumin and globulin levels, A/G ratio and BSP retention. There was some correlative tendency in alkaline phosphatase activity. 4) There was no correlation with the thymol turbidity test, cholesterol levels, transaminase activities and bilirubin levels. 5) The spleen was visualized in 38.6% of total patients with liver cirrhosis. Excluding normal scans in liver cirrhosis, the spleen was visualized in 41.3%. 6) The scoring system appears to confirm the clinical diagnosis and to give a reliable estimate of the degree of hepatocellular dysfunction in patients with liver cirrhosis.

• Clinical and Experimental Pediatrics
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• 제56권1호
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• pp.19-25
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• 2013

Purpose: Childhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan. Methods: This study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy. Results: Factors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%. Conclusion: APRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD.

• 대한핵의학회지
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• 제22권2호
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• pp.181-185
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• 1988

Since hepatocyte clearance, leading edge parencymal transit time and biliary excretion can be evaluated separately with hepatobiliary scan using $^{99m}Tc-DISIDA$, hepatobiliary scan may be useful in differentiating intrahepatic cholestasis from extrahepatic cholestasis. Excretory liver function was analysed in 13 healthy subjects and 11 patients with clinically suspected hepatocellular disease and 9 patients with extrahepatic biliary obstruction confirmed by surgery, radiological and clinical evidence. Indices of total liver activity (% TLA), liver parechymal uptake (% LPU), heart pool clearance (% HPC) and liver-heart rate (% LHR) were calculated from time activity curve over heart and liver. Compared with healthy subjects, significant reduction (p<0.05) in total liver activity (% TLA) and liver-heart rate (% LHR) was observed in all patients group. But no useful indices was demonstrated in differentiating hepatocellular disease from extrahepatic biliary obstruction.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1966년도 제5회 학술대회
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• pp.93.3-94
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• 1966

The fact that colloidal particulates of rdaiogold are mainly and effectively eliminated from the blood stream by phagocytic activity of Kupffer's cells of the liver has been successfully adopted to the diagnosis if certain liver diseases and the same principle has opened a new avenue to the study of the organ by obtaining scan. Indeed, the latter procedure has been widely used for the detection of space-occupying lesions of cirrhosis of the liver. Nevertheless problem of differential diagnosis of monochromatic "cold" areas or "mottling" of the internal structure on the scan limited the value of this diagnostic modality. The present investigation is aimed at improving intepretation of photoscan findings with the aid of blood clearance rate of the intravenously injected colloidal $^{198}Au$.