• 제목/요약/키워드: Postoperative MRI

검색결과 216건 처리시간 0.025초

신속 조형 기술로 제작된 인체모형을 이용한 술전 모의 두개악안면성형수술 (3-Dimensional Model Simulation Craniomaxillofacial Surgery using Rapid Prototyping Technique)

  • 정경인;백롱민;임주환;박성규;허찬영;김명국;권순성
    • Archives of Plastic Surgery
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    • 제32권6호
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    • pp.796-797
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    • 2005
  • In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.

이하선 종양 수술술식 선택에 있어 임상병리학적 요인 - 245예의 후향적 분석 - (Clinicopathologic Factors in Selection of Surgical Procedure in Parotid Tumor Surgery - A Retrospective Review of 245 Cases -)

  • 김운원;김상효
    • 대한두경부종양학회지
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    • 제19권2호
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    • pp.137-141
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    • 2003
  • Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA. Results: Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2 Conclusion: Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.

8개월 영아의 좌측 이하선 부위에서 발생한 배아형 횡문근육종 1예 (A Case of Embryonal Rhabdomyosarcoma at Left Parotid Gland in 8-Month-Old Infant)

  • 조민혁;김연수;신유섭;김철호
    • 대한두경부종양학회지
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    • 제30권2호
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    • pp.119-122
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    • 2014
  • Rhabdomyosarcoma is the most common sarcoma in children less than 15 years of age. Two major histological subtypes are embryonal and alveolar. Embryonal rhabdomyosarcoma is diagnosed by immunopathology and treatments require coordinated management plans that include surgery, chemotherapy, and usually radiotherapy. 8-month-old male infant visited with swelling in left parotid area. Computed tomography scan showed a heterogeneous mass in the left parotid area and the result of fine-needle aspiration cytology was suspicious malignancy. Left total parotidectomy was performed and CSF leakage was noted and repaired. Confirmed by positive reactions to desmin and myogenin, the diagnosis was embryonal rhabdomyosarcoma. On postoperative brain MRI, extension along the meninges was noted and for treatment, chemotherapy and gamma knife radiosurgery were done. Five years after initial surgical resection(3 years and 10 months after completion of chemotherapy and gamma knife radiosurgery), the child did not show any evidence of local recurrence or distant metastasis.

진행된 경부 전이암에서 경동맥 절제를 위한 술전검사와 절제술의 의의 (Preoperative Evaluation and Significance of Carotid Resection in Advanced Cervical Metastatic Cancer)

  • 조정일;김영모;최원석;최상학;한창준
    • 대한두경부종양학회지
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    • 제17권1호
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    • pp.13-18
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    • 2001
  • Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

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흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고- (Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.585-588
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    • 1996
  • 식도평활근종은 식도암에 비해 매우 드물지만 식도양성종양의 대부분을 차지한다. 식도질환의 수술 은 개흥을 통해 시행되 었으나 흥강경수슬의 발달과 함께 일부 식도수술을 흉강경을 이 용하여 수술을 하 게되었다. 저자들은 상부식도에 발생한 평활근종을 흥강경을 이용하여 절제하고 좋은 결과를 얻었다. 환자는 24세 남자로 내원 2개월전부터 발생한 흥골후방 불쾌감과 경미한 연하곤란을 호소하였다. 식도 위장관촬영과 식도경검사에서 상부식도에 점막의 변화없는 점 막하종양이 있었으며 흉부전산화단층 및 자기공명영상 촬영으로 종양의 위치,크기 및 주위조직으로의 침범과 종격동 림프절종대가 없음을 확인 하였다. 종양은 흥강경을 이용하여 제거하였고, 크기는 4$\times$2xlcm로 병리조직검사상 평활근종으로 진 단되었다. 환자는 수술후 10일째 이상없이 퇴원하였다.

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이하선에서 발생한 근상피종 치험례 (Myoepithelioma of the Parotid Gland: A Case Report)

  • 장철호;임소영;현원석;방사익;오갑성;문구현
    • Archives of Plastic Surgery
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    • 제34권2호
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    • pp.258-260
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    • 2007
  • Purpose: Myoepithelioma is a rare tumor that originates exclusively from myoepithelial cells of the salivary glands, breast and the prostate. Myoepithelioma accounts for less than 1% of all salivary gland tumors. The objective of our study is to present our experience of the infra-auricular mass which was finally diagnosed as a myoepithelioma. Methods: A 54-year-old woman was presented with a firm, movable, slow-growing infra-auricular mass with 3 cm in diameter. MRI scans and fine needle biopsy was performed for preoperative diagnostic study. A superficial parotidectomy was preceded and removed tumor successfully. Results: Histopathological study revealed a myoepithelioma of plasmacytoid type. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor for 9 months follow-up period. Conclusion: Myoepithelioma in the parotid gland shows similar clinical courses and intraoperative finding to the pleomorphic adenoma and superficial parotidectomy was selective choice for treatment.

협부에 발생한 점액양 지방육종의 치험례 (A Case of Myxoid Liposarcoma of the Cheek)

  • 유준호;노시균;이내호;양경무;차은정
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.505-507
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    • 2011
  • Purpose: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. Methods: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. Results: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. Conclusion: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.

복부흉터에 발생한 자궁내막종 (A Case of Endometrioma at the Abdominal Scar)

  • 이태민;김유진;김선구;이세일
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.843-846
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    • 2010
  • Purpose: Plastic surgeon can easily misdiagnose the mass on the postoperative scar as hypertrophic scar. We present a case of endometrioma at abdominal scar after cesarean section. Methods: A 36 year-old female visited with a protruding, rubbery hard mass on her abdominal scar. The mass grew slowly after cesarean section performed 7 years ago. She has felt intermittent pain, not with menstrual cycle, for 2 months. The ultrasonography showed a solid irregular, ill defined mass with heterogenous echogenicity. The MRI finding is suggestive of malignant soft tissue tumor with deep fascial invasion. Incisional biopsy showed acanthosis, melanophage, lymphoplasmacytic infiltration. So we excised mass elliptically, we could see chocolatelike discharge from the mass, adhering to external oblique muscle fascia. The mass confirmed histologically as an endometrioma. Results: The mass was completely removed and did not recurr. The patient does not complain more about pain or any discomfort. Conclusion: Plastic surgeons should be aware of the possibility of endometrioma when the patient present with mass on her abdominal scar after surgery of the pelvis and abdomen.

외상에 의해 동시에 발생한 가성 좌심실류와 하행 대동맥류의 치험1례 (Traumatic Aneurysm Involving Left Ventricle and Descending Thoracic Aorta)

  • 이서원;이계선
    • Journal of Chest Surgery
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    • 제30권6호
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    • pp.617-620
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    • 1997
  • 외상에 의한 흉부손상중 좌심실류와 하행대동맥류는 매우 드문데 그 이유는 아마도 대부분의 환자가 사고 당시 즉시 사망하기 때문일 것이다. 본 예는 5세 남자 환아로 버스에 치어 급성호흡부전과 폐부종으로 인한 ARDS 로 다발성 장기부전이 발생하여 뇌경색과 신부전의 합병증이 동반되어 치료후 퇴원하여 외래 추적조사중 심초음파 검사상 좌심실류와 전자자기공명(hm))상 좌심실류 및 하행대동맥류 진단하에 외상후 74일만에 전순환 정지하에 좌심실류절제술과 하행대동맥류절제술 및 인조혈관대체술을 시행하였으며, 술후 환자는 특별한 문제없이 퇴원하였다.

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Inadvertent Self-Detachment of Solitaire AB Stent during the Mechanical Thrombectomy for Recanalization of Acute Ischemic Stroke : Lessons Learned from the Removal of Stent via Surgical Embolectomy

  • Kang, Dong-Hun;Park, Jaechan;Hwang, Yang-Ha;Kim, Yong-Sun
    • Journal of Korean Neurosurgical Society
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    • 제53권6호
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    • pp.360-363
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    • 2013
  • We recently experienced self-detachment of the Solitaire stent during mechanical thrombectomy of acute ischemic stroke. Then, we tried to remove the detached stent and to recanalize the occlusion, but failed with endovascular means. The following diffusion weighted image MRI revealed no significant increase in infarction size, therefore, we performed surgical removal of the stent to rescue the patient and to elucidate the reason why the self-detachment occurred. Based upon the operative findings, the stent grabbed the main thrombi but inadvertently detached at a severely tortuous, acutely angled, and circumferentially calcified segment of the internal carotid artery. Postoperative angiography demonstrated complete recanalization of the internal carotid artery. The patient's neurological deficits gradually improved, and the modified Rankin scale score was 2 at three months after surgery. In the retrospective case review, bone window images of the baseline computed tomography (CT) scan corresponded to the operative findings. According to this finding, we hypothesized that bone window images of a baseline CT scan can play a role in terms of anticipating difficult stent retrieval before the procedure.