• 제목/요약/키워드: Radiologic assessment

검색결과 81건 처리시간 0.04초

요추부 불안정증의 방사선학적 소견 (Lumbar Spinal Instability and Its Radiologic Findings)

  • 양경훈;김남규;김영수;고용;오성훈;오석전;김광명
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.78-86
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    • 2000
  • Objective : Lumbar spinal instability occurs when normal biomechanics support in lumbar vertebrae interrupted. Despite the recent enthusiastic studies, the precise radiological assessment has not been fully established, yet. Therefore, we carefully studied our cases to analyze the radiologic findings in lumbar spinal instability. Patients and Methods : We have put together radiological analysis and assessment based on 38 patients who have been diagnosed and treated for lumbar spinal instabilities from June 1994 to December 1998, Patients who have been diagnosed and treated for trauma were excluded from study. Results : The outcomes are as follows : 1) Lumbar lordotic curve was statistically significant in unstable group by 23.7, compared to the control group ($17.0^{\circ}$). 2) According to the resting x-ray, sagittal plane angulation measured on unstable group was $21.1^{\circ}$, control group $18.0^{\circ}$. Therefore unstable group was noticeably higher(p<0.01). 3) According to the resting x-ray sagittal plane displacement, unstable group had 4.3mm, the comparison had 1.2mm. Therefore measurement from the unstable group were significantly higher(p<0.01). 4) According to stress view, sagittal plane translation was 4.1mm for the unstables and 2.7mm for the comparisons. Therefore unstables were noticeably higher(p<0.01). 5) According to stress view, sagittal plane rotation was $15.1^{\circ}$ at L3-4, $22.0^{\circ}$ at L4-5, $27.9^{\circ}$ at L5S1 for the unstable group and $11.3^{\circ}$, $18.1^{\circ}$, $21.0^{\circ}$ each for the comparison. 6) Facet angle for unstable group, left $29.3^{\circ}-61.5^{\circ}$, right $24.4^{\circ}-63.2^{\circ}$ and the mean for each are $43.1^{\circ}$, $47.2^{\circ}$. The difference between left and right facet angle was $3.5^{\circ}-20.7^{\circ}$ and the mean value $15.3^{\circ}$. Facet angle for the comparisons for the left was $29.3^{\circ}-59.5^{\circ}$, right was in between $25.7^{\circ}-64.5^{\circ}$ range and the each mean are $44.9^{\circ}$ and $47.6^{\circ}$. Also, the difference between left and right facet angle was $4.1^{\circ}-9.3^{\circ}$ and the average was $17.1^{\circ}$. The average and the difference between the left and right angle are found not to have statistic necessity for both unstable and stable measurements(p>0.01). 7) 19 patients were found to have vacuum facet phenomenon among unstable group etc. results were collected. Conclusion : According to above results, we attempted to prepare the application to the patient of radiological analysis and assessment for lumbar spinal instability early checkup.

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디지털 환경에서 Humerus 검사 시 촬영인자 변화에 따른 선량 및 화질 평가 (Dose and Image Assessment according to Radiologic Factors Variation at Digital Humerus X-ray Examination)

  • 김성민;홍선숙;이관섭;하동윤
    • 대한디지털의료영상학회논문지
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    • 제14권2호
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    • pp.1-8
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    • 2012
  • Purpose : We aim at presenting the optimum radiologic factor through the evaluation of dose variation and of image quality through the use of a grid in Humerus examination and the change of dose because of the change of radiologic factor. Materials and Methods : We divided it in 3 cases: when using a grid or not and when using IP(Image Plate) in a digital system. Also, as fixing kVp to 70kVp it changed mAs, and fixing mAs to 10 it changed kVp, we put up resolution chart and Burger rose phantom on the acrylic phantom of 7cm (the same level of Humerus) to evaluate the dose and image. We used Image J program to evaluate the quantitative resolution of the obtained image, and made the qualitative evaluation and statistical analysis of the image saved in PACS for 20 radiologic technologist with more than 10 years of experience in order of evaluate its contrast. We used SPSS10(SPSS Inc. Chicago, Illinois) for statistical analysis. Results : We observed the analytic result of resolution by the change of kVp that it was $4.539dGycm^2$ in 60kVp and $757.472dGycm^2$ in 75kVp, which increased about 64.6% of dose, while for the resolution it had the pixel value 30.7% better with 851 in 60kVp than 651 in 75kVp. Also, we analyzed the result of resolution by the change of mAs that it was $3.106dGycm^2$ in 5mAs, and $12.470dGycm^2$ in 20mAs, which increased about 400% of dose, while for the resolution DR had 678 in 5mAs, and 724 in 20mAs that increased about 6.8% of resolution. We made the qualitative evaluation of contrast by the change of kVp that DR showed the higher quality than CR, but the contrast by the change of kVp had no special different at the moment of visual evaluation, nor statistically significant difference(P>0.05). We observed the qualitative evaluation of contraste by the change of mAs that the contrast increased as DR increased mAs, and had statistically significant difference(P<0.05). On the other hand, CR had no significant difference for more than 10mAs nor statistically significant difference(P>0.05). Conclusion : In case of some patients with radiographic exposure by the repeated examination such as emergent patient or Follow up patient, they are considered to try to limit the use of a grid, to set kVp under 65kVp in fixed mode, to select less than 10mAs and to reduce the possibility of patient being bombed.

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X선진단(診斷) 영역(領域)에 있어서의 심부선량분포(深部線量分布)의 측정(測定) (Measurement of Dose Distribution for Diagnostic X-ray)

  • 김유현;허준;김성철;윤종민
    • 대한방사선기술학회지:방사선기술과학
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    • 제18권1호
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    • pp.55-62
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    • 1995
  • This study was performed to find out dose distribution, pdd, surface dose and off center ratio. A few articles is analysis of dose data in radiotherapy field, there is no standardized measure of an assessment of exposure dose at diagnostic radiology, yet. And authors demonstrated a new assessment measure by ion chamber, TLD and film dosimetry system. We assurance that our data is useful to quantiative analysis of exposure dose and clinical fields for reduction of radiation dose.

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견봉 쇄골 관절 탈구의 수술적 치료 - Weaver-Dunn 변법과 Phemister 변법의 비교 - (Surgical Treatment of Acromioclavicular Dislocation -Comparison of modified Weaver-Dunn method and modified Phemister method-)

  • 배기철;손승원;조철현;정수원
    • Clinics in Shoulder and Elbow
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    • 제9권2호
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    • pp.155-161
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    • 2006
  • Purpose: To compare the clinical and radiological results between the modified Weaver-Dunn method and modified Phemister method in the acute acromioclavicular joint dislocation. Materials and Methods: We reviewed 19 patients who were treated for the acute acromioclavicular joint dislocation from 2001 to 2002. 10 patients were operated with the modified Weaver-Dunn method (group A) and the others with modified Phemister method (group B). The classification of preoperative injury was analyzed by using the Rockwood system, the clinical assessment of preoperative and postoperative by the modified UCLA rating scale and the radiological assessment by simple x-ray. Results: With the modified UCLA rating scale, group A showed 5 cases(50%) of excellent and 5 cases(50%) of good, group B showed 4 cases(44.4%) of excellent and 5 cases(55.6%) of good. In the radiologic findings of the coracoclavicular distances, group A was 16.2 mm at preoperative, 8.8 mm at postoperative, 9.7 mm at last follow-up and group B was 12.9 mm, 6.7 mm and 7.9 mm respectively. Postoperatively there were no complications such as surgical wound infection and failure of Kirschner wires. Conclusion: Both the modified Weaver-Dunn and modified Phemister methods have shown satisfied clinical and radiologic results, and there was no difference in these result between two groups (p>0.05).

Pseudoprogression and Pseudoresponse in the Management of High-Grade Glioma : Optimal Decision Timing According to the Response Assessment of the Neuro-Oncology Working Group

  • Chang, Ji Hyun;Kim, Chae-Yong;Choi, Byung Se;Kim, Yu Jung;Kim, Jae Sung;Kim, In Ah
    • Journal of Korean Neurosurgical Society
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    • 제55권1호
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    • pp.5-11
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    • 2014
  • Objective : We evaluated pseudoprogression (PsPD) following radiation therapy combined with concurrent temozolomide (TMZ), and we assessed pseudoresponse following anti-angiogenic therapy for patients with recurrent disease using the Response Assessment of the Neuro-Oncology Working Group. Methods : Patients who were pathologically confirmed as having high-grade glioma received radiotherapy with concurrent TMZ followed by adjuvant TMZ. Bevacizumab (Avastin) with CPT-11 were used as a salvage option for cases of radiologic progression. Magnetic resonance imaging (MRI) was routinely performed 1 month after concurrent radiochemotherapy (CRT) and every 3 months thereafter. For cases treated with the bevacizumab-containing regimen for progressive disease, MRI was performed every 2 months. Results : Of 55 patients, 21 (38%) showed radiologic progression within 4 weeks after CRT. Of these patients, 16 (29%) showed progression at second post-CRT MRI (etPD) and five (9%) showed improvement (PsPD). Seven of thirty-four initially non-progressed patients showed progression at the second post-CRT MRI (ltPD). No difference in survival was observed between the etPD and ltPD groups (p=0.595). Five (50%) of ten patients showed a radiological response after salvage bevacizumab therapy. Four of those patients exhibited rapid progression immediately after discontinuation of the drug (drug holiday). Conclusion : Twelve weeks following treatment could be the optimal timing to determine PsPD or true progression. MRI with gadolinium enhancement alone is not sufficient to characterize tumor response or growth. Clinical correlation with adequate follow-up duration and histopathologic validation may be helpful in discriminating PsPD from true progression.

자세성 사두증의 진단과 치료 (Diagnosis and Treatment of Deformational Plagiocephaly)

  • 정규진;김용하
    • 대한두개안면성형외과학회지
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    • 제14권2호
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    • pp.73-80
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    • 2013
  • It is important to distinguish deformational plagiocephaly from craniosynostosis, the two conditions are different with respect to clinical progression and treatment options. Deformational plagiocephaly is diagnosed based on the patient's medical history and physical examination. Until recently, there has been no standardized method of evaluation. Visual assessment, anthropometric assessment, digital scanning, and radiologic evaluation are mostly commonly used modalities for diagnosis and assessment. Treatment of deformational plagiocephaly requires an understanding of natural progression of the disease. Deformational plagiocephaly should be classified according to its severity before the proper method and time for treatment are determined. Treatment includes repositioning, physiotherapy and remodeling with the use of orthotic devices. In general, repositioning is preferred for patients younger than six months old while treatment with the use of orthotic devices such as helmet is preferred for patients over six months old. Moreover, treatment with the use of orthotic devices is also favored for severe plagiocephaly. There is continuing research on the relation between deformational plagiocephaly and developmental delay.

측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 대한물리치료과학회지
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    • 제5권4호
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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The assessment of the automatic exposure control system for mammography x-ray machine

  • Kim, Hak-Sung;Kim, Sung-Chul
    • International Journal of Contents
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    • 제9권2호
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    • pp.66-69
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    • 2013
  • In the U.S., performance assessment on the Automatic Exposure Control system (AEC) is managed according to the Mammography Quality Standards Act (MQSA). However, The AEC is not available in the performance assessment conducted in Korea. Also, there is no study made on the performance of the automatic exposure control system for mammography in Korea. For this reason, this study examined the performance of the automatic exposure control system for mammography that was clinically used in the Incheon area. Result showed that the difference of the mean optical density was 0.79 ~ 2.81. This implies that some devices caused unnecessary x-ray exposure to patients. Furthermore, only 61.5% of the entire experimental device was shown to be satisfactory in terms of change in mean optical density. Moreover, in terms of the subject's thickness, change in radiographic density was shown to be severe among lower X-ray tube voltage while there was severe density change in X-ray image depending on X-ray tube voltage among the subjects with more thickness. Therefore, it is suggested to provide performance management on the AEC for mammography.

한국 의료기관의 방사선 영상검사 평가 현황 및 과제 (A Study on the Status and Improvement Direction of Radiographic Imaging Examination Assessment in Korea Medical Institutions)

  • 조영권
    • 한국방사선학회논문지
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    • 제17권4호
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    • pp.565-572
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    • 2023
  • 본 연구에서는 국내 공공 부문에서 실시하고 있는 의료기관 평가 중 영상검사와 관련된 현황을 살펴보고 개선 방향을 제시하고자 하였다. 의료기관 평가 중 영상검사와 관련된 주요 평가는 의료기관 인증평가와 영상검사 적정성 평가가 있으며, 의료기관 인증평가에서는 영상검사 운영과정, 정확한 결과 제공, 안전관리 절차 준수 등을 평가하고 있다. 영상검사 적정성 평가에서는 인력, 장비와 관련된 구조 지표, 환자평가 실시율, 피폭 저감 프로그램 등이 포함되어 있었다. 하지만 좀 더 안전하고 질 높은 영상검사를 위해서는 의료기관의 인증평가 참여율을 높이는 방안 마련이 필요하며, 영상검사 적정성 평가의 인력지표 개선과 인센티브 지급에 대한 고려도 필요하다. 마지막으로 국가 차원의 방사선 노출 통합관리도 함께 병행되어야 할 것이다.