• 대한핵의학회지
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• 제36권3호
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• pp.203-208
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• 2002

만성간질환 환자에서 호흡곤란을 초래하는 간폐 증후군 발생한다는 사실은 잘 알려져 있다. 단락을 입증하기 위해서는 대비증강심초음파, 폐혈관조영술, $^{99m}Tc-MAA$ 폐관류스캔 등을 이용할 수 있다. 이 중에서도 $^{99m}Tc-MAA$를 이용한 폐관류스캔은 매우 안전하고 간편하게 단락의 존재 여부를 확인할 수 있으며, 단락의 양을 계산할 수도 있다. 정량이 가능하므로 병의 경과를 추적하는 지표로서도 유용할 것이다. 저자들은 $^{99m}Tc-MAA$ 폐관류스캔으로 진단한 간폐증후군의 증례를 문헌고찰과 함께 보고하였다.

• 대한핵의학회지
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• 제35권4호
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• pp.288-290
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• 2001

A 61 year-old woman underwent perfusion and inhalation lung scan for the evaluation of pulmonary thromboembolism. Tc-99m MAA perfusion lung scan showed multiple round hot spots in both lung fields. Tc-99m DTPA aerosol inhalation lung scan and chest radiography taken at the same time showed normal findings (Fig. 1, 2). A repeated perfusion lung scan taken 24 hours later demonstrated no abnormalities (Fig. 3). Hot spots on perfusion lung scan can be caused by microsphere clumping due to faulty injection technique or by radioactive embolization from upper extremity thrombophlebitis after injection. Focal hot spots can signify zones of atelectasis, where the hot spots probably represent a failure of hypoxic vasoconstriction. Artifactual hot spots due to microsphere clumping usually appear to be round and in peripheral location, and the lesions due to a loss of hypoxic vasoconstriction usually appear to be hot uptakes having linear $borders^{1-3)}$. Although these artifactual hot spots have been well-known, we rarely encounter them. This report presents a case with artifactual hot spots due to microsphere clumping on Tc-99m MAA perfusion lung scan.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.163-169
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• 1986

Intrapulmonary shunt was measured by $^{99m}Tc$-MAA perfusion tung scan. The study was included 76 patients. Significant amount of intrapulmonary shunt was observed in the pulmonary disease patients and liver disease patients. The shunt amount was correlated well with $PaO_2$ and $AaDO_2$ level. Further study is needed to search the various factors affecting the amount of intrapulmonary shunt.

• Tuberculosis and Respiratory Diseases
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• 제50권1호
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• pp.117-121
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• 2001

간성수흉증은 폐나 심장에 일차적인 질환 없이 간경변증 환자에서 흉수가 동반된 경우로 대부분의 경우에서 복수를 동반하며 복수가 없는 간성수흉증은 매우 드물다. 저자 등은 호흡곤란을 주소로 내원한 75세 여자 환자에서 동위 원소로 증명된 복수를 동반하지 않은 간성수흉증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한핵의학회지
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• 제31권3호
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• pp.365-371
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• 1997

The aim of this study is to evaluate the efficiency of the pulmonary perfusion scan(Pp scan) in the experimental animal single lung transplantation. Eight left lung transplanted mongrel dogs were included in this study. The serial Pp scan with 111MBq $^{99m}TC-MAA$ were done at the periods of immediate postoperative period, POD 3 days, and POD 10-14 days and finally autopsy was done in each cases. The transplanted lung perfusion was analysed as a percentage radioactivity of trans planted/native lung(T/N) ratio. The Pp scan of a donor mongrel dog was used as a reference(left/right lung (T/N) ratio 85.2%). The average T/N ratio of all cases on immediate postoperative state(reperfusion injury) : 19.2%, three acute rejections. 12.6%, three bronchial dehiscences 6.1% and two pulmonary thromboses : 2.0%. Two cases showed moderate improvement of reperfusion injury as increasing the T/N ratio in POD 3 days Pp scan. The T/N ratio showed sequentially decreased in six cases. As a conclusion, the Pp scan could be a non-invasive method in the evaluation of the experimental one-lung transplanted mongrel dog.

• 대한핵의학회지
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• 제24권2호
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• pp.293-298
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• 1990

We performed 17 intraarterial scintigraphies in six patients with recurrent cervix cancer. With Seldinger method, the agent (four different radiopharmaceuticals) was perfused at the same speed of infusion of anticancer drugs (25 cc/hour) through internal iliac artery. There were four different radiopharmaceuticals; I-131-Lipiodol, Tc (Technetium)-99m-HSa (Human Serum Albumin), $^{99m}Tc-Sucralfate$ and $^{99m}Tc-MAA$ (Macroaggraegated Albumin). We evaluate the distribution pattern of radioactivity by the use of ratio of Tumor/Extratumor uptake (T/ET ratio). Our results reveals that $^{99m}Tc-MAA$ scan showed the highest T/ET ratio and the other were not ideal agents for intraarterial therapy of recurrent cervix cancer. In conclusion, an ideal radioisotope and tracer which can block capillary, for example MAA, should be re-evaluated or produced in order to treat the patient with recurrent cervix cancer.

• 대한기관식도과학회지
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• 제1권1호
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• pp.75-81
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• 1995

To evaluate the diagnostic value of pulmonary perfusion scan, we obtained 99mTc MAA per-fusion lung scan from 25 cases of airway foreign bodies. The results were as follows. 1) Significant changes in blood gases were not observed after the establishment of regional hypoperfusion caused by airway foreign body. 2) Near total or total defect was noted on perfusion scan from most of the airway foreign body. 3) There was correspondance of findings of perfusion lung scan and duration of airway foreign body. 4) After the removal of airway foreign bodies, perfusion scan abnormalities were reversed in parallel with the recovery of pulmonary blood flow. We concluded that pulmonary perfusion scan may be valuable for detection of foreign body and reversible hypoperfusion.

• 대한핵의학회지
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• 제28권3호
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• pp.350-356
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• 1994

Purpose : Hepatic arterial perfusion scintigraphy with Tc-99m-macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma(HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and usefullness of HAPS. Materials and Methods : HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4-5 mCi of MAA mixed with 2ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1ml/sec. We analysed 21 HCCs over 2cm in diameter(average diameter; 6.4cm) and 17 of 21 HCCs were over 4cm in diameter(Table 1). CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Results : Three different pattern of tumor perfusion were observed in 16 patients with HCC (Table 2). 1) diffuse increased perfusion in 16 of 21(76%)(Fig. 1) 2) increased peripheral perfusion in 4 of 21(19%) (Fig. 2) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16(56%)(Fig. 4). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16(13%). There was no accumulation of radioactivity on RBC-blood pool scan in all six patients with HCC examined (Fig. 1). Conclusion : HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

• Tuberculosis and Respiratory Diseases
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• 제41권2호
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• pp.111-119
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• 1994

배경 및 목적: 폐암 환자의 다수가 흡연력이 있고 만성 폐쇄성 폐질환이 병발되어 있으므로 수술후 폐기능의 변화를 정확히 예측하는 것은 수술후 합병증을 예방하는데 중요하다. 폐 절제술 후 잔여 폐기능을 예측함에 있어 현재까지 99mTc-MAA를 이용한 폐관류 스캔이 많이 이용되어 왔지만 이론적으로 폐환기와 폐관류의 불일치가 있는 경우 오차가 있을 수 있어 $^{99m}Tc$-DTPA 연무흡입 환기 스캔을 이용해 잔류 폐기능을 예측하여 관류 스캔을 비교하여 보았다. 방법: 수술전 연무 흡입스캔과 관류 스캔을 시행하고 수술전에 폐기능을 실시하여 잔여 폐기능을 예측하고 수술후 2개월 뒤에 폐기능을 실시하여 상관관계를 비교하여 보았다. 전 폐절제술인 경우: 수술전 폐기능$\times$전체 폐에 대한 잔류폐의 비 폐엽 절제술인 경우: 수술전 폐기능$\times$(1-침범된 폐의 전체폐에 대한 비$\times$절제될 폐의 분절 수/침범된 폐의 총 분절 수) 결과: 1) $FEV_1$에서 연무 흡입스캔을 이용하여 예측한 값과 실측치 간의 상관 계수는 0.94(p<0.0001), 폐관류 스캔을 이용한 경우는 0.86(p<0.0001)이었으며 두 군간에 통계학적으로 유의한 차이는 없었다. 2) FVC에 흡입스캔을 이용한 경우 상관 계수가 0.91(p<0.0001)이었고 폐관류 스캔에서는 0.72(p=0.0005)로 연무 흡입스캔으로 예측한 군에서 상관 관계가 좋았다. 3) $FEF_{25-75%}$에서의 결과는 연무 흡입스캔을 이용한 경우 상관 계수가 0.87(p=0.0001), 폐관류 스캔에서는 상관 계수가 0.87(p<0.0001)로 두 군간에 유의한 차이는 없었다. 4) 두 스캔을 동시에 시행한 군에서 비교한 결과를 보면 연무 흡입 스캔에서 상관 계수는 $FEV_1$ 0.97(p<0.0001), FVC 0.95(p<0.0001), $FEF_{25-75%}$ 0.85(p<0.001)이었고 폐관류 스캔에서는 $FEV_1$ 0.97(p<0.0001), FVC 0.96(p<0.0001), $FEF_{25-75%}$ 0.83(p<0.002)로 두 군간에 유의한 차이는 없었다. 결론: 수술후 잔여 폐기능을 예측함에 있어 연무 흡입스캔 및 관류 스캔사이에 큰 차이가 없었으며 비교적 정확했고 폐기능중에서는 $FEV_1$이 가장 상관 관계가 좋았다.

• 대한핵의학회지
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• 제21권2호
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• pp.199-205
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• 1987

The fact there are increase of intrapulmonary arterioveneous shunt amount in the liver cirrhosis patient has been known since 1950. And the method of shunt amount calculation by radionuclide method using $^{99m}Tc-MAA$ was introduced in the middle of 1970. We measured intrapulmonary shunt amount by means of perfusion lung scan using $^{99m}Tc-MAA$ in the various type of liver diseases especially in chronic liver diseases and acute liver disease. The results were as followed. 1) The amount of arteriovenous intrapulmonary shunt in the total case of liver disease was $9.3{\pm}3.9%$, and that of in the control group was $4.6{\pm}2.1%$. 2) The amount of arteriovenous intrapulmonary shunt in the chronic liver disease was $10.8{\pm}4.4%$, and that of in the acute liver disease was $7.2{\pm}2.8%$. We observed significant differences between normal control group and liver disease group, and between chronic liver disease group and acute liver disease group in the amount of shunt by the nucleolide method.