• 제목/요약/키워드: contrast-enhanced CT

검색결과 171건 처리시간 0.027초

복부 둔상 및 유강장기 손상에 있어서 초기 나선형 복부전산화 단층촬영의 진단적 가치 (Impact of Initial Helical Abdominal Computed Tomography on the Diagnosis of Hollow Viscus Injury and Blunt Abdominal Traumare)

  • 조영덕;홍윤식;이성우;최성혁;윤영훈;임성익;장익진;백승원
    • Journal of Trauma and Injury
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    • 제21권1호
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    • pp.28-35
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    • 2008
  • Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

저작근극에서 발생한 전이된 갑상선 여포상암 (Metastatic thyroid follicular carcinoma of masticator space)

  • 강태인;허민석;안창현;최미;이삼선;최순철;박태원
    • Imaging Science in Dentistry
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    • 제32권3호
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    • pp.175-179
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    • 2002
  • Follicular carcinomas are the second most common form of thyroid cancer, accounting for 10 to 20% of all thyroid cancers. Follicular carcinomas have a propensity to metastasize via the bloodstream, spreading to bone, lungs, liver, and elsewhere. We described the case of a 48-year-old woman who presented with swelling of the left preauricular area, which was a consequence of a metastatic follicular carcinoma of the masticator space. Plain films showed illdefined erosive bony changes from the left condylar head to the mandibular notch. Contrast-enhanced CT images showed a well circumscribed round mass with well enhancement within left masticator space. On MR images, the mass was heterogenously hyperintense to the muscle on T2-weighted images and isointense or hyperintense to the muscle on Tl-weighted images, and showed good enhancement on contrast-enhanced Tl-weighted images. Upon microscopic examination, the metastatic mass was found to be composed of fairly uniform cells forming small follicles containing colloid, showing capsular and vascular invasion.

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흰쥐 미세구조 관찰을 위한 Micro-CT 3D 영상의 유용성에 관한 연구 (A Study on the Usefulness of 3D Imaging in Micro-CT for Observing the Microstructure of Mice)

  • 이상호;이종석;임청환;정홍량;채규윤;한범휘;한상현;홍동희;한태종;박성훈;모은희;전홍영
    • 디지털융복합연구
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    • 제12권3호
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    • pp.367-375
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    • 2014
  • 본 연구는 실시간 동적영상(Real-time dynamic image)을 획득할 수 있는 고해상도 엑스선 영상장치인 마이크로 CT 을 이용하여 흰쥐의 미세 혈관구조를 관찰함은 물론 국내 원광 방사선영상 과학연구 센터에서 개발한 마이크로 CT 에 대한 유용성을 알아보고자 한다. 흰쥐 몸 전체의 2D 영상을 얻은 후 MIP(maximum intensity projection), VRT(volume rendering technique)기법을 이용하여 혈관구조의 조영된 3D 영상을 얻을 수 있었고 이 3D 혈관 영상을 머리, 복부, 심장과 몸 전체의 혈관시스템으로 각각 분류하였다.

개에서 요추부 척수를 압박하는 척추 골육종 발생례 (Vertebral Osteosarcoma Causing Compression of the Lumbar Spinal Cord in a Dog)

  • 강병재;류학현;박성수;;성규진;김용선;박준원;김완희;윤정희;김대용;권오경
    • 한국임상수의학회지
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    • 제27권5호
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    • pp.588-592
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    • 2010
  • 15년 령의 중성화 수컷 요크셔 테리어가 양측 후지의 보행 장애로 내원하였다. 5개월 전부터 후구 부전마비가 시작되어 점점 진행되었고, 4일 전부터는 증상이 빠르게 악화되었다. 후구 부전마비를 일으킬 수 있는 신경 질환을 감별하기 위해 컴퓨터 단층 촬영과 자기 공명 영상이 실시되었다. 컴퓨터 단층 촬영을 통해 4번 요추의 골 결손과 인접 부위의 연부 조직 종괴를 확인하였다. 자기 공명 영상을 통해서는 4번 요추의 왼쪽에서 T1강조 영상에서의 등신호종괴와 T2강조 영상에서의 고신호 종괴가 척수를 압박하는 것을 확인하였다. T1강조 영상에서 조영제 주입 후 종괴의 신호가 균일하게 증가하였다. 종괴의 절제 후 통증은 완화되었다. 조직병리학적 검사를 통해 병변이 척추 골육종임을 확인하였다. 컴퓨터 단층 촬영과 자기 공명 영상은 개에서 척추 골육종을 진단하고 수술적 제거를 위한 계획을 세우는데 유용하게 이용될 수 있다.

폐동맥색전술로 치료된 Rasmussen 동맥류 1예 (A Case of Rasmussen Aneurysm Treated by Pulmonary Arterial Embolization)

  • 박성오;고혁;김수희;박완;이덕희;류대식;정복현
    • Tuberculosis and Respiratory Diseases
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    • 제51권1호
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    • pp.53-58
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    • 2001
  • 기관지 동맥 색전술에도 불구하고 반복되는 대량 객혈을 보이는 동공성 폐결핵 환자에서 나선형 CT를 이용하여 Rassmusen 동맥류의 위치 및 크기를 비교적 정확히 진단하여 coil 이용한 경도관 폐동맥 색전술로 성공적으로 지혈 시킨 사례를 경험하였기에 보고하는 바이다.

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Analysis of Image Quality and Optimized Reconstruction Window through Heart Rate and Its Variation in Retrospectively ECG-gated Coronary Angiography Using Multi-Detector Row CT

  • Lee, Sang-Ho;Park, Byoung-Wook;Kim, Hee-Joung;Haijo Jung;Kang, Won-suk;Son, Hye-Kyung;Choe, Kyu-Ok
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.461-463
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    • 2002
  • Image quality and selection of optimized window for good quality reconstruction in coronary angiography using multi-detector row CT (MDCT) have not been studied by heart rate and its variation. Therefore, the effect of heart rate and its variation was systemically analyzed. Eighty-three patients were undergone contrast-enhanced coronary angiography using MDCT. In this study, sixty cases were enrolled. Two radiologists graded image quality as follows: 4, excellent; 3, good; 2, fair; l, bad. The starting points of the reconstruction window were chosen at seventy and forty percent of R wave interval. Optimized window was scored as 1 when 40% reconstruction was better quality than 70%, as 2 when 40% reconstruction is same as 70%, and as 3 when 70% reconstruction was better than 40%. Regression analysis was performed. The range of variation of beats per minute (BPM) was well correlated with image quality (r=-0.55, p=0.000), however correlation with optimized window percentage was not statistically significant (p=0.969). By contraries, median value of BPM was comparatively well correlated with optimized window grade (r=-0.24, p=0.086). Median value of BPM was not well correlated with image quality (r=0.l70, p=0.l97). Image quality is more affected by variation of heart rate (VHR) than by higher heart rate. Selection of optimized reconstruction window for good image quality is mainly affected by heart rate and there is a tendency that systolic phase reconstruction is better in image quality than diastolic reconstruction in higher heart rate.

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Bacterial Stringent Signal Directs Virulence and Survival in Vibrio cholerae.

  • Oh, Young Taek;Kim, Hwa Young;Yoon, Sang Sun
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2019년도 추계학술대회
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    • pp.8-8
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    • 2019
  • The stringent response (SR) is characterized as a bacterial defense mechanism in response to various growth-inhibiting stresses. It is activated by accumulation of a small nucleotide regulator, (p)ppGpp, and induces global changes in bacterial transcription and translation. Recent work from our group has shown that (p)ppGpp plays a critical role in virulence and survival in Vibrio cholerae. The genes, relA and relV, are involved in the production of (p)ppGpp, while the spoT gene encodes an enzyme that hydrolyzes it in V. cholerae. A mutant strain defective in (p)ppGpp production (i.e. ${\Delta}relA{\Delta}relV{\Delta}spoT$ mutant) lost the ability to produce cholera toxin (CT) and lost their viability due to uncontrolled production of organic acids, when grown with extra glucose. In contrast, the ${\Delta}relA{\Delta}spoT$ mutant, a (p)ppGpp overproducer strain, produced enhanced level of CT and exhibited better growth in glucose supplemented media via glucose metabolic switch from organic fermentation to acetoin, a neutral fermentation end product, fermentation. These findings indicates that (p)ppGpp, in addition to its well-known role as a SR mediator, positively regulates CT production and maintenance of growth fitness in V. cholerae. This implicates SR as a promising drug target, inhibition of which may possibly downregulate V. cholerae virulence and survival fitness. Therefore, we screened a chemical library and identified a compound that induces medium acidification (termed iMAC) and thereby loss of wild type V. cholerae viability under glucose-rich conditions. Further, we present a potential mechanism by which the compound inhibits (p)ppGpp accumulation. Together, these results indicate that iMAC treatment causes V. cholerae cells to produce significantly less (p)ppGpp, an important regulator of the bacterial virulence and survival response, and further suggesting that it has a therapeutic potential to be developed as a novel antibacterial agent against cholera.

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External Auditory Canal Atresia with Otitis Media in a Dog

  • Kim, Ah Reum;Han, Changhee;Hwang, Gunha;Kim, Rakhoon;Go, Woohyun;Lee, Ji Yeong;Lee, Jongbong;An, Soyon;Hwang, Tae Sung;Lee, Dongbin;Lee, Jae-Hoon;Lee, Hee Chun
    • 한국임상수의학회지
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    • 제38권3호
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    • pp.159-162
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    • 2021
  • A 5-year-old, intact male, poodle dog with right external auditory canal obstruction and subaural mass was presented. Physical examination revealed that right external auditory canal opening was absent and right head tilt was identified. Aspiration in right subaural mass revealed a small amount of dark brown exudate. Streptococcus canis and Staphylococcus spp. were identified on the microbial culture. Radiography of the skull was revealed absence of air-filled ear canal at the right external ear canal (EEC) level. Computed tomography (CT) revealed well capsulated, hypoattenuated mass in the right EEC region. On the contrast enhanced CT images, rim enhancement around the mass and ear canal obstruction were identified. Fluid attenuated material filled with right bulla. Mild thickening of the right tympanic bulla wall with mild lytic lesion of the ventral wall were found. Based on the images findings, the case was tentatively diagnosed as right external auditory canal atresia with otitis media. Total ear canal ablation and lateral bulla osteotomy was performed. The entire ear canal was removed, numerous hair in the canal and the thickening wall were founded. Right ear canal was sent for histopathological evaluation and found to otitis externa. The patient was followed up for two weeks and there were no complications. This report described the CT diagnosis of right EEC atresia with otitis media rarely reported in small breed dogs.

개에서 컴퓨터단층촬영술과 자기공명영상을 이용한 창상성 두개관내 출혈의 평가 (Evaluation of Traumatic Intracranial Hemorrhage Using Computed Tomography and Magnetic Resonance Imaging in Four Dogs)

  • 최호정;이기자;강상규;이희천;장동우;이기창;정성목;조성환;이영원
    • 한국임상수의학회지
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    • 제23권2호
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    • pp.96-101
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    • 2006
  • 두개 창상에 의해 신경증상을 나타내는 4 마리의 환자가 내원하여 일반 방사선 검사 및 컴퓨터단층촬영술(CT)과 자기공명영상(MRI)을 실시하였다. 일반 방사선 사진에서는 내원한 4 마리의 개에서 모두 특이소견을 관찰할 수 없었다. 3마리 개에서 실시한 CT 결과, 3마리 중 2마리의 환자에서 전두엽 부위에 고밀도로 나타나는 병변을 확인할 수 있었으나 소뇌 부위의 병변은 관찰되지 않았다. 이어서 실시한 MRI 검사 결과, 일부의 환자에서는 T1-강조영상에서 저신호로 나타나고 T2-강조영상에서 고신호로 나타나거나 T1-강조영상과 T2-강조영상에서 각각 등신호, 고신호로 나타나는 병변을 확인할 수 있었다. 병변 부위는 좌측과 우측 대뇌 부위, 소뇌전정 부위, 경막하 부위로 다양했다. 이들 환자는 내과적 치료를 실시한 후, 임상적으로 호전되었음을 확인하고 일부 환자는 MRI를 통해 추적검사를 하였다.

개정된 아틀란타 분류법에 근거한 초기 CT에서의 괴사성 췌장염의 예측 (Prediction of Necrotizing Pancreatitis on Early CT Based on the Revised Atlanta Classification)

  • 송연선;박희선;유미혜;김영준;정성일
    • 대한영상의학회지
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    • 제81권6호
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    • pp.1436-1447
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    • 2020
  • 목적 간질부종성 췌장염으로 진단된 환자군에서 괴사성 췌장염으로의 진행을 예측할 수 있는 입원 당시 초기 임상소견 및 CT 소견을 알아보고자 한다. 대상과 방법 간질부종성 췌장염으로 진단되어 입원 당시 및 14일 이내 추적 조영증강 CT를 시행한 178명의 환자를 대상으로 하였다. 두 명의 영상의학 전문의가 추적 CT를 분석하여 간질부종성 또는 괴사성 췌장염을 결정하였다. 입원 당시 혈액검사 소견도 기록하였다. 간질부종성-간질부종성 췌장염 환자군과 간질부종성-괴사성 췌장염 환자군 간에 임상소견, CT 소견 및 혈액검사 소견들을 비교하였다. 다변량 분석도 시행하였다. 결과 간질부종성-간질부종성 췌장염 환자군은 112명, 간질부종성-괴사성 췌장염 환자군은 66명이었다. 알코올성 췌장염의 비율은 간질부종성-괴사성 췌장염 환자군이 더 높았다. 입원 당시 CT 소견 중 췌장주위 액체저류, 췌장실질의 비균질성은 간질부종성-괴사성 췌장염 환자군에서 더 흔하게 나타났다. 입원 당시 혈액검사 소견 중 혈청 C-반응성 단백 수치 및 백혈구수가 간질부종성-괴사성 췌장염 환자군에서 더 높게 나타났다. 다변량 분석을 시행했을 때 췌장주위 액체저류와 췌장실질의 비균질성 소견이 두 환자군을 구별하는데 유의한 인자로 나타났다. 결론 초기 CT상 간질부종성 췌장염으로 진단된 환자군에서 CT 소견 중 췌장주위 액체저류, 췌장실질의 비균질성은 괴사성 췌장염으로의 진행을 예측하는 데 도움이 된다.