• Title/Summary/Keyword: diagnostic radiology

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The Performance of Ictal Brain SPECT Localizing for Epileptogenic Zone in Neocortical Epilepsy (신피질성 간질에서 발작기 $^{99m}Tc$-HMPAO 뇌혈류 SPECT의 간질병소 국소화 성능)

  • Kim, Eun-Sil;Lee, Dong-Soo;Hyun, In-Young;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Sang-Kun;Chang, Kee-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.445-450
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    • 1995
  • The epileptogenic zones should be localized precisely before surgical resection of these zones in intractable epilepsy. The localization is more difficult in patients with neocortical epilepsy than in patients with temporal lobe epilepsy. This study aimed at evaluation of the usefulness of ictal brain perfusion SPECT for the localization of epileptogenic zones in neocortical epilepsy. We compared the performance of ictal SPECT with MRI referring to ictal scalp electroencephalography(sEEG). Ictal $^{99m}Tc$-HMPAO SPECT were done in twenty-one patients. Ictal EEG were also obtained during video monitoring. MRI were reviewd. According to the ictal sEEG and semiology, 8 patients were frontal lobe epilepsy, 7 patients were lateral temporal lobe epilepsy, 2 patients were parietal lobe epilepsy, and 4 patients were occipital lobe epilepsy. Ictal SPECT showed hyperperfusion in 14 patients(67%) in the zones which were suspected to be epileptogenic according to ictal EEG and semiology. MRI found morphologic abnormalities in 9 patients(43%). Among the 12 patients, in whom no epileptogenic zones were revealed by MRI, ictal SPECT found zones of hyperperfusion concordant with ictal SEEG in 9 patients(75%). However, no zones of hyperperfusion were found in 4 among 9 patients who were found to have cerebromalacia, abnormal calcification and migration anomaly in MRI. We thought that ictal SPECT was useful for localization of epileptogenic zones in neocortical epilepsy and especially in patients with negative findings in MRI.

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A Study on the Estimation of Regional Myocardial Blood Flow in Experimental Canine Model with Coronary Thrombosis using Rb-82 Dynamic Myocardial Positron Emission Tomography (실험 개에서 Rb-82 심근 Dynamic PET 영상을 이용한 국소 심근 혈류 예측의 기본 모델 연구)

  • Kwark, Cheol-Eun;Lee, Dong-Soo;Kang, Keon-Wook;Hwang, Eun-Kyung;Jeong, Jae-Min;Chang, Kee-Hyun;Chung, June-Key;Lee, Myung-Chul;Seo, Joung-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.48-53
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    • 1995
  • This study investigates a simple mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery thrombosis using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Ten Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10 and 20 second acquisition protocol, respectively, and three regions of interest were drawn on the transaxial slices, one on left ventricular chamber for input function and the other two on normal and decreased perfusion segments for the flow estimation in those regions. Single compartment model has been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardial flow estimates with the three parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (1) single compartment model suggested by Kety-Schmidt could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion, and (3) mathematically fitted input and tissue time activity curves were more suitable than the direct application of the measured data in terms of convergence.

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Scintigraphic Features of Choledochal Cyst Using Technetium-99m-DISIDA Hepatobiliary Scan (총담관낭종의 $^{99m}Tc$-DISIDA 간담도 스캔)

  • Choi, Chung-Il;Kim, Jeong-Gyun;Bae, Sun-Kun;Kwak, Dong-Suk;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Zeon, Seok-Kil;Lee, Hyung-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.71-80
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    • 1993
  • In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.

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Internal Jugular Vein Patency after Modified Radical Neck Dissection (변형적 경부청소술 후 내경정맥의 유지)

  • Cho Jung-Il;Kim Young-Mo;Kim Chul-Ho;Kim Hyung-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.169-174
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    • 1998
  • Background: To avoid the major mobidity associated with bilateral radical neck dissection, modified radical neck dissection has become established as an effective adjunctive procedure in the management of head and neck cancer. But several studies reported early postoperative internal jugular vein(IJV) occlusion in patients who underwent modified radical neck dissection. Objectives: To determine internal jugular vein patency following modified radical neck dessection performed in various head and neck cancer and to identify factors associated with venous occlusion. Materials and Methods: From Aug. 1996 to Oct. 1997, twenty three patients underwent either unilateral or bilateral modified radical neck dissection; 19 males and 4 females, ranging in age from 28 to 75 were retrospectively examined. All patients had a preoperative doppler imaging or CT or both for their initial evaluation. A follow-up examination was obtained(after a minimum postoperative period of 2 months and a maximum one of 4 months). Results: Thirty-four IJVs were examined. All but six IJVs examined were found patent postoperatively. The preservation rate of patency of the IJV in modified radical neck dissection was found to be high(28 of 34 IJVs or 82%). Conclusion: The preservation rate of patency of the IJV in modified radical neck dissection was found to be high. These results favor the use of modified radical neck dissection for IJV preservation, particularly in bilateral neck dissection. A retrospective chart review revealed that trauma of the vessel and extrinsic compression of the vein by the musculocutaneous flap or recurrent carcinoma in the neck may be the cause of the vein occlusion.

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Clinical Analysis of Branchial Anomalies : A Review of 72 Cases (새성기형에 관한 임상적 고찰)

  • Kim, Moo-Pil;Choe, Hwan;Park, Se-Jin;Chung, Eun-Jae;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Lee, Nam-Joon;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.12-17
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    • 2009
  • Background and Objectives : Branchial anomaly is a common neck pathology seen by otolaryngologist. Although there is still controversy regarding the origin, almost all surgeon agree that branchial anomalies result from incomplete involution of the branchial apparatus. Depending on its anatomic location, branchial anomalies can be classified into first, second, third and fourth anomaly. The purpose of this study is to evaluate the incidence of different categories of branchial anomalies and to determine proper method of diagnosis and treatment. Subjects and Method : A retrospective chart review was conducted for 72 patients with branchial anomalies operated on at the Korea University Anam Hospital from 1996 to 2007. The patient's sex, age, presenting symptoms, classification, site of lesion, diagnostic studies, surgical therapy and post-operative surgical complication were reviewed. Results : Patients were commonly seen in the 3rd decades. Eleven patients(15.3%) were first branchial anomalies, 52(72.2%) were second, 1(1.4%) was third, and 8(11.1%) were fourth. Of the types of anomalies, cyst were most commonly seen. In cases of 3rd and 4th branchial anomalies, barium contrast study can delineate the course of sinus or fistula. All cases was operated on for branchial anomalies, there were no major post-operative complication. Conclusion : Cervical mass and recurrent cervical infection or abscess are suspect for branchial anomalies. Especially, clinical history of dysphagia, and recurrent painful swelling in the thyroid region in young patients should raise the suspicion of 3rd and 4th branchial anomalies. Careful history, clinical examination and radiographic study were essential parts in diagnosis of branchial anomalies. Although surgical management of branchial anomalies depend on its type, nature and extent, complete excision is the major surgical procedure.

The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis (측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성)

  • Roh, Chang-Se;Jung, Yun-Hoa;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.81-90
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    • 2009
  • This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.

Head motion during cone-beam computed tomography: Analysis of frequency and influence on image quality

  • Moratin, Julius;Berger, Moritz;Ruckschloss, Thomas;Metzger, Karl;Berger, Hannah;Gottsauner, Maximilian;Engel, Michael;Hoffmann, Jurgen;Freudlsperger, Christian;Ristow, Oliver
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.227-236
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    • 2020
  • Purpose: Image artifacts caused by patient motion cause problems in cone-beam computed tomography (CBCT) because they lead to distortion of the 3-dimensional reconstruction. This prospective study was performed to quantify patient movement during CBCT acquisition and its influence on image quality. Materials and Methods: In total, 412 patients receiving CBCT imaging were equipped with a wireless head sensor system that detected inertial, gyroscopic, and magnetometric movements with 6 dimensions of freedom. The type and amplitude of movements during CBCT acquisition were evaluated and image quality was rated in 7 different anatomical regions of interest. For continuous variables, significance was calculated using the Student t-test. A linear regression model was applied to identify associations of the type and extent of motion with image quality scores. Kappa statistics were used to assess intra- and inter-rater agreement. Chi-square testing was used to analyze the impact of age and sex on head movement. Results: All CBCT images were acquired in a 10-month period. In 24% of the investigations, movement was recorded (acceleration: >0.10 [m/s2]; angular velocity: >0.018 [°/s]). In all examined regions of interest, head motion during CBCT acquisition resulted in significant impairment of image quality (P<0.001). Movement in the horizontal and vertical axes was most relevant for image quality (R2>0.7). Conclusion: Relevant head motions during CBCT imaging were frequently detected, leading to image quality loss and potentially impairing diagnosis and therapy planning. The presented data illustrate the need for digital correction algorithms and hardware to minimize motion artefacts in CBCT imaging.

A Case of Tracheal Bronchus Associated with Bilateral Superior Vena Cava Anomaly (양측성 상대정맥 기형을 동반한 기관성 기관지 1예)

  • Jeong, Jae-Hee;Park, Moo-Suk;Kim, Hee-Man;Park, Jung-Tak;Chung, Jae-Ho;Choi, Byoung-Wook;Kim, Young-Sam;Chang, Joon;Kim, Sung-Kyu;Kim, Se-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.337-343
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    • 2002
  • A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.

A Case of Respiratory Bronchiolitis-Associated Interstitial Lung Disease (호흡성 세기관지염-연관 간질성 폐질환 1예)

  • Ahn, Byeong-Hoon;Park, Hyung-Suk;Do, Jung-Ho;Suh, Gee-Young;Chung, Man-Pyo;Rhee, Chong-H.;Kim, Kwan-Min;Lee, Kyung-Soo;Han, Jung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.103-109
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    • 1999
  • Respiratory bronchiolitis-associated interstitial lung disease has been described among current or former smokers and has features consistent with interstitial lung disease. Symptoms include cough, dyspnea on exertion. Lung pathology is characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent air spaces associated with mild thickening of the peribronchiolar interstitium. It must be separated from the other interstitial lung disease because of marked differences in treatment and prognosis. Recently we experienced a case of respiratory bronchiolitis-associated interstitial lung disease in a 48-year-old man. As far as we know, this is the first case in Korea.

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Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease

  • Lim, Su Jin;Kim, Ju-Young;Lee, Seung Jun;Lee, Gi Dong;Cho, Yu Ji;Jeong, Yi Yeong;Jeon, Kyung Nyeo;Lee, Jong Deog;Kim, Jang Rak;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.123-131
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    • 2018
  • Background: Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. Methods: We enrolled 85 patients with COPD (76 males, 9 females; mean age, $70.6{\pm}7.1years$) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. Results: The average AP diameter was significantly greater in patients with COPD compared with normal controls ($13.1{\pm}2.8cm$ vs. $12.2{\pm}1.13cm$, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls ($0.66{\pm}0.061$ vs. $0.61{\pm}0.86$; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=-0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). Conclusion: Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.